This abstract explores the integration of phenomenology and neuroscience in understanding and managing Autism Spectrum Disorder (ASD) through Exchange and Development Therapy (EDT). EDT, developed by Professor Gilbert Lelord, focuses on restoring impaired functions in children with autism through principles of calm, receptiveness, and reciprocity.

This study investigates the similarities between EDT principles and phenomenological concepts like intersubjectivity, intercorporeality, and intentionality, aiming to demonstrate the value of phenomenology in understanding autism.

The research involved a two-part approach:

1. 1. Theoretical argumentation, explaining EDT principles and relevant phenomenological concepts in autism.

2. 2. Phenomenological analysis of autobiographies of individuals with autism to identify recurring themes and align them with EDT principles.

The study revealed a significant convergence between EDT principles and phenomenological concepts. Calmness in EDT aligns with intercorporeality, receptiveness with intentionality, and reciprocity with intersubjectivity. This convergence suggests that phenomenology is crucial for understanding the lived experiences of individuals with autism, which can inform and enhance neuroscience-based therapeutic approaches.

The integration of phenomenology and neuroscience offers a promising avenue for developing more effective and compassionate autism therapies. By incorporating the subjective experiences of individuals with autism, therapists can tailor interventions that resonate with their unique phenomenological worlds, leading to improved therapeutic outcomes. This research advocates for a more holistic and individualized approach to autism treatment, highlighting the indispensable role of phenomenology in contemporary psychiatry.

S. Bora Grant / Research support from: International Exchange Award from the Renewing Phenomenological Psychopathology funded by the Wellcome Trust

Bipolar disorder (BD) is a chronic illness affecting approximately 2-3% adults worldwide. Mood stabilizers, such as lithium, valproate, carbamazepine, and lamotrigine are mainstays of the treatment. Despite their benefits, mood stabilizers carry a risk of side effects, which can lead to treatment discontinuation and non-adherence rates ranging from 10 to 60% in BD patients (Dols et al. Int Clin Psychopharmacol 2013; 28, 287-296). Dermatologic side effects, also known as cutaneous adverse drug reactions, are particularly distressing, often impacting patients’ self-esteem and social interactions, and contributing to non-compliance. These reactions can range in severity from mild rashes, acneiform eruptions, hair loss and psoriasis to severe, life-threatening conditions like Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) (Mitkov et al. Psychosomatics 2014; 55, 1-20).

Despite the well-documented association between mood stabilizers and dermatologic adverse effects (AE), the overall prevalence of these reactions across mood stabilizers remains unclear. This systematic review and meta-analysis aims (1) to estimate the prevalence of dermatologic AE associated with mood stabilizer (lithium, valproate, carbamazepine and lamotrigine) use in patients with BD, and (2) to summarize the available evidence on the onset and timing of these reactions.

We searched Ovid MEDLINE®, Embase, Cochrane Library, Web of Science, Scopus, and PsycINFO from 1970 onward for studies on dermatologic AEs in BD patients treated with lithium, valproate, carbamazepine, or lamotrigine (CRD42022357268). Study selection, data extraction, and bias risk assessment were performed by two reviewers. Meta-analyses were conducted to estimate the prevalence rates for dermatologic AEs.

The initial database searches yielded 5,354 studies. 47 articles were deemed relevant and included in this systematic review. Study designs included 16 randomized controlled trials, 10 non-randomized open-label trials, 12 cohort studies, and 9 cross-sectional studies.

Lithium was associated with acneiform eruptions in 4.4% (95% CI: 1.0-17.0%), rash in 1.8% (95% CI: 0.7-4.8%), and hair loss in 1.7% (95% CI: 0.4%-6.4%) of patients. For valproate, hair loss was observed in 4.6% of patients (95% CI: 3.0-6.7%) and rash in 2.9% (95% CI: 1.6-5.3%). Carbamazepine was associated with rash in 6.0% of patients (95% CI: 4.4-7.6%), but severe reactions such as SJS and TEN were not reported. Lamotrigine had the highest rash prevalence with 9.2% (95% CI: 7.2-11.8%), while severe reactions were rare (0.04%, 95% CI: 0.00-0.63%).

Mood stabilizers showed varying levels of dermatologic AEs, but severe reactions were rare. Future studies should explore factors influencing these outcomes, their impact on quality of life and treatment participation, and potential management strategies.

None Declared

People with bipolar disorder (BD) have an increased risk of premature mortality, and the respiratory mortality rate is higher than those of the general population. However, the evidence on respiratory disease in this population has not been meta-analyzed.

To systematically review and meta-analyze the frequency of respiratory diseases in patients with BD and to compare prevalence and Odds Ratio (OR) with the general population.

A systematic literature search was conducted in Pubmed, PsycINFO, Scielo and Scopus from inception to June 2, 2023, and a snowball search of reference and citation lists was conducted. Inclusion criteria were studies reporting diagnoses of respiratory diseases (asthma, chronic obstructive pulmonary disease (COPD), pneumonia, lung cancer and tuberculosis) in people with BD according to operationalized criteria and where possible, control group. This study followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and MOOSE reporting guidelines. A pair of reviewers independently extracted data using a predefined data extraction form and a senior co-author was consulted in cases of disagreement. The risk of bias and methodological quality was assessed using the adapted Newcastle-Ottawa scale.

Of the 2,158 articles screened, 20 including 962,352 people with BD and 37,340,405 control group, met the inclusion criteria (see Figure 1). Prevalence and OR of respiratory disease in people with BD was the main outcome as percentage point estimates with corresponding 95% CIs. In people with BD, the prevalence of COPD was 9.14% (95%CI: 6.61%-12.5%), asthma 6.4% (95%CI: 4.56%-8.91%), pneumonia 2.78% (95%CI: 2.51%-3.08%) and lung cancer 0.44% (95%CI:0.23%-0.84%) (see Figure 2). Compared to the general population (see Figure 3), people with BD had significantly higher rates of COPD (OR: 1.73; 95% CI: 1.40-2.14), showing an increased rate in younger and female patients; asthma (OR: 1.91, 95% CI: 1.25-2.94), with a greater rate in younger patients; and pneumonia (OR: 2.82, 95% CI: 1.33-5.99).

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In the first meta-analysis on the topic, BD was associated with an increased risk of respiratory illness versus the general population. In COPD and asthma, young people and women are at particular risk. Prevention programs are urgently needed.

None Declared

Research on temperament in individuals with familial high risk for psychosis (FHR-P) and bipolar disorder (FHR-BD) suggests that specific temperament patterns may mirror characteristics of the associated disorders. Terms such as schizotaxia and cyclotaxia describe these patterns: schizotaxia is linked to traits such as cognitive disorganization and social withdrawal seen in those at risk for psychosis, while cyclotaxia involves emotional instability and reactivity associated with bipolar disorder.

This study aims to investigate the relationship between temperament traits associated with psychosis and bipolar disorder as suggested in the concept of schizotaxia and cyclotaxia.

We recruited a total of 94 participants, comprising 29 people at familial high risk for psychosis (FHR-P), 41 people at familial high risk for bipolar disorder (FHR-BD), and 24 controls (HC). Participants from familial high-risk groups were identified through patient records or outpatient settings at Dokuz Eylül University. Several self-report measures are selected to investigate the temperament traits of schizotypy and cyclothymia. Those measures listed as; the Schizotypal Personality Questionnaire (SPQ), Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) Scale, Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire version (TEMPS-A), Pittsburgh Sleep Quality Index (PSQI), Barratt Impulsiveness Scale (BIS). One-way ANOVA is used to analyze the data using Jamovi Version 2.6.2.0.

FHR-P individuals, but not FHR-BD, had significantly higher scores of depressive(p<.001), cyclothymic (p=.005) and anxious(p=.002) temperament than HC in TEMPS-A subscales. Both familial groups had significantly higher scores in activation(p=.001) but not in inhibition in BIS/BAS. Moreover, they had worse sleep quality indicated by significantly higher PSQI (p=.014) scores. BIS scores and SPQ total scores do not significantly differ across groups however, FHR-P had significantly higher scores in negative subscores(p=.032) of SPQ than HC.

Our findings show significant differences in the FHR-P group across most temperament scores, indicating a greater vulnerability to schizotypal and cyclothymic traits. This may result from various factors, such as participants being recruited from outpatient psychiatric settings. Both familial groups also demonstrated lower educational levels and premorbid IQ scores on the WAIS, with more pronounced differences in the FHR-P group compared to the FHR-BD group. Additionally, the unequal sample sizes among the groups could affect the results. Therefore, further research is needed to account for the influence of common psychiatric conditions associated with participants’ help-seeking behaviour and to ensure better educational matching with healthy controls.

None Declared

Bipolar disorder (BD) is a psychiatric condition characterized by a wide range of symptoms, for which many interventions have been proposed. Although the literature contains numerous meta-analyses (MAs) and network meta-analyses (NMAs) summarizing this evidence, the large volume and variability of information can make it difficult to apply in daily clinical practice, guide researchers, or inform the development of clinical guidelines.

To offer a freely accessible platform, developed within the U-REACH framework, providing updates on the latest therapeutic strategies for BD in terms of efficacy and safety, aligned with patient preferences. Informed by a living umbrella review, the platform aims to grade the current evidence to support informed decision-making.

We conducted an umbrella review by searching PubMed, PsycINFO, and the Cochrane database up to December 31, 2023, for (N)MAs of randomized controlled trials investigating interventions for BD. Each association was assessed using the GRADE. Effect sizes were standardized into equivalent standardized mean differences (eSMD), with eSMD>0 indicating clinically positive effects and eSMD<0 indicating clinically negative effects. The results are made available on an open-access online platform. Users can filter data by age group, BD stage, intervention, effect size, outcome, comparison, type of meta-analysis, GRADE evidence level, and (N)MA quality. For any filter combination, users can visualize key interventions, outcomes, and a forest plot with eSMD. The database will be regularly updated. Additionally, a preference-based tool allows users to rank safety outcomes by importance (0-10) and the system will recommend medications based on these preferences.

From the 4,352 records retrieved, we included 71 (N)MAs evaluating the effects of pharmacological (n=87), brain stimulation (n=13), psychosocial (n=8), and circadian rhythm-based therapies (n=3), on 132 efficacy (n=85) and safety (n=47) outcomes. For the preference-based tool, we included 10 first-line interventions for at least one mood state of BD (aripiprazole, asenapine, cariprazine, lamotrigine, lithium, lurasidone, paliperidone, quetiapine, risperidone, valproate) and 15 safety outcomes based on clinical judgment (e.g., akathisia, weight increase, QTc prolongation, insomnia), resulting in 150 potential combinations.

This platform represents a pioneering approach to delivering the most complete evidence on interventions for BD. With its regular updates, it provides clinicians and researchers with a freely accessible resource to guide treatment decisions based on efficacy, safety, and patient preferences. This tool aims to support the development of future guidelines, facilitate ongoing professional education, and ultimately improve the quality of care for individuals with BD.

None Declared

Individuals with first-episode bipolar disorder (FEBD) may have language abnormalities and sub-threshold formal thought disorder (FTD). Natural language processing (NLP) methods that have been shown to assess FTD in psychosis can be used in the early stages of bipolar disorder (BD).

The purpose of this study was to examine the differences between FEBD and healthy controls (HC) utilizing NLP methods.

Speech samples were collected from 20 FEBD and 20 HC while describing eight Thematic Apperception Test images. The manually transcribed text was then processed using word2vec to generate vectors. The semantic similarity between words was computed utilizing a moving window method to windows ranging in size from 5 to 10. Finally, the average, variance, maximum, and minimum of these similarities were calculated.

All mean similarities (windows of 5 to 10) were significantly higher in FEBD (p< .001, p=0.001, p=0.002, p=0.002, p=0.003, and p=0.004, respectively). Additionally, all variances of similarities were highly significant and were increased in FEBD (all p values< .001). Regarding maximum values, except for the window of 5, all of the remaining windows were significantly higher in FEBD (all p values <.05.).

Our findings indicate that semantic similarity increased in the FEBD group compared to HC. Overall, NLP methods offer an easily applicable approach for assessing FTD in FEBD and discriminating between FEBD and HC.

None Declared

The significant psychological burdens posed by cannabis use on adolescents and young adults, make them a target for interventions to enhance their health literacy regarding patterns of cannabis use (dose and frequency) that lead to higher health risks. Critically incorporating this information is known as health literacy (HL). Within the Cahly project we have designed a psychoeducational intervention to enhance HL regarding cannabis use among students aged 15-25 years old.

Explore the efficacy of the intervention in improving HL among the students.

Prospective, randomised controlled trial with a duration of 1-month. 50 high-school centers and universities located in Barcelona were offered to participate. In those accepting, students were randomised to the experimental (received the intervention) or control groups (did not receive it). Both groups completed a baseline questionnaire on: HL, HL on cannabis use, substance use in the previous year and in the previous month, as well as sociodemgraphic data. These questions were repeated after one month of entering the study. In the present stage, we will present the baseline HL level (means, %), and the comparison among groups for the follow-up measures (using either Pearson’s Chi-squared test or Fisher’s exact test as appropriate, group mean comparisons utilized either the Student’s t test or Wilcoxon rank sum test,).

300 students have so far finalised the study. Baseline results indicate low levels of general health literacy, and lower knowledge regarding HL on cannabis, with a predominance of use of informal sources of information. Those receiving the intervention improve significantly their knowledge regarding the patterns of cannabis use that lead to higher risks. However, the intervention did not affect their patterns of substance use.

We propose an innovative intervention aiming to disseminate a definition of cannabis risky use among a vulnerable population such as youth. Preliminary results are promising.

None Declared

Data from community samples have shown that the risk of negative outcomes during the transition to adulthood is greater for those who engage in substance use. Alcohol use is common among young adults in the U.S., with 82% using in the past year and 34% engaging in havy episodic drinking . Marijuana is the second most widely used substance among young adults and regular use has been connected to an increased risk of anxiety and depression, and linked to both psychoses and poorer outcomes in people diagnosed with schizophrenia.

The goal of the current study is to understand the role of adverse childhood experiences (ACEs) on the likelihood of frequent marijuana and alcohol use among a sample of low-income young adults (N=182) in the U.S.

Some original ACE study items were examined, such as types of child maltreatment. Additional items were added, including time spent in foster care as a child, involvement in a serious accident, experienced a serious injury, violent death of a family member or friend, and witnessed a serious injury or death. Frequent alcohol and marijuana use was defined as once a week or more in the past 30 days. Logistic regression models were developed to understand the magnitude of the contribution of each individual factor on the frequent use of both alcohol and marijuana. Separate models were developed to predict marijuana use and alcohol use.

The participants’ mean age was 20.5. The majority of the sample identified as Black (59%) or White (34%). A little more than half (53%) identified as female. Thirty percent reported using alcohol and 35% reported using marijuana at least once a week in the past 30 days.

The logistic regression model predicting frequent alcohol use showed several significant independent variables. Time in foster care (OR=2.88), childhood sexual abuse (OR=2.59), and childhood emotional abuse (OR=4.01) were all significant. Additionally, having a close family or friend who died violently (OR=6.63) and witnessing a serious injury or death (OR=2.92) were statistically significant.

The model predicting frequent marijuana use showed similar significant independent variables. Time in foster care (OR=3.48), childhood physical abuse (OR=3.67), childhood emotional abuse (OR=9.65), and having a close family member or friend who died violently (OR=4.99) all significantly increased the odds of marijuana use.

Study results show the sustained negative impact of both child maltreatment and out-of-home placement. While less studied than other forms of maltreatment, emotional abuse was predictive of both alcohol and marijuana use. Youth who experienced violence in their community also showed a greater likelihood of alcohol and marijuana use. These results highlight the importance of identifying and addressing child maltreatment. Efforts to prevent and address substance use in young adults should take experiences of violence and abuse into account.

None Declared

The study was designed to determine the prevalence of drug abuse and its perceived effect on the mnetal health and academic performance of secondary school students in Bauchi State, Nigeria.

Objectives of the Study

The aim of this study is to examine the prevalence of drug abuse and its perceived effects on the mental health and academic performance of secondary schools student in Bauchi state. The specific objectives are:

1. 1. To determine the prevalence of drug abuse among secondary school students in Bauchi metropolis.

2. 2. To identify the perceived drugs commonly abused by students in secondary schools.

3. 3. To investigate perceived reasons secondary school students abuse drug in Bauchi metropolis.

4. 4. To investigate the perceived negative effect of drug abuse on the mental health and school performance of the students in secondary schools of Bauchi metropolis.

The study adopted a cross sectional descriptive design. Multistage sampling procedure was used to select 26 Secondary Schools in Bauchi state. The schools have a combined population of 11,439 students. The instrument for Data collection was a WHO Youth Drug Survey (WHOYDSQ) and drug abuse screening test (DAST) adapted questionnaire and a sample size of 399 was obtained using Yamane formula. The reliability of the instrument was established using a test and re-test. Data generated analysed using frequency distribution tables, cross tabulation and chi square.

Out of 399 copies of the questionnaire distributed, 372 were correctly filled and analyzed. Majority (80%) of the respondents were between 18-20 years. More than half, 208 respondents (55.9%) reported to have used drug for non-medical reasons once or more in the past one year. The commonest substances abused were codeine, cough syrup, cannabis and tramadol. More than half of the users of each of the substances take it occasionally. Among the respondents, 42.8% who used psychoactive substances were introduced to the substance by their friends. Major reasons for using psychoactive substance include reduction of stress (37.1%), out of curiosity (28%) and memory improvement and retention (26.6%). There was significant difference (p < 0.05) in the academic performance of the respondents that abuse drug and those that do not.

In conclusion the prevalence of substance abuse among Secondary School students was high (55.9%) as such government, parents, teachers, stakeholders and the community leaders needs to join hands to fight and address the problem.

None Declared

Minority groups in terms of sexual orientation are exposed to specific stressors, unlike the stressors of the general population. Discrimination, stigma, prejudice and violence are more common in minority groups in terms of sexual orientation than heterosexuals, and they affect mental health negatively. Minority stress factors such as perceived discrimination, self-stigmatization and internalized homophobia have negative effects on mental health.

External and internal minority stressors, which are associated with social anxiety like many mental illnesses, are also associated with self-esteem and quality of life. Minority stress factors should also be well understood in order to understand the consequences they cause. In this study, it was aimed to examine the relationship between discrimination and internalized homophobia experienced in gay and bisexual men with social anxiety, self-esteem and quality of life.

85 participants who defined themselves as gay or bisexual man were included in the study.The study is cross-sectional and descriptive, and the participants were reached by the snowball method.Sociodemographic and clinical data form, including the experienced discrimination questions prepared by the researcher, Internalized Homophobia Scale, Libowitz Social Anxiety Scale, Social Interaction Anxiety Scale, Rosenberg Self-Esteem Scale, World Health Organization Quality of Life Scale Short Form Turkish Version (Whoqol-bref Tr) has been applied.The relationship between experienced discrimination in the sample and internalized homophobia; social anxiety, self-esteem and quality of life were examined separately.

It was found a significant relationship between experienced discrimination and social anxiety levels, an inverse relationship was found with self-esteem. A same-way relationship was found between internalized homophobia and social anxiety levels, while an inverse relationship was found with self-esteem. Experienced discrimination and internalized homophobia were both found to be inversely related to quality of life.

In our study, it was found and discussed that experienced discrimination in gay and bisexual men was positively related to the level of social anxiety, and negatively related to self-esteem and quality of life;similarly there was a positive relationship between the level of internalized homophobia and the level of social anxiety, and a negative relationship between self-esteem and quality of life.When these results are evaluated, it is understood that discrimination experiences and negative mental consequences should be taken into account when evaluating homosexual and bisexual men who are minorities in terms of sexual orientation in mental health clinics and practices, psychological support process, preventive mental health practices and policies to be developed.

None Declared

Facial emotion recognition is a fundamental component in social interaction. Facial emotion recognition is disturbed both in women with Premenstrual Dysphoric Disorder (PMDD), and in those with a history of childhood trauma. PMDD affects up to 5% of women of childbearing age, exert influence on women’s recognition of emotions, and on the emotion recognition processing. Women with PMDD are more likely to have a history of childhood trauma.

To explore whether there is a link between a history of trauma and the perception of emotions in women with PMDD. We hypothesize that women with PMDD and a history of childhood trauma will show larger deficits in emotion recognition compared to women with PMDD but without a history of childhood trauma.

Data were derived from a sample of forty women diagnosed with PMDD (18-30 y.o., right handed, educational level >9y., regular cycle duration), who have visited Mental Health Centre of Rethymno (participants completed the Premenstrual Syndrome Questionnaire). The participants completed the Childhood Trauma Questionnaire (CTQ), which measures five types of maltreatment experiences. Three types are related to abuse (physical, sexual and emotional) and two to physical and emotional neglect. The Emotion Recognition Task (ERT) was also administered. ERT is a computer-generated paradigm for measuring the recognition of six basic facial emotional expressions: anger, disgust, fear, happiness, sadness, and surprise. During this test, video clips of increasing length are presented.

The majority of the participants (82.5%) reported a history of maltreatment during childhood. Women without trauma, when they completed the ERT did not show any significant emotion dysregulation. On the contrary, maltreated women, especially physically or sexually abused, had a distorted perception of emotions expressed on adult faces. Happiness is less detected, whereas fear and anger are recognized more rapidly and at a lower intensity compared to women not exposed to childhood trauma. The higher the score in abuse, the higher the emotion dysregulation is.

The main conclusion of this study contributes to the current knowledge on the link between the long-term effects of childhood trauma both to PMDD and to emotion dysregulation. Women with PMDD are more likely to have a history of childhood trauma, which is associated with poorer performance in facial emotion recognition. Trauma, however, is a treatable factor with. Therefore, interventions targeting both to heal trauma and to promote adaptive emotion regulation strategies, could be encouraged to improve the capability of women with a history of childhood trauma to challenge premenstrual symptoms.

None Declared

Attention Deficit and Hyperactivity Disorder (ADHD) affects both males and females, however, sex differences can be found in presentation, epidemiology and even influence clinical management. Male-to-female ratio is different in childhood from adulthood, meaning girls with ADHD are probably less referred to medical care and underdiagnosed. Women with ADHD have more prevalence of depression and anxiety than men. Also, fluctuating levels of estrogen and progesterone interferes in symptoms and medication response

To study sex differences regarding sociodemographic, mental health care access, and psychiatric comorbidity in a sample of patients from our ADHD outpatient clinic

We collected data from all patients who attended the Adult ADHD Outpatient Clinic of our hospital from 2017-2022 (N = 262), excluding those without written information or an ICD-11 diagnosis of 6A05 - attention deficit hyperactivity disorder (n=209). We performed a descriptive statistical analysis comparing male (n=132) and female (n=76) on sociodemographic factors, educational achievement, age of diagnosis, treatment and comorbidities

Average of age was 39,4 for females (F) and 34,3 for males(M). Levels of primary education were 5% for both, secondary education 41% F and 53% M, and tertiary education 41% F vs 37% M. 30% F and 37% M had failed at least once during their academic path. 26% F vs 25% M were students, 45% F vs 48% M were working actively and 8% F vs 15% M were unemployed. Only 8% F had an ADHD diagnosis during childhood and adolescence whether 41% of M had a history of early diagnosis and/or treatment. At least once psychiatric comorbidity was found in 75% F and 67% M, and medical comorbidities were present in 36%F and 44% M. Comorbid psychiatric diagnosis were anxiety disorders (36% F vs 26% M), depressive disorders (29% F vs 18% M), intellectual developmental disorders (5% F vs 13% M), substance abuse disorders (5% F vs 9% M), bipolar disorder (11% F vs 5% M), and autism spectrum disorders (3% F vs 5% M). In F, 75% were treated with stimulants and 11% with non-stimulants as in M 80% were treated with stimulants and 8% with non-stimulants. 37% F vs 24% M maintain follow-up, while 50% F vs 61% M abandoned it

In our study, women were less diagnosed in childhood and adolescence than men, regardless of failing in school in a similar percentage, which reflects underdiagnose in girls. Women had more percentage of psychiatric comorbidities, including anxiety, depressive, and bipolar disorders, whereas men had more prevalence of substance abuse and intellectual developmental disorders, meaning that women with ADHD are more prone to develop mood-related comorbidities than men. The percentage of follow-up abandon is also lower on women which indicates that, in spite of being less referred to medical care for ADHD, they are probably more likely to adhere to treatment

None Declared

Infertility represents a serious biopsychosocial crisis. Faced with infertility in a society that emphasizes parenthood as a desirable role, and driven by their own desire to become a parent, a person is forced to (re)define themselves as an adult and find their place in society. Research shows that women are more affected by this issue. Firstly, medical treatment for infertility is more uncomfortable for women than for men. Moreover, in most societies, women are considered the responsible partner for reproduction. The experience with this problem can be traumatic enough to become a reference point for identity and for attributing meaning to other experiences in one’s life.

This research aimed to examine the mediating role of psychological problems caused by infertility in the relationship between self-stigma and the degree of integrating trauma (i.e. infertility) into one’s identity, on the one hand, and the level of depression, on the other.

The study involved 197 women with difficulties conceiving who had not yet become mothers, aged between 27 and 47 years (M=37.7; SD=5.1). The following questionnaires were used: the Female Infertility Stigma Instrument (ISI-F), designed to assess self-stigma in women facing infertility. The Centrality of Event Scale (CES) measures integrating trauma into one’s identity (adapted here to measure the integration of infertility into one’s identity). The Psychological Evaluation Test for Infertile Couples (PET), is aimed at assessing psychological problems in various aspects of life caused by infertility, and the Patient Health Questionnaire (PHQ-9), is used to assess the degree of depression.

The results show that the zero-order correlations between the predictors, mediators, and criterion are positive and significant. Mediation analysis shows that problems caused by infertility mediate the relationship between self-stigma and the level of depression (indirect effect: ß=.292, p< .001, 95%CI = .199 - .411), and between the integration of trauma (i.e., infertility) into one’s identity and the level of depression (indirect effect: ß=.147, p<.001, 95%CI = .083 - .226). In both cases, full mediation is observed. Tables and figures will be added to the poster if accepted.

The results indicate that the degree of internalized stigma and the integration of infertility into one’s identity are significant for a person’s adjustment to this problem and that, together with the level of psychological problems caused by infertility, have an effect on mental health. The study underscores the “traumatic” potential of infertility and the effect of this issue on identity and mental health. The findings could also serve as guidelines for designing psychological interventions, which should focus on the problem of self-labeling, self-blame, and the redefinition of oneself as an adult.

M. Mitrović Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, N. Ćirović Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, J. Opsenica Kostić Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, I. Janković Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, M. Guberinić Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, M. Spasić Šnele Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, M. Trenkić Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe.

The postpartum is a high-risk period for onset and recurrence of maternal mental health disorders. If left untreated these disorders can have important consequences on mother, baby and family. When the disorder is severe or there are no conditions to manage it in the community the mother may need to be hospitalized and the gold-standard are the mother-baby units (MBU) in which mothers are co-admitted with their infant.

We aim to explore this model of care (MBU), the pros and cons and how it has been done worldwide, so you can better understand how they work and improve the care we provide to our patients.

To this purpose we conducted a literature review by searching and analyzing papers on mother-baby units. The search was on PubMed and Google Scholar, with the following key-words: “mother-baby unit”, “maternal mental health”, “postpartum mental health” and “postnatal psychiatry”.

The MBU are considered the best practice by the National Institute for Health and Care Excellence (NICE) and their guidelines for Antenatal and Postnatal Mental Health recommend MBUs be staffed by specialist perinatal mental health staff. The postnatal period is a critical time for mother and baby binding and there is scientific evidence that separating the mother and infant during the first year could impact negatively on the developing attachment relationship and be a detrimental and traumatic experience for both. Also, by committing both mother and baby, we have an opportunity to watch and guide the mother to baby care. The United Kingdom pioneered in MBUs and in 1958 opened the first separate MBU and then France opened theirs in 1979 and Belgium in 1990.

To summarize, the dyad admission, allows for the mother to receive adequate treatment for her psychiatric disorder, whilst also receiving support in developing parenting skills. In the last years many countries worldwide have adopted this as standard of care, with excellent outcomes for both mother and baby.

None Declared

Premenstrual disorders (PMDs), including premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), manifest a range of affective, cognitive, behavioral, and physical symptoms during the late luteal phase of the menstrual cycle. Several studies have indicated that women with PMDs have a lower health-related quality of life, though findings on specific affected dimensions vary. Most of them relied on community- or clinical setting-based sampling, limiting the generalization. Furthermore, no prior study has formally assessed the association by accounting for the potential confounders. Therefore, we conducted a cross-sectional study based on the LifeGene cohort to evaluate the difference in quality of life among women with and without PMDs.

We seek to understand, to what extent and in which way PMDs may impact the quality of life of women in Sweden.

We conducted a cross-sectional study of 8311 women enrolled to the LifeGene cohort during 2009-2019 in Sweden. PMDs were assessed with the modified Premenstrual Symptom Screening Tool at baseline, while data on quality of life (QoL) was obtained using the EQ-5D-3L scale (the higher the score, the worse the quality of life) from the LifeGene baseline dataset. Linear regression models were employed to assess the QoL score change associated with PMDs, as well as the separate analyses for PMDD and PMS. The models were adjusted for age, education level, country of birth, marital status, obesity, smoking, alcohol consumption, and childhood abuse.

At a mean age of 34.01 years (SD=9.63), 1903 (22.90%) women met the criteria for PMDs. In the crude analysis, PMDs were positively associated with a lower quality of life (mean increased QoL score: 0.37, CI: 0.32-0.42). After adjustment for demographics and potential confounders, similar results were yielded (mean increased QoL score: 0.34, CI: 0.29-0.39). Among the five indicators included in the questionnaire (mobility, self-care, activity, pain and anxiety), only self-care was not associated with PMDs. For PMD subtypes, we found a lower quality of life among women with PMDD (mean increased QoL score: 0.35, CI: 0.30-0.41) but not among women with PMS.

Our findings suggested that women with PMDD had a lower quality of life compared to those without PMDD. While evidence based on prospective data is warranted in future, effective management is needed to improve the quality of life for women suffering PMDD.

None Declared

Women generally have a later age of onset, and may therefore have a more favourable course of psychotic illness than men regarding psychopathology. Little is known about a broader range of outcomes, including well-being and recovery, and about the influence of age of onset.

This study examines longitudinal sex-related and age of onset-related differences in well-being and recovery of people with a psychotic disorder with long illness durations.

Routine outcome monitoring data (2012-2021) of n=3843 patients were used. Well-being (quality of life and personal recovery) and recovery (clinical and societal recovery and psychosocial functioning) were assessed. Latent class growth analysis (LCGA) was performed to assess whether classes with different trajectories of well-being and recovery could be identified. Classes were related to sex and (early/late) age of onset of psychosis (EOP/LOP).

LCGA identified five classes with varying combinations in levels of well-being and recovery, which were stable over time. Sex, age of onset and the combination of these two were significantly related to class membership. Women and individuals with LOP were more prevalent in better functioning classes than men and individuals with EOP.

This study showed sex differences in long-term recovery patterns of psychosis. Not only women but also individuals with LOP had a higher chance of better well-being and recovery, while men with EOP were at risk for worse outcomes. Taking these sex differences into account when deciding on policy and treatment protocols for individual patients might provide better mental health care to people with psychosis.

None Declared

Women with a history of major depression are at risk of perinatal depression (PND). The associations between PND and other types of psychiatric disorders are less clear, although a recent GWAS revealed genetic correlations with almost all psychiatric disorders.

The aim of this study was to examine the association between PND and overall, and 17 type-specific, psychiatric disorders in a life course approach.

Leveraging Swedish nationwide health register and primary care data, we included all birthing women diagnosed with depression or prescribed for antidepressants during pregnancy or within a year postpartum, i.e., women with PND (n=122,720), during 2001-2022. Using incidence density sampling, we matched each case to 10 unaffected birthing women. We ascertained any diagnosis of psychiatric disorder over the lifetime from the National Patient Register. Using multivariable conditional logistic regressions, we estimated the association between PND and any, or subtypes of, psychiatric disorders dated before or after the PND diagnosis in a liftecourse approach. Moreover, we conducted a nested case control study to investigate the association of psychiatric disorders and subsequent PND, and a matched cohort study to investigate PND and subsequent psychiatric disorders.

In preliminary results, at a mean age of 31.0, we found that PND was highly associated with any other psychiatric disorders (adjusted odds ratio (aOR)=9.02, 95%CI 8.9-9.2). The association remained when excluding depression (aOR=6.2, 95%CI 6.1-6.3), and was comparable for psychiatric disorders dated before PND diagnosis (aOR = 9.0), whereas attenuated for diagnoses dated after PND (OR= 3.9). Most pronounced association was noted for bipolar, personality disorders, depression, and anxiety. The association was stronger in primiparous women and in women born ourside of Europe (p-for interaction <0.001).

Throughout life course, PND is associated with psychiatric disorders, particularly with bipolar disorder, personality disorder, depression and anxiety. These findings may shed light on shared genetic/risk factors between PND and other psychiatric disorders.

None Declared

Sleep deprivation (SD) is a global health concern that impairs cognitive and psychomotor functions (PF). While it can temporarily improve mood, its effects on mood and connection to depressive symptoms (DS) remain unclear. These impacts may involve circadian rhythm gene regulation, though distinct evidence from human studies is lacking.

To assess the impact of SD on the expression of circadian rhythm regulation genes and its associations with the alleviation of DS. Additionally, to explore the relationship between changes in gene expression and PF following SD.

Participants (n = 72) underwent a baseline sleep assesment by polysomnography (PSG), later being subjected to SD. In total, evaluation of mood And cognitive functions (Bimanual Eye-Hand Coordination Test - BEHCT) was conducted four times, pre/post PSG and SD. Moreover, circadian rhythm regulation genes expression: Circadian Locomotor Output Cycles Kaput (CLOCK), Brain and muscle Arnt-like protein-1 (BMAL1), Period Circadian Regulator 1 (PER1), Cryptochrome Circadian Regulator 1 (CRY1), Nuclear Receptor Subfamily 1 Group D Member 1 (NR1D1) and Neuronal PAS Domain Protein 2 (NPAS2) was evaluated. Participants were divided into respondents (RE, n = 49) and non-respondents (NR, n = 23) depending on changes in DS under the influence of SD by the Montgomery–Åsberg Depression Rating Scale evalluation.

No relationship was found between BEHCT parameters and the studied genes in the entire study group. NRs exhibited a negative correlation in number of motor function errors in relation to all examined genes of CLOCK (r=-0.52, p=0.02), BMAL1(r=-0.55, p=0.007), CRY1(r=-0.45, p=0.048), PER1(r=-0.6, p=0.023), and NR1D1 (r=-0.19, p=0.523) is except for NPAS2. Additionally, In NRs, the BEHCT error time negatively correlated with the PER1 and NR1D1 (r=-0.6, p=0.006; r=-0.52, p=0.045; respectively). In contrast, within the RE group, only NPAS2 expression showed a positive correlation with the number of errors (r= 0.35, p=0.049).

Reduced expression of CLOCK, BMAL1, CRY1, PER1, and NR1D1 is associated with impaired PF, only in individuals with worsening DS after SD. Increased NPAS2 expression appears to be an orgin of reduced PF results in the RE group. These genes, integral to the circadian system’s feedback loop, may mediate the complex effects of SD on mood and cognitive function, warranting further investigation.

None Declared

With increase in life expectancy, there is growing interest in quality of life. Sleep is receiving increasing attention among the elderly.

This study aimed to investigate the changes in sleep quality with increasing age and the effect of age on the components of the Pittsburgh Sleep Quality Index (PSQI).

We used data from the Community Health Survey conducted by the Korea Center for Disease Control and Prevention in 2018. A total of 228340 participants in this nationwide survey. Sleep quality was assessed using the PSQI. Adults aged ≥ 19 years were divided into six age groups and one-way analysis of variance (one-way ANOVA) was used to compare the mean values of PSQI of each group. By comparing the scores for each PSQI component in those aged ≥ 65 years and < 65 years, we aimed to reveal the differences in special components according to age group.

In total, 223334 respondents were included in the study. Based on a one-way ANOVA, the PSQI score generally increased with age. Although the average PSQI score of patients in their 40s was lower than that of patients in their 30s, there was no significant difference between the two groups (p = 0.11). When the PSQI component was compared between the population aged over and under 65 years, the population aged ≥ 65 years scored higher in most components. In contrast, daytime dysfunction scored higher in the population aged < 65 years.

Sleep quality tends to decrease with increasing age. Several factors, including physiological changes, underlying physical conditions, and psychosocial factors, may contribute to a decrease in sleep quality with age.

None Declared

Insomnia is the most common sleep disorder, which may favor, precipitate, and prolong mental disturbances, including mood disorders. The treatment of insomnia in the context of mood disorders may contribute to improving their trajectories, possibly by improving mood symptoms via sleep regulation. Daridorexant is a new pharmacological option for insomnia treatment, which is a dual orexin receptor antagonist (DORA).

The aim of the present study was to treat consecutive patients with insomnia disorder with and without mental co-morbidities with this new therapeutic option.

Ninety consecutive patients with insomnia disorder according to the DSM-5-TR criteria were treated with daridorexant 50 mg. Baseline, 1 month, and 3-month evaluations were performed. Demographic and clinical data were incorporated. Insomnia severity (Insomnia Severity Index-ISI), mood symptoms (Beck Depression Inventory II-BDI-II, Young Mania Rating Scale-YMRS), suicidal ideation (Suicidal Ideation Scale-SSI), and emotional dysregulation (Difficulties in Emotion Regulation Scale-DERS) were evaluated. The evaluation of psychiatric diagnosis was conducted in accordance with the DSM-5-TR criteria (SCID-5) and the concurrent use of pharmacological therapy was taken into account.

The final sample included 80 patients (N° 40, 50.0% females, mean age 60 ± 13.2). Most of them (N°50 62.5%) suffered from insomnia comorbid with unipolar/bipolar depression. Repeated Anova analyses showed that ISI and DERS total score decreased across time (respectively F=63.42, p<0.001, F=41.12, p<0.001). Similarly depressive and mixed symptoms, suicidal ideation and anxiety symptoms significantly improved over time and after 3 months of treatment (respectively F=62.45, p<0.001, F=31.48, p<0.001, F=41.14, p<0.001, F=21.44, p<0.001). Analyses conducted on a subsample of patients with comorbid unipolar and bipolar disorder revealed a distinct beneficial effect on insomnia and mood symptoms. Multiple regression models demonstrated that improvement of depressive symptoms was best predicted by the improvement in emotion regulation -DERS score at T1 and T2, and the improvement in insomnia symptoms at T1. An improvement in manic symptoms-YMRS score was best predicted by an improvement in insomnia symptoms-ISI score and in emotion regulation at T1 and T2.

The treatment of chronic insomnia with daridorexant improved insomnia symptoms in patients with and without mental comorbidities across time. It was particularly effective in patients with unipolar and bipolar disorders, where the improvement in mood symptoms was related to the improvement in insomnia across time. These data are in line with the data showing that targeting insomnia in the context of mood disorders might be useful for improving sleep and mood symptoms by regulating the sleep system.

L. Anastasio: None Declared, G. Alfi: None Declared, G. Aquino: None Declared, E. Annuzzi: None Declared, G. Cerofolini: None Declared, A. Coccoglioniti: None Declared, M. Gambini: None Declared, M. Pioltino: None Declared, G. Perugi: None Declared, A. Gemignani: None Declared, L. Palagini Consultant of: Consultancy for Laura Palagini, Bruno, Idorsia, Fidia, Pfizer, Sanofi