Targeting insomnia may have a therapeutic value for mental disturbances. Indeed, insomnia chronic nature may necessitate switching between various insomnia approaches and medications. 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 and during the deprescripion of previous hypnotic medications which have failed in insomnia treatment.

Ninety consecutive patients with insomnia disorder according to the DSM-5-TR criteria (sleep condition indicator SCI<16) 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 and anxiety symptoms (Beck Depression Inventory II-BDI-II, Young Mania Rating Scale-YMRS, Self Reported Anxiety Scale-SAS), and pre sleep arousal(Pre Sleep arousal Scale-PSAS) 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. For previous insomnia treatment discontinuation, cross-tapered programs were developed following the 25% per week rule while inserting daridorexant.

The final sample included 80 patients (N° 40, 50.0% females, mean age 60 ± 13.2). Most of them (75.5%) suffered from insomnia comorbid with unipolar/bipolar depression, anxiety disorders and sedative-hypnotics use disorders. Repeated Anova analyses showed that ISI and PSAS total score decreased across time (respectively F=63.42, p<0.001, F=61.44, p<0.001). Similarly mood symptoms, 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 sedative-hypnotics use disorders (50%) revealed a beneficial effect on insomnia, arousal and anxiety symptoms. Multiple regression models demonstrated that the clinical improvement of anxiety symptoms was most best predicted by the improvement in emotion regulation -PSAS score at T1 and T2, and the improvement in insomnia symptoms at T1and 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 sedative-hypnotics use disorders, where we deprescribed previous sedative hypnotics including neuroleptics and sedative antodepressants. These data are in line with the data showing that sleep is involved in the regulation of the reward 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

Identifying early-life risk factors for chronic depression symptomology in young people, is essential to informing early targeted interventions. One highly prevalent symptom (and potential risk factor) in depression is sleep problems, such as insomnia or hypersomnia. However, most studies have measured sleep disturbances and depression symptoms at only one time point, and the prospective relationship between persistent shorter or longer sleep duration in childhood and chronic depression symptoms in adolescence through to adulthood has not been explored.

To identify whether longitudinal trajectories of persistent shorter sleep and persistent longer sleep duration between 6 months to 7 years of age, are associated with increased risk of developing chronic depression symptoms between 13-22 years of age.

Prospective associations were explored using the Avon Longitudinal Study of Parents and Children (ALSPAC), in the UK. Childhood night-time sleep duration was parent-reported at 6, 18, and 30 months and at 3.5, 4 to 5, 5 to 6, and 6 to 7 years. Depression symptoms were self-reported via the Short Mood and Feelings Questionnaire (SMFQ) at, 12.5, 13.5, 16, 17.5, 18, 21 and 22 years of age. Latent Growth Curve Analysis was used to identify longitudinal trajectories of night-time sleep duration from 6 months to 7 years of age (i.e. longer (63%), shorter (2%), average-shorter sleep (22%) and average-longer sleep (13%)) and depression symptoms (i.e. chronic (5%), non-chronic (95%)) from 13 to 22 years. Logistic regressions were conducted to identify the prospective association between persistent shorter and persistent longer sleep trajectories and chronic depression symptoms.

Preliminary results revealed that persistent shorter sleep duration across childhood was associated with increased likelihood of presenting with chronic depression symptoms, even after adjusting for the effects of sex, birthweight, maternal age, child ethnicity, family adversity and maternal socioeconomic status (OR = 1.94, 95% CIs, 1.01, 3.73 p =. 046). Persistent longer sleep however did not show significant associations.

A persistent pattern of shorter sleep duration across childhood is associated with chronic depression symptoms in adolescence through to adulthood. Sleep is a modifiable risk factor and targeted interventions for those presenting a sustained pattern of shorter sleep duration across childhood is suggested to prevent future mental health problems, such as depression.

None Declared

New treatments for negative symptoms (NS) in schizophrenia spectrum disorders (SSD) are urgently needed. NS are believed to stem from disruptions between the mesocorticolimbic dopamine system and networks for socioemotional processes. Oxytocin (OXT) enhances connectivity between the neural networks, improving social cognition and NS. Lower plasma OXT levels are linked to greater NS severity and social cognition deficits in SSD. While OXT increases social cognition in healthy individuals, its effects in SSD are inconsistent. The social salience hypothesis suggests OXT’s effect varies with social context. Our pilot study showed reduced NS with OXT administration in a positive social setting using mindfulness-based group therapy (MBGT).

This trial aims to assess the effects of combining OXT with MBGT on each of the five NS in individuals with SSD. We hypothesize that OXT nasal spray administered before MBGT will significantly reduce NS compared to placebo. The primary outcome is the change in NS, measured by the Positive and Negative Syndrome Scale (T1 - T0 score difference) after 4 weeks and as secondary outcome on the Brief Negative Symptom Scale (BNSS) as well as changes of stress and affect.

The research design is a triple-blinded, randomized, placebo-controlled study comparing OXT to placebo. Manual-based MBGT sessions, led by experienced psychotherapists, occur weekly for four weeks with groups of up to six patients. Participants receive intranasal OXT (24 I.U.) or placebo 30 minutes before sessions, aligning with the peak effect window (30-80 min) for optimal social behavior reinforcement. Plasma oxytocin levels are measured by radioimmunoassay. Recruitment will be at the Department of Psychiatry, Charité, Berlin, including both genders in mixed-sex groups, controlling for contraceptive use and menstrual cycle phase. Nasal sprays are indistinguishable. The primary outcome will be analyzed using ANCOVA, with treatment condition and training group as covariates. Based on pilot and previous study effects, a conservative effect size of f = 0.25 is assumed. With 1:1 randomization, 80% power, a 5% two-sided significance level, and a 10% drop-out rate, 140 subjects will be recruited.

This project explores how OXT augmentation enhances the positive effects of MBGT. It is expected that combining OXT with MBGT will significantly improve NS, stress, and affect in SSD patients. Preliminary results already show a significant reduction in social withdrawal and blunted affect in the OXT group compared to placebo.

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Current treatments for NS in SSD are insufficient, highlighting the urgent need for new or combined strategies. Evidence supports the benefits of augmented psychotherapy. This project could pave the way for innovative, personalized psychiatric treatment for SSD.

None Declared

Psychotic disorders, particularly schizophrenia, are severe mental illnesses associated with high rates of disability and functional impairment, causing significant individual burden and incurring high societal costs. Typical onset of schizophrenia is in late adolescence or early adulthood and the complex management requires often life-long pharmacological and non-pharmacological treatment. Early symptom recognition and timely intervention can improve the course of illness and result in better outcome and prognosis, effective management leads to a functional recovery. However, recent reports have identified significant gaps in access to timely assessment and shared decision-making interventions, with inadequate care pathways. In the face of an unprecedented demand for mental healthcare for young people, it can be challenging for health services to deliver high-quality mental healthcare which, according to the World Health Organization, should be timely, effective and evidence-based, safe and person-centered. The project covers nine countries in Europe.

Building on the European Brain Council Rethinking Schizophrenia Beyond The Voices Policy Report (2024), the survey and literature review aim to: (1) evaluate the effectiveness of integrated models of youth mental healthcare on a broader range of outcomes, including both mental health outcomes, such as clinical symptoms, functioning and quality of life and health service outcomes, including access and satisfaction with care in young people; and (2) identify the common components of integrated care pathways for young people with first episode psychosis.

Using the care pathway as a tool at the first step of the research, a cross-country survey was co-designed with the Board of experts and anonymously launched earlier this year. By complementing the survey, the literature review on the care pathway will address quality and continuity of care from the first onset of psychosis and schizophrenia to long-term care in the selected countries including existing guidelines and overview country health situation assessments.

Patients and mental health professionals’ insights will be collected. Obtained data will also be analysed by the stakeholders and used to formulate recommendations for policy makers, care payers, mental health professionals, patients and their families (both country specific and at the EU level).

A policy report, based on the consensus, will be released at the Brain Awareness Week 2025 with results and recommendations which will provide valuable insight into understanding the needs of patients with first-episode psychosis and defining the optimal care pathways to engage with them. In order to show that there is a progress in the field of care for schizophrenia patients, the utilization of new technologies is included.

None Declared

The human body hosts a vast array of commensal microbes known as the gut microbiota, which plays a crucial role in various physiological functions, including immune system maturation, digestion, and central nervous system development. Recent studies suggest a significant link between gut microbiota and psychiatric disorders, particularly schizophrenia. Imbalances in gut microbiota composition have been associated with symptom severity and treatment response in schizophrenia patients.

This study aims to synthesize current knowledge on the role of gut microbiota in the severity of symptoms and the prediction of treatment response in schizophrenia, highlighting its potential as a biomarker for therapeutic strategies.

We conducted a systematic literature review following PRISMA guidelines, focusing on articles published between 2014 and 2024. Using databases like PubMed and Google Scholar, we searched for keywords related to gut microbiota, schizophrenia, first episode psychosis, treatment response, and symptoms severity.

Our review included eight studies that utilized 16S rRNA sequencing to analyze fecal microbiota. The findings revealed significant correlations between specific gut microbiota profiles and the severity of psychiatric symptoms. Notably, families such as Lachnospiraceae and Bacteroidocacae were linked to increased symptom severity, while others, including Flavobacteriaceae, Enterococcaceae and Flintibacter butyricus , correlated with symptom remission. Additionally, variations in gut microbiota composition were predictive of treatment outcomes, suggesting its role as a potential biomarker for response to antipsychotic treatments.

The gut microbiota presents a promising avenue for understanding the complex interplay between microbial communities and psychiatric health. By identifying specific microbiota profiles associated with symptoms and treatment responses in schizophrenia, we can pave the way for novel personalized therapeutic approaches.

None Declared

Psychosis is characterized by hallucinatory and delusional experiences. Although, it was mostly considered to be present among clinical populations, there is strong evidence it can also be found in the general population. Limited reviews currently exist on the quality of the assessment methods designed to evaluate psychotic-like experiences in the general population. None of them assessed whether the existing instruments measure the same construct and, consequently, neglected problems associated with the “jingle-jangle fallacy” (Weidman et al., 2017; Flake and Fried, 2020). This fallacy might account for contradictions in the literature, as well as, issues with generalizability of the results.

The goal of our study is to better understand the agreement between various instruments used to assess hallucinations and paranoia-like experiences.

We conducted a systematic search of the scales assessing hallucinations and paranoia-like experiences among the general population. Labels for the content analysis were created based on their definition in literature by the first authors and revised by another researcher. Three researchers coded each item independently of each other. We then estimated to which extent any item overlaps with any item from the other scale included in the analysis. We used Jaccard index to assess similarities between sets (from 0 with no overlap among scales) to 1 (complete overlap). The analysis was done in R and Excel.

For 263 items from 11 hallucination scales, we estimated 38 labels with a mean overlap of 0.19 (very weak). CAPS demonstrated the highest mean overlap of 0.26. The highest overlaps were observed between MUSEQ and CAPS (0.5), MUSEQ and SPQ (0.4), and between LSHS-R and RHS (0.4). For the paranoia scales, the analysis of 183 items drawn from 12 scales resulted in 18 labels. The mean overlap across these labels was 0.30 - a weak association. The PIQ exhibited the highest mean overlap at 0.42, whereas the PSQ displayed the weakest overlap with a value of 0.17.

The overlap between hallucination scales was very weak. This disparity may be due to different instruments adopt varying interpretations of the hallucination continuum (Laroi, 2012). The weak overlap in paranoia scales may be less problematic, as theoretical models and empirical data suggest a more clear continuum of suspiciousness within the general population (Freeman et al., 2005) that maps our results. It is necessary to establish certain common grounds regarding what experiences represent which sides of the continuum, both in their variability, and severity in the field.

None Declared

This study explores whether high-dose treatment with SGA LAIs may benefit patients with schizophrenia who are inadequately controlled on a standard dose

The objectives of this study have been to evaluate the retention, effectiveness and tolerability of high doses of second-generation antipsychotic long-acting injectable formulations (SGA LAI) in the treatment of patients with severe resistant schizophrenia.

A 72-month observational, mirror-image study of patients with severe (CGI-S ≥ 5) resistant schizophrenia receiving treatment with ≥75 mg of risperidone long-acting injectable (RLAI) (N = 60), ≥175 mg of monthly paliperidone palmitate (PP) (N = 60), and ≥600 mg of aripiprazole once-monthly (AOM) (N = 30). All of the patients were previously treated with at least two different APs, with poor outcomes. Patients were eligible if deemed likely to benefit from treatment with SGA LAIs: at risk of medication non-compliance, with a lack of effectiveness, or adverse effects with previous APs. The assessment included the CGI-S, the WHO-DAS, the Medication Adherence Rating Scale (MARS), laboratory tests, weight, adverse effects, reasons for treatment discontinuation, hospital admissions and suicide attempts.

The average antipsychotic doses were: RLAI = 111.2 (9.1 SD) mg/14 days; PP = 231.2 (12.3 SD) mg eq./28 days; and AM = 780 (120 SD) mg/28 days.

Tolerability was good for all LAIs, reducing the side effects reported and the changes in biological parameters compared to previous treatments, especially in the AOM group. Weight and prolactin levels decreased in all LAI treatments; the reduction was statistically significant only among patients treated with AOM (p < 0.05). Two patients discontinued treatment due to side effects with AOM, five with PP and nine with RLAI .

There were four discontinuations with RLAI, two with PP, and one with AOM due to a lack of effectiveness. After three years, the scores decreased in CGI-S (p < 0.01) and in WHO-DAS in the four areas with all injectables. MARS increased with all LAIs (p < 0.01), especially with PP and AOM.

We report a statistically significant decrease in both hospital admissions (p <0.001) and suicide attempts (p < 0.001) at the end of 36-month treatments, compared to the previous three years, without any difference across the three LAIs. In the previous three years, 60 patients discontinued their AP treatment, and 11 during the three-year follow-up (p < 0.0001

Our study indicates the good effectiveness and tolerability of RLAI, PP and AM at high doses. These SGA LAI treatments improved treatment adherence and outcomes of the patients, with good tolerability, helping them to achieve clinical stabilization and better functioning. Therefore, we suggest that, in some illness-critical conditions, high doses of SGA LAIs could represent an alternative to clozapine.

None Declared

Capturing the complex and heterogeneous clinical phenotypes across Schizophrenia Spectrum Disorders (SSD) is still challenging and Artificial Intelligence is a promising tool. In the past years, machine learning (ML) models have been developed for diagnostic classification, highlighting both neuroimaging and language measures as relevant predictors (Zucchetti et al. It J of Psy (2024). Fewer studies focused on predicting symptom severity or quality of life, based on clinical variables, but with relatively low performance (Beaudoin, et al. Schizophrenia (2022); 8.1 29; Podichetty et al. Clin and Transl Sc (2021), 14(5), 1864-1874). However, to the best of our knowledge, no previous studies have applied ML regression tasks using neurophysiological features, nor combining them with language ones.

The aim is to combine neurophysiological and language features via ML to predict symptoms severity in schizophrenia.

Forty-one individuals with a diagnosis of schizophrenia were enrolled and assessed for psychopathology, communicative-pragmatic abilities and underwent a 5-minute resting state EEG recordings.

A Least Absolute Shrinkage and Selection Operator (LASSO) regression was employed to identify significant EEG and language features, extracted through Natural Language Processing to predict symptoms severity. After feature selection, two LASSO models were built and compared: Model 1 (M1) included the most important EEG features, while Model 2 (M2) included both the most important EEG and language features.

Feature selection led to the identification of main predictors, including EEG microstates and aperiodic activity, lexical-semantic features and imageability of words.

Both models reached an acceptable performance (MSE=0.590, adj. R2= 0.344; MSE= 0.334, adj. R2 =0.582), but the Diebold-Mariano test and BIC highlighted a significant difference between M1 and M2, indicating an improved performance in predicting symptoms, when adding language features. See Fig.1 for more details

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These preliminary results identify relevant features, confirming the role of EEG and language measures as potential biomarkers for SSD. Innovatively, data also show that EEG variables alone, can reliably but only partially predict psychopathology, while the inclusion of linguistic variables further improves the model. Overall, EEG and language measures, obtained quickly through simple tasks, appear as relevant features that may discriminate clinical outcomes within SSD and implementation of ML tools mat help to guide diagnosis and refine treatments.

None Declared

In high-income countries, Coordinated Specialized Care for First Psychotic Episode (FEP) programs have been shown to be effective in reducing symptoms and disability. Chile guarantees universal access to these services through a national policy, but previous research indicates that evidence-based approaches are not used. Our team adapted the OnTrackNY (OTNY) program to the Chilean context, called OnTrackChile (OTCH), to evaluate its effectiveness and implementation. This summary presents preliminary results on model fidelity, one of the primary outcomes of the study.

To evaluate the fidelity of the implementation of the OTCH program in comparison with usual care services for FEP, analyzing its compliance in 18 key domains of care and its alignment with the National Mental Health Plan.

A fidelity scale was designed to guide data collection on OTCH implementation. The scale included the name and definition of each domain, along with a set of expectations. The scale assessed 18 key domains, such as staffing, team integration, communication, burden of care, service flexibility, crisis, treatment planning, prescribing, care management, working with families, and education and employment support, among others. The scale was applied in the 5 OTCH intervention sites and 8 control sites that maintained usual care included in the cluster-randomized controlled clinical trial.

OTCH sites met more than 80% of the criteria for the domains assessed in the fidelity scale, which is more than twice the compliance observed in the control sites. In domains related to the usual functioning of the centers coincident with those established in the National Mental Health Plan, OTCH intervention sites exceeded compliance standards to control sites (p<0.001). In situations where the frequency of problems was similar between both types of centers, such as suicidal risk and risky substance use, OTCH centers showed significantly better performance (p<0.001) compared to control centers.

The implementation of the OTCH model has not only allowed the introduction of specific aspects of the program, but has also improved the overall performance of the centers in key areas defined by the National Mental Health Plan. This suggests that the implementation of OTCH in the Chilean context is not only feasible, but can also improve the quality of community mental health care.

OnTrack Chile is funded by the U.S. National Institute of Mental Health (R01MH115502).

None Declared

Transformation images, widely circulated on social media, depict a contrast between an ‘unideal’ body state and an ‘ideal’ one, often categorized under ‘thinspiration’ or ‘fitspiration’. Unlike ‘ideal’ images shown individually, transformation images not only showcase an ‘ideal’ physique but also suggest its attainability. Although research has found that exposure to ‘ideal’ images is linked to risk factors for eating disorders, scant research has focused on the effects of transformation images.

This study aims to investigate the impact of viewing transformation images on body dissatisfaction, weight management intentions, and emotions in adult young women.

137 Chinese adult women (mean age 21.7±3.0 years) were randomly assigned to one of four image conditions: side-by-side thinness transformation images, side-by-side fitness transformation images, thinness images shown individually, and fitness images shown individually. After baseline assessment of Body Dissatisfaction, Body Mass Index, Internalization of Thinness/Muscularity, participants underwent a 7-day Ecological Momentary Assessment. Prompts were delivered four times per day at 3 to 4-hour intervals. Each prompt included the display of an image for 5 seconds, followed by a survey assessing body dissatisfaction, weight management intentions (intentions to diet, binge eating, and work out), and emotions (positive and negative emotions). Linear mixed models were used to analyze the data, controlling for baseline assessments, autocorrelation, and within-person variability.

Fitness transformation images significantly increased intentions to diet (p < 0.05), binge eating (p < 0.01), and work out (p < 0.05) compared to fitness images shown individually (Table 1). However, this impact was not observed with thinness transformation images (Table 2). Neither thinness nor fitness transformation images had a significant impact on body dissatisfaction or emotions.

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Our study demonstrates that fitness transformation images have a stronger impact on weight management intentions than fitness images presented individually. This finding aligns with the cultural shift in the ideal of physical attractiveness, which now emphasizes ‘fitness’ and a ‘healthy lifestyle’ over ‘thinness’ in women. It is essential to focus on the exposure fitness transformation images on social media and to develop strategies for mitigating potential negative effects in the future.

S. Pan: None Declared, X. Zeng: None Declared, Y. Huang: None Declared, Q. Sun: None Declared, J. He Grant / Research support from: This research was partially supported by the Presidential Fund of the Chinese University of Hong Kong, Shenzhen, to Jinbo He (Grant Number: PF.01.001428)

Avoidant/Restrictive Food Intake Disorder (ARFID) was introduced as a diagnostic category in DSM-5 to describe individuals with restrictive eating behaviors without fear of weight gain, differentiating it from Anorexia Nervosa (American Psychiatric Association, DSM-5, 2013). Although prevalent in children with Autism Spectrum Disorder (ASD), ARFID’s co-occurrence with ASD and its prevalence in parents of children with ASD, particularly regarding the Broad Autism Phenotype (BAP), remains underexplored. This study investigates the prevalence of ARFID in both children diagnosed with ASD and their parents, focusing on BAP features in parents and their relationship with ARFID symptoms.

1. 1. To determine the prevalence of ARFID in parents of children diagnosed with ASD.

2. 2. To explore the relationship between ARFID symptoms and ASD symptoms in both parents and children, examining the role of BAP in parents.

A cross-sectional study was conducted at Başkent University Psychiatry Clinic. The sample consisted of 69 children aged 2-18 diagnosed with ASD and 115 parents. ARFID diagnosis was determined using structured clinical interviews and the Nine-Item ARFID Screen (NIAS), while autism symptoms were assessed using the Childhood Autism Rating Scale (CARS) for children and the Autism Spectrum Quotient (AQ) for parents. Psychosocial, anthropometric, and clinical assessments were performed, including body mass index (BMI), nutritional status, and vitamin deficiencies. Statistical analysis included t-tests, chi-square tests, and correlation analyses (SPSS 24).

The study found that 34.8% of children with ASD (n=24) and 13% of parents (n=15) were diagnosed with ARFID, significantly higher than general population estimates (3.5%, p<0.001) (Thomas et al. Curr Psychiatry Rep 2017; 19: 54). Children with ARFID scored higher on the CARS (mean=38.58, SD=7.92) compared to non-ARFID children (mean=33.73, SD=5.59), with a statistically significant difference (t=-2.878, p=0.005). Furthermore, positive correlations were found between ARFID symptoms and autism-related features in both children and parents, particularly in the AQ imagination subscale (r=0.358, p<0.01).

This study highlights a significantly higher prevalence of ARFID in children with ASD and their parents compared to the general population. The strong correlation between ARFID and ASD symptoms, particularly BAP features in parents, suggests shared neurodevelopmental pathways. These findings underscore the need for increased clinical awareness of ARFID in both ASD children and their families, as well as the importance of incorporating ARFID assessments into ASD treatment plans. Future research should focus on the genetic and developmental mechanisms linking ARFID and ASD.

None Declared

Eating disorders are a group of mental illnesses determining general health consequences. Several studies suggest that social media influence body image concerns, considered the core of eating disorder pathology. Thin idealization has become an increasing cultural focus, leading young people to pursue body image as a symbol of success.

Aim of this study is to assess the quality and quantity of Social Network (SN) use and their influence on body uneasiness in individuals with Disordered Eating Behaviours (DEB) or Eating Disorders(ED)

69 individuals suffering from Disordered Eating Behaviours (Grazing, Sweeteating, Food Addiction) or Eating Disorders (Night Eating Syndrome, Anorexia nervosa, Bulimia nervosa or Binge eating disorder) were enrolled. Mean age was 34 (SD ±11,33), mean BMI 28,68 (SD ±12,23). 93% of individuals were females. 20,29% (14) of the sample suffered from ED and 79,71% (55) from DEB. A social network self-administered questionnaire was used to investigate which SN was most used and what contents were most shown in users’ feed; domains investigated by the questionnaire are reported in fig. 1

Questionnaire analysis allowed to investigate individuals preferences about social media use and the kind of contents they consumed the most. The data showed the most frequently used social network are Facebook (42%), Instagram (33%) and Tiktok (22%). Healthy and/or fit contents were frequently displayed on SN feed 57.9% (40), but only 26,08% (18) of users were influenced in their lifestyle and food habits. 39,13% (27) of the individuals also felt like this kind of contents increased their sense of body uneasiness.

The study emphasize that 42,85% of the individuals diagnosed with an ED answered that SN content influenced their lifestyle and 71,42% that it increased their feeling of body uneasiness. In individuals with DEB only 21,8% were influenced in their lifestyle and 30,9% describe a worsening of their body uneasiness, as is shown in Tab.1.Tab 1

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Social media contents about health, diet and sport impact on individuals body image, diet and body uneasiness, mostly in individuals diagnosed with ED. This evidence stresses the importance to take into account every component of ED and DEB for a global approach to individuals including an assessment on interests, hobbies and use of social media.

None Declared

Binge-eating disorder (BED) is a significant global health challenge associated with obesity and psychological issues. The combination of Naltrexone-Bupropion (NB) has emerged as a promising pharmacological approach for managing eating behaviors.

This meta-analysis aims to evaluate the efficacy and safety of Naltrexone-Bupropion compared to placebo in managing eating behaviors, focusing on weight loss, binge-eating frequency, eating disorder psychopathology, quality of life, and adverse effects.

PubMed, Embase and Cochrane databases were searched for randomized controlled trials (RCT) comparing NB versus placebo for BED. Primary endpoints were weight loss and binge-eating frequency. Secondary endpoints included eating disorder psychopathology, depression, quality of life, food cravings, and adverse effects.The mean differences (MD) were applied with their 95% confidence intervals (95%CIs) for continuous outcomes, using a random-effects model. We used RevMan 5.4.1 for statistical analyses. Heterogeneity was assessed using the I² statistic.

Five RCTs with 2,466 adult participants (mean age 46.5 years, BMI 21.5-50 kg/m²) were included. NB was associated with a statistically significant reduction in weight loss percentage compared to placebo (MD -3.67%, 95% CI [-4.30; -3.03], I²=98%; Figure 1). However, no significant differences were found between NB and placebo in reducing binge-eating episodes(SMD 0.02, 95% CI [-0.30; 0.34], I2 =0%, Figure 2) , improving eating disorder psychopathology, alleviating depression, or decreasing food cravings. Although NB showed some benefits in improving the quality of life, the results were not statistically significant. NB was associated with a higher risk of adverse effects, including nausea, headache, constipation, dizziness, vomiting, insomnia, and dry mouth. The certainty of the evidences is in the Summary of findings (SOF) of GRADE evaluation (Figure 3). After leave-one-out sensitivity analysis, no single study was found to influence the effect estimate or drive heterogeneity excessively.

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NB demonstrated efficacy for weight loss in individuals with eating behavior issues but showed no significant benefits for core eating disorder symptoms. The higher risk of adverse effects necessitates careful consideration in clinical decision-making. Further research is needed to determine optimal patient populations, treatment duration, and strategies to mitigate adverse effects.

None Declared

Myoclonus-dystonia syndrome (MDS) is a rare childhood-onset movement disorder characterized by the combination of myoclonus and dystonia. It is caused by loss of function of the epsilon-sarcoglycan gene (SGCE) due to mutations, although the pathogenic mechanism is not fully understood. Deep brain stimulation is used in patients that are refractory to pharmacological treatment. A higher prevalence of psychiatric disorders has been observed in MDS patients, especially obsessive-compulsive disorder (OCD) (Timmers et al. Parkinsonism Relat Disord. 2019; 69 85-90). A dysfunction of cortico-basal ganglia-thalamo-cortical (CBGTC) loops is present in both conditions, but the mechanism by which they display high comorbidity is unknown.

To determine the presence of OCD comorbidity in pediatric and young adult patients that are candidates for DBS treatment for motor disorders, and the effects that the treatment may have on OCD symptoms.

This study is part of an ongoing cohort (n = 34) of children and adolescents (at the time of diagnosis) receiving internal globus pallidus DBS as treatment for motor disorders in Vall d’Hebron Hospital. The candidates go through a psychiatric evaluation before the procedure, including the diagnostic interview K-SADS, to diagnose psychiatric comorbidity. Long-term evaluation is performed by subsequent visits to the specialist.

Of the seven patients with SGCE+ MDS that underwent DBS treatment, four of them presented OCD symptoms before the procedure, two did not, and one did not receive an evaluation. Of the patients with OCD symptoms, all four of them showed significant improvement in motor function after DBS but had worsening of OCD symptoms. Some of the patients also had a worsening of other psychiatric symptoms, such as anxiety, mood and behavioral symptoms.

OCD symptoms are present in a significant proportion of our patients with SGCE+ MDS. OCD and other psychiatric symptoms worsened during follow-up in our patients, although it is not clear if this is due to DBS treatment or due to the natural course of the disorder. Further studies are needed to explore this observation.

None Declared

Mental health reform represents one of the most transformative changes in the field of healthcare, as it not only changes the forms of services, but also the nature of services offered. While many countries have successfully implemented such reforms, others, including Georgia, have struggled with a protracted and inconsistent process. Despite decades of advocacy by professionals for deinstitutionalization psychiatric hospital treatment continues to dominate in Georgia’s mental healthcare system.

The purpose of the review is to explore the concept of deinstitutionalization within the mental health landscape and assess its status in the context of Georgia. It aims to study the lessons learned from successful deinstitutionalization and illuminate achievements and challenges surrounding deinstitutionalization in Georgia’s reality.

A qualitative analysis including desk review, in-depth interviews and focus group discussions was conducted. Proceeding from the research objectives we analyzed the existing legislation, strategic documents and clinical practices concerning individuals with mental disorders; Interviews were also conducted with key informants on the shortcomings and problems in deinstitutionalization practices

The review findings reveal, that despite recent progress such as the development of community mobile teams and increased funding allocated for community services within mental health budget, a number of issues still remain a problem: there is no agreement among stakeholders on how to restructure existing hospital beds and financial provisions remains unresolved. The field of mental health in Georgia suffers from a lack of human resources. Attracting new personnel, ensuring regional distribution, and enhancing qualifications are necessary components of deinstitutionalization that require the involvement of all stakeholders, coordinated and time-planned action. The current mental healthcare system in Georgia is characterized by a lack of coordination and collaboration among its various components. Establishing patient care pathways between services with clear referral criteria is crucial for improving the efficiency of mental health services.

This research highlights that successful deinstitutionalization requires additional funds, time, and trained people. Institutions should have a long-term (3-5) year development plan, detailing the source of funding, activities to be implemented, and expected outcomes. In the absence of such a plan, progress remains sporadic, intermittent, uncoordinated, and less effective.

By addressing identified challenges and promoting coordination among mental health components, Georgia can guide a more effective course toward a community-based, patient-centered mental healthcare system.

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Accumulating evidence supports the mental health benefits of self-compassion. However, longitudinal research unravelling how self-compassion affects mental health outcomes is scarce.

This study aimed to clarify whether mindsets of negative emotions serve as a mechanism of how self-compassion exerts impacts on youth mental health.

The longitudinal school-based survey was conducted annually across three years among 719 secondary school students (mean age: 14.65, SD: 0.72). Mediation models were examined with self-compassion at T1 as the independent variable, negative emotion mindsets at T2 as the mediator variable, and depression, anxiety, and life satisfaction at T3 as the dependent variables. Alternative mediation models with negative emotion mindsets at T1 as the independent variable and self-compassion at T2 as the mediator variable were also tested to corroborate the hypothesized direction of the mediation effects. The mediation models all controlled for age, sex, socioeconomic status (SES), and respective measurements of mediator and dependent variables at baseline.

Negative emotion mindsets at T2 significantly and fully mediated the effects of self-compassion at T1 on mental health (indexed by depression, anxiety, and life satisfaction levels) at T3 (see Fig. 1, Fig. 2, and Fig. 3, respectively). The alternative mediation models were all insignificant, corroborating that negative emotion mindsets serve as the pathway through which self-compassion impacts mental health, rather than the reverse.

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This study highlights the belief-in-change of negative emotions as a key mechanism underlying the impact of self-compassion, and has important implications for research and interventions aimed at promoting youth mental health.

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Schizophrenia and bipolar disorder are severe psychiatric disorders influenced by genetic and environmental factors, sharing clinical features, risk factors, and genetic predispositions. Cognitive impairment is a central aspect of both disorders, affecting various domains like memory, attention and executive function. Distinguishing disorder-specific cognitive impairments from those shared across psychoses is challenging. Research on Clinical High Risk (CHR) and Familial High Risk (FHR) populations is vital for identifying cognitive impairments related to vulnerability. CHR populations exhibit cognitive changes, but the evidence on FHR populations remains less clear, even though offspring of individuals with severe mental disorders face a high risk of developing these conditions.

This study aims to perform a meta-analysis of neurocognitive functioning in offspring of individuals with affective psychoes and non-affective psychoses, compared to healthy controls (HC-Off). This meta-analysis seeks to improve statistical power of individual studies and offer more reliable estimates of cognitive deficits related to genetic vulnerability to psychotic disorders.

Following PRISMA, MOOSE, and EQUATOR guidelines, a systematic literature search was conducted up to December 12th 2023. Articles were screened, and those relevant were assessed for eligibility. The inclusion criteria focused on original studies comparing neurocognitive performance between offspring of individuals with affective or non-affective psychoses and healthy controls. The primary outcome was the difference in performance across neurocognitive domains. Meta-analyses were conducted on the overall sample and separately for affective and non-affective offspring, using a random-effects model.

Within the analyzed domains, individuals with affected parents performed significantly worse in every domain in comparison with control group, except in Motor Functioning domain. When studied separatley, offspring of parents with affective psychosis showed significant cognitive impairments in visual and verbal learning, processing speed, and memory, with smaller deficits in other domains. In contrast, offspring of parents with non-affective psychosis exhibited more severe impairments. Social cognition and motor functioning were less affected in both groups.

Key deficits in learning, memory, and general intelligence highlight the potential for these cognitive domains to serve as markers of vulnerability to psychosis. While both groups of offsrping show impairments, the more pronounced deficits in the non-affective group indicate a distinct cognitive risk profile. These insights may inform early interventions tailored to the specific cognitive challenges faced by high-risk populations.

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Research indicates that for psychiatric services to be generally effective, individuals have to complete the treatment. Although treatment completion does not necessarily equate to treatment success, it has been found to consistently lead to improved outcomes including improved rates of recovery and reduced risk of involvement with the justice system and other adverse outcomes. Treatment non-completion, on the other hand, has been associated with a higher risk of readmissions for inpatient care, legal, and other health-related problems (Dreyer et al. S Afr J Psychiatr 2020; 26 a1255). These findings underscore the importance of examining factors associated with treatment completion.

The goal of the study was to identify predictors for treatment completion among individuals receiving psychiatric services from state-administered behavioral health systems in Indiana, USA. Three domains of predictors were examined, including sociodemographic characteristics, comorbid conditions, and the type of treatment patients received.

Statewide records from merged administrative data sets were used for this analysis. Multivariate logistic regression was conducted using a sample of 15,412 adults receiving behavioral health services in fiscal year 2020.

Among demographic characteristics only race was associated with treatment completion. Individuals who were non-Hispanic White were 20% more likely to complete their treatment compared to their minority (e.g., Black, Hispanic) counterparts (p < .05, OR = 1.20). Having more than one mental health disorder was associated with 16% decreased odds of completing treatment (p < .05, OR = 0.87). Individuals who were institutionalized for psychiatric conditions had 26% decreased odds of completing the treatment (p < .05, OR = 0.80), but those who received inpatient substance abuse related care were over four times more likely to complete their treatment (p < .05, OR = 4.61). Finally, individuals who attended any self-help groups had 63% greater odds of completing the treatment.

Findings suggest that individuals who simultaneously received substance abuse and mental health treatment had the greatest chances to complete treatment successfully. Study implications also suggest that self-help or support groups should be promoted as ways to motivate patients to adhere to treatment.

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As of January 1, 2020, the new Dutch Mental Health Compulsory Care Act (WVGGZ) came into effect, replacing the Special Admissions to Psychiatric Hospitals Act (Wet BOPZ).

One of the expectations of the WVGGZ was that earlier (medication-based) involuntary intervention in outpatient settings would lead to fewer or shorter hospital admissions. The most important change was the outpatient use of involuntary medication, which was not allowed before the law.

Data from the Argus rating scale (Noorthoorn et al, 2016) and its successor, the compulsory care registration were combined with background data on admissions and wards. For this study, patients with a court order (RM) in 2016 and 2017 and a cumpulsory care authorization (ZM) in 2022 and 2023 were selected.

In 2016 and 2017, 549 patients received an RM, and 958 RM’s were issued. In 2022 and 2023, there were 405 patients, and 546 ZM’s were implemented. The total number of admission days for these patients before the law was 78,183 compared to 76,099 after the law. The average length of stay increased from 81 days per patient to 140 days per patient (t=-8.93, p<0.001). Seclusion decreased from 45,893 hours to 2,985 hours (t=4.93, p<0.001). Intramuscular (IM) medication was administered 137 times before the law and 369 times in clinical settings after the law (2022-2023) (chi-square= 325.10, p<0.001). IM medication was administered 777 times in outpatient settings.

Contrary to expectations, the legislative change did not result in shorter admissions for patients with a ZM. The data indicate significant differences in involuntary treatment for patients before and after the legal change. The presentation will explore possible factors influencing these figures.

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Emergency departments (ED) and intensive care units (ICU) are high-stress environments where healthcare professionals are continuously exposed to critical situations. This results in substantial mental health burdens, leading to increased levels of depression, anxiety, stress, and burnout. These issues negatively affect both the well-being of professionals and patient care.

This study aims to evaluate the prevalence and severity of depression, anxiety, stress, and burnout among ED and ICU professionals. The goal is to understand mental health issues and identify contributing factors to improve prevention and support systems.

A total of 242 healthcare professionals from Bezmialem Vakif University Hospital were included: 120 ICU staff (80 females, 40 males), 66 ED personnel (42 females, 24 males), and 56 office personnel (38 females, 18 males) serving as a control group. The study employed validated instruments: the Beck Depression Inventory, the Beck Anxiety Inventory, Perceived Stress Scale, and Maslach Burnout Inventory. Non-parametric tests (Kruskal-Wallis H and Chi-Square) were used due to non-normal data distribution, with pairwise comparisons adjusted using Bonferroni correction. The significance level was set at p < 0.05.

The results showed significant differences in age, depression scores, stress levels, and burnout indicators between the ICU, ED, and control groups. ICU and ED staff reported significantly higher depression scores compared to the control group (p < 0.001). Stress levels were also significantly elevated in ICU workers compared to office personnel (p = 0.001). Burnout indicators were notably higher in ICU professionals (p = 0.011). Conversely, no significant differences were observed in anxiety scores, emotional exhaustion, and hours of sleep.Table 1:

Summary of Key Results

The findings underscore the necessity for targeted interventions to reduce psychological distress among ED and ICU professionals. Implementing support systems, promoting work-life balance, and improving mental health resources can significantly alleviate the mental burden on these professionals, thereby enhancing both their well-being and patient care quality.

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