Depression is a leading cause of disability among youth, with stigma significantly hindering mental health service utilization. Untreated depression is associated with greater severity, poorer outcome, and cognitive impairment. In addition to structural barriers to service use, stigma towards mental health is a profound obstacle that impedes individuals from seeking needed services. Reducing stigma toward depression can improve perceptions of treatment and engage young individuals with depressive symptoms in behavioral services.

This study evaluates the feasibility and acceptability of delivering brief video interventions, proven to reduce depression stigma, via Instagram to promote help-seeking among youth. We hypothesized that the intervention would be both feasible and acceptable, generating higher link clicks and lower cost-per-click (CPC) compared to control videos.

A two-week Instagram campaign in February 2024 targeted U.S. adolescents aged 14-22. The campaign featured a 60-second human-narrated personal story video, previously shown to reduce depression-related stigma. The video showcased a young individual sharing their experience with depression, misconceptions about treatment, and the support they received. Engagement metrics assessed included impressions (video displays), reach (distinct viewers), link clicks (engagement with mental health resources), and CPC (cost-effectiveness). These were compared to four control videos: AI-narrated personal story (“Control 1”), human-narrated educational text (“Control 2”), AI-narrated educational text (“Control 3”), and an un-narrated educational text with background music (“Control 4”).

All five videos successfully reached a broad audience, with a combined total of 808,000 impressions, 287,000 viewers, and 4,148 link clicks. The Human-Narrated Personal Story (Intervention) video was highly effective, achieving 874 link clicks and a competitive CPC of $0.92, outperforming three of the four control videos. The AI-Narrated Educational Text (Control 3) had the highest number of link clicks (985) and lowest CPC ($0.82), while the AI-Narrated Personal Story (Control 1) had the fewest link clicks (680) and highest CPC ($1.18).

The intervention video successfully engaged the target audience, supporting its feasibility and acceptability for broader dissemination. Instagram proves to be a viable platform for disseminating evidence-based mental health interventions aimed at reducing depression stigma among youth. The study supports the potential for using social media in public mental health strategies, though further research is needed to evaluate its impact on help-seeking behaviors and across diverse demographic groups.

None Declared

Hysteria has been historically linked primarily to women; however, its importance in men has recently gained attention. This is why we found it interesting to study male hysteria. Therefore, understanding psychopathological theories offers a valuable framework for highlighting its clinical characteristics.

Describe the main psychopathological theories of male hysteria and its key clinical specifications referring to the theories.

We conducted a narrative literature review of articles and thesis published between 2009 and 2022, using databases such as PubMed, Google Scholar, and HAS (Haute Autorité de Santé) with predefined keywords such as “men”, “hysteria”, “masculine” and “conversion”. This review culminated in a narrative synthesis that aims a cohesive discussion integrating key findings from the literature.

The bibliography first distinguished between two pairs in order to define masculine hysteria: Anatomical (male/female) and psychological (feminine/masculine), highlighting that masculine hysteria can occur in both men and women. Therefore, a male may identify with either masculine hysteria or feminine hysteria, the latter of which can be related to male homosexuality.

Research indicates that masculine hysteria is associated with theories of sexual identity conflict, which involve the repression of feminine traits and fears of castration. Additionally, cultural norms often restrict men’s emotional expression, favoring strength over vulnerability, along with personal, relational, and environmental influences.

Clinical observations suggest that masculine hysteria typically presents with physical symptoms and dramatic expressions. The type and intensity of these symptoms may vary based on different early life experiences.

Referring to literature, the specific clinical signs leading to a diagnosis of men hysteria seem to be difficult to identify and not well developed. We also concluded that hysteria is too much related to lived gender rather than anatomical gender.

None Declared

Alexithymia is characterized by difficulty in verbally expressing emotions, a trait commonly observed in patients with psychosomatic symptoms, such as those with asthma. These individuals struggle to identify their emotions and are more prone to developing somatic health issues.

• - To study the prevalence of alexithymia, anxiety and depression in asthma patients

• - To identify the relationship between these aspects.

It was a cross-sectional, case-control, descriptive and analytical study, conducted in the pulmonology department at Hedi Chaker University Hospital in Sfax. The study involved 50 asthma patients and a control group consisting of 50 healthy nurses. Data collection was based on a sociodemographic and clinical questionnaire, as well as two psychometric scales: the Toronto Alexithymia Scale 20 (TAS-20) and the Hospital Anxiety and Depression Scale (HADS).

The mean age of the patients was 44.08 ± 12.78 years and the male-to-female ratio (M/F) was 0.92.

More than half of the patients (62%) had experienced an acute severe asthma requiring hospitalization. The disease was controlled in 70% of the cases.

The prevalence of alexithymia was 40% in the asthma patients and 36% in the control group, with no significant difference between the two groups (p = 0.68).

The prevalence of anxiety was 38% in patients and 34% in the control group with a significant difference between the two groups (p = 0.012).

The prevalence of depression was 38% in patients and 28% in the control group with a significant difference between the two groups (p = 0.002).

Alexithymic patients were significantly more anxious (p = 0.01) and more depressed (p = 0.01) than non-alexithymic patients.

Patients with ashtma present high rates of anxiety, depression and alexithymia. This latter does not appear to be a determining factor in asthma. However, it seems to be associated with the emotional distress caused by anxiety and depression. Timely screening for emotional distress and its early management is essential in this population.

None Declared

Although still somewhat reluctantly used (and thus underutilized) by many clinicians, it is the well-evidenced fact that clozapine is an effective drug for treatment-resistant schizophrenia. In order to optimize its therapeutic potential and to minimize side effects, therapeutic drug monitoring (TDM) of plasma clozapine and N-desmethylclozapine is an essential clinical tool. TDM can also help to reveal insufficient adherence or individual differences in the rates of metabolism. Moreover, clozapine plasma levels can be affected by other factor, such as smoking or concomitant medication (fluvoxamine). In our study sample, we were able to demonstrate the relationship between the dosage and clozapine plasma levels and their impact on clinical efficacy and safety.

None Declared

Women face a greater incidence of mental health issues than men, stemming from societal expectations, gender stereotypes, organizational structures that prioritize male leadership, and the need to balance work responsibilities with home life. Research indicates that women are twice as likely to suffer from depression, generalized anxiety disorder, and post-traumatic stress disorder (PTSD) compared to men. They are also more likely to battle eating disorders.

The authors will review the current literature on this topic.

43% of female executives experience burnout, compared to 31% of their male counterparts (Mc Kinsey 2024). Research is definitely needed to better understand the pathophysiology and socioeconomic mechanisms that drive sex-specific risk factors of psychological disorders in women. There is also an urgent need for studies that addressed the specific needs of women including insights around: the biological, life stage, socioeconomic, political and cultural factors associated with being female that have a significant impact on women’s mental health.

A mental health reform is necessary to prevent mental illnesses in women, provide specific care to vulnerable women and increase the overall well-being of women living with existing mental health conditions.

None Declared

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

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

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

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

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

None Declared

Jacobsen syndrome (JS) is a rare genetic disorder caused by a partial deletion of the long arm of chromosome 11 (11q23.3qter), affecting approximately 1 in 100,000 births. It is associated with physical and developmental abnormalities, including pre- and postnatal growth retardation, facial dysmorphism, and multiple congenital malformations. Intellectual disability and psychomotor retardation are also common, with 97% of individuals presenting with varying degrees of cognitive impairment. Autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and, in rare cases, severe psychiatric disorders like schizophrenia or bipolar disorder, may complicate the clinical picture. JS management is complex, often requiring multidisciplinary care. Partial trisomy 10q is a rare chromosomal disorder, with around 40 reported cases worldwide. It is characterized by distinctive facial features, minor physical anomalies, and possible cardiac or renal malformations, with severity depending on the duplicated region.

The aim of this case report is to present a 13-year-old female with Jacobsen syndrome and Partial Trisomy 10q Syndrome who was diagnosed with ASD and intellectual disability (ID) who later developed psychotic symptoms.

The patient, a 13-year-old girl, was diagnosed with Jacobsen syndrome and Partial Trisomy 10q Syndrome following a neurological evaluation conducted at two months of age. Medical records were reviewed from her initial assessments to recent follow-ups.

The patient has ASD and ID, with poor verbal communication, repetitive behaviours, and social isolation. A notable regression in both language and behaviour was observed after the age of 10, coinciding with her school integration. Neuroimaging showed ventriculomegaly and loss of white matter, but no active demyelination or epileptic features were found. Due to impaired attention, we suspected ADHD, and started her on methylphenidate, later changing it to atomoxetine with poor response. Due to patient’s very limited speech, mental state examination was difficult. We observed that she was anxious, had hearing phenomena, and was talking in jargon, so we suspected psychotic symptoms in the form of auditory hallucinations. Treatment with Aripiprazole was initiated at doses of up to 7 mg daily, with a good response. Aripiprazole also helped to reduce social withdrawal and improve attention. Currently, the patient is maintained on a stable dose of Aripiprazole, alongside behavioural therapies and educational support.

This case highlights the complexity of managing young people with neuropsychiatric symptoms in patients with genetic syndromes, especially when poor language and speech skills are associated. Future research is needed to better understand the neuropsychiatric implications of JS Partial Trisomy 10q Syndrome and optimize treatment strategies for these patients.

None Declared

Quality of life (QoL) is a comprehensive concept encompassing an individual’s satisfaction with various aspects of life, including material, social, spiritual needs, intellectual and physical development, and safety. During the COVID-19 pandemic, the quality of life in Russia declined due to environmental and social disruptions. Behavioural self-regulation, which reflects an individual’s ability to manage internal and external conditions, plays a key role in adapting to challenging situations. Thus, exploring the relationship between QoL and self-regulation styles can provide insight into adaptive behaviours under pandemic conditions.

The study aimed to explore the interconnections between quality of life and self-regulation styles in humanities students and people living with HIV during the second wave of COVID-19.

Data were collected from January to July 2021 via a Google form. Participants included 35 Russian university students in humanities and 59 HIV-positive patients. Self-regulation styles were measured using V.I. Morosanova’s “Style of Self-Regulation of Behaviour” questionnaire, and quality of life was assessed with the WHOQOL-BREF, adapted for Russian respondents.

In the group of students positive correlations of physical and psychological well-being with programming (rs = 0.405, p < 0.05); self-perception — with programming (rs = 0.522, p < 0.01), evaluation of results (rs = 0.586, p < 0.01) and general level of self-regulation (rs = 0.389, p < 0.05); microsocial support — with evaluation of results (rs = 0.336, p < 0.05) were found. In the patient group, physical and psychological well-being were associated with outcome evaluation (rs = 0.343, p < 0.01); self-image — with modelling (rs = 0.605, p < 0.01), outcome evaluation (rs = 0.467, p < 0. 01), flexibility (rs = 0.444, p < 0.01) and overall level of self-regulation (rs = 0.439, p < 0.01); microsocial support — with modelling (s = 0.366, p < 0.01); social well-being — with modelling (rs = 0.442, p < 0.01) and flexibility (rs = 0.346, p < 0.01).

The study found that self-perception was the most frequently correlated factor with self-regulatory behaviour in both students and HIV-positive group, indicating that satisfaction with life, sense of purpose, and emotional stability contribute to self-regulation even in challenging conditions. However, social well-being was a unique influencing factor for people living with HIV, highlighting a dependency on material and societal conditions that was less pronounced in student’s group. This suggests that HIV patients are more sensitive to social and environmental stability, whereas students rely more on internal self-regulatory mechanisms for adaptation.

None Declared

Melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) are critical regulators of circadian rhythms and various non-image-forming visual functions, such as the pupillary light reflex (PLR), which adjusts the amount of light entering the eye. ipRGCs, through their direct responsiveness to circadian light, influence both circadian entrainment and neurophysiological processes that affect mood regulation. Emerging evidence suggests that melanopsin-mediated PLR may be disrupted in mood disorders, including bipolar disorder (BD) and even patients with increased bipolar disorder-traits. Given the well-documented association between circadian dysregulation and BD pathophysiology, it is hypothesized that changes in ipRGC function may contribute to the neurobiological mechanisms underlying BD.

The primary aim of this review is to synthesize and evaluate the existing body of literature on melanopsin-mediated pupillary responses in individuals with bipolar disorder. Specifically, this review seeks to assess the extent to which these responses are altered in BD and to explore the potential utility of melanopsin-driven PLR as a biomarker for mood dysregulation and circadian disruption in this patient population.

A non-systematic review of the literature on the melanopsin-mediated pupillary light reflex in patients with bipolar disorder, through a targeted search of databases.

The reviewed studies demonstrate consistent alterations in melanopsin-mediated pupillary responses in individuals with BD. Several investigations report reduced PLR amplitude and delayed latency in BD patients, with variability depending on mood state. Manic and depressive episodes appear to be associated with distinct patterns of dysregulation, suggesting that melanopsin signaling may be differentially affected by the phase of illness. One study also shows a variation in ipRGCs responses in remitted BD patients, suggesting an alteration of this system throughout the disease. (Madsen et al. Int J Bipolar Disord 2021;9,7) These findings align with circadian disruptions commonly observed in BD, further supporting a mechanistic link between ipRGC dysfunction and mood regulation.

Melanopsin-mediated pupillary responses have emerged as a promising avenue of investigation for identifying biomarkers of bipolar disorder, particularly concerning circadian rhythm and mood dysregulation. Despite encouraging preliminary findings, the current literature is limited by methodological heterogeneity and small sample sizes. Future research should standardize assessment protocols and investigate how ipRGC dysfunction contributes to BD pathophysiology, potentially leading to novel treatments targeting circadian regulation and improving clinical outcomes.

None Declared

Illness Anxiety Disorder denotes an excessive fear of becoming critically ill. Even when a medical exam does not indicate a significant medical problem, people may have no physical symptoms or think that familiar body sensations or minor symptoms are symptoms of a dangerous sickness.

We aimed to estimate and compare the prevalence of illness anxiety disorder among health colleges students at King Saud University. Also, we examined whether the prevalence of illness anxiety disorder is influenced by the specific field of study within the medical disciplines and whether the disorder manifests differently among students based on their chosen area of specialization.

This was an observational cross-sectional study. Data were collected through an online self-administered questionnaire called The Short Health Anxiety Inventory (SHAI) and was analyzed using SPSS 23rd version.

The prevalence of IAD in this study was found to be 5.8% (n=325). with a significant relation to gender, college, the presence of psychiatric disorders, and being subjected to abuse or neglect.

This study found that the prevalence of illness anxiety disorder was low compared to other studies published in the past.

None Declared

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

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

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

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

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

None Declared

According to the World Health Organization, the global population aged 60 and older is projected to nearly double between 2015 and 2050, increasing from 12% to 22%. This demographic shift presents unique challenges in the management of psychopharmacological treatment in the elderly. Factors such as multimorbidity, atypical presentations of psychiatric disorders, age-related alterations in pharmacokinetics and pharmacodynamics, and the high prevalence of polypharmacy— often defined as the concomitant use of five or more medications—complicate therapeutic approaches in this population.

This review synthesizes the current evidence on the prevalence, contributing factors, and consequences of polypharmacy in elderly psychiatric patients.

A narrative review was conducted using key terms and their combinations, including “polypharmacy”, “elderly”, “geriatric” and “psychiatry”. Relevant studies, case reports, and reviews published from 2000 to 2024 were included.

The prevalence of polypharmacy in the population varies across the literature; however, several well-established risk factors have been identified. These include age 65 years and older, living in a nursing home, comorbidities like diabetes mellitus, cardiovascular disease, metabolic syndrome, and COPD, as well as cognitive impairment. Additionally, prescription-related factors contribute to polypharmacy, such as poor quality of clinical records, automatic prescription renewals, and the involvement of multiple prescribers. The high rate of polypharmacy in older adults is associated with several challenges, including inappropriate medication use, difficulties in adhering to treatment regimens, increased risk of hospitalization, a higher likelihood of adverse effects, functional and cognitive decline, higher healthcare costs, and an increased risk of mortality. Additionally, a recent meta-analysis revealed for the first time that polypharmacy was significantly associated with the incidence of dementia and worsened its prognosis.

Advanced age is a significant risk factor for polypharmacy, often resulting in adverse outcomes such as reduced quality of life, increased morbidity, and higher mortality rates. Identifying and regularly assessing polypharmacy cases, alongside evaluating potentially inappropriate medications, are critical steps. Implementing safe prescribing practices and deprescribing strategies specifically adapted to the needs of elderly patients can effectively reduce risks and improve overall well-being in this vulnerable population.

None Declared

The ongoing armed conflict in Ukraine has significantly destabilized Europe’s geopolitical and economic situation, leading to a war-inflation crisis that may substantially affect the mental health of women during the perinatal period.

Our primary objective was to investigate the prevalence of depressive symptoms and assess the role of resilience as a protective factor against anxiety and depression in Polish perinatal women during the war-inflation crisis. We analyzed the percentage of women experiencing anxiety related to childbirth and the war-economic crisis, as well as their relationship with perinatal depression. The study also aimed to identify risk factors for perinatal depression and various types of anxiety, including those related to childbirth, war, and the global situation.

152 women participated in three online surveys – two conducted during pregnancy and one after childbirth. To evaluate mental well-being and the intensity of depressive and anxiety symptoms, we utilized the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI-2), Labour Anxiety Questionnaire (LAQ), along with research team-developed questionnaires assessing anxiety related to the war (WAQ) and global situation (GSAQ). Resilience was assessed using the Resilience Measure Questionnaire (KOP-26).

About 32.2% of perinatal women were diagnosed with depression based on the EPDS scale with a cutoff of ≥14. Nearly 70% scored 14 or higher on the LAQ scale, indicating a significant rise in labour-related anxiety. Additionally, 24.3% experienced high levels of anxiety due to the war, while 25% faced severe anxiety related to the global situation. The Kruskal-Wallis analysis, with resilience as the independent variable, revealed statistically significant differences in the distribution of depression (F=28.302; df=2; p<0.001) and global situation anxiety (F=7.183; df=2; p<0.028) variables between the groups. Post hoc analysis showed differences in the severity of depressive symptoms and global situation anxiety between the low and high resilience groups. The correlation heat map between psychometric scores at the start of the study is presented in Table 1.

The prevalence of depressive disorders among women in the perinatal period may increase during crises caused by war and inflation, compared to periods of geopolitical and economic stability. This is a strong argument for improving the screening system for perinatal depression in Poland. A lower level of resilience during pregnancy may be a significant predictor of increased severity of depressive symptoms and higher levels of anxiety related to global situation among the perinatal population.

None Declared

Postictal Psychosis (PIP) is a severe psychiatric complication of epilepsy, defined by a brief psychotic episode, with a mean duration about 10 days, occurring after a cluster of seizures, or a focal seizure evolving to bilateral tonic-clonic seizure, and sometimes after a single seizure. Around 2 % of patients are affected by this disorder, mostly in long-lasting, drug-resistant temporal lobe epilepsy, but its prevalence is probably underestimated. (Kanemoto et al. Cambridge, 2011; p.67-79). PIP can lead to severe behavioral disturbances, such as agitation, violence and suicide (Tarrada et al. Epilepsy Behav, 2022). Multiple hypotheses exist about the pathophysiology of Postictal Psychosis (de Toffol et al. Encephale, 2016; p443-447). As the clinical manifestations of PIP are roughly stereotyped regardless of the epileptogenic zone, we assumed the existence of a common neurological pathway.

We aimed to determine if a specific brain network sustained the psychotic episode, regardless of the localization of the epileptogenic zone.

We conducted a systematic review following the PRISMA guidelines (Cheval et al. Seizures, 2024; p 44-55). We included studies that provided EEG, and metabolic imaging performed during the presence of psychotic symptoms. Studies were not included, when the diagnosis of PIP was doubtful, or when the results EEG and/or imaging were not detailed enough.

We included a total of 24 studies providing electrophysiological results(n=22) and metabolic imaging performed during the PIP(n=5). Temporal and frontal lobes seemed frequently involved, without clear evidence for lateralization. The EEG patterns were heterogenous, varying from unchanged to diffuse slowing. Metabolic pattern showed an increased perfusion within temporal and frontal lobes during PIP. These results correspond to the patterns described during postictal state, but they persisted throughout PIP, within regions larger than the epileptogenic zone and resolved with the recovery (Cheval et al. Seizures, 2024; p 44-55).

PIP symptoms are associated with an excessive persistence of postictal changes within extended frontotemporal networks. A hypothesis could be that PIP results from an abnormally prolonged and diffuse post-ictal dysregulation. Nonetheless this results is relatively imprecise and further studies should elucidate the subjective experience of the epileptic seizure, and the neuropsychological profile of patients with PIP episodes. Finally, these results could be also compared to the results of invasive EEG in patients with schizophrenia obtained in a previous controversial study, that showed the presence of epileptic activities in depth regions of the brain (Heath et al. Epilepsy Behav, 2005; p633-645), a pattern distinct from PIP, that would suggest epileptic psychoses have a pathophysiology different from primary psychoses.

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

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

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

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

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

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

Participants were interviewed during a personal meeting.

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

Qualitative analysis of the interviews contents showed a good

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

According to participants, the SPIN device will:

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

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

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

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

None Declared

People with severe mental illness die 10-20 years earlier than the general population. This is largely due to non-communicable diseases (NCDs) such as hypertension, diabetes and hypercholesterolaemia increasing the risk of cardiovascular disease, which is the greatest contributor to the excess mortality seen. The effect of these NCDs is likely to be greater in low-and middle-income countries such as Bangladesh, India and Pakistan due to additional barriers to health care access, lack of resources and other sociodemographic variables.

Our study aimed to estimate the proportion of individuals with SMI in Bangladesh, India, and Pakistan who were screened for NCDs and offered health risk modification advice. Furthermore, we also explored socio-demographic factors associated with the likelihood of being screened for NCDs within this demographic.

This cross-sectional study gathered data from three national mental health institutions in South Asia. Participants aged ≥18 years diagnosed with SMI were included. Data collection involved face-to-face interviews based on the World Health Organisation Stepwise (WHO-STEPS) approach to NCD risk factor surveillance, supplemented by anthropometric measurements and blood tests to confirm NCDs. The prevalence of screening, diagnosis, health risk modification advice, and treatment for diabetes, hypertension, and high cholesterol was assessed. A logistic regression model assessed the associations of sociodemographic characteristics with NCD screening.

3,989 participants were recruited. Screening prevalence varied by country and disease, with hypertension being the most commonly screened NCD (Bangladesh = 52.5% [50.0-55.1], India = 43.1% [40.3-45.9], Pakistan = 60.9% [58.2-63.5]), and cholesterol was the least common (Bangladesh = 4.1% [3.2-5.2], India = 14.8% [12.9-17.0], Pakistan = 9.6% [8.1-11.3]). Characteristics such as BMI, age and education level were positively associated with screening, and females were more likely to be screened than males. The provision of health risk modification advice was most common in India (diet = 66.7% [62.1-71.1], physical activity = 71.5% [67.0-75.6], smoking = 17.1% [13.8-21.0]), and least common in Bangladesh (diet = 17.8% [15.8-20.0], physical activity = 12.0% [10.3-13.8], smoking = 9.8% [8.3-11.5]).

There is a consistent gap in the screening of NCDs among individuals with SMI in South Asia, with marked sociodemographic disparities. There is a pressing need for standardised screening protocols and health risk modification interventions tailored to South Asian populations. Improving health literacy and implementing culturally sensitive, cost-effective prevention strategies could mitigate the increased risk of NCDs in South Asian individuals with SMI.

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Schizophrenia is one of the most disabling mental disorders, affecting around 1% of the population. Although most patients respond to antipsychotic treatment, one third have a limited response to antipsychotic medication, being considered treatment resistant schizophrenia (TRS). Clozapine is the only effective medication for TRS, but 30-40% of TRS patients do not respond to it. Patients with schizophrenia who do not respond to clozapine experience more severe disability, persistent symptoms, a lower quality of life and incur higher economic costs compared to those who respond to treatment.

The aim of the present study is to review evidence for therapeutic strategies for patients with treatment-resistant schizophrenia not responding to clozapine.

Review of the literature regarding treatment-resistant schizophrenia not responding to clozapine. The research was carried out through the PubMed® database, using the terms “treatment resistant schizophrenia”, “schizophrenia resistant to clozapine” and “clozapine augmentation”.

For patients with treatment-resistant schizophrenia who do not respond to clozapine, several therapeutic strategies have been explored. These include pharmacological approaches, non-pharmacological interventions and brain stimulation procedures [Electroconvulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS)]. However, the evidence is weak and the reported benefits were modest.

The current evidence is weak for efficacy of pharmacological augmentation strategies to clozapine. There are contradictory data regarding ECT and clozapine augmentation. More studies are necessary to clarify the potential of these strategies in order to manage these complex patients.

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Previous studies show the aggregation of major psychiatric disorders (MPDs; a combined category of schizophrenia, bipolar disorder, depression, and anxiety) among siblings. However, few studies have examined whether MPDs in childhood and early adulthood are associated with siblings’ future socioeconomic status (SES).

To assess subsequent SES outcomes among siblings of individuals with an MPD diagnosed at age 5–25.

This cohort study included 54,742 full siblings, 4,490 paternal, and 4,858 maternal half siblings of individuals born in Finland between 1975–1985 with MPDs diagnosed at ages 5–25 (affected probands). We defined the reference groups as identical types of siblings of individuals without any MPD diagnosis (matched unaffected probands). The siblings of both the affected and the unaffected probands were followed from the diagnosis date of affected probands until December 31, 2020. MPD diagnoses were obtained from the Finnish Care Register. SES was measured through employment status, annual disposable income (measured in EUR), and educational achievement derived from the FOLK module of Statistic Finland. Conditional logistic regression, median regression, and Generalized Estimating Equations (GEE) models were applied to estimate the adjusted associations.

The median age (interquartile range, IQR) at baseline was 20 years (16–24) for full siblings, 17 years (12–26) for maternal half-siblings, and 18 years (12–26) for paternal half-siblings of the affected and unaffected probands. Compared to siblings of the unaffected probands, the odds of unemployment were 50% higher (95% CI: 1.46-1.55) in full siblings of affected probands with any MPD; this association was particularly pronounced in full siblings of an affected proband diagnosed before age 15 (aOR: 1.68, 95% CI 1.49-1.90). Full siblings of the affected probands were more likely not to attain a university degree (aOR: 1.37, 95% CI 1.33-1.41). The median annual disposable income was 1,518.3 EUR lower (95% CI: -1647.4, -1389.3) in full siblings of affected probands. Similar but weaker associations were observed in maternal and paternal half-siblings. For example, compared with the half siblings of the unaffected probands, the odds of unemployment were 29% (95%CI 1.16-1.44) and 23% (95%CI 1.10-1.38) higher in maternal and paternal half-siblings of affected probands with any MPD, respectively.

Our findings suggest that the unfavorable socioeconomic consequences of MPDs might extend to siblings.

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Hormones such as ghrelin and the recent described human liver expressed antimicrobial peptide-2 (LEAP-2) play a pivotal role in regulating food intake and energy metabolism. In this context, their aberrant functioning has been suggested as a mechanism underlying the pathophysiology of eating disorders (ED) and obesity. Considering the high comorbidity between binge spectrum disorders (BSD) and obesity, whether this dysfunction could be a potential shared neurobiological mechanism remained underexplored.

To analyze plasma ghrelin and liver expressed antimicrobial peptide-2 (LEAP-2) concentrations in fasting among individuals with obesity (OB), with and without an eating disorder (ED), and compare them with a group of healthy controls (HC). Besides, to assess associations between these concentrations, psychopathological variables, and body mass index (BMI) in the clinical sample with OB.

The sample comprised 162 adult women (67 OB-ED, 35 OB+ED, and 62 HC). Peripheral blood samples, eating psychopathology, trait impulsivity, food addiction (FA), fat mass, and BMI were collected. The between-group comparisons were performed using analyses of covariance (ANCOVA), adjusting for age and fat mass, and the link between variables was evaluated through correlation and path analyses.

Individuals with OB (with and without an ED) showed lower significant ghrelin concentrations than HC (p<.001). The OB+ED group reported significantly higher eating psychopathology, trait impulsivity, and FA than the OB-ED and HC groups. In the OB+ED group, LEAP-2 concentrations positively correlated with BMI, fat mass, novelty seeking, and FA scores. The path analysis showed that higher LEAP-2 levels and FA scores were linked to more severe eating psychopathology

The results suggest an interplay between biological and clinical factors that contribute to delineate vulnerability pathways in ED and OB, which could help fit more tailored therapeutic approaches.

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