Frequent attenders (FAs) are defined as patients who repeatedly visit emergency services, commonly characterized as those making ≥4 visits to the emergency department within a year (Pek et al. Ann Acad Med Singap 2022; 51:483-492). Their identification is considered a potentially preventable misuse of resources (Pines et al. Acad Emerg Med 2011; 18).

To identify and describe the frequent attenders of the Psychiatric Emergency Department at Hospital Universitario Infanta Cristina.

A descriptive analysis was carried out on all patients who made ≥4 visits to the emergency department at the hospital during 2023.

We identified 28 frequent attenders (FAs) in our emergency department, 16 women and 11 men, who made a total of 162 visits to the emergency service. Of these, 23 patients were aged between 18 and 65 years, with a mean age of 32.87 years. The most common diagnosis was Personality Disorders, observed in 17 patients, followed by Depression in 16 patients. However, the patients with the highest number of visits on average were those diagnosed with Psychosis, recording an average of 8.30 visits per year, followed by those diagnosed with Personality Disorders, with an average of 7.76 visits per year. No patients with Bipolar Disorder were identified among the described FAs.

When analyzing temporal trends, the months with the highest number of visits from FAs were July, August, and September, with 22, 18, and 19 visits respectively. This pattern is mirrored among patients diagnosed with Psychosis, who made 30 visits during these months. In contrast, patients with Personality Disorders made 28 visits in these months, compared to 24 visits in April and 30 visits in January and February.

An additional noteworthy finding is that, out of the 162 visits made by FAs, only 20 resulted in hospital admission—14 women and 6 men. More than half of these admissions involved patients with neurotic spectrum disorders, specifically 7 cases of Personality Disorders and 6 cases of Depression

Finally, it is worth noting that of the 162 visits made by FAs, 47 were due to suicidal ideation or attempts, with 29 of these cases involving women.

The analysis of these patients suggests that individuals with severe mental disorders may be more affected during summer months, often requiring urgent evaluations, while those with neurotic spectrum disorders seem to be more influenced by seasonality, with a higher likelihood of requiring hospitalization. Additionally, there is a significant gender bias, with women tending to visit the emergency department more frequently, presenting with more severe conditions, and having a higher rate of hospital admissions. Accurate characterization of these patients can facilitate the prevention of potential decompensations by enhancing monitoring strategies based on the data presented.

None Declared

Recently it was highlighted that individuals not only vary in their beliefs but also in the manner of their thinking, and this diversity can significantly predict various crucial psychological outcomes.

This research addresses the underexplored relationship between cognitive styles and psychosocial factors like hope, subjective well-being, coping and social support, specifically in Kosovo. These variables have not been investigated in Kosovo before, making this study the first of its kind.

Its cross-sectional study. The sample consisted of 490 students aged 15 to 23 (Mage=19.06; SD=4.17). Participants completed the instruments below: Adult Hope Scale ; Brief COPE Scale ; Oslo 3-item Social Support Scale; WHO-5 Well-Being Index ; Rosenberg Self-Esteem Scale and Cognitive Reflection Test . Data processing was done with SPSS 27.0 and Microsoft Excel 2019.

Significant negative correlations were observed between Cognitive Reflection Test scores and gender (r = -.197, p < 0.00), Adult Hope Scale score (r = -.173, p < 0.00), WHO-5 Well-being Index (r = -.098, p < 0.04) and Emotion–Focused Coping (r = -.125, p < 0.01). However, no significant correlations were found with Social Support, Problem-Focused-Coping, or Dysfunctional Coping (all p > 0.05). The correlational analysis, suggested that individuals with higher analytical thinking tendencies are more likely to be male, have lower levels of hope, employ less emotion-focused coping strategies and reported lower subjective well-being.

The study emphasized that psychosocial factors are intricate, influenced by diverse elements. While cognitive abilities, as measured by the Cognitive Reflection Test, played a role in some aspects of these factors, they didn’t fully explain their complexity. Therefore, the research suggests that further investigation is needed to grasp the underlying mechanisms and implications of these correlations in a Kosovo context.

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For patients with schizophrenia, effective treatment of early episodes may improve long-term outcomes, reduce the risk of relapse, and limit functional impairment.

To evaluate the efficacy and safety of brexpiprazole versus placebo in adult and adolescent patients with early-episode schizophrenia.

Data were analyzed from four Phase 3, 6-week, randomized, double-blind, placebo-controlled trials: three in adults (Clinical Trials.gov: NCT01396421 [Vector], NCT01393613 [Beacon], NCT01810380 [Lighthouse]), and one in adolescents (NCT03198078 [Study 331-10-234]). For the trials in adults, patients aged 18–65 were randomized to placebo (total N=531), brexpiprazole (total N=1,093; 0.25, 1, 2 or 4 mg/day, or 2–4 mg/day, depending on the trial), or quetiapine extended-release (N=154; active reference in one trial). For the trial in adolescents, patients aged 13–17 were randomized to placebo (N=104), brexpiprazole 2–4 mg/day (N=110), or aripiprazole (N=102; active reference). Mean baseline Positive and Negative Syndrome Scale (PANSS) Total scores indicated that adult and adolescent patients were of similar disease severity. In all four trials, the primary efficacy endpoint was change from baseline to Week 6 in PANSS Total score. In this post hoc analysis, early-episode schizophrenia was defined as age 13–35, and ≤5 years’ duration of illness. Data from the four trials were pooled and compared between brexpiprazole 2–4 mg/day (FDA-recommended target dose in adults and adolescents) and placebo. Efficacy outcomes were analyzed using least squares (LS) mean change from baseline (mixed model for repeated measures). Safety was also evaluated.

The post hoc early-episode schizophrenia sample comprised 292 patients treated with brexpiprazole 2–4 mg, and 190 treated with placebo (analyzed for safety), of whom 289 and 187 were analyzed for efficacy, respectively. The post hoc efficacy sample comprised 19.3% of the corresponding efficacy sample of the adult trials (pooled), and 98.1% of the corresponding efficacy sample of the adolescent trial. In the post hoc efficacy sample, mean (standard deviation) baseline age was 22.4 (6.6) in the brexpiprazole group and 20.5 (6.6) in the placebo group, and baseline PANSS Total scores were 97.9 (13.5) and 100.4 (14.2), respectively. The LS mean (standard error) change from baseline to Week 6 in PANSS Total score was -21.4 (1.1) with brexpiprazole, and -17.8 (1.4) with placebo (p=0.042). The overall incidence of treatment-emergent adverse events (TEAEs) was 50.7% with brexpiprazole, and 46.3% with placebo. The TEAE with the highest incidence in the brexpiprazole group was akathisia (6.5%; placebo, 2.1%).

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In this post hoc analysis of patients with early-episode schizophrenia, brexpiprazole was associated with greater improvement in schizophrenia symptoms than placebo. No new safety observations were made.

None Declared

The high prevalence of anxiety and depression among patients with cancer has an impact on a decrease in quality of life. there are practically no studies among people with lymphoproliferative diseases, which determines the relevance of our study.

Purpose: to assess the prevalence of anxiety-affective spectrum disorders and their impact on the quality of life and adaptability in patients with non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL) and a group, including malignant neoplasm of the body of the stomach and T- and B- cellular lymphoma.

95 patients (women - 52, men - 44) diagnosed with NHL, HL, others were examined using a continuous sampling method.

Clinical interviews; the author’s questionnaire; HADS, EQ-5D, EQ-VAS, PSM-25. STATTECH were used to process the data.

The average age was 52.8±8.3 years (18 to 86). 3 groups: 1-non–Hodgkin’s lymphoma, 2-Hodgkin’s lymphoma, 3- malignant neoplasm of the stomach body and T- and B-cell lymphoma. In gr-s 1 and 2 (90% and 85%), no symptoms of anxiety were detected. In gr 3, clinically pronounced anxiety levels were uniformly detected in 50%. Depressive symptoms a predominantly absence in all groups (1 - 95%; 2 - 86% and 3 - 75%) p>0.05. The assessment of quality of life: in gr 1 and 2, most of the patients noted that they experience some difficulties in the final indicator (55% and 61%), pronounced problems prevail in gr 3 (50%). The mobility of the majority in all groups does not suffer or suffers to a minor extent, 80% of all noted the absence of difficulties in self-care. “daily activity” were a statistically significant - 64% maintained it at a high level (p=0.006); Pain/discomfort is experienced by more than half of the respondents to a moderate degree 55% (p=0.003). In gr 1 and 3, the average of EQ-VAS determined at a level of more than 70 (the arithmetic mean 78 and 73), which indicates a more favorable sense of self. In gr 2 the average was determined at 68, also characterizes a high level of assessment of their general condition, in all patients with CLL, according to PSM 25, the stress level was determined to be low, indicates a state of psychological adaptation to workloads in 100%. In the gr 1, 12 people (17%) were identified with an average level of stress and reduced adaptation and need the rest for this contingent.

our pilot study showed that patients with lymphoproliferative diseases are characterized by a slight decrease in their quality of life, a high level of life satisfaction, good stress resistance to workloads. The main symptoms (reliably expressed in 55%), are moderate severity of pain and discomfort. The obtained data make it possible to emphasize the heterogeneity of the prevalence and severity of anxiety-affective symptoms in patients with various types of oncological diseases.

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Childhood sexual abuse, a serious issue for all societies, is a complex experience that requires many legal and professional initiatives(Odacı et al. Psikiyatride Güncel Yaklaşımlar,2023).It is a widespread, multidimensional problem worldwide, with physical, mental, social, moral, cultural, and legal aspects(İşeri et al. Çocuk ve Ergen Psikiyatrisi Temel Kitabı,2008).

This study aimed to evaluate risk factors and medicolegal assessment results in children who were sexually abused.

The records of children who were victims of sexual abuse retrospectively reviewed at Dokuz Eylül University Faculty of Medicine, Department of Child and Adolescent Psychiatry, between January 2010 and December 2023.Sociodemographic, clinical, psychometric, and medicolegal evaluation data were analyzed.

Of the 537 cases that underwent medicolegal evaluation, 80.3% were male and 19.7% were female.The mean age at the time of sexual abuse incident was significantly higher in females(12.5±3.4) than in males(9.8±3.4).Before the incident, 63.0% of cases had at least one psychiatric diagnosis(most commonly Mental Retardation or Developmental Delay(57.5%), MDD(5%), and Conduct Disorder(4.7%)).The period after the incident, 77.1% had at least one psychiatric diagnosis(most commonly PTSD(57.9%) and MDD(49.7%)), most of which occurred after the incident.22.7% of the cases were victims of incest, 77.3% were victims of extra-familial abuse.The most common abuser was the father in incest(7.1%) and a familiar person(neighbor, etc.) in extra-familial abuse(22.4%).51.4% of cases experienced simple sexual abuse, while 48.6% faced sexual penetration.In 42.7% of the cases, sexual abuse was first disclosed to family members. In incest victims, compared to cases of extra-familial sexual abuse; the rates of being female(86.9%-78.3%), having successful-average academic success(55.2%-43.3%), having normal-borderline intelligence(77.7%-67.7%), having an unemployed father(25.5%-16.2%), being subjected to simple sexual abuse(63.1%-48.0%), being subjected to sexual abuse by a single perpetrator(90.2%-81.2%), being subjected to repeated sexual abuse(69.7%-45.8%), living in a broken family(66.7%-38.9%), not having a psychiatric diagnosis before the incident(50.8%-34.2%), and withdrawing the abuse allegation/complaint(18.9%-6%) were statistically significantly higher.The age at the date of the incident was significantly younger(median:11-13), and the time taken to apply to judicial authorities (months) was significantly longer(median:18.5-12).Predictive variables of incest have also been evaluated using logistic regression analysis.

In this study, the findings found in cases that underwent medicolegal evaluation support the literature findings regarding risk factors for sexual abuse and the negative effects of sexual abuse on children and adolescents.

None Declared

Self-report instruments assessing self-injurious thoughts and behaviors (STBs) are widely used, but their effectiveness and predictive validity vary.

This study aimed to synthesize findings from previous reviews and identify self-report instruments assessing suicidal thoughts and behaviors (STBs) in adults, followed by a network analysis to explore psychometric properties and inter-item relationships.

Systematic searches were conducted in MEDLINE/PubMed, EMBASE, and the Cochrane Database of Systematic Reviews, covering inception to July 2023, using terms like “suicide risk,” “self-report instruments,” and “psychometrics.” From 318 publications, 22 manuscripts were selected, including reviews, guidelines, and book chapters on STB instruments. Data were extracted under PRISMA guidelines, focusing on scale characteristics, predictive validity, item composition, and psychometric performance. Seven frequently cited scales (SPS, SSI, RFL, ASQ, SBQ-R, ACSS, and C-SSRS) were analyzed using Harmony, which uses NLP via Sentence-BERT to evaluate semantic similarity among items. A correlation matrix based on cosine similarity measured inter-item relationships, forming an undirected weighted graph analyzed with the Louvain community detection algorithm. Centrality measures (strength, betweenness, closeness) and questionnaire-based aggregation enabled scale comparisons. Additionally, Exploratory Graph Analysis (EGA) with the GLASSO model and Walktrap algorithm, assessed by the Total Entropy Fit Index (TEFI), explored network dimensionality and community structures.

Thirty-four scales were identified, with 35% having 1-10 items and 29% having 11-20 items. ASIQ and ASQ displayed high predictive validity (sensitivity: 96% and 96.9%, respectively). The Beck Scale for Suicide Ideation (SSI) had the highest strength centrality (68.1) and eigenvector centrality (0.871), while the CSSRS had the highest betweenness centrality (488.0). Four clusters were identified (Image 1) with a modularity score of 0.0838, indicating moderate cluster separation. The EGA (Image 2) confirmed a multidimensional structure, with an edge density of 0.667 and the Walktrap algorithm identified two main communities focused on cognitive and behavioral/protective aspects. The TEFI score of -3.778 indicated a multidimensional network structure.

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The findings underscore the need for multidimensional approaches to STB assessment. Key tools like the SSI and CSSRS are central, with future research recommended to enhance predictive validity and enable cross-cultural adaptation. To advance psychometric evaluation, future work will include a systematic review and meta-analysis following the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) protocol to assess these scales’ psychometric properties in depth.

None Declared

Laughter can be regarded as a distinct form of cathartic experience, arising from the violation of various well-established cultural norms. The balance between the emotions of laughter and fear depends on the extent and nature of the norm violation, as well as the specifics of its perception. The development of regulatory functions enables younger schoolchildren to comprehend increasingly complex forms of humor, which involve the transgression of cultural norms—ranging from behavioral violations to breaches of logical and linguistic norms.

To examine the specific features of humor perception and production by younger schoolchildren, as well as the potential for regulating their subjective experiences of danger and safety in situations involving norm violations in humor.

The empirical study involved 360 younger schoolchildren (aged 7-10). The “Sometimes It Happens” (T. Artemyeva) method was used to study humor. The analysis of the schoolchildren’s responses was based on the following indicators: identification of rules (norms) in academic, extracurricular, and family interaction situations; the creation of humorous event scenarios; and the selection of event outcomes (adaptive or maladaptive humor).

The study revealed that the development of regulatory functions in younger schoolchildren allows them not to fear violating certain cultural norms or rules of social interaction in a joke. The positive correlation between maladaptive event outcomes and the identification of norms and rules by younger schoolchildren indicates the development of their regulatory function, mastery over their own cognitive processes, and their ability to interpret “dangerous” or “fear-inducing” scenarios as subjectively non-threatening, allowing them to emotionally distance themselves from such situations. Younger schoolchildren recognize the potential of humor in violating cultural norms, understanding that something in the event does not occur as it should according to the rule. In the child’s view, adherence to cultural norms guarantees a sense of safety in interactions with adults and peers.

The findings of the study provide a foundation for the development of programs aimed at enhancing the regulatory functions of younger schoolchildren.

This paper has been supported by the Kazan Federal University Strategic Academic Leadership Program (PRIORITY-2030).

None Declared

Depressive disorder is one of the health problems that carries the greatest burden of morbidity, with high prevalence and impact on people’s quality of life. It also affects the family environment and contributes to the social and economic burden on health systems (World Health Organization, depression, 2023). Currently, the treatment of depression has limitations and there is a high frequency of patients who do not respond despite multiple trials of antidepressants. Up to two-thirds of patients diagnosed with depression do not achieve remission despite treatment, and 30% of patients are considered treatment-resistant, defined as a minimum of two failures to previous treatments, in adequate doses and duration (Gaynes et al., 2019). Recent innovations in the management provide promising opportunities to improve the symptomatology of these patients. New drugs such as ketamine and esketamine, which have glutamatergic neuromodulatory properties, are used under supervision for the treatment of patients with treatment-resistant depression (Vasiliu, 2023).

The aim is to describe a sample of real-world patients with a diagnosis of resistant depression referred to esketamine/ketamine treatment. The individuals were being followed by psychiatrists of a public hospital in the city of Barcelona and were selected to start treatment indicated by the refractoriness and severity of the episode.

We used a database that collected multiple sociodemographic, clinical and treatment variables of 32 patients with refractory depression who were referred to treatment with esketamine/ketamine. SPSS software was used for data processing. All the patients in the group were followed up by psychiatry in a public hospital in the city of Barcelona during the period from July 2015 to September 2024.

Of the 32 patients evaluated, 11 were male (34.4%) and 21 were female (65.6%). The mean age at the time of receiving ketamine/ketamine treatment was 53 years with a standard deviation of 10.7. Nearly 60% had a comorbid psychiatric diagnosis. Twenty-eight percent had undergone electroconvulsive therapy. The mean number of previous episodes was 3.72 with a median of 2.5. Regarding the response to treatment we found that it was partial in 15 patients (46.9%) and complete remission could be obtained in 7 patients (21.9%), with no response to treatment in 10 of them (31.2%). In 5 patients the response was considered a late response.

In most of the patients a partial improvement was assessed as evidenced by a reduction in the Montgomery-Asberg Depression Rating Scale (MADRS). Few cases obtained a complete remission with treatment.

As limitations to the results, we can refer to the small sample size. However, we consider that the severity and chronicity of the episodes make the description of the response in a real world group seem of interest for future studies.

None Declared

The Lancet Commission noted severe mental health service disparities in low- and middle-income countries facing crises. Regarding this, the World Health Organization (WHO) developed the early adolescent skills for emotions (EASE), an experimental group-based intervention delivered by non-specialists, to offer evidence-based psychological support for adolescents with mental distress.

This systematic review and meta-analysis assesses EASE’s effectiveness in alleviating post-traumatic stress disorder (PTSD) compared with enhanced treatment as usual (ETAU).

We systematically searched PubMed, Cochrane, and Scopus for randomized controlled trials (RCTs) comparing EASE with ETAU. Our outcomes included the overall improvement in post-traumatic and depressive symptoms, measured by the Children’s Revised Impact of Event Scale (CRIES-13) and the Patient Health Questionnaire-Adolescent version (PHQ-A) scores respectively. We pooled mean differences (MD) with 95% confidence intervals (CI) in RStudio using a random-effects model. Heterogeneity was assessed with I² statistics.

Six RCTs were included with 1,417 patients, of whom 642 (45.3%) received EASE treatment. In 67% of the studies, Syria was the main location of RCT’s. A total of 688(49%) were female. CRIES-13 (MD = -0.18, 95% CI [-1.88, 1.52], p = 0.84, I² = 0%; Figure 1) and PHQ-A (MD = -0.69, 95% CI [-1.47, 0.09], p = 0.08, I² = 15%; Figure 2) scores in the EASE intervention group compared to the ETAU group showed no significant difference. In both outcomes the heterogeneity was low.

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The benefit of EASE in improving mental distress in adolescents is uncertain. Additional trials will provide new evidence for EASE potential therapeutic benefits.

None Declared

Comparing long-term outcomes in psychosis can be challenging due to widely differing definitions, measures, and populations. The remission working group led by Andreasen et al. suggested remission criteria based on positive symptoms and duration. However, there is no internationally agreed definition of functional recovery. The TIPS study is one of very few with very long-term follow-up, and this presents a unique opportunity both to investigate outcomes as well as use findings to develop valid definitions for the future.

In this longitudinal study, we explore remission patterns and functional status with regards to social contacts, living situation and employment status over 20 years.

A representative sample originally consisting of 201 first episode psychosis patients from two Norwegian well defined catchment areas in the Scandinavian TIPS study have been followed for more than 20 years with symptom and functional measures. Assessments have taken place at inclusion, one, two, five, ten and twenty years. At the 20-year follow-up, 43% of living participants were retained; 15% had died.

Data analysis is in progress, and symptoms and function results will be presented.

None Declared

Psychiatry focuses on disorders of affect, behavior, and cognition (ABC), with half of all psychiatric disorders emerging by age 14 and three-quarters by age 24. Disorders are categorized into four types: Type 1 (affective disorders like depression and anxiety), Type 2 (behavioral disorders like ADHD and ODD), Type 3 (developmental disorders like mental retardation and speech/language issues), and Type 4 (dysfunctional disorders, including psychotic illnesses and mood disorders). These categories—emotional, behavioral, cognitive, and dysfunctional—form the ABCD framework in child psychiatry.

The study aimed to categorize childhood and adolescent mental and behavioral disorders into four groups: developmental, disruptive, emotional, and dysfunctional. It also sought to examine intra- and inter-group comorbidities, and analyze the clinical variables of these groups and their comorbidities by age and sex.

This was an observational cross-sectional study conducted at Gauhati Medical College Hospital (GMCH), Guwahati, Assam, from September 7, 2018, to September 6, 2019. Existing diagnostic systems do not distinguish between child/adolescent and adult mental health, and there is a lack of a unified “common language” for childhood and adolescent mental and behavioral disorders. The study aimed to address this gap, particularly in the local geo-cultural context, where data for a new classificatory system is scarce. Participants included children and adolescents admitted to the Child Psychiatry Unit or attending the Child Guidance Clinic. Demographic (age, sex) and clinical variables (ICD-10 diagnoses) were studied, with diagnoses categorized into types 1–4.

Total sample size was 137. Adolescents (ten to 18 years of age) were almost double in numbers to that of children (below ten years of age). Boys outnumbered girls. Adolescents were more than children in both among girls and boys (even the single third gender was an adolescent). Most of the children and adolescents were having type 3 disorders, followed by type 1 and type 2 disorders. While majority had type 3 disorders below ten years of age (children), type 1 disorders were highest in the adolescents. Type 1 and type 3 disorders were almost equally distributed among girls, while boys predominantly had type 3 disorders. Within group comorbidity was maximum with type 3 disorders. Across group comorbidity was found mostly in type 2-type 3 disorders.

John Lennon “imagined” of having no countries and no religion too; thus, there will be nothing to kill and die for! Bono of U2 wanted to be there “where the streets have no name”! Likewise, we too dream of a land for child and adolescent psychiatry where if we cannot live without names then let us at least have a few and simple ones: ABCD!

None Declared

Schizophrenia is a highly complex mental disorder. It is associated with hallucinations and delusions. Caring for a patient with schizophrenia presents major challenges, especially for mothers. The mother-child relationship is one of the first relationships to be formed, serving as the basis for other human relationships [1,2]. The mother is the most important person shaping the child’s behaviour.

Although schizophrenia has biological and genetic causes, the environment in which the person grew up is very important.

Translated with DeepL.com (free version)

To explore the childhood experiences of patients with schizophrenia with their mothers in order to identify the early mother-child relationship in these patients.

This was a descriptive cross-sectional study using a questionnaire including sociodemographic and clinical criteria as well as questions to assess patients’ childhood experiences with their mothers and patients’ feelings towards their mothers.

Inclusion criteria were patients’ willingness to participate in the study. Participants were male schizophrenic patients over 18 years of age hospitalised at the Arrazi Psychiatric Hospital in Salé.

Exclusion criteria: intellectual disability.

Schizophrenia, mother-child relationship, emotions, patients.

In this study, a total of 88 male patients with schizophrenia were collected. The majority had an average socio-economic status. Almost 77% were single and 89% lived with their families. All participants were unemployed. 91% had a substance use disorder, including tobacco and cannabis. 77% had reported psychological abuse by their mother and 55% had reported physical abuse. All the participants had received comparisons with other children and the majority reported having already felt that they were going to be abandoned by their mother. 75% reported having played the role of parent for their parents in childhood. 88% of the participants had feelings of anger and blame for their mother, 20% had feelings of security, 51% had ambivalent feelings of love and hate at the same time.

The present study showed that the early relationship between mother and child in patients with schizophrenia was associated with complex and ambivalent emotions and was also characterised by alternating feelings of hatred and love. Feelings of abandonment of the child and lack of attention to the child’s basic needs caused patients many emotional problems towards their mothers.

None Declared

First psychotic episodes (FPE) have a significant impact not only on the individual who experiences them but also on their close environment, particularly their family. The onset of a FPE typically occurs in the early twenties, a stage of life where individuals are planning and developing their adult life project. The changes in family dynamics following a FPE are part of the recovery process and are considered a prognostic factor for recovery.

Since the beginning of the Comprehensive Care Program for First Psychotic Episodes, a weekly support group for families has been conducted. The group is open, lasts 90 minutes.The group has an open theme and is co-facilitated. Participants may attend after starting the psychoeducation workshop for FPE and can continue attending even after the patient has been discharged from the facility.

The aim is to analyze the predominant family figures, age range, and gender, as well as the main themes that arise and concern the families of patients with first psychotic episodes.

A retrospective study with a mixed-method approach (qualitative and quantitative) is proposed, based on the narrative records collected during the weekly sessions from 2023 until June 2024.

The average attendance is 10.7 participants per group, mostly women (80%). The range age is from 18 to 70 years, with and average of 58 years. In terms of the roles concerning the patient: parents (95%), siblings (5%), with no representation of partners during the period analysed.

The predominant themes identified from the analysis of the collected verbatims include: guilt regarding the onset of the illness; the timing of recovery and managing the sense of urgency from the institution, the family, and the patient; regression in relational family dynamics; caregivers’ fear of their own death; shame and stigma; the traumatic experience of hospitalization; the distinction between behaviors associated with personality versus the illness; the rupture with identity; the fear of relapse and suicide.

Families highlight the role of the group as an emotional support, an improvement in communication strategies and bonding with the sick relative, better capacity for mentalization, and managing their own anxieties and emotions related to guilt and self-care.

The onset of a FPE generally affects the entire family system. Past conflicts and regressive attachment dynamics are activated. Communication based on guilt harms the elements of the system. Family support groups play a crucial role in the recovery process and in helping to establish new dynamics that promote the well-being and autonomy of both the patient and caregivers. The group stands out as a source of hope, which is the main healing factor. Additionally, participants report gaining healthy coping tools and reducing their experience of isolation and stigma.

None Declared

Treatment of schizophrenia remains a challenge despite the development of numerous antipsychotics (AP) (Pompili et al CNS NDDT 2017; 16 870-884). The various strategies to address patients’ unmet needs, such as AP polypharmacy or switching AP, do not seem to provide adequate benefit. A reason for this may reside in the similarity of mechanisms of action of most APs. However, the monoaminergic systems targeted by these drugs are not always disrupted in schizophrenia, as it is widely accepted that patients who fail to respond to AP have glutamatergic, but not dopaminergic dysfunctions (Moghaddam et al NPP 2012; 37 4-15). Evenamide normalizes excessive glutamate release without affecting its basal levels, and it does not interact with >150 CNS targets. It has been shown to be effective in animal models of psychosis as monotherapy and add-on to AP. Previous trials indicate that evenamide benefits patients with schizophrenia with inadequate response and have shown clinically important benefits lasting up to 1-year in TRS (Anand et al IJNPP 2023; 26 523-528).

Study 008A, a phase 2/3 international, randomized, double-blind, placebo-controlled, 4-week trial, assessed the efficacy and safety of evenamide 30 mg bid as add-on in patients poorly responding to an SGA.

Outpatients with a diagnosis of schizophrenia, still symptomatic (PANSS 70-85; CGI-S 4-6) despite treatment with an SGA at a therapeutic dose (confirmed through plasma levels) for an adequate period, were enrolled. Efficacy was assessed on the PANSS, CGI-S, and LOF through the comparison of changes from baseline to Day 29 between evenamide and placebo groups using a MMRM analysis. Moreover, the proportion of patients reaching a clinically important improvement on the PANSS and CGI-C were compared between groups using a logistic regression model (chi-square test). Safety measures comprised: TEAEs, vital signs, labs, ECG/EEG, seizure checklist, physical/neurological/eye examinations, C-SSRS, ESRS-A, CDSS.

291 patients were randomized in the study in 11 countries (EU, Asia and LATAM), and 280 completed the study. The low attrition rate (<4%), and proportion of patients with TEAEs (~25% in both groups) indicate that evenamide was well tolerated. A statistically significant greater improvement was found on the PANSS total score and on the CGI-S in the evenamide compared to the placebo group. Furthermore, a significantly higher proportion of patients treated with evenamide, compared to those receiving placebo, experienced clinically meaningful benefit measured on the PANSS (≥20% improvement) and CGI-C (at least much improved).

This is the first randomized, placebo-controlled trial to demonstrate the clinical benefit of adding a NCE modulating glutamate in patients with schizophrenia who did not experience adequate response from treatment with a SGA.

R. Anand Consultant of: AbbVie, Acadia, BiolineRx, Domain, Enkam, Erydel, Forest, Janssen, Hoffman La Roche, Lundbeck, Noema, Ono, Pfizer, UCB, Shire, Sigma-Tau, Takeda, Teva, A. Turolla Employee of: Newron Pharmaceuticals SpA, G. Chinellato Employee of: Newron Pharmaceuticals SpA, R. Giuliani Employee of: Newron Pharmaceuticals SpA, F. Sansi Employee of: Newron Pharmaceuticals SpA, R. Hartman Consultant of: Newron Pharmaceuticals SpA.

Tobacco and alcohol use are two of the main risk factors for most of the non-communicable diseases and causes of death worldwide. Healthcare professionals can play an important role in helping patients to quit smoking and alcohol consumption, but this role is undermined if they themselves have the same addictions.

The aim of this study was to study the effect of smoking and alcohol use on healthcare professionals’ quality of life. In addition we aimed to identify any demographic and occupational factors that affect quality of life.

The research sample of the present cross-sectional study consisted of 200 health professionals. The Demographic Questionnaire, the Smoking Addiction Inventory (Fagerstrom), the Alcohol Addiction Inventory, and the Quality of Life Inventory (EQ-5D) were used. The statistical analysis was performed using the statistical package IBM Spss v.27

Among the sample, the 46.5% stated that were smokers. The mean score of alcohol dependence was found to be 3.61 (±3.29), while the corresponding mean value of Fagerstrom was calculated to be 3.96 (±2.27). The EQ-5D quality of life score was found to be 0.93. Finally, the EQ-Vas score was found to be 7.95 (± 1.57).

A particularly high prevalence of smoking was found among the healthcare professionals in the study, while alcohol consumption was moderate. The results showed that tobacco and alcohol consumption negatively affects the quality of life of healthcare professionals.

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Open access to psychological treatment manuals is critical for advancing research and clinical practice, particularly in low- and middle-income countries, where access to mental health care is scarce. Despite growing recognition of the need for freely available manuals to ensure replicability, transparency, and wider dissemination of evidence-based interventions, open and free access to intervention manuals remains limited.

We aimed to quantify the availability of protocols and manuals for psychological interventions used in randomized clinical trials (RCTs) for severe mental disorders. This research is part of the broader European Research Council – funded project DECOMPOSE, in which we employ a systematic and reproducible approach for decoding, classifying, and evaluating the active ingredients of psychological interventions.

Using recent network meta-analyses of RCTs, we collected psychological interventions for psychotic, bipolar, substance use, eating, and borderline personality disorders. We attempted to retrieve intervention protocols and manuals directly from trial publications or their published protocols and referenced manuals. If the protocols or manuals were not accessible, we contacted the study authors to request the materials.

We identified a total of 259 RCTs, but only 18 had published protocols. Of the 71 RCTs pre-registered on platforms such as ClinicalTrials.gov, only 5 provided an adequate description of the psychological treatment components, all of which overlapped with already published protocols. To retrieve missing materials, we contacted 450 authors from 241 RCTs. We received positive responses from 75 RCTs, negative responses from 55 RCTs, and no replies from 100 RCTs. We were not able to retrieve contact information for the authors of 11 RCTs.

Of the 75 positive responses, we obtained the complete requested materials for only 47 trials. In the remaining cases, we were instructed to purchase the manuals (n=11), provided with only partial materials (n=4), or given additional references that were not the full intervention manual (n=13). Negative responses included the trial being too old or no authors’ access to the materials (n=22), commitment to send the materials without further follow-up (n=8), suggesting the paper as the sole available resource (n=11), and various other reasons (n=14)

Our findings reveal a significant lack of freely available intervention manuals, limiting the implementation and replicability of psychological treatments. Coordinated action is needed to ensure open access to these materials for more replicable research, wider dissemination of results, and improved access to evidence-based mental health care.

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Adropin is a unique hormone or biomarker that is produced in the liver, brain, and peripheral tissues such as the heart and gastrointestinal tract. It was discovered in 2008 by Kumar and others. It is encoded by a gene associated with energy homeostasis. Adropin plays a key role in the development of various CNS disorders such as stroke, schizophrenia, bipolar disorder, Alzheimer’s disease, and Parkinson’s disease.

Depressive disorder affects a large number of people worldwide, with symptoms such as loss of energy and motivation, sadness, fatigue, and weakness significantly impacting quality of life and functionality. Numerous studies have shown that depression has various neurobiological mechanisms. Deregulation of energy metabolism in the brain is one of the mechanisms associated with the onset of depressive disorder. Adropin can activate BDNF, and since BDNF plays a crucial role in neurogenesis, synapse formation, plasticity, learning, memory, and has a neuroprotective function, adropin may play an important role in the development of depression.

We conducted a study in which we examined adropin concentrations in depressive disorder in individuals who were diagnosed with depression for the first time and compared adropin levels with healthy controls. We followed up with depressive patients after six months of introducing SSRIs (Selective Serotonin Reuptake Inhibitors) antidepressants.

The adropin values after the introduction of antidepressants and improvement of depressive symptoms were significantly higher after six months compared to the initial blood draw.

Our study measured serum adropin levels in patients who had not previously been treated for depressive disorder. After introducing SSRIs (Selective Serotonin Reuptake Inhibitors) and six months after the initiation of therapy, we repeated the adropin measurements. The results showed a statistically significant difference between the first and second measurements. In the second measurement, adropin levels were higher than in the first. We can conclude that with the improvement of depressive symptoms, the serum adropin levels, as a neuroprotective biomarker, also increased.

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Physical rehabilitation is usually required after serious illness or injury; there is a significant need for simultaneous psychiatric rehabilitation as well. Psychiatric consultation to inpatient rehabilitation units presents with unique clinical questions distinct from consultation to other units.

To present a literature review and an illustrative case series of common psychiatric referrals from physical rehabilitation units.

First, the current literature was reviewed on PubMed looking at current models of psychiatric consultation to inpatient physical medicine and rehabilitation units. Second, cases were reviewed from tertiary post-acute care units including stroke, acquired brain injury, post-fracture fast and slow stream, and complex continuing care. Third, thematic analysis was performed to extract illustrative themes presented in a case series of four mock patients.

There is a paucity of literature on psychiatric consultation to inpatient physical rehabilitation units. The current literature, however, supports high utilization of psychiatric consultation in comorbid physical illness (Daly et al 2023, PMR). Four major themes emerged on psychiatric consultation to inpatient physical rehabilitation: (1) Interdisciplinary management of basophobia [the fear of falling], (2) Managing severe persisting mental illness and addressing medications that increase the risk of falling, (3) Managing new onset trauma-related disorders and pain-related disorders, (4) Assessing partial cognitive improvement and impairment in the setting of brain injury.

Psychiatrists often deal with patients recovering from an episode of serious physical illness or injury. There is significant overlap between the work done in physical and psychiatric rehabilitation. Patient and staff education, judicious prescribing and de-prescribing, and interdisciplinary management are critical to successful outcomes.

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“Sex work” refers to the provision of sexual services in exchange for monetary or material compensation. The exact number of sex workers in Germany, where prostitution is legal, remains uncertain, but estimates suggest it could be as high as 700,000. The majority of the group is female and has a migration background. Sex work covers different areas. These include work in brothels and strip clubs, street prostitution, hostess services and work in the porn industry. Previous research into sex work has mainly focused on sexually transmitted diseases. While results from Switzerland indicate elevated prevalences of depression, anxiety disorders, and substance use among sex workers, to date, there has been no research specifically addressing mental illnesses among sex workers in Germany.

The research project aims to fill this gap by determining the 1-year prevalence as well as risk and resilience factors for mental illness among sex workers in Berlin. The research findings aim to enhance psychosocial care services for sex workers and foster meaningful contributions to the broader social discourse.

The socio-demographic composition of the sex worker population is constantly shifting, making it difficult to obtain a truly representative random sample. Quota sampling offers the closest alternative, with interviewees being approached at various workplaces. Additionally, we ensure a diverse age range is included in the study. A total of 500 participants will be surveyed using structured interviews. The interview consists of a sex work questionnaire, standardized research instruments, and a mental health screening. The sex work questionnaire gathers data on work type and intensity, socio-demographic characteristics, and individual access to counseling and support services. Standardized instruments include assessments for personality (TIPI), coping behaviors (Brief COPE), health-related quality of life (SF-12), stigmatization experiences (PASS 24), and childhood trauma (CTQ). The mental health screening will be conducted using the Mini-DIPS.

The submitted poster will offer a detailed overview of the study design and methodologies. In addition, preliminary results will be shared, shedding light on the mental health status and access to healthcare services among sex workers.

This pioneering study seeks to address a significant gap in current research. The final findings will form the foundation for more in-depth analysis and guide future recommendations to improve support services for this population.

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According to literature, the link between childhood trauma and mental health disorders is well-established. However, focusing on the mechanisms explaining this pathway remains insufficiently studied mainly among incarcerated population.

The current study aimed to assess the mediation effect of sleep disorders in the path from childhood physical neglect and emotional abuse to suicide and self harm behaviors among male prisoners.

We conducted a cross sectional study among incarcerated males in Mahdia prison on April 2023. The participation was anonymous, voluntary and the measurement tool was self-administrated. Illiterate participants were interviewed by investigator doctors. We assessed physical and emotional abuse using items from the validated Arabic version of the World Health Organization ACE questionnaire. Self-directed violent behaviors were subdivided into suicidal behaviours and self harm. The Hospital Anxiety and Depression Scale and The Pittsburgh sleep quality index were also used.

A total of 540 prisoners were recruited with a response rate of 74.6%. Their mean age was 33.75± 10.89 years. Among participants, 73% reported emotional abuse and 39.2% had experienced physical neglect during their childhood. In the six previous months, 35% of them had suicidal thoughts and 45.9% were engaged in self-harm. Anxiety and depression were screened among 83.2% and 79.6% of them respectively. During incarceration, 88.4% of prisoners reported sleep disorders.

After adjusting for anxiety and depression, we found that physical neglect and emotional abuse predict self harm behaviors through sleep disorders among male prisoners (%mediated= 28.5% and 15% respectively, p< 0.001).

Our study emphasize the need for preventing and screening childhood trauma and implementing mental health approaches in jail in order to deal with sleep disorders and to prevent suicidal behaviors among prisoners.

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