Postpartum depression (PPD) affects approximately 9% of new mothers and can have profound consequences on both maternal well-being and infant development. Additionally, around 50% of women experience depressive symptoms or mood disturbances during pregnancy and lactation. A growing body of research suggests a potential link between omega-3 polyunsaturated fatty acids (PUFAs) and mood regulation, particularly in the prevention of PPD. Omega-3 PUFAs, primarily docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are found in high concentrations in oily fish and seafood. Over the past century, dietary intake of omega-3 fatty acids has significantly declined in industrialized societies, coinciding with increased rates of mood disorders. Notably, populations with higher fish consumption, such as those in Hong Kong, China, and Japan, report lower incidences of depression compared to Western countries, where lower fish consumption has been linked to higher rates of PPD. During pregnancy and lactation, women become particularly depleted in omega-3 PUFAs, as these essential fats are preferentially diverted to support fetal development, potentially increasing the risk of depression in mothers.

This study aims to explore the effectiveness of omega-3 PUFAs in preventing PPD.

A comprehensive literature review was conducted to evaluate the effectiveness of Omega-3 in preventing PPD. The search was performed on PubMed using key terms such as “Omega-3,” “Postpartum Depression,” and “Prevention.”

In one study, women with low LCP intake were supplemented with 220 mg of DHA, which had no effect on depression, like in another study that reported no effect of 1,8 g of Omega-3 PUFAs on maternal depressive symptoms. Another trial involving 2,399 women found no significant difference in depressive symptoms between those receiving 800 mg of DHA and a control group during the first six months postpartum. A randomized controlled trial of 126 women at risk PPD also showed no benefit from EPA or DHA supplementation in reducing Beck Depression Inventory (BDI) scores compared to placebo. A meta-analysis of 11 trials (N = 3,181) similarly found no significant difference in depression scores between Omega-3 and placebo groups, and no association between the daily doses of DHA or EPA and PPD prevention

Based on the reviewed trials, there is insufficient evidence to recommend Omega-3 fatty acid supplementation (DHA and EPA) at any dosage for the prevention of postpartum depression.

None Declared

Perinatal disorders occur in 25% of childbearing women. Postnatal depressive symptoms (PDS) have been widely studied, whilst PDS usually overshadows bonding disorder (BD) in clinical practice and research. BD includes mild disorders, such as delay, ambivalence or loss of maternal emotional response, and severe disorders, such as pathological anger or rejection of the child (Brockington et al., Arch Womens Ment Health 2006; 9(5) 243-251).

To estimate the prevalences of PDS and BD in mothers during the six months after birth.

Women and their male partners aged ≥ 18, without delivery and neonatal complications, were recruited at the Maternity Ward in a public hospital in Madrid, during 2021-2022. Data was collected at immediate puerperium (T0), sixth week (T1), fourth month (T2), and sixth month (T3). The last observation carried forward (LOCF) was used. An Ad hoc Socio-Demographic questionnaire was used. To determine the presence of PDS and BD, respectively, there were used the Edinburgh Postnatal Depression Scale (EPDS), cut off ≥ 11 (Ascaso-Terrén et al., Med Clin (Barc) 2003; 120(9) 326-329) and Postpartum Bonding Questionnaire (PBQ), cut off ≥ 13 for BD, and ≥ 18 for severe BD (Torres-Giménez et al., Span J Psychol. 2021; 24, e47, 1-9).

1502 couples were recruited at T0. The main characteristics of female participants were: mean age 34.1 years, 53.9% married, 54.1% primiparous, 27.8% migrants, 67.3% university degree or higher, 83.2% employed, 14.8% financial difficulties, 4.9% smoking during pregnancy and, 21.7% c-section. At T0, the prevalences of PDS were 13.0% of mothers, 10.5% of fathers, and 3.5% of both parents. Applying LOCF, 874 women responded to the questionnaires at some timing during the follow-up. The results were divided into two groups (see Table 1 and Table 2) depending on whether they presented PDS at T0. In mothers with PDS at T0, PDS and BD rates eventually decrease at T3. In the other group, while BD rates decrease at T3, a slight increase in PDS presentation at T3 is observed.Table 1.

LOCF of mothers with PDS at T0

Depressive symptoms and impaired bonding could have different severity and timing during the postnatal period. More research on bonding disorder is needed to clarify more accurately the psychopathological features that distinguish it from postnatal depression to provide more targeted treatment that will also reduce the associated stigma of childbearing difficulties.

None Declared

The onset of the COVID-19 pandemic necessitated the declaration of a global emergency. The pervasive fear of contagion has transformed daily life practices, and lockdown measures globally implemented to mitigate virus transmission have led to a spectrum of adverse psychological effects, including anxiety, sadness, frustration, disorientation, and potential for post-traumatic stress disorder, significantly affecting mental health.

This study aims to evaluate the psychological effects of the COVID-19 pandemic on the well-being of trainee teachers.

A descriptive analysis was conducted on a cohort of 370 Moroccan trainee teachers, with a mean age of 28.30 ± 5.99 years. Data were collected using a self-administered questionnaire designed to assess the presence and extent of psychological distress, along with sociodemographic and professional characteristics, during the lockdown.

The findings revealed that 65.1% of the confined trainees experienced obsessive tendencies, and 40% reported that their daily activities were restricted, affecting their normal life pursuits. Furthermore, 68.3% expressed moderate to high stress levels due to various factors, such as financial and professional concerns, potential loss of family members, or personal hospitalization. Half of the trainees expressed concern for their future prospects and feelings of ennui during these unprecedented times.

The findings reveal the enduring psychological impacts of the COVID-19 pandemic on trainee teachers, with significant stress and psychological disorders noted. This emphasizes the critical need for targeted mental health support and proactive resilience-building within educational systems, not only aiding recovery but also preparing educators for future pandemics.

None Declared

Body dysmorphic disorder is a diagnostic entity within the somatoform disorders of the obsessive-compulsive spectrum according to the DSM-V. Its prevalence is between 0.7% and 2.5%, being more frequent in men and usually beginning in adolescence or early adulthood. Its central symptom is cognitive distortions regarding appearance, with concern about imaginary physical defects, slight or even invisible to others and in some cases close to a delusional condition.

To delve deeper into the clinical aspects and nosological conditions through the description of a clinical case.

This is a 16-year-old patient who was admitted three times to the Acute Psychiatric Unit of the Puerta de Hierro Hospital due to behavioral disorders in the context of dysmorphophobia with intense concern about the shape of his nose. The patient gradually abandoned his daily routines, stopped attending classes at school and isolated himself from his social circle.

He is the youngest of two sisters. He lives with his parents and sister. He had good academic results until the time of diagnosis.

The patient’s concern about his nose began at about age 15, coinciding with the diagnosis of leukemia of his mother, who was undergoing chemotherapy treatment. The patient reports that the symptoms have increased until causing significant functional limitation.

He says that his nose is very large and he doesn’t allow anyone to see it. He leaves the house wearing a mask, performs rituals of checking it for hours in front of the mirror and has even manipulated his nose with objects to try to deform it. He appears to have a delusional component with significant emotional and behavioural repercussions.

Several pharmacological treatments were started, including SSRIs (sertraline) and various antipsychotics (risperidone, pimozide and olanzapine), with little response in all cases. Psychotherapeutic treatment was carried out in a day hospital for adolescents, but this was also unsuccessful. Finally, he was involuntarily transferred to a Medium Stay Unit given the significant impact of the symptoms on his life, showing progressive improvement after several months of treatment.

The nosology of TDC has evolved: the DSM IV specified a delusional variant within the psychotic spectrum and a non-delusional one within the somatoform spectrum. The DSM V integrates it within the obsessive-compulsive spectrum. In order to assess a correct treatment, a continuum could be established between TDC and eating disorders. Both present similar symptoms: dissatisfaction and distortion with body image, need for continuous checking and concern about imperfections in perceived appearance. Given the chronicity of TDC and the tendency to abandon treatment in the first months, long-term follow-up by a multidisciplinary team is necessary, as well as psychoeducation and the establishment of a solid therapeutic alliance.

None Declared

The war has affected every Ukrainian to some extent. With the mobilization comes the increased risk of people with dark triad traits (DT) (psychopathy, machiavellianism and narcissism) to be exposed to stress on the battlefield. Being vulnerable, these individuals are in need of protection for their mental health. One of such protections is the emotional intelligence (EI). This makes the relation between DT and EI highly valued as the basis for future development of effective measures against stress disorders for combatants.

The aim of this research is to study the existing knowledge exploring the relation between the emotional intelligence and dark triad traits and to determine the limitations of these studies.

In order to analyse this relation the literature review of scientific studies on the topic of the relation between the EI and DT was conducted.

The literature sources published in 1994-2023 years were reviewed for this study. 1,87% of studies showed that DT related negatively to general EI. 5,66% showed that some facets of DT related positively to some facets of EI, while 2,83% showed negative relation. 2,83% demonstrated that psychopathy (P) related positively to general EI, 13,21% reported negative relation, 0,94% showed no relation, 2,83% demonstrated mixed relation. 5,66% reported that some facets of P related positively to some facets of EI, while 38,68% discovered negative relation. 14,15% demonstrated that narcissism (N) related both positively and negatively to general EI, 4,72% observed no relation. 16,98% found that some facets of N related positively to some facets of EI, 21,7% showed negative relation. 5,66% demonstrated that M related positively to general EI, 7,55% reported negative relation. 10,38% found that some facets of M related negatively to some facets of EI.

Among reviewed papers most of them reported that some facets of DT related positively to some facets of EI, with P mostly relating negatively to general EI and some of its facets, N mostly relating positively to some facets of EI and M mostly relating negatively to general EI and some of its facets. Found and known limitations of mentioned studies included: sample population being too heterogenous, sample population including criminal offenders only, size of sample population being too small, use of self-report measures, lack of unified approach to measure EI, possibility of comorbidity influencing EI, possibility of individual’s secondary gain influencing EI measure, non-exclusion of individuals with mental disorders from general population. This highlights the need to take mentioned limitations into account in order to acquire accurate data in further research on the topic.

None Declared

Daridorexant, a dual orexin receptor antagonist [DORA] which works by selectively reducing the orexin-induced wake signalling, has been shown to induce a dose-dependent reduction in wake time after sleep onset [WASO] in patients with insomnia disorder (Dauvilliers et al. Ann Neurol 2020; 87 347–356).

This exploratory analysis examined the efficacy of daridorexant in reducing the duration of awakenings in each quarter of the night, when compared to placebo and to the GABA-receptor agonist zolpidem, which induces sleep through widespread CNS sedation.

This was a multi-centre, double-blind trial (NCT02839200), including adult (18–64y) patients with insomnia randomized (1:1:1:1:1:1) to placebo, daridorexant (5, 10, 25, or 50mg), or zolpidem (10mg) for 30 days. Polysomnography [PSG]-determined WASO was evaluated using descriptive statistics by quarter of the night (Q1–Q4) i.e. every 2 hours over 8 hours at Days 1 & 2, 15 & 16, and 28 & 29. Baseline was defined as the mean of the two PSG nights during the run-in period and Days 1&2 as the mean of the first two PSG treatment nights; Days 15&16 and 28&29 were defined similarly.

Dose-dependent decreases in mean change from baseline in Q1–Q4 WASO were observed with daridorexant (5–50mg) at Days 1 & 2 (Figure 1). Whereas the approved doses of daridorexant (25mg and 50mg) provided similar response to zolpidem 10mg in the first half of the night, mean reductions from baseline in WASO were numerically greater with daridorexant 50mg versus zolpidem 10mg during the second half of the night – with the difference most pronounced in the fourth quarter (mean WASO change from baseline Q3: –13.49 min versus –9.73 min; Q4: –17.51 min versus –7.81 min). Similar effects were seen at Days 15 & 16, and Days 28 & 29.

Image 1:

In patients with insomnia disorder, daridorexant reduces the duration of awakenings throughout the entire night, including the last two quarters.

B. Steiniger-Brach Employee of: Idorsia Pharmaceuticals, O. Briasoulis Employee of: Idorsia Pharmaceuticals, A. Olivieri Employee of: Idorsia Pharmaceuticals, S. Pain Employee of: Idorsia Pharmaceuticals, L. Palagini Consultant of: Bruno, Fidia, Idorsia Pharmaceuticals, Pfizer, Sanofi, Pharmanutra, Neopharmed Gentili, D. Kunz Consultant of: Austrian Association of Skiing (ÖSV), Idorsia Pharmaceuticals, Speakers bureau of: AbbVie, Idorsia Pharmaceuticals, German Ministry for Economy (BMWi), Austrian Association of Skiing (ÖSV), P.-A. Geoffroy Consultant of: Apneal, Arrow, Biocodex, Dayvia, Di&Care, Idorsia Pharmaceuticals, Janssen-Cilag, Jazz pharmaceuticals, Myndblue, Mysommeil, Posos, ResilEyes, Withings, Speakers bureau of: Biocodex, Bioprojet, Ibsa, Idorsia Pharmaceuticals, Janssen-Cilag, Isis Medical, Jazz pharmaceuticals, Lundbeck, MySommeil, Withings.

Background: Substance-induced psychosis is an acute psychotic condition occurring after substance use, where the psychotic symptoms are alleviated with abstinence. Some of those diagnosed with substance-induced psychosis later develop schizophrenia, and this transition occurs most often for psychosis induced by cannabis. This talk will present results from a register-based study investigating transition rates. The results will be discussed together with other factors that together question the validity of the diagnostic entity of “cannabis-induced psychosis” Method: In our study, we used data from National Patient Register in Norway from 2010 to 2015 to estimate the cumulative hazard for transition from any substance-induced psychosis (F1x.5) and cannabis-induced psychosis (F12.5) to schizophrenia spectrum disorder (F20, F22 and F23). Results: The six-year cumulative hazard for transition from substance-induced psychosis to schizophrenia was 27.6% (25.6-29.7) for any SIP, and highest for those with cannabis-induced psychosis, 36% (95% CI 31.4-41.0). Conclusion: Cannabis-induced psychosis constitutes a significant risk for later schizophrenia. This raises a question of whether the initial diagnosis of CIP was correct, or whether these may have been cases of a development of primary psychosis concealed by cannabis use. Further, the term “cannabis-induced psychosis” places a major explanatory emphasis on the substance use, ignoring other potential contributing factors such as vulnerability including genetic disposition for psychosis.

None Declared

Artificial intelligence (AI) is transforming psychiatric training and education by enhancing diagnostic accuracy, improving therapeutic decision-making, and personalizing learning experiences for trainees. AI-driven simulations, virtual patients, and natural language processing (NLP)-based assessments allow for more effective skill development in psychiatric diagnosis and psychotherapy. Machine learning models provide evidence-based guidance, reinforcing clinical reasoning and treatment strategies. Ethical considerations, including patient confidentiality and bias mitigation, remain central to AI implementation in training. This session explores the latest advancements in AI-driven psychiatric education, discussing practical applications, challenges, and future directions for integrating AI into clinical training programs.

AI, psychiatry, education, machine learning, clinical training

1. Ahmed, M., & Rush, A. J. (2023). Artificial intelligence in psychiatry: Current applications and future directions. Journal of Psychiatric Research, 157, 106-121.

2. Ryu, S., & Kim, H. (2022). AI-based learning tools for medical education: A systematic review. Medical Teacher, 44(5), 512-520.

3. Luxton, D. D. (2021). Ethical implications of AI in mental health care. Journal of Ethics in Mental Health, 12, 1-14.

None Declared

Adherence to treatment plays a key role in the effectiveness of therapy of the cardiovascular diseases. Patient’s personality becomes an inevitable determinant of health behaviour influencing the way the patient reacts to the illness itself. The painful sensations, the need to adapt to the disease may be the cause of frustration in patients (Heszen-Klemens. Soc Sci Med 1987, 24 (5) 409-416). Hence, it is necessary to assess how the frustration reactions are connected with the adherence to treatment.

The aim of the research was to study the relationship between the frustration reactions and the adherence to treatment in patients with cardiovascular diseases.

The Picture Frustration Test (Rosenzweig. Journal of Personality 1945, 14 3-23) was used to assess frustration reactions of the patients. The Questionnaire for Comprehensive Assessment of Treatment Adherence was used to provide a complex evaluation of the adherence to treatment (Nikolayev, Skirdenko. Clinical Pharmacology and Therapy 2018, 1 74-78). The study was conducted from January 2024 to April 2024. The sample consisted of 42 male patients hospitalised with multiple cardiac pathology, whose average age was 49.40±7.71.

The average adherence to treatment of the patients with cardiovascular diseases in our sample was 61.17±18.53%, with twelve (30%) participants being defined as low-adherent and nine (22.5%) as high-adherent. What concerns direction of frustration reactions, low-adherent patients were more likely to exhibit extrapunitive reactions (H=7,760, p=0,021), whereas high-adherent patients demonstrated intropunitive reactions more often (H=6,062, p=0,048). More interestingly, there were significant differences in types of frustration reactions, with need-persistent reactions being more characteristic for the high adherent-patients (H=6,551, p=0,038). Intropunitive and need-persistent frustration reactions were associated positively with the adherence to treatment (r=0.428, p=0.013; r=0.459, p=0.007). Extrapunitive reactions were found to be negatively associated with the adherence (r=-0.409, p=0.004).

Our study was the first to consider the connection between the frustration reactions of the patients with cardiovascular diseases and their adherence to treatment. The results indicate that the way in which patients typically react to the frustration is connected with the way in which they handle limitations and requirements of the treatment process. When the patient is more likely to react to frustration in problem-solving manner, the chances are that their health behaviour will also lead to a sufficient adherence to treatment.

None Declared

Access to university marks a crucial stage in the lives of young adults. This transition can generate high levels of stress and anxiety, influencing their mental and emotional well-being.

To overcome these challenges, some students may resort to the increasingly common use of psychotropic drugs, particularly anxiolytics, to ease their distress.

To determine the relationship between anxiolytic dependence, anxiety and depression in students.

This was a cross-sectional, descriptive and analytical study conducted on Gabes institute of nursing sciences, for a period of two months(March to May 2024).

We used:

• - Benzodiazepine Attachment Cognitive Scale (BACS) : to study BZD dependence.

  A score above 6 indicates dependance to BZD.

• - Hospital and anxiety depression scale (HAD): to assess the severity of anxiety and depressive symptoms. Seven questions relate to anxiety (total A) and seven to depression (total D), giving two scores (maximum score for each = 21).

The sample comprised 33 students. The mean age of our population was 21.30 ±1.51 years and the sex ratio (M/F) was 0.65.

The mean score of the ECAB scale was 6.93, with extremes of [3-10].

According to our results, dependence on BZDs was clearly predominant, found in 28 students (84.8%).

According to the HAD scale, 82% of students showed anxiety symptoms and 24.2% were depressed.

According to our study, we found that BZD dependence in students was strongly correlated with anxiety with p=0.007.

Similarly, we found that those dependent on BZDs were more likely to develop depressive symptoms compared with non-dependents, with a significant difference (p=0.04).

Our findings suggest that the greater the dependence on anxiolytics, the greater the risk of developing anxiety and depressive symptoms.

None Declared

Patients with End-Stage Renal Disease (ESRD) undergoing hemodialysis (HD) are particularly susceptible to psychological disorders, such as anxiety and depression, which can significantly affect their quality of life and clinical outcomes. However, in spite of its prevalence, psychiatric comorbidity in this population remains under-recognized, contributing to worse health outcomes and increased mortality.

The primary aim of this study is to explore the prevalence of psychiatric comorbidities, particularly depression and anxiety, among HD and PD patients. Insights into the different psychological effects of different dialysis treatments are offered, emphasizing the importance of integrated mental and physical healthcare in improving patient outcomes.

A narrative review was carried out using PubMed and Google Scholar to identify relevant articles with the keywords “dialysis,” “psychiatry,” and “comorbidities.”

The review underscores the important burden of psychiatric disorders among dialysis patients. Studies suggest that depression may affect up to 50% of these individuals. Both HD and PD patients exhibit varying degrees of psychological distress, exacerbated by factors such as the invasiveness of dialysis, comorbid medical conditions (e.g., diabetes), and socioeconomic challenges. The evidence suggests that HD patients may experience an even more heightened psychiatric burden due to the more invasive nature of HD compared to PD, which imposes greater restrictions on daily activities. Psychiatric disorders in these patients are often underdiagnosed, leading to treatment non-compliance, increased hospital admissions, and elevated mortality rates. The findings stress the necessity of regular mental health screenings and the integration of psychiatric care into routine dialysis practice.

Psychiatric comorbidities are prevalent among dialysis patients, with HD patients exhibiting a greater psychological burden. This review highlights the urgent need for routine mental health screening and intervention within the dialysis care framework. The integration of mental health support into dialysis treatment protocols could lead to improved patient outcomes, fewer hospitalizations, and better treatment adherence. Future research should focus on developing customized mental health interventions that address the specific challenges faced by dialysis patients, thereby enhancing their quality of life and clinical outcomes.

None Declared

Suicide and self-harming behaviors represent significant public health challenges across Europe, with profound implications for individuals, families, and communities. This presentation aims to explore current trends in suicide and self-harm, highlighting variations across different European countries and demographic groups. Recent data indicate a concerning rise in self-harming behaviors, particularly among adolescents and young adults, often linked to factors such as mental health disorders, social isolation, and the impact of the COVID-19 pandemic. Furthermore, the stigma surrounding mental health issues continues to hinder open discussions and access to care, exacerbating the problem.Looking ahead, this presentation will propose future directions for research and practice, advocating for a multidisciplinary approach that integrates psychological, social, and medical perspectives. By fostering collaboration among healthcare providers, policymakers, and community organizations, we can enhance our understanding of suicide and self-harm, ultimately leading to more effective prevention and intervention strategies. This session aims to stimulate dialogue and inspire innovative solutions to address these pressing issues in Europe, promoting mental well-being and reducing the incidence of suicide and self-harming behaviors.

P. Saiz Grant / Research support from: “laCaixa” Foundation, Government of the Principality of Asturias, Instituto de Salud Carlos III, Consultant of: Angelini Pharma, Ethypharm Digital Therapy, Johnson & Johnson, Rovi, and Viatris España.

Relapse refers to the recurrence of psychotic symptoms following a phase of improvement or stability. It often leads to the disruptive re-hospitalization of patients. Notably, a history of relapse is a strong indicator of future relapses and poorer outcomes. According to the literature, relapse rates might be higher in men compared to women due to better response to medication in women. Cariprazine (CAR), a D3-D2 partial agonist, has shown effectiveness in preventing relapse compared to a placebo in stabilized schizophrenia patients

We aimed to investigate whether there is a difference in the efficacy of CAR in preventing relapse by sex.

A post-hoc analysis was conducted on data from a multicentre, randomized, double-blind, placebo-controlled, parallel-group study lasting approximately 96 weeks in adults with schizophrenia. The study included two phases: a 20-week open-label treatment phase and a double-blind treatment phase lasting up to 72 weeks. During the open-label phase, patients were stabilized on CAR at doses of 3.0-9.0 mg/day. Subsequently, they were randomized to either continue CAR (at fixed doses of 3.0, 6.0, or 9.0 mg/day) or switch to a placebo (PBO). Relapse was defined by a worsening of symptom scores on the Positive and Negative Syndrome Scale (PANSS), psychiatric hospital admission, aggressive behaviour, or suicide risk. In this analysis, patients were separately analysed based on their sex. Baseline characteristics, hazard ratios by sex during the double-blind phase were calculated.

Of 200 patients, 132 (66%) were male (M) and 68 (34%) were female (F). In the female group, 57% were receiving CAR treatment, while in the male group 47% were on CAR. The mean age of the patients was between 36-41 years. The open-label baseline PANSS scores were comparable. The adherence of patients during the double-label phase was similar in all four groups (98-99%).

More relapses were documented in the placebo groups (M: 47%, F: 48%) than in the CAR groups (M: 27%, F: 21%). In females, those who received CAR during the double-blind phase had 66% less risk for relapse (HR=0.34, 95%CI= 0.14-0.82) than those who were on placebo. Similarly, male patients on cariprazine had 49% less risk for relapse (HR=0.51, 95%CI= 0.28-0.91) than those receiving placebo. The Cox regression analysis between groups showed that sex of patients did not affect the risk of relapse significantly.

In summary, sex does not seem to significantly influence risk of relapse. CAR decreases the risk of relapse compared to placebo in both males and females.

C. Correll: None Declared, Z. Dombi Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., P. Herman Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., Á. Barabássy Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine.

While many evidence-based mental health prevention, promotion, and treatment interventions exist, they are poorly and inequitably scaled across populations. Too often, research produces interventions and implementation strategies that are difficult to scale due to misalignment with culture, policy, system, community, provider, and individual realities. This presentation will introduce the Lancet Psychiatry Commission on Transforming Mental Health Implementation Research, which makes five recommendations to transform the research enterprise to produce more actionable evidence and address the mental health implementation gap. These recommendations focus on strategies for integrating research and real-world implementation; centering health equity in mental health intervention and implementation research; using a complexity science lens to study strategies for scaling effective interventions; expanding research designs beyond the traditional randomized clinical trial; and using transdisciplinary approaches. The Commission also made cross-cutting recommendations related to elevating work on mental health systems and policy and the importance of strengthening mental health implementation research globally.

None Declared

In this presentation, I will explore how the exposome paradigm can be leveraged to advance clinical practice in psychiatry. Specifically, I will highlight the potential of cumulative environmental risk scores to predict outcomes in severe mental disorders, such as the exposome score for schizophrenia (ES-SCZ).

Numerous socio-environmental factors have been linked to mental disorders, including childhood adversities, stressful life events, substance use, obstetric complications during pregnancy and childbirth, and urban living. Environmental factors do not exist in isolation; they form complex networks of interrelated and interactive elements. In this regard, the exposome represents the totality of an individual’s environmental exposures throughout their lifetime. The exposome framework introduces a holistic approach to embrace this complexity and a theoretical framework to investigate the poly-gene and poly-environment etiology of psychiatric disorders.

Guided by the exposome framework, we have recently estimated the ES-SCZ, a cumulative environmental exposure score for schizophrenia, including cannabis use, winter-birth, hearing impairment, bullying, and five domains of childhood adversities (emotional and physical neglect, along with emotional, sexual, and physical abuse). The ES-SCZ successfully differentiated individuals with schizophrenia, accounting for 28% of the variance in an independent case-control sample. Subsequently, we have tested the risk stratification properties and the predictive performance of the exposome score for schizophrenia in the general population. The ES-SCZ had strong discriminative performance for schizophrenia (AUC = 0.84) and was associated with the degree of psychosis risk in the general population. Finally, we tested the performance of ES-SCZ for dissecting the functional and symptomatic outcome heterogeneity in patients with psychosis in four different cohorts (EUGEI, GROUP, Athens FEP, and HAMLETT-OPHELIA). ES-SCZ was associated with poor overall functioning and cognitive impairment at baseline and follow-up visits. ES-SCZ was also temporally associated with poor symptomatic improvement from baseline to follow-up assessments, particularly the negative symptom dimension. Furthermore, models that included the polygenic risk score for schizophrenia and clinical features showed that the relationship between ES-SCZ and functional outcomes cannot be explained by genetic or clinical risk factors alone.

Overall, our findings demonstrate the potential benefits of the exposome score for schizophrenia, which can be integrated for early detection, outcome prognostication, clinical staging, and risk stratification in the future.

None Declared

Psychiatric hospitalization to manage acute symptoms of mental disorders in children and adolescents may be necessary, although there is a growing concern about the clinical and economic effectiveness of psychiatric admission in this population. This suggests the need for the implementation of new intensive family and community care models that would reduce hospitalization.

Home hospitalization provides an opportunity to offer the child or adolescent with intensive treatment within the infrastructure of their home and the supervision of their family or primary caregivers. It therefore requires fewer resources than traditional inpatient treatment while allowing the patient‘s immediate environment to be involved in the treatment, potentially reducing the risk of a failed transition to the home once the patient is discharged.

The main objective is to analyze the cost-effectiveness of two Mental Health Home Hospitalization interventions for adolescents as an alternative to traditional hospitalization in two hospitals in Madrid, Spain (La Paz University Hospital and Principe de Asturias University Hospital).

This is a quasi-experimental pre-post intervention study that examines two models of Mental Health Home Hospitalization as an alternative to full hospitalization. It will analyze various outcome variables, including clinical, functioning, satisfaction, quality of life, and costs /use of clinical resources.

Participants must be adolescents and young adults aged 12 to 18 years (inclusive), who present a psychiatric decompensation requiring an intensity of care similar to that provided in the hospital. Assessments, including CGI, HoNOSCA, C-SSRS, CSQ-8, EQ-5D-Y, will be conducted at the baseline visit, and at the end of the treatment. Resource use and costs will be recorded at the baseline and six months after the treatment.

Home-based mental health hospitalization for adolescents is an emerging area of interest in the treatment of acute symptoms of mental disorders in this population, but there are not standard protocols for such interventions. Several issues remain to be clarified, including the care pathways for adolescents in crisis who require hospital care and whether organizational differences between interventions impact the outcomes.

None Declared

Excessive preoccupation of having a serious illness (EPHSI) or illness anxiety disorder is frequently reported by doctors and medical students

Our objectives were to estimate the frequency of EPHSI in a population of medicine residents in Tunisia and to determine the factors associated with this pathology.

This was a cross-sectional study via internet, carried out among 404 medicine residents practicing in Tunisia during the period of November and December 2020 and January 2021.

The information was collected using a pre-designed questionnaire, edited using the Google site and disseminated via social networks. This questionnaire was inspired by the Health Anxiety Questionnaire, the MSD score, and the DSM-5 criteria for illness anxiety disorder

In the end of the study period, 404 medicine residents responded to the questionnaire. The mean age was 27.4 years, the sex ratio was 0.47. Residents who fulfilled the DSM5 criteria of anxiety illness disorder represented 33.7% of the total group.

The most preoccupying diseases were neoplastic diseases (40.8%), neurodegenerative disorders (14.3%), and psychiatric disorders (10%).

EPHSI was associated to several sociodemographic, anamnestic and psychological factors

The establishment of psychological support systems for students, emphasizing coping and stress management techniques, should be implemented to prevent the EPHSI.

None Declared

Patients with bipolar disorder (BD) and major depressive disorder (MDD) face an elevated risk of early mortality from various physical illnesses, particularly cardiovascular disease (CVD). However, it remains uncertain whether depressive or manic symptoms contribute more significantly to CVD outcomes.

This study aimed to assess the association between manic and depressive symptoms and long-term CVD risk factors.

A retrospective study was conducted on patients hospitalized in the female unit of psychiatric department “B” in Sfax, Tunisia, between January and June 2023. Sociodemographic, clinical, and CVD risk factor data were collected from medical records to calculate Framingham Scores. The relationships between mood symptoms (depressive and manic) and Framingham scores, as well as individual CVD risk factors (lipids, blood pressure, BMI, smoking, and fasting glucose), were analyzed.

The study included 50 female patients with a mean age of 45 years (SD = 9.9). Of the patients, 18% were diagnosed with MDD, while 82% were diagnosed with BD; 64% were admitted for manic symptoms, and 36% for depressive symptoms. Clinical obesity was observed in 64% of patients, with 60% diagnosed with hyperlipidemia, 34% with hypertension, and 26% with type 2 diabetes. Notably, 12% of patients had a Framingham score of ≥ 10%, indicating a moderate to high 10-year risk of CVD. Bivariate analysis revealed that patients with manic symptoms had a significantly higher CVD risk than those with depressive symptoms (p=0.034). Manic symptoms were also significantly associated with elevated BMI (p=0.034), fasting glucose (p=0.039), and blood pressure (p<0.001).

This study demonstrates a strong association between manic symptoms and long-term CVD risk in patients with mood disorders, particularly with elevated blood pressure, glucose levels, and BMI. These findings underscore the importance of specific monitoring and intervention programs for CVD risk factors in patients with mood disorders, especially those with BD.

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Autism Spectrum Disorder is characterized by persistent deficits in communication and social interaction in multiple contexts, including deficits in social reciprocity, in nonverbal communication behaviors used for social interaction and in skills to develop, maintain and understand relationships,in addition to repetitive patterns of activity. Individuals with Autism Spectrum Disorder (ASD) present a wide variety of cognitive profiles, with levels of symptom severity that differ between those with the same diagnosis. In language development, there are individual differences, both in the acquisition process and in speed and quality. Sleep is an important parameter for child development and its relevance has been associated with healthy physical, cognitive and behavioral development, as well as cognitive functions in children and adolescents. Researchers estimate that between 40% and 80% of children with ASD have sleep disorders.

To relate sleep disorders frequently present in cases of ASD to delays in language development in children with ASD.

The research was approved by the USP ethics committee. To investigate sleep disorders, the Cognitive Speech Therapy Protocol aimed at ASD was used, an accessible and understandable instrument for parents or guardians. To identify language disorders, the ADL2 Language Development Assessment was used. 40 parents and/or guardians of children with ASD, aged between 2 and 12 years, participated in the research. A logistic regression analysis was performed to evaluate the relationship between sleep disturbances and language delay in children with ASD. The sample included 32 children, 28 of whom reported sleep disorders and all of whom had language delays

The results showed that children with sleep disorders are 2.3 times more likely to have delays in receptive and/or expressive language compared to those without sleep disorders. This association is statistically significant, indicating that sleep disorders are a relevant risk factor for language delays in children with ASD.

Sleep disorders can impact the development of expressive language in several ways, such as by reducing the time available for language and interaction practices or by direct effects on cognitive and neurological processes. Therefore, sleep quality should be considered an important factor to be addressed to improve both receptive and expressive language in children with ASD. Therefore, sleep quality should be considered an important factor to be addressed to improve both receptive and expressive language in children with ASD.

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Severe personality disorders have a significative impact not only on patients but also among their families, causing emotional distress and relevant burden related to care giving. Psycho-educational intervention targeting family members can improve their understanding of the disorder and their ability to cope with symptoms.

Forlì Mental Health Centre multi-professional team undertake this study with the scope to evaluate the efficacy of a nine sessions’ psycho-educational program targeting a group of family members, based on the dialectical behavioral therapy (DBT) principles and skills.

12 participants completed the program and filled self report questionnaires administered at the first (t0) and ninth (t1) session: Symptom Checklist - 90 (SCL-90) and Zarit Burden Interview (ZBI). They also answered a qualitative format investigating their subjective experience.

Results at baseline (t0) indicate high scores on the SCL-90 subscales such as Somatisation (mean = 1,21; st. dev = 0,91), Depression (mean = 1,08; st. dev = 0,86), Sleep disturbances (mean = 1,39; st. dev = 1,03).

Statistical analysis suggest an increase of SCL-90 subscales, at the end of the program (t1), such as Somatisation (mean = 1,38; st. dev = 0,85), Obsessions and compulsions (mean = 1,19; st. dev = 0,78), Depression (mean = 1,40; st. dev = 0,93), Paranoia (mean = 0,93; st. dev = 0,78), Sleep disturbances (mean = 2,18; st. dev = 1,03). ZBI questionnaire total scores indicate an increase of perceived caregiving burden(mean = 42; st. dev = 24,7). Qualitative indicators were administered at the end of the program showing a general satisfaction for the intervention described as “useful”, “important”, “helpful”, “comforting”. The most liked session was the one about “validation” skill.

Despite the perceived psychological distress and burden’ increase, participants have intended the psycho-educative program as useful and worth it. Results suggest that their learnings may be paired with complementary skills and their generalization to enable a significative reduction of psychological impact of caregiving. Future development will include a follow up session to explore this possibility.

None Declared