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.

None Declared

Although criminal behavior is not expected in the elderly, especially those diagnosed with dementia, it is important to keep in mind the potential forensic significance of dementia. Also it is especially important to focus attention on the participation of people with dementia in the legal process, given that their cognitive impairments may impair their ability to participate in the judicial process, as well as their capacity to protect their rights and interests.

The aim of the study is to provide an overview of the forensic meaning of dementia and the assessment of persons with a diagnosis of dementia in a legal context.

For the purpose of the research, a review of relevant studies in the PubMed database was performed, related to the field of forensic psychiatry of offenders diagnosed with dementia and criminal behavior of the elderly.

During the forensic assessment of people with dementia, it is important to assess their cognitive impairment, for which purpose various psychological tests and diagnostic processing are applied in addition to diagnosing other comorbid diagnoses, especially depression or the existence of a psychotic disorder. In dementia, an important criminogenic factor can be the use of alcohol, along with the potential for committing violent crimes.

Depending on the severity of cognitive impairment and the existence of psychotic symptoms or a delirious state, the legal capacity of people with dementia can be significantly impaired. It is important to assess the need for security measures of psychiatric treatment, as well as the possibility of participating in the court process with regard to cognitive impairment. It is also necessary to pay attention to the protection of the rights and interests of people with dementia, as well as the ability to reason.

None Declared

Eating disorders are life-threatening. They affect both physical and mental well-being, specially among young adults in high-stress environments such as military training.

Bulimia Nervosa (BN) is characterized by binge eating and inappropriate compensatory behavior to control weight with potentially dangerous sequelae.

Early recognition is essential to optimise treatment management.

This study sought to determine the prevalence of Bulimia Nervosa, its symptoms and its severity, among military nursing students in Tunisia.

Between March and May of 2024, a cross-sectional descriptive survey was conducted for nursing students at the Tunisian Military Health School. Data were gathered using a data file and a self-report questionnaire: Bulimic Investigatory Test, Edinburgh (BITE). The BITE is designed to identify binge eating and compensatory behaviors, providing information on cognitive and behavioral aspects of bulimia nervosa. The scores are classified into two subscales: symptoms and severity. Excel software was used to analyze the obtained data.

The study enrolled 148 nursing students with 57.4% male. The average age was 21.3 [19-24] years. Among our participants, 57.4% came from northern Tunisia. Of them, 48.6% were in their third year and 19.6% in their second one. Of the surveyed, 85.1% were in a middling socioeconomic position followed by 9.5% in a high one.

With an average weight of 75.1±14.8 [48-105]kg, 47.3% weighed more than 70kg with 4.05% between 90kg and 100kg and 2.02% exceeding 100kg. Of the students, 67.56% were taller than 1m70. The average Body Mass Index BMI was 23[17-32]. Around 71.6% had a normal BMI, while 24.32% were overweight[BMI:25-30], and 1.35% were obese[BMI>=30].

In terms of physical appearance, 89.9% expressed satisfaction with their bodies’ looks and 67.6% with their weight. Growing up, 73.6%(N=109) did not have any weight issues while 8.1%(N=12) reported they were obese.

Prior to completing the BITE, 57.4% said they had no eating disorders while 18.2% estimated they had BN.

Of the surveyed, 83.3% expressed dissatisfaction with school meals mainly due to insufficient quantity, poor quality, or tasteless food.

According to the study, the BITE’s average score was 8±6 [0-34]. Of the participants, 17.5%(N=26) had Bulimia Nervosa with a BITE score of 20 or above. The majority (76.92%,N=20) were female with one reported severe case; their average BITE’s score was 23±15 [1-32]; the male’s BITE average score was 20±9 [0-34].

Furthermore, according to the survey results, students suffering from BN had a BMI of 29±5 [weight:81±11kg] whereas those without eating disorders had a BMI of 25±3 [weight:69±12kg].

This study highlights the remarkable prevalence of Bulimia Nervosa among Tunisian military nursing students underscoring the urge to pay attention to early symptoms for better targeted interventions and mental health promotion.

None Declared

Tele-rehabilitation (Tele-TR) has emerged as a promising alternative to traditional, in-person cardiac rehabilitation (Conventional-CR), offering accessible and convenient rehabilitation options for patients who may face logistical or health-related barriers to attending conventional programs. Advances in digital health technologies, coupled with the increasing demand for remote healthcare solutions, have led to the widespread adoption of Tele-TR, particularly for patients recovering from cardiac events or undergoing surgery. However, there is a need for a comprehensive evaluation of the comparative effectiveness of Tele-TR versus Conventional-CR, especially in terms of clinical outcomes. Given the rise in mental health concerns among patients undergoing cardiac rehabilitation, the impact of these rehabilitation modalities on psychological well-being, particularly depressive symptoms, has become an important area of focus.

This meta-analysis aims to evaluate the efficacy of Tele-TR in comparison to Conventional-CR, specifically assessing their effects on depressive symptoms. The primary objective is to determine the mean differences in health assessment scores, such as the PHQ-9, across studies that compare Tele-TR and Conventional-CR. By synthesizing the findings from multiple randomized controlled trials (RCTs), this analysis will provide insights into the relative effectiveness of these two rehabilitation approaches, with a particular emphasis on mental health outcomes and their implications for patient recovery and quality of life.

Three studies were included, comparing Tele-TR with Conventional-CR. Outcomes were assessed based on mean differences (MDs) and 95% confidence intervals (CIs) for continuous data. Heterogeneity among studies was quantified using Tau² and I² statistics, and a random-effects model was employed to account for variability across studies.

The analysis of post-treatment improvement in PHQ-9 scores across included studies demonstrated an overall mean difference of -1.94 (95% CI [-4.02; 0.15]), suggesting a trend favoring Tele-TR over Conventional-CR. However, this improvement did not reach statistical significance (Z = -1.82, P = 0.07). High heterogeneity was noted (Tau² = 3.36, I² = 100%, P < 0.01), indicating substantial variability in treatment effects among studies.

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While Tele-TR showed a trend toward improvement over Conventional-CR, the findings did not achieve statistical significance. High heterogeneity suggests differences in study design and patient populations, warranting further research to clarify the potential benefits of Tele-TR and identify the contexts where it may offer the most significant advantages.

None Declared

For over 50 years, there has been based on Vladimir Hudolin method a family preventive program for the addicted of psychoactive substances and actions (Zoricic 2006; 42(1) 35). Family therapeutic communities (family sobriety clubs) exist in many countries in Europe and the world, in Russia there are over 50 clubs. In Russian clubs, a change in the lifestyle of rehabilitants is accompanied by a transformation of value systems and semantic formations into traditions of religious worldview.

To study the dynamics of changes in value systems and religious beliefs among family sobriety club members during rehabilitation, which includes a spiritually-oriented component.

50 Russian patients with alcohol addiction who participated in rehabilitation in a community setting were examined: 25 (“participants” group) - with remission from several months to two years, 25 (“leaders”) – with remission over two years were also the heads of family sobriety clubs. There were used psychometrical (Schwartz Value Survey – SVS, Religions Orientation Scale - ROS) and statistical methods.

Leading values among “participants” are “kindness”, “safety” and “conformality”, the most significant values among “leaders” are “kindness”, “traditions” and “universalism” (р<0,05). Benchmarking: self-transcedence values prevail among “leaders”, high levels of self-raising among “participants”. Analysis of variance (ANOVA): increasing the significance of values of kindness (p = 0.025) and tradition (p = 0.009) at the level of ideals, tradition (p = 0.0003) and safety (p = 0.04) at the level of priorities at remote stages of rehabilitation. The cohesion of values among “leaders” is higher than among “participants” (conformity (p = 0.03) and kindness (p = 0.09)). Over time a detailing of spiritual ideas takes place, rehabilitants identify themselves as believers and aim to change their lifestyle according to religious Faith values. According to ROS, there is a more meaningful religiosity among “leaders” than among “participants,” the predominance of internal religiosity over external religiosity at long stages of assistance.

Change in value orientations correlates with the duration of rehabilitation, their greater cohesion is noted, values are more consistent with the normative for the population as a whole. Religious idias become more harmonious, a transformation of dysfunctional manifestations of external religiosity into adaptive forms of internal religiosity is noted, which is associated with the increase of overall meaningfulness of life.

None Declared

Major Depressive Disorder (MDD) is a prevalent mental health condition that significantly impairs daily life and increases suicide risk. Selective serotonin reuptake inhibitors (SSRIs), such as paroxetine, are widely prescribed due to their efficacy and favorable safety profile. However, SSRIs can impact glucose metabolism, leading to both hyperglycemia and hypoglycemia, particularly in diabetic patients.

In rare instances, SSRIs have induced hypoglycemia in non-diabetic individuals. Paroxetine, known for its strong inhibition of serotonin reuptake, has been implicated in cases of hypoglycemia, though the precise mechanisms remain unclear.

With the present report, we examined wheter the hypotesis that paroxetine induces hypoglycemia is valid.

This case report discusses an episode of paroxetine-induced hypoglycemia in a 60-year-old female, non-diabetic patient with a history of MDD.

The patient was admitted to our in-patient psychiatric unit due to worsening depressive symptoms and recurrent episodes of sweating, dizziness, tremors, and loss of consciousness, suggestive of hypoglycemic crises. Over the previous three years the patient had been on paroxetine 40 mg/day, thus the drug was suspected as a potential cause of these hypoglycemic episodes and it was discontinued whereas fluoxetine and trazodone were administered. By discharge, her depressive symptoms and insomnia had improved significantly

This case highlights the potential for SSRIs, particularly paroxetine, to induce hypoglycemia even in non-diabetic patients. Although hypoglycemia is typically linked to diabetic treatments, this case demonstrates that antidepressants can also play a role in disrupting glucose regulation. In this case, the symptoms subsided after the discontinuation of paroxetine, strongly suggesting its role in the hypoglycemic episodes, as supported by a "probable" causality score on Naranjo’s scale. Given the nonspecific nature of hypoglycemic symptoms and the risk of misdiagnosis as psychiatric or somatic conditions, it is crucial for healthcare providers to consider medication-related causes. This report underscores the importance of monitoring glycemic levels in patients on SSRIs, particularly when presenting with atypical symptoms. Increased awareness can help prevent misdiagnosis and facilitate timely intervention to avoid severe complications.

None Declared

Institute of Mental Health (IMH) is the only tertiary psychiatric hospital in Singapore and does not provide acute medical care. The on-call doctors, who are Advanced Cardiac Life Support (ACLS) certified, respond to medical emergencies. Resuscitation skills are expected to decay with time when not used frequently and thus can pose an important challenge to maintain the doctors’ skills in settings with low volumes of code blue situations (Au et al. Resuscitation 2009;138:284-296). Our code blue aduits revealed significant competency gaps. IMH introduced a biannual resuscitation training program which includes a video demonstration of the optimal code blue response, hands-on session to review airway management techniques, operation of the defibrillators used in IMH, recognition and management of cardiac arrest rhythms including a pre-course ECG worksheet, familiarisation with the emergency drugs used in IMH, and a code blue drill. Due to COVID-19, the original course was shortened by removing the video demonstration and code blue drill, augmenting the home-based question paper with IMH-specific clinical vignettes.

We aimed to determine the common conditions resulting in code blue activations and whether the modified course was equivalent to the original course or ACLS in maintaining resuscitation currency and doctors’ confidence in responding to emergency scenarios.

Data was collected from June to August 2023 with consent via an electronic feedback form, to reduce non-response bias, from doctors who have responded to code blue activation in IMH. Qualitative justification on the responses were collated. Efforts were made to collect at least 25 responses from doctors with different levels of experience to minimize sampling bias. Surveys were anonymised, questions were vetted by 2 senior doctors and the survey was kept short to reduce response bias. Binary responses were tabulated for analysis and content analysis was done for feedback obtained.

Of 28 respondents, most were Psychiatry trainees (60.7%) with 1-2 years of experience working in IMH (36.7%) and more than 30 overnight duties (53.6%). The most commonly encountered emergency scenarios were hypotension (31%) and desaturation (20%). 92.9% of participants agreed that the modified course was useful for emergency scenarios faced. 53.6% of participants attended both the full and modified course, amongst whom, 60% reported that the modified course was equivalent to the full course. Only 50% felt that ACLS alone would suffice. Qualitative feedback obtained from participants reiterated that it was a context-specific and timely refresher course.

IMH doctors were satisfied with the modified resuscitation course and found it effective for frequently encountered emergency scenarios suggesting it as a valuable training adjunct in low code blue volume settings.

None Declared

Major depressive disorder (MDD) is a severe mental disorder with a prevalence rate of 10%. Approximately 30-40% of patients suffering from MDD show higher levels of proinflammatory cytokines, associated to low response to pharmacotherapy. Thus, modulation of immune system might have a key role in the management of MDD.

This study is aimed to: 1) assess the interrelation between immune hyperactivation and neuronal plasticity; 2) assess how non-pharmacological treatments impact on the immune hyperactivity in patients suffering from MDD; 3) identify biological makers able to predict the course of MDD and the effectiveness of treatments.

Immune4Plasticity is a longitudinal, multisite trial funded by Italian Ministry of Health. Preclinical analyses aimed at investigating the interrelation between immune hyperactivation and neuroplasticity as well as the identification of biological markers of MDD will be carried out at National Institute of Health in Rome. Clinical part of the study will be performed at the Department of Psychiatry of University of Campania, Naples, and at the Vita-Salute San Raffaele University, Milan. Seventy patients aging 18-65, with a diagnosis of MDD according to the DMS-5 criteria without psychotic symptoms, scoring more than 14 at the 17-item Hamilton Depression Rating Scale and able to release informed consent will be included. Thirty-five participants will attend a lifestyle psychosocial intervention in Naples; thirty-five will undergo light-therapy sessions in Milan. Assessments of both groups will be performed at recruitment (T0), after 3 months (T1) and after 6 months (T2), by using standardized psychometric tools and blood samples. The project will be carried out for 24 months.

This multidisciplinary, translational study will shed more light on the complex interrelationship between MDD, immune system and neuroplasticity by investigating the role of psychosocial intervention and light therapy as ‘modulators’. This will make it possible to develop innovative therapeutic strategies by integrating non-pharmacological approaches with anti-inflammatory drugs and to identify new peripheral markers to assess the response to treatment of patients with MDD.

MDD is a complex mental disorder associated with higher expression of inflammation. Sometimes, it is not adequately responsive to pharmacotherapy. Understanding the effect of non-pharmacological treatments as “modulators” of the inflammatory pattern of MDD may be an important strategy to optimize clinical management of this disorder.

None Declared

Lumateperone, an atypical antipsychotic drug, has a dual mechanism of action by combination of activity at central serotonin (5-HT2A) and dopamine (D2) receptors.

This subgroup analysis of an Indian Phase 3 study was conducted to evaluate the efficacy and safety of Lumateperone 42mg compared to Quetiapine 300mg in treatment of Bipolar II depression when stratified based on prior hypomanic episodes.

The phase-III, randomized, multi-centric, assessor-blind, parallel-group, active-controlled, comparative, non-inferiority study included Indian patients with Bipolar II depression with moderate severity having a Montgomery-Asberg depression rating scale (MADRS) score ≥20 and Clinical global impression–bipolar version–severity (CGI-BP-S) score ≥4. The study was conducted after receiving regulatory and ethics committee approvals. The patients were randomized (1:1) to either receive Lumateperone 42mg [Test] or Quetiapine 300mg [Comparator] for 6 weeks. The patients were stratified based on number of prior hypomanic episodes in lifetime: Subgroup 1 [S1]: 1 episode and Subgroup 2 [S2]: >1 episode. For efficacy outcomes MADRS score, CGI-BP-S (total score, depression subscore and overall bipolar illness subscore), and Quality of life enjoyment and satisfaction-short form questionnaire (Q-LES-Q-SF) score were evaluated and for safety outcomes treatment emergent adverse events (TEAEs) were assessed. [Clinical trial registration: CTRI/2023/10/058583]

This subgroup analysis included 462 patients, out of which 251 in S1[Test=129; Comparator=122] and 211 in S2[Test=102; Comparator=109]. The baseline demographic characteristics were comparable in between treatment arms across subgroups. The primary endpoint of reduction in MADRS score from baseline to Day 42 in Test arm was non-inferior to Comparator arm in both subgroups [Figure 1] as the upper 95% CI was below the pre-defined margin of 3.0. The reduction of CGI-BP-S (total score, depression subscore and overall bipolar illness subscore) from Day 14 to Day 42 were comparable in both Test and Comparator arms in both subgroups. The improvement in Q-LES-Q-SF score from baseline to Day 42 were comparable in both Test and Comparator arms in both subgroups. The incidence of TEAEs were similar in both treatment arms [S1: Test=37.2% and Comparator=35.2%; S2: Test=31.4% and Comparator=35.8%] and no serious adverse events were reported.

Image 1:

This subgroup analysis demonstrated that Lumateperone 42mg is non-inferior to Quetiapine 300mg in treatment of Bipolar II depression as assessed via MADRS score from baseline to Day 42, irrespective of number of previous hypomanic episodes and both treatments were found to be well tolerated.

A. Dharmadhikari: None Declared, P. Chaurasia: None Declared, Y. Patel: None Declared, D. Choudhary: None Declared, P. Dasud: None Declared, M. Bhirud: None Declared, P. Meena: None Declared, F. Shah: None Declared, G. Ganesan: None Declared, B. P. Rathour: None Declared, K. Mistry: None Declared, M. Dutta: None Declared, A. Ramaraju: None Declared, S. Mangalwedhe: None Declared, S. G. Goyal: None Declared, G. Kulkarni: None Declared, A. Mukhopadhyay: None Declared, P. Chaudhary: None Declared, G. T. Harsha: None Declared, M. Parikh: None Declared, S. Dey: None Declared, S. Sarkhel: None Declared, N. Jyothi: None Declared, A. Kumar: None Declared, N. Sooch: None Declared, A. Shetty Employee of: Sun Pharma, S. Saha Employee of: Sun Pharma, P. Devkare Employee of: Sun Pharma, A. Shetty Employee of: Sun Pharma, D. Patil Employee of: Sun Pharma, P. Ghadge Employee of: Sun Pharma, A. Mane Employee of: Sun Pharma, S. Mehta Employee of: Sun Pharma.

Studies on the psychological impact of a vegan diet and its effect on mental health are still, although the interdisciplinary literature points to significant diet-related cognitions associated with the active choice of a plant-based diet. This study addresses this research gap by framing veganism as an identity-associated aspect of self-concept in young vegans and examines the influence of self-esteem resulting from the vegan diet on symptoms of unipolar depression in a biopsychosocial framework model.

veganism as an identity-associated aspect of self-concept

influence of self-esteem resulting from the vegan diet on symptoms of unipolar depression

alternative perspective on the connections between psyche and nutrition

In a representative sample of n = 659 students from German universities, the absolute and additional influence of diet-related self-esteem on depressive symptoms was investigated using hierarchical regression, taking biopsychosocial covariates into account.

It was found that the self-esteem experience of the test subjects specifically gained from the vegan diet exerts a statistically significant influence on depressive symptoms (B = - 37, SE(B) = 0.02, p <.001) and can also explain a statistically significant additional proportion of the total variance in a biopsychosocial model of depression (ΔR2 = .18, F [1,649] = 272.34, p <.001). Together, the model of eight covariates and nutrition-related self-esteem can explain 57% of depressive symptoms (R2 = .57, F [9,649] = 94.81, p < .001¸ f2 = 0.13). This statistically significant influence of diet-related self-esteem also persists in an exploratory study of different severity levels of depressiogenic distress

The results provide evidence of a psychological impact factor in relation to a vegan diet and identify psychological consequences and thus open up a new research perspective in clinical psychology.

None Declared

Aripiprazole monthly (Ar1M) has been the first long-acting injectable (LAI) partial agonist antipsychotic. The benefits of long-acting injectables in terms of relapse reduction are well known.

The aim of this study is to assess the level of acceptance and the doubts presented by patients before switching to 2-monthly Aripiprazole (Ar2M).

25 patients diagnosed with schizophrenia and related disorders in symptomatic remission were asked consecutively whether they would switch to the new bimonthly formulation of aripiprazole and the doubts expressed were collected.

The sample is composed of 25 patients (12 women and 13 men). The mean age is 52.64 years. All are being treated with Ar1M with a mean dose of 408 mg/monthly. Most of the patients present a diagnosis of affective psychosis (N=12 (42%)), 36% a non-affective psychosis (N=9) and 16% a delusional disorder (N=4). Presenting an average of 3.8 previous admissions.

Acceptance was mostly positive, with an initial acceptance rate of 76 % (N=19). Twelve percent (N=3) did not initially want the treatment. Another 12% had doubts and preferred to postpone the decision. 20% of the patients had doubts, related to possible appearance of side effects. 75% of the patients who do not want the treatment have doubts, as do the patients who prefer to wait. Of the patients who initially accepted the treatment, only 1 expressed doubts about it.

The level of acceptance of Ar2M is very high, exceeding 75%. Of the doubts expressed about the possible change, the appearance of side effects is a matter of concern. Given the high level of acceptance, the treatment proposal is important given the wide-ranging benefits it can bring to patients. The clarification of doubts and the successive proposals of the treatment can contribute to a greater acceptance.

None Declared

Neuromodulation technologies became the safe and effective alternative to treat psychiatric and neurological disorders. The current evidence from the up-to-date state in vagus nerve stimulation application in studies of emotional state modulation demonstrates a strong impact of vagus stimulation on the state of patients with a range of disorders. The normalizing effect of vagus nerve stimulation on abnormal sympathetic nerve activity may explain the beneficial effect on burnout, which is thought to be a manifestation of decreased vagus-mediated heart rate variability (HRV) under everyday stress.

Considering all of the above, we aimed to explore the influence of a novel VNS stimulation protocol on emotional state, as well as highlighting specific features of the activation-related neurodynamics and the effects on HRV time, frequency and non-linear metrics.

11 right-handed male volunteers aged 18-22 years participated in the 1st (EEG) study (6 persons-taVNS group and 5-SHAM) and 62 healthy volunteers 18-49 years old were recruited for 2nd (HRV) study (26-VNS group and 22–Sham). We used the combination of pleasant meditative classical music and a slow bi-polar wave of electrical non-invasive transcutaneous stimulation of auricular area (BrainPatch platform for non-invasive stimulation). Vagus nerve stimulation was arranged as a 4-day course. Psychological testing (State Anxiety, STAI; psychological stress level, PSM-25; severity of emotional burnout, MBI; depression, IDS) was carried out.

Non-invasive stimulation was rated by the participants as a positive experience. We detected beneficial changes in the psychoemotional state of the respondents (improvement of mood, reduction of job related stress – emotional burnout). The increase of vagally mediated parameter RMSSD and decrease of LF/HF ratio has reflected the activation of parasympathetic nervous system (PNS) during stimulation. HRV effects of VNS turned out to be short-term, which was manifested in a drop in the value immediately after the stimulation. EEG analysis indicated a long-term effect of VNS. Increased alpha and beta rhythms (generalized growth in the frontal and posterior cortex) and gamma activity (frontal region) after a series of 4 VNS sessions may indicate the improvement of mental processes and creative thinking (attention, information processing and memory storage). Enhanced activation level was mirrored in an increased beta/alpha ratio.

Our data suggests that VNS has a normalizing effect on the psychoemotional state shifting “sympatho-vagal balance” to the functional optimum. EEG data showed the prolonged stimulating effect on the brain processes related to the cognitive functioning while attenuating the stress impacts at the same time.

None Declared

There can be a considerable mental health burden to living with diabetes. Health behaviours are modifiable factors that influence mental health in the general population. However, despite the centrality of health behaviours to diabetes management, there are significant gaps in our understanding of their longitudinal impact on mental health in people with diabetes.

This scoping review aimed to synthesise the longitudinal evidence from observational and intervention research on the impact of health behaviours on mental health and related psychological factors in people with type 1, type 2, and gestational diabetes.

PubMed, PsychINFO, Embase, CINAHL, and PsycArticles were searched for intervention and observational studies examining the effect of health-promoting, health-risk, or diabetes-specific health behaviours on aspects of mental health, diabetes distress, and quality of life, in people with all types of diabetes. Abstracts, titles, and full texts were screened by two independent reviewers.

In total, 100 relevant studies were identified, including 29 observational studies and 71 intervention studies. Studies had a mean follow-up time of 12.9 ± 17.8 months. The health behaviours investigated in the included studies were adherence, alcohol, carbohydrate-counting, diet, diet and exercise combined, exercise, fasting, medical visits, sleep, self-monitoring blood glucose, smoking, and weight. The review identified knowledge gaps surrounding diabetes-specific behaviours, behaviour interactions/clusters, sleep, sedentary behaviour, screen-time, gestational diabetes, mood and ecologically valid and objective measurements. Exercise was the most freqently investigated health behaviour and also the most likely to be found to have a mental health promoting impact.

Findings suggest that health-promoting behaviours influence mental health in people with diabetes. There is less conclusive evidence regarding the impact of health-risk or diabetes-specific health behaviours. In particular, a broad range of physical activities may improve mental health and wellbeing in people with diabetes.

None Declared

Internet gaming addiction (IGA) can have a significant impact on the characteristics of individual gamers, and may even be a contributing factor to the development of social anxiety symptoms. This study of adolescent Saudi Arabian Internet gamers examined the influences of Internet gaming time and probable Internet Gaming Disorders (IGDs). It investigated the association between Internet game addiction and social anxiety symptoms among them.

The aim of this study was to investigate the association between internet game addiction and social anxiety symptoms among Saudi adolescents. Since very few researches examined the association between internet game addiction and psychiatric illnesses among Saudi youth, Our study focused on social anxiety symptoms which has not been done so far.

A cross-sectional, survey was conducted from March to June of 2023 among adolescents in the Saudi population. Probable Internet Game Addiction was measured by using the DSM-5 checklist and the Arabic version of the Social Phobia Inventory (SPIN) was used to evaluate social phobia or anxiety.

A total of 764 participants were enrolled in the current study, majority of gaming addiction participants were 15-16 years old. There was a significant association between gender and gaming addiction (p-value ≤ 0.05). 86.6% of Saudis have been significantly associated with gaming addiction. The majority of the participants have moderate social phobia compared to severe social phobia. There was a significant association between social phobia and age (p-value ≤ 0.05). 34.9% of male participants have moderate social phobia and 24.6% of females have moderate social phobia. There was an insignificant association between social phobia and nationality. The participants with gaming addiction showed 37.2% had mild, 60.5% had moderate, 68.1% had severe and 79.5% had very severe social phobia. There was a significant association between Social Phobia and gaming Addiction (p-value≤0.05).

This study examines the association between video game addiction and social anxiety amongadolescents in Saudi Arabia. Despite its limitations of less sample size and small setting, the findings imply a significant correlation between IGA and these psychological concerns, particularly among male adolescents. Excessive video gaming use leads to higher levels of social anxiety. Future research should adopt experimental or longitudinal designs to establish causal relationships and consider the potential reciprocal nature of the association. Mental health educators and practitioners should be mindful of the adverse impacts of excessive video gaming, with a specific focus on male adolescents who might be more susceptible to heightened social anxiety.

B. Alsubaie Employee of: General physician in psychiatry department. Declare no conflict of interest, N. Alhujaili Consultant of: Psychiatry. Declare no conflict of Interest, S. Alzahrani Employee of: General physician. Declare no conflict of interest, F. Aljahdali Employee of: Medical Intern. Declare no conflict of interest, W. Alghamdi Consultant of: Associate professor of psychiatry. Declare no conflict of interest, M. Almatrafi Consultant of: Psychiatry. Declare no conflict of Interest, A. Alghamdi Consultant of: Psychiatry. Declare no conflict of interest

Pain has a significant impact on a person’s quality of life, limiting general activity (work, social interaction, problems with family relationships, hobbies/interests, self-care ability), contributing to the development of mental disorders such as depression and anxiety.

Our study aimed to determine the level of anxiety, depression, and functional disabilities caused by chronic pain among outpatients in order to further dynamic research of the long-term consequences.

The study group included 85 outpatients with chronic pain. As a part of psychiatric screening, the HADS depression and anxiety scale was used to study psychopathological symptoms. The WHO self-questionnaire WHODAS 2.0 was used to study the dysfunction caused by chronic pain.

The study found that a significant part of patients with chronic pain had symptoms of anxiety 38% and depression 46% of varying severity. The medial WHODAS 2.0 score among all patients with pain and patients with comorbid depression and anxiety was 23.62 (95% CI: 21.19-24.63), 32.80 (95% CI: 30.33-35.16), and 34.35 (95% CI: 32.11-37.60), respectively. Disability was significantly higher in patients with depression (1.72, p <0.01) and anxiety symptoms (1.60, p <0.01) than in patients with chronic pain without anxiety and depression.

Effective treatment of chronic pain requires a comprehensive approach using psychotherapeutic, psychopharmacological, and physical therapy.

None Declared

Increased sick leave among educators can detrimentally impact students’ productivity, and academic achievement. It remains unknown whether the number of sick days taken by educators in the preceding school year correlates with the prevalence or severity of psychological problems among educators in the subsequent school year.

This study aimed to examine the number of self-reported sick days taken by educators in three Canadian provinces during the 2021/2022 academic year and its association with measures of stress, burnout, low resilience, depression, and anxiety during the 2022/2023 school year.

Data was collected from educators in three Canadian provinces, Alberta, Nova Scotia, and Newfoundland and Labrador, from September 1, 2022, to August 30, 2023. The Maslach Burnout Inventory-Educator Survey (MBI-ES), the Brief Resilience Scale (BRS), and the Perceived Stress Scale were used to assess burnout, resilience, and stress, respectively. Likely Generalized Anxiety Disorder (GAD) and likely Major Depressive Disorder (MDD) were assessed using the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 scales, respectively. Statistical analysis was conducted using SPSS version 28.

763 subscribers completed all the demographic, professional questions, and clinical scales, giving a response rate of 39.91%. Of these, there were 94 (12.3%) males and 669 (87.7%) females. Educators who reported taking 11 or more sick days in the previous academic year were at least three times more likely to exhibit high stress, emotional exhaustion, likely GAD, low resilience, and likely MDD than educators with no sick days during the preceding year. Similarly, educators with 11 or more sick days had significantly higher mean scores on the GAD-7 scale, the PHQ-9 scale, the PSS-10, the MBI Emotional Exhaustion subscale, and the MBI Depersonalization subscale than those with zero sick days.

This study demonstrates a significant association between sick days and the prevalence and severity of high stress, low resilience, burnout, anxiety, and depression among educators. Short-term sick leave can escalate into long-term absences without adequate support for teachers. Governments and policymakers in the education sector must foster a supportive environment that enables teachers to thrive and effectively perform their professional role without taking prolonged sick days, which can undermine student learning and achievement.

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There are recent studies examining the cognitive functions, depressive symptoms, social cognitive characteristics (Terms of Theory of Mind) and acute symptoms of patients with substance-induced psychosis, as well as varying effects of different substances on development of psychosis (Beckmann et al. Child Adolesc Psychiatr CNA.2020;131-143).

It was aimed to examine sociodemographic characteristics, clinical symptoms in acute psychotic period, cognitive functions, social cognition characteristics of hospitalized patients diagnosed with substance related psychosis; compare the severity of clinical symptoms, improvement in acute period symptoms with treatment, cognitive functions and social cognitions according to substance (methamphetamine, cannabis, polydrug).

34 hospitalized patients in acute psychotic episode diagnosed with Substance-Induced Psychosis according to DSM-5 were included in study. Socidemographic Data Form, Reading the Mind in the Eyes Test, Stroop Test, Calgary Schizophrenia Depression Scale and every 3 days during the treatment PANSS (Positive Negative Syndrome Scale) were administered.

Statistical analyses done with R program. Kruskal-Wallis test was used to compare numerical variables between groups. For the significant differences between groups, Bonferroni correction was applied in post hoc analyses. P-value of less than 0.05 was considered statistically significant for all analyses. Chi-square test was used to analyze categorical variables.

It was determined that drug-induced psychosis patients were mostly male, unemployed, young adults, started using drugs before the age of 18, lived in irregular urban areas. Methamphetamine, cannabis and polydrug-related psychosis were compared; There was no difference in cognitive functions and social cognition characteristics between all groups. At the end of treatment, it was observed that the rate of improvement in positive and negative symptoms and the decrease in PANSS scores were greatest in methamphetamine group, there was no difference between cannabis and polydrug groups. We found that PANSS and negative symptom severity before starting treatment were not different between methamphetamine and cannabis, and initial positive symptoms were more severe in methamphetamine than cannabis.

Methamphetamine group showed greater improvements in positive and negative symptoms and total PANSS scores compared to cannabis and polydrug. The fact that there was less improvement in cannabis group than in methamphetamine group supports the data in the literature identifying the relationship between cannabis and chronic psychosis (D’Souza et al, The World Journal of BP, 2022, 719–742).

No difference was found between social cognitions and cognitive functions of 3 groups.

Drug Induced Psychosis, Methamphetamine, Cannabis, Theory of Mind.

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Major Depressive Disorder (MDD) significantly impacts global disability and quality of life. Some variables such as the trait anxiety and experiencing stressful life events (SLEs) are usually related to the MDD. However, the relationship between these variables in depression needs further investigation. Emerging research suggests the STAI-trait could be a nonspecific measure of negative effect and increase susceptibility to stress-induced depression.

This study assesses the State-Trait Anxiety Inventory (STAI) trait scores and SLEs, depressive symptoms, outcomed and functionality in MDD patients, with the hypothesis that STAI-trait may predispose individuals to stress-induced depression.

A prospective observational study was conducted with 25 MDD patients recruited at Hospital Universitari de Bellvitge. The STAI-trait and SLE exposure were measured during the initial visit. Depression symptom and outcome variables were assessed in three sequential clinical evaluations.

Preliminary findings show a significant association between anxiety trait and SLEs, high STAI-trait scores correlated positively with increased SLEs. This, correlating with more severe MDD symptoms and a complex disease course.

These findings support the notion of the STAI-trait as a possible mediator between life stressors and depression.

They highlight that increased STAI-trait anxiety might lead to greater vulnerability to stress and its potentially depressive effects, underscoring the need to consider this trait in clinical practice and the development of preventive strategies.

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Obesity is a growing problem in several developed countries and has a complex etiology in teenagers. Approximately one-third of children and adolescents in the United States are overweight or obese. However, it is not clear how depression and obesity are screened and treated in the primary care setting for adolescents.

This study aims to describe the prevalence, screening, and treatment rates for depression in adolescents in ambulatory settings in the United States.

Data on 444,080,295 male and female adolescents ages 13-18 were extracted from the 2008-2018 CDC National Ambulatory Medical Care Survey datasets. Adolescents were stratified by weight groups based on CDC guidelines (i.e., body mass index percentile).

Of the adolescents, 16.89% were obese, 13.81% were overweight, 43.39% were normal weight, and 25.91% were underweight. Depression screening rates in adolescents with obesity is 2.89%, overweight is 3.35%, normal weight 3.49%, and underweight is 2.83% (p=0.382). Prevalence of depression in adolescents with obesity is 7.17%, overweight is 6.04%, normal weight is 6.31%, and underweight is 12.14% (p<0.0001). Prevalence of counseling and psychotherapy in adolescents with obese status is 2.70%, overweight status is 2.89%, normal weight is 2.92%, and underweight is 11.27% (p<0.0001). Patients seen by primary care health workers, age, female gender, number of chronic conditions, and increased visits are significant predictors of depression diagnosis in adolescents.

Depression in adolescents who are overweight or obese is under-screened for, under-identified, and under-treated. More mental health counseling and psychotherapy must be offered to those with both depression and obesity.

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Perinatal psychiatry is a rapidly evolving subspecialty focused on diagnosing, recognising early, and treating mental disorders in pregnant and postpartum individuals, up to two years after childbirth (timeframes vary globally). The field has gained attention as governments around the world work to meet the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (health and well-being) and SDG 5 (gender equality), aiming to improve maternal, infant, and child health outcomes.

In most countries, perinatal mental illness is managed by family doctors, midwives, and general adult psychiatrists, although some countries have developed specialist community and inpatient perinatal mental health services. The goal is effective treatment to improve pregnancy outcomes, parental mental health, social functioning, and child development. Studies show that infants of mothers with untreated perinatal depression and psychosis are at higher risk of long-term mental health disorders and poor social and educational outcomes. Early detection and efffective and acceptable interventions are key to breaking this cycle.

This presentation will address global advances and ongoing challenges. Significant progress includes increased awareness, emerging specialist services, novel pharmacological treatments with improved safety profiles, expanded evidence-based psychosocial interventions, and a focus on maternal suicide prevention, a key driver of maternal mortality. However, major challenges remain: perinatal suicide is a leading cause of maternal death, poor quality of evidence for prescribing in pregnancy and lactation, long-term morbidity due to untreated mental illness is often overlooked, and access to care is limited especially in low- and middle-income countries. Social stigma and structural barriers also prevent many from seeking help. Addressing these issues requires a global, multidisciplinary approach, integrating public health initiatives, policy changes, workforce training, and research innovations to ensure equitable access to high-quality perinatal mental health care worldwide.

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