This study includes the characteristics of Compex PTSD among Ukrainian IDPs who experienced the horrors of the war - during the Russia-Ukraine war in 2022-2024. It also reflects the new and permanent stressors characteristic of the digital age.

Objective of the Study was to identify how cyber age and modern technologies affected on outcomes of traumatic stress.

The study was carried out iamong the victims of the Ukrainian war temporarily displaced in Georgia. A specially developed questionnaire based on the guidelines of the Istanbul Protocol was used.

A total number of direct target beneficiaries applied to the Empathy was n = 68 persons; Most refugees were with experience of war crimes. Mainly two types of life threatening traumatic events was identified: Locally in place of war and Russian occupation; They flowed from Ukraine through the Russian territory and additionally are with experience of ill – treatment during the filtration procedures in the so-called “filtration camps”. Chronic Repetitive Traumatic Stressors were identified as well: Misinformation; Adhering to online war scenes, the vast amount of information flow; Inability to dissociate from warfare. Observed: Rapid development of C - PTSD in 52 persons of total 68. Alongside with PTSD symptoms reveled: Affective Dysregulation – aggression, self – aggression, depression; Feeling of Guilty – for not being in Ukraine, not supporting to their relatives and Country; Problems in interpersonal relations; Addictive behavior; Additional stressors related to the digital warfare and disinformation supported the prolongation of multi natural stressors that consequently created significant problems for recovery.

The results were discussed in the context of Carl Jaspers’ conception regarding reactive conditions. According to his concept, reactive psychoses develop on the basis of a conflict between a person and an unbearable reality for him, and at the same time, this reality is necessarily reflected in the clinical picture of the disease. However, it should be noted that by the 60s, delayed forms of reactive states were described, i.e., forms far removed from the traumatic moment, during which Jasper’s criterion of “time connection” is violated, although the traumatic event is fully reflected in the clinical picture. The reason for this is mainly the prolonged process of intrapsychic processing and final realization of the trauma. The rapid development of complex PTSD under the combined influence of endless multi-stress factors was revealed; The researchers were faced with an effective treatment - the search for ways of rehabilitation in the current multi-stress conditions. Furthermore studies have to be addressed to create new complex recovery strategies in modern multi – face unsolved stress situations.

None Declared

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

Technological advancements have identified numerous genetic variations linked to mental disorders, providing potential explanations and, in some cases, enabling targeted treatments. However, clinical genetic testing remains underutilised in psychiatric care, potentially due to inconsistent clinical guidelines across Europe.

This scoping review aims to compile, summarise and evaluate European clinical practice guidelines (CPGs) on genetic testing in mental disorders, identifying gaps and variations in recommendations to inform current practice and future guideline development.

A scoping review was conducted across scientific databases (PubMed/MEDLINE and Ovid) and grey literature sources (Image 1. Flow diagram). Inclusion criteria centred on European CPGs published in English from 2010 onward with specific recommendations on genetic testing in mental disorders. Quality assessment was performed using the International Centre for Allied Health Evidence (iCAHE) checklist. Data extraction focused on guideline characteristics, target populations, and genetic test recommendations.

Sixteen CPGs met the inclusion criteria, displaying considerable heterogeneity in quality and content, and covering a limited range of mental disorders. Six guidelines addressed neurodevelopmental disorders. Most recommended genetic testing in Autism Spectrum Disorder (ASD) when indicators such as intellectual disability (ID) or dysmorphic features were present; however, one guideline recommended routine testing. Only one guideline included recommendations for genetic testing in ID; routine access to Fragile X testing, chromosomal microarray, and whole genome sequencing was recommended as standard care.

Eleven guidelines provided recommendations on genetic testing in neurodegenerative disorders. In dementia, consensus on routine testing was generally limited to young-onset cases or those with distinct genetic profiles. APOE genotyping was generally discouraged. Guidelines for diagnostic testing for Huntington’s Disease (HD) were consistent. Access to predictive testing with appropriate genetic counselling for at-risk adults was also recommended.

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Based on our findings and the wider literature, we recommend considering genetic testing for: 1) all patients with ID, 2) patients with ASD exhibiting features suggestive of a genetic cause, such as ID and dysmorphic traits, and 3) patients with dementia with a young age of onset or a family history indicative of a Mendelian disorder. For HD, testing should be informed by phenotypic features and family history. Establishing harmonised, evidence-based guidelines is essential to integrate testing effectively. Key considerations include clinical utility, patient autonomy, and access to genetic counselling to ensure informed and supportive care.

None Declared

While gambling problems are increasingly recognized as a public health concern, knowledge of the prevalence and impact within psychosocially vulnerable populations is scarce. Never before has the prevalence of gambling problems been studied in a forensic psychiatric patient population. Given the risk for gambling problems to exacerbate existing mental health conditions, cause financial strain, and contribute to criminal behavior, understanding its prevalence and associated factors within this population is critical.

The study aims to estimate the prevalence of gambling behavior and gambling problems among forensic psychiatric patients in Denmark and compare the results to the general Danish population. Additionally, the study seeks to identify associations between psychosocial and demographic variables and the occurrence and severity of gambling problems. Lastly, the study will explore gambling motives and their relation to gambling problems in this patient population.

This observational, cross-sectional study will include inpatients and outpatients in Central Denmark Region forensic psychiatric care and inpatients in Capital Denmark Region forensic psychiatric wards from June 1 to December 31, 2024. Participants must be 18, and speak Danish, English, or Greenlandic. Data will be collected via self-report questionnaires and electronic patient records. Key measures include gambling behavior (past year gambling, frequency, and expenditure), gambling problems (the Problem Gambling Severity Index), and gambling motives (the Gambling Motives Questionnaire-Financial).

Data collection ends by December 31, 2024; preliminary findings will be presented at the conference.

Results will provide valuable insights into the prevalence and characteristics of gambling problems in this population, informing clinical care and potentially guiding the development of targeted interventions. By highlighting the need for attention to gambling issues in forensic psychiatric settings, the study may enhance rehabilitation and recovery efforts and successful discharge by addressing potential risk factors for recidivism.

None Declared

Occupational stress has been identified as a significant predictor of job satisfaction among university staff.

This paper aims to find out the relationship between occupational stress and job satisfaction among university workers in Sfax, Tunisia.

We conducted a cross-sectional study, during the period from September 2022 to October 2023. We used a self-administered questionnaire distributed to university staff. The questionnaire included socio-professional characteristics and assessment of occupational stress using the Work Stress Screener (WoSS-13). Job satisfaction was rated on a 5-point Likert scale from 1 (extremely dissatisfied) to 5 (extremely satisfied).

The average age of the workers was 49.31±8. years. There is a slight female predominance (78 (53.1%)). Among the respondents, 57 (38.3%) were very to extremely satisfied. The medians of WoSS-13 subscales were 11 for WOSS-A1, 6 for WOSS-A2 and 3 for WOSS-B. Job satisfaction was positively associated with WOSS-A1 and WOSS-A2 (positive stress) but negatively associated with WOSS-B (negative stress). In bivariate analysis, being extremely satisfied was positively associated to WOSS-A1 and WOSS-A2 (p=0.000 for each respectively). However, it was negatively associated to WOSS-B (p=0.000).

Occupational stress has a significant impact on job satisfaction among university workers. Addressing job stress through targeted interventions can improve job satisfaction, productivity, and overall well-being among university staff.

None Declared

Orthorexia Nervosa (ON) is characterized by an obsessive focus on healthy eating, leading to extreme restrictions and negative impacts on mental and social health. ON shares traits with eating disorders (EDs) and obsessive-compulsive disorder (OCD), but its diagnostic status remains unclear. Recent studies suggest ON may be linked to personality traits like perfectionism, common in both EDs and OCD (3,5). The COVID-19 pandemic has exacerbated these issues, stressing the need for better understanding of ON and its overlaps with other disorders (6).

This study reviews literature from the past seven years to explore the connections between ON, EDs, and OCD. It examines ON as a possible distinct diagnosis, focusing on the role of personality traits like perfectionism and evaluates the clinical implications and treatment needs, considering cultural and contextual factors.

A systematic review was conducted using PubMed, PsycINFO, and Scopus, covering studies from 2017 to 2023. The studies included clinical and non-clinical samples, focusing on psychopathological features and personality traits linked to ON, EDs, and OCD (1-2). The review analyzed diagnostic criteria, prevalence, personality trait correlations, and the impact of contextual factors like the COVID-19 pandemic.

ON has a complex relationship with EDs and OCD. In ED patients, especially those with anorexia nervosa (AN) and bulimia nervosa (BN), orthorexic behaviors were more prevalent, suggesting ON might be a subtype of EDs rather than a separate condition. ON scores in ED patients decreased after targeted treatment, supporting this connection (1). Personality studies showed that orthorexic individuals often display perfectionism, particularly concerns about mistakes and unrealistic standards. These traits are transdiagnostic, affecting ON, EDs, and OCD (2-3). ON was also linked to specific personality profiles, such as paranoid and narcissistic traits, which worsen symptoms and complicate treatment (2). ON symptoms were strongly correlated with anxiety, depression, and ED and OCD symptoms, indicating shared psychopathological mechanisms (5). The ego-syntonic nature of ON, where behaviors are seen as normal, may lead to underdiagnosis and reduced treatment-seeking (5). The COVID-19 pandemic further exacerbated orthorexic behaviors, highlighting the need for tailored clinical interventions for at-risk individuals (6).

ON should be viewed within the ED spectrum, with significant overlaps with OCD and influence from traits like perfectionism. Cultural and definitional differences complicate its classification as a distinct disorder. The COVID-19 pandemic has highlighted the clinical importance of ON and the need for effective prevention and treatment strategies. Future research should aim to develop standardized diagnostic criteria and explore personality traits to improve ON diagnosis and treatment.

None Declared

Frontotemporal dementia (FTD) is the second most common cause of early-onset dementia and is clinically characterised by progressive behavioural changes, executive dysfunction and language difficulties. FTD is often confused with Alzheimer’s disease and other psychiatric disorders. Clinical features of FTD include personality changes, agitation, loss of inhibition, apathy, social withdrawal and impulsivity. In some cases, the disease is accompanied by mood or psychotic symptoms, resulting in the diagnosis of an additional psychiatric disorder. (Gliebus G.(2014). SAGE open medical case reports,2, 2050313X13519977.). This article presents the case of a middle-aged woman who was diagnosed with an anxiety spectrum disorder before developing and being diagnosed with FTD.

A 57-years-old right handed female with previous history of anxiety disorder admitted to psychiatry clinic with restlessness, decreased sleep, and complain of constant non-purpose walking. Physical examination revealed bradymimia and grabellar reflex. Additionally in her psychiatric evaluation she had short-term memory impairment, disinhibition and verbal perseverations. She had been given multiple combinations of medications by outpatient providers and her restlessness only increased. At the time of admission she was taking mirtazapine,olanzapine and clonazepam. The initial impression was that she had akathisia, and her medications were tapered. She was then started on propanolol and lorazepam. After several days her symptoms had not changed.

In routine biochemical and hematological tests, electroencephalogram (EEG) were within normal limits. 18F-FDG PET/MRI revealed hypometabolism in the bilateral temporal-frontoparietal region, more pronounced in the frontal region which is consistent with FTD.

Trazodone was started to control behavioural symptoms and the dose was gradually increased to 150 mg/day. The dose of propranolol was increased to 80 mg/day, and lorazepam was tapered and discontinued. During the follow up with this treatment, there was an improvement in her restlessness and anxiety symptoms, but her memory problems were persistent.

Frontotemporal dementia may overlap and be confused with other psychiatric disorders. Therefore, a comprehensive history, physical and neurological examination are required to differentiate each clinical entity (Khan I, De Jesus O. (2023).Frontotemporal Lobe Dementia. In: StatPearls ). Additionally, the use of functional neuroimaging, such as 18F-FDG PET/MRI, enables the different distribution of pathology in dementing disorders to be highlighted, as can be seen in our case. This case report highlights the importance of re-evaluating patients with psychiatric diseases, especially when symptoms are resistant to treatment.

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

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.

A history of psychiatric disorders significantly impacts patient evaluation and treatment in healthcare. Nearly 80% of excess mortality in individuals with mental illnesses is due to physical health issues. While suicide risk is widely recognized, most mortality from mental illnesses stems from physical conditions like cardiovascular diseases, respiratory issues, and cancer, leading to a life expectancy reduction of 15-20 years compared to the general population.

To exemplify through a case the possible impact of psychiatric history on healthcare provision.

We present the case of a 55-year-old woman with a history of severe functional neurological disorder resulting in mobility limitations, dyskinetic movements, and functional pain characterized as allodynia. She has been followed by neurology for the past year. She began mental health follow-up one year earlier due to reactive anxiety stemming from work-related issues. Her substance use history includes being a tobacco smoker for over 20 years (FTND score>50) and a former consumer of three liters of beer daily for two years, with periods of abstinence. The patient presented to the emergency department due to weight loss and low mood, worsening over the past few weeks, in the context of intense muscle pain and loss of strength. Blood tests and a brain CT scan were performed without abnormalities. She was initially admitted to Neurology for severe functional neurological disorder for symptom control, but was later transferred to Psychiatry due to suicidal threats. During her psychiatric admission, she experienced improvement in pain and subsequently in her mood. After discharge from psychiatry, the patient returned several times to the emergency department due to worsening neurological symptoms, being discharged with a diagnosis of functional disorder.

Two months after her discharge from psychiatry, the patient returned to the emergency department due to rib pain. After emergency assessment, she was referred to Neurology for worsening neurological symptoms. With suspicion of paraneoplastic polyneuropathy, an MRI of the brain and spine, EMG, lumbar puncture, and CT scans of the neck, chest, abdomen, and pelvis were performed during her neurology admission. She was diagnosed with small cell lung carcinoma stage IVA and asymmetric paraneoplastic sensory neuropathy. Following the diagnosis, she was referred to Oncology, receiving one cycle of chemotherapy. However, given the unfavorable progression, it was decided, in agreement with the patient, not to continue active oncological treatment, and she was transferred to a Palliative Care Center.

This case emphasizes the need to recognize how psychiatric history affects medical care. Stigma and the patient’s challenges in communicating symptoms can hinder the diagnosis and treatment of organic conditions, contributing to the excess mortality associated with mental health issues.

None Declared

Early detection of neurodevelopmental disorders (NDD) allows for timely intervention and tailored support to address behavioral and learning issues and reduce the impact of severe disabilities. Certain populations of newborns, particularly premature infants, are at higher risk for developing such disorders; identifying them enables the establishment of preventive monitoring and screening.

to evaluate the frequency of neurodevelopmental disorders (NDD) in preterm children seen at the outpatient Neonatology department

Our study was a descriptive cross-sectional study conducted on 193 premature infants hospitalized in the Neonatology service. All children underwent at least two psychiatric assessments evaluating child development, early interactions, and behavioral problems. These assessments were conducted at the Neonatology outpatient department by a child psychiatrist in the presence of at least one parent, from 2016 to June 2024. Sociodemographic and clinical data were collected from their medical records.

In our sample, the average age of infants was 2 years, with a range from 10 months to 3 years. The sex ratio was 1:1. According to the psychiatric interview and clinical examination, we found that 74.1% of children exhibited psychomotor developmental delays, 15% of them have global developmental delays, 11.4% of children have language delays, and 6.7% of them have been diagnosed with autism spectrum disorder, according to DSM-5 criteria. Among the assessed children, 6.7% showed behavioral issues, and 2.5% presented with reactive attachment disorders. Among the examined children, 24.4% were referred for regular follow-up at the outpatient child psychiatry clinic.

Our study indicates that preterm infants are at a high risk of developing neurodevelopmental disorders due to the immaturity and vulnerability of their brains during critical developmental periods. These findings underscore the importance of Child Psychiatry examination for this population.

None Declared

In the last 50 years, obesity has become a leading cause of morbidity and decreased life expectancy, being associated with the development of cardiovascular disease, decreased mental health and overall decreased quality of life. The development of bariatric surgery as a treatment strategy in those in which attempts at conservative treatment yielded no satisfactory results has revolutionized treatment of refractory obesity. While short term gains in cardiovascular health are undeniable, long-term impact remains uncertain. More recently, there is emerging evidence of bariatric surgery being associated with de novo alcohol use disorder.

We aimed to study the possible correlation between bariatric surgery and alcohol use disorder, specifically the individual risk factors that may promote such outcome. Moreover, we aimed to evaluate which surgical procedures are more eliciting of alcohol use disorder.

We performed a literature review using the database MEDLINE and obtained 241 results using the query terms “bariatric surgery” and “alcohol”. Of these, we read all the summaries and subsequently selected 51 different scientific articles which we afterwards read in full. We then performed a literature review aiming to understand the maladaptive alcohol consumption patterns following bariatric surgery

Most studies report maladaptive alcohol use following bariatric surgery. Outstandingly, this consumption pattern develops only at later follow up stages, usually over 3 years after surgery. Furthermore, not all types of bariatric surgery appear to pose the same iatrogenic risk. Gastric bypass poses the highest risk of new onset alcohol misuse, in comparison to sleeve gastrectomy or gastric band surgery. It is not yet fully understood the mechanism behind this pattern of alcohol misuse following surgery, but common reasons have been identified, including different social interaction patterns, addiction transfer, ambivalence towards bodily changes, increased mental vulnerability and different body response to the effects of alcohol.

The screening of alcohol misuse before and after bariatric surgery is of paramount importance to decrease the surgical iatrogenic risk and improve outcomes. Further research should be developed in understanding what are the risk factors and mechanistic pathways for alcohol misuse following bariatric surgery. Also, it should be investigated whether the treatment of alcohol misuse disorder differs between patients submitted to bariatric surgery or not.

None Declared

Alcohol withdrawal syndrome is a significant challenge in the management of alcohol use disorder, with traditional treatments often relying heavily on benzodiazepines like diazepam. This study aimed to explore the efficacy and safety of incorporating baclofen (30 mg/day) alongside minimal, tailored diazepam doses—adjusted according to alcohol intake and CIWA-Ar scores—to manage withdrawal symptoms more effectively than conventional diazepam protocols. By reducing the total diazepam needed and shortening detoxification time, the study highlights the potential of baclofen to offer a faster, safer approach to alcohol withdrawal treatment.

To evaluate the efficacy and safety of combining baclofen (30 mg/day) with minimal diazepam doses—calculated based on alcohol consumption and adjusted by CIWA-Ar scores—in managing alcohol withdrawal symptoms more rapidly than standard diazepam protocols.

Sixty-nine patients with alcohol use disorder were enrolled and randomized into two groups. The baclofen group (n = 32) received baclofen 30 mg/day plus minimal diazepam, with initial diazepam doses based on average daily alcohol units consumed (1 mg diazepam per unit) and adjusted using CIWA-Ar scores. The standard group (n = 37) received a conventional diazepam-based detoxification regimen with fixed starting doses adjusted by withdrawal symptoms. Primary outcomes were the total diazepam dosage required and the duration of detoxification. Secondary outcomes included daily CIWA-Ar scores and incidence of adverse effects. Statistical analyses employed independent t-tests and chi-square tests, with p < 0.05 considered significant.

The baclofen group required significantly less diazepam compared to the standard group (mean total dose: 30 ± 10 mg vs. 50 ± 15 mg; p < 0.001). They also experienced a shorter detoxification duration (mean: 15 ± 1 days vs. 19 ± 1 days; p = 0.01), indicating a faster withdrawal process. CIWA-Ar scores were consistently lower in the baclofen group throughout detoxification (mean: 6 ± 2 vs. 10 ± 3; p < 0.001), reflecting milder withdrawal symptoms. No significant adverse effects were observed in either group, including over-sedation, respiratory depression, or hallucinations.

Combining baclofen (30 mg/day) with minimal diazepam—calculated based on alcohol consumption and adjusted by CIWA-Ar scores—effectively controlled alcohol withdrawal, reduced diazepam use by 40%, and shortened detoxification by about four days. The protocol was well-tolerated and may benefit patients at risk from high benzodiazepine doses or in settings aiming to limit benzodiazepine use. These findings suggest baclofen can reduce medication needs and speed up recovery. Larger trials are needed to confirm these results and evaluate long-term outcomes like relapse rates and sustained abstinence.

None Declared

Post-ictal psychosis is a kind of epileptic psychosis in which psychotic features appear 12h – 7 days after the epileptic seizure causing them.

To present a challenging case reflecting upon presentation, management and considerations of post-ictal psychosis.

Case presentation and non-systematic literature review.

A 40-year-old female, living in a European foreign country with her partner and child, flies to Lisbon 5 days previously to her admission as a sudden decision because she believed she was the daughter of a portuguese yoga master. She was brought to psychiatry ER by the police due to disorganized and aggressive behavior in public, where she presented with severe agitation, disorganized and coprolalic speech, persecutory, mistic and filiation delusions, somatic and affective passivity, and very uncollaborative. She had no analytic or image alterations except for positive cannabinoids in urine. She was admitted in psychiatry and started on risperidone titled till 6mg and diazepam 15mg, with remission of symptomatology. When she was able to collaborate, she admitted she had a history of Epilepsy for which she was not having treatment, and a previous post-ictal psychotic episode some years ago. Family confirmed she had a generalized tonic-clonic seizure about a week ago, and delusional ideas starting the following day, having left home unannounced. Although the EEG was normal, considering suggestive history post-ictal psychosis was admitted ad most probable diagnosis and she was slowly stopped medication without symptom resurgence. The importance of anti-epileptic treatment in order to avoid subsequent seizures and post-ictal psychosis was explained, however the patient denied treatment and was discharged back to her hometown with indication to follow-up in neurology.

Post-ictal psychosis corresponds to 25% of epileptic psychosis. It is associated with temporal lobe epilepsy, psychotic symptoms of mistic and religious themes, aggressive behavior, and increased suicide risk. It has a sudden onset and complete remission although a risk of recurrence as in this case. Treatment consists of seizure control to avoid following episodes. Antipsychotics that don’t increase convulsive risk such has risperidone may be useful to acute control of psychotic features and behavior alterations.

None Declared

A growing body of research has demonstrated the positive effects of Acceptance and Commitment Therapy (ACT) delivered in the workplace on employees’ well-being and psychological flexibility. Delivering ACT in the workplace aims to enhance employee performance and reduce stress levels by promoting psychological flexibility, a skill to consciously live in the present, observing thoughts and emotions, and engaging in value-driven actions.

The short-term effects of a 5-week ACT-based psychological flexibility training program were tested.

Participants were 21 corporate employees (62 % women, Mage = 43.9 years, SD = 9.5) recruited from a large company in the financial sector. The six core processes of psychological flexibility were examined before the first training session and after the fifth training session of the 5-week training. Psychological flexibility, value-driven living, thought suppression, five facets of mindfulness and cognitive fusion were assessed.

Results showed a statistically significant difference in one core process of psychological flexibility, namely Contact with the present moment. Acting with awareness, Describing and Nonjudge showed significant difference before and after the training. Presumably, changes in Cognitive defusion and Non-reactivity are also evident, however results did not show significant difference.

The present research has provided further empirical evidence for the effectiveness of ACT-based psychological flexibility training with regard to three aspects of Contact with the present moment, which is a core process of psychological flexibility (Acting with awareness, Describing, and Nonjudge). The findings provide a basis for future research to investigate longer-term effects, including monitoring how participants in the research program practice the learnt techniques in their everyday lives.

Á. Magyary Grant / Research support from: ÁM was supported by the ÚNKP-23-2 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund., Z. Demetrovics: None Declared, Á. Zsila: None Declared, N. Mészáros: None Declared

Mental health is an integral and essential component of health. An important implication of this definition is that mental health is more than just the absence of mental disorders or disabilities. Brain health can be defined as a life-long dynamic state of cognitive, emotional and motor domains underpinned by physiological processes. Exercise is a good model, since training the body improves Brain and Mental Health. Pathophysiological research and biomarkers are required.

None Declared

Historically, syphilis has been known as “the Great Imitator” due to its heterogeneous clinical manifestations. Though its incidence decreased with the widespread use of penicillin, recent data suggest a resurgence, particularly among those experiencing delays in treatment. This resurgence creates diagnostic challenges, especially when patients have coexisting psychiatric conditions like Borderline Personality Disorder (BPD).

This report explores the psychiatric and cognitive manifestations of neurosyphilis in patients with preexisting personality disorders. The primary objective is to highlight how neurosyphilis complicates psychiatric diagnosis and care and to emphasize the need for early detection and intervention.

A thorough literature review was conducted using PubMed database covering studies published from 2000 to 2023. Keywords included “neurosyphilis,” “borderline personality disorder,” “psychiatric symptoms,” “syphilis resurgence,” and “cognitive impairment.” Additionally, the case of a 35-year-old female with BPD who developed neurosyphilis is presented, demonstrating the complexities in distinguishing between overlapping psychiatric symptoms. The case also emphasizes the importance of comprehensive care.

The psychiatric symptoms of neurosyphilis, such as impulsivity, mood instability, and cognitive dysfunction, significantly overlap with those of BPD, complicating diagnosis and treatment. Literature indicates that neurosyphilis occurs in 0.5% to 2% of untreated syphilis cases. Common psychiatric manifestations of neurosyphilis—such as irritability, cognitive decline, and affective dysregulation—are often misattributed to underlying psychiatric disorders, leading to delays in proper treatment. In the case of the 35-year-old patient, her longstanding BPD symptoms, including emotional instability and impulsivity, worsened with the progression of neurosyphilis. Cognitive testing revealed mild impairment, which was consistent with the cognitive decline seen in neurosyphilis, further complicating the clinical picture.

This case underscores the critical need for timely syphilis screening, particularly for individuals with a history of untreated or inadequately treated infections. Early diagnosis and treatment of neurosyphilis can significantly improve cognitive and psychiatric outcomes while promoting overall wellness. Routine sexually transmitted disease screenings, especially in psychiatric populations, can prevent severe neuropsychiatric complications and support holistic well-being. Given the global resurgence of syphilis, a proactive approach to sexual health is essential in fostering both mental and physical health.

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Autoscopic Phenomena (APs) are rare perceptual experiences where individuals perceive a visual double or duplicate of their own body. It has been recognized since ancient times, but gained significant attention in the 19th century, both through its depiction in romantic literature and in neuropsychiatric studies; in the literature, their association with epilepsy and schizophrenia is very extensively documented. Recent research brought new insights into the neurobiology of these phenomena.

In this article, we aim to review the phenomenology and psycopathology of APs.

Narrative literature review.

From a phenomenological perspective, three main conditions can be identified. In Autoscopy, the person sees a double, but does not feel a connection with it, meaning that they can distinguish between themselves and the double. In Out-of-body Experience (OBE), the individual feels as though they have left their body and observe themselves from an external perspective. In Heautoscopy, the boundary between the self and the double is blurred, causing uncertainty about where one’s “self” is located, representing a middle ground between autoscopy and OBE.

Current research suggests that APs are linked to dysfunctions in the normal integration of body ownership, self-location, and perspective-taking, caused by lesions in regions responsible for integrating multisensory inputs (visual, proprioceptive and vestibular). All types of APs have in common a dysfunction specifically in the temporo-parietal junction (TPJ), a brain area involved in processing self-location and integrating sensory inputs to create a unified sense of self; other common areas include the insula and cingulate cortex.

Regarding to the different networks of APs, Autoscopy primarily involves abnormalities in the visual processing regions (as the occipital and parietal lobes), causing a visual perception of double; OBEs are caused by dysfunctions in areas responsible for self-location and vestibular processing (such as the medial prefrontal cortex), leading to a sensation of floating outside one’s body; lastly, Heautoscopy engages more widespread brain dysfunctions, including the regions involved in self-representation and embodiment, leading to ambiguity in self-location.

APs challenge our understanding of the bodily self and how identity is constructed, raising questions about how the brain creates a unified sense of being in a body and how this can break down under certain pathological conditions. Although much is unknown, one thing is for sure: these phenomena demonstrate that the sense of self is not fixed, and the study of its disruption, by exploring its phenomenology and psychopatology, may contribute to reveal the underlying processes involved in bodily self-consciousness.

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This study examined the interplay between marital relationships and individual adjustment to cancer, considering the influence of attachment styles and marital duration under high-stress conditions.

This research aims to elucidate how these factors modulate the marital quality and the psychological well-being of individuals and their partners.

A total of 312 participants, comprising 223 cancer patients and 89 partners, completed the Golombok-Rust Inventory of Marital State and the Adult Attachment Inventory. Linear mixed-effects models were used to analyze the relationships between marital adjustment, attachment styles, and marital duration.

The findings indicated that females diagnosed with cancer reported significantly poorer marital adjustment compared to their male counterparts (both p < .05). Notably, secure attachment was significantly positively associated with better marital adjustment (β = .18, p = .016), while ambivalent attachment was significantly negatively associated with worse marital adjustment (β = -.11, p = .029). These patterns persisted across both patients and their partners, with no significant differences based on sex. Additionally, the impact of attachment styles on marital adjustment did not vary significantly with marital duration (all p > .05).

These results underscore the complexity of the marital dynamics among couples confronting cancer. The data reveal that secure attachment enhances marital stability, whereas ambivalent attachment detracts from it, irrespective of the sex of the respondent or marital duration. This study adds to the body of literature by highlighting the nuanced ways in which attachment styles influence marital dynamics under the strain of cancer. The implications for clinical interventions emphasize the importance of fostering secure attachment behaviors in couples therapy, particularly in contexts involving significant health challenges.

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Depressive disorders and anxiety disorders are typical comorbidities in autism spectrum disorder (ASD), with a reported prevalence of 20% and 9%, respectively (Lai, 2019). Autistic subjects are more at risk for suicidal thoughts and behaviors compared to typically developing peers; moreover, depressive symptoms are often resistant to both pharmacological and psychotherapeutic treatments. In 2019 intranasal esketamine was approved in Italy for treatment-resistent depression (TRD). We observed two young outpatients affected by autism (diagnosis made by “Lab-Aut”, a specialized mental health service in Pavia) treated with esketamine in our ambulatory for TRD. Clinical information and personal details were summarized in Image 1.

To evaluate the clinical response to intranasal esketamine in subjects with major depression in ASD and to compare the outcome with neurotypical patients.

Autism diagnosis wase made according to ADOS-2 and ADI-R scores, confirmed by a clinical judgment of senior psychiatrist. Our follow-up protocol during esketamine treatment consists in the following scales: MADRS, C-SSRS, DES-II, Psychace Scale, Reading the Mind in the Eyes Test, HAM-A, HAM-D, BDI, PANSS. Psychometric evaluation was performed at T0 (before esketamine), T1 (one week of pharmacotherapy), T2 (one month), T3 (2 months) T4 (3 months) and T5 (6 months). We collected results from neurotypical patients (n=12) and autistic patients (n=2) between 2022 and 2024.

Both in autistic patients and in neurotypical ones we noticed a premature decrease in depressive symptoms and a reduction of suicidal thoughts. This improvement was testified by a reduction from T0 to T1 in MADRS total score and in C-SSRS sub-score focused on intensity of suicidal ideation. The reduction was maintained during the observation period (Image 2). Due to the small sample size of autistic patients, we couldn’t reach the statistical significance threshold for this population. Considering the entire sample (n=14) we obtained significant results (T0-T1: MADRS decrease p=0,00006, C-SSRS decrease p=0,00009. T0-T5 MADRS and C-SSRS variations p<0,00001). Comparing our sub-samples, it’s possible to notice a similar trend in follow-up between autistic and neurotypical patients. (Image 3).

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Our preliminary data coming from clinical experience suggest the efficacy of intranasal esketamine in depressive episodes occurring in autistic patients. A larger sample size of autistic patients will be necessary to set a comparative study and to give significance to these results. Esketamine could represent an important therapeutic option in depressed patients with ASD comorbidity.

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