In recent years, there has been an increase in alcohol consumption among women. Given that a significant percentage (1 in 3) of pregnancies are unplanned, fetal exposure to alcohol is inevitable in some.

The main objective of this work is to present a review of the current state of the art regarding the impact of alcohol use during pregnancy.

Evidence-based review, using a search on PubMed and selection of the most relevant studies on this topic, published in the last decade.

Although the international consensus recommends total abstinence from alcohol consumption during pregnancy, its global prevalence is 9,8%, with the highest percentage found in Europe (25,2%), which constitutes an important public health problem. Contrary to expectations, a recent study highlights that women who continue to consume alcohol during pregnancy were more likely to be older and have a higher socioeconomic status and educational level. Alcohol consumption during pregnancy is associated with high rates of maternal and child morbidity and mortality, with serious social, personal and family consequences. Prenatal alcohol exposure is the leading preventable cause of birth defects and neurodevelopmental disorders. The psychopharmacological treatment of alcohol use disorder during pregnancy is a challenge, given the limited evidence.

The main guidelines recommend total alcohol abstinence as no safe amount to consume has been identified. Stopping alcohol consumption during pregnancy is the only effective way to eliminate the risk of complications associated with this substance. A focus on early prevention and identification is essential, as well as, when necessary, referral for specialized treatment.

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The nature-based therapeutic perspective includes: green therapy, blue therapy, animal-assisted therapy, and natural landscape therapy. Until now researchers haven’t clearly recognized underlying mechanisms of nature-related mental health well-being.

The study aimed to clarify the relationships between experienced nature connectedness (NC) and social connectedness (SC) before and after blue nature based intervention and mental health (WHO-5, PHQ-4)

Study group included 54 adults (Mean = 30.6; SD 13,2). Participants completed semi-structured questionnaires before and after blue interventions (one week high sea sailing under supervision of two psychologists). The questionaire measured following variables: nature connectedness, social connectedness, well-being, and mental health.

Results showed a significant increase in social and nature connectedness as well as in mental well-being after the blue interventions. Full results will be shown on the e-poster.

The mental health and wellbeing benefits of contact with nature are becoming increasingly recognized in psychology and medicine. The findings support hypothesis that nature connectedness and social connectedness increased after nature based interventions, and therefore they seem to be important factors conected with mental health.

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Inflammatory processes and innate immune system activation have been implicated in psychiatric disorders. While our prior research highlighted elevated neutrophils, monocytes, and C-reactive protein (CRP) associated with symptom severity in schizophrenia, this study investigates whether similar immune alterations characterize major depression (MD).

Differential blood counts, CRP levels, depression severity (HAMD-21), and psychosocial functioning (GAF) were assessed in controls (n = 129) and patients with first-episode (FEMD: n = 82) or recurrent (RMD: n = 47) MD at hospital admission (T0) and after 6 weeks of treatment (T6). Functional immune parameters, including the phagocytic activity of neutrophils and monocytes, were also measured in a subset of patients with MD (n = 16) and healthy controls (n = 27).

At T0, both FEMD and RMD patients exhibited increased neutrophils (p = 0.034) and CRP levels (FEMD: p < 0.001, RMD: p = 0.021) and decreased eosinophils (FEMD: p = 0.005, RMD: p = 0.004) compared with controls, adjusted for covariates (smoking, BMI, gender). Baseline lymphocyte counts were elevated in RMD (p = 0.003) but not FEMD. Functional analyses revealed significantly increased phagocytic activity of neutrophils in MDD patients compared to controls, both at baseline and T6. Changes in monocyte phagocytic activity correlated with ΔHAMD, indicating a link between immune cell function and symptom improvement.

At T6, eosinophils increased in FEMD (p = 0.011) without significant changes in RMD. Improvement in depression severity correlated with changes in neutrophil counts in FEMD (r = 0.364, p = 0.024). Comparatively, immune alterations in MD showed smaller effect sizes than those observed in schizophrenia. Notably, lymphocyte elevations were specific to recurrent MD, suggesting potential involvement of adaptive immunity in chronic MD.

These findings highlight state- and trait-dependent immune alterations in MD, including heightened neutrophil activity in early stages and adaptive immune involvement in recurrent cases. Functional data further support the role of innate immune activation in MD, with phagocytic activity potentially serving as a biomarker for treatment response. Future studies may inform stage-specific immune-targeted interventions in MD.

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Anxiety is a common and often debilitating condition in individuals with Multiple Sclerosis (MS), significantly affecting their quality of life. The challenges associated with managing MS symptoms and the potential for disability can contribute to increased levels of psychological distress.

The aim of our study was to determine the prevalence of anxiety and identify the its associated factors.

A cross-sectional study was conducted in the neurology department of Razi University Hospital (Tunisia) between October 2023 and June 2024. Patients with a diagnosis of MS based on the 2017 McDonald criteria were recruited, excluding those with active disease relapses. Participants completed questionnaires covering sociodemographic data, medical history, clinical and radiological characteristics, disability status, and psychological symptoms. Depression, anxiety and stress were assessed using the DASS-21 scale. Insomnia was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Data analysis was performed using SPSS version 26.

A total of 83 patients with MS were recruited, with ages ranging from 19 to 66 years. The study population had a predominantly female sex ratio of 3.4. The majority of participants (75.9%) were from urban areas, and 74.7% had a university-level education. Moreover, 49.1% were married, and 60.2% were employed. Regarding medical history, 40.3% had a comorbid condition, and 30.1% had a psychiatric history. The mean age at disease onset was 26 ± 10 years, and the most common clinical presentations were sensory and pyramidal symptoms.

The median time since the last relapse in our sample was 24 months. In our sample, first-line treatments (interferon, glatiramer acetate, teriflunomide, dimethyl fumarate) were prescribed to 27.7% of patients. Second-line treatments (natalizumab, ocrelizumab, fingolimod) were prescribed to 69.9% of patients

In our study, the prevalence of anxiety was 55.4%. In our population. 26.5% of the patients had severe anxiety. A significant association was found between anxiety and female gender (p=0.02), stress (p<0.001), and insomnia (p=0.003).

The findings indicate that anxiety is a considerable concern for individuals with MS. Addressing this mental health issue is essential for healthcare providers to offer effective support. By prioritizing mental health, we can enhance the overall well-being of individuals living with MS and improve their quality of life.

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Major depressive disorder (MDD) presents as episodes lasting at least two weeks, affecting mood, cognitive, and neurovegetative functions, leading to significant distress [1]. Remission is challenging, with rates of only 30-50% after 6-8 weeks of antidepressant treatment [2]. The STAR*D study shows that 30-40% of patients achieve remission with first-line treatment, and a third fail even after four trials [3]. Recurrence risk is high, reaching 90% after three or more episodes [4][5].

The study aims to identify predictive factors for recurrence in major depressive disorder patients at Arrazi Psychiatric Hospital in Salé and to assess the impact of sociodemographic, biological, psychological, socio-environmental, and treatment-related factors on recurrence risk.

This retrospective, descriptive, and analytical study will collect data from medical records of major depressive disorder patients at Arrazi Psychiatric Hospital in Salé, including sociodemographic, clinical, and therapeutic details. Standardized data extraction ensures anonymity, and factors will be analyzed through univariate, bivariate, and multivariate statistical methods (logistic regressions), with adjusted odds ratios calculated for significant factors and a p-value threshold of < 0.05 applied.

The study shows that women represent approximately 60-70% of patients, with an average age of 30-40 at the first episode and often limited social support in 50-60% of cases. About 40% present psychiatric comorbidities, and 20-30% have physical comorbidities. Nearly 50% of patients have recently experienced stressful events, and 30-40% live in precarious conditions. Therapeutic adherence is insufficient for 30-40% of cases, and 25-35% discontinued treatment prematurely. Meanwhile, those who benefited from combined therapy represent 50-60%, showing a lower recurrence risk.

The recurrence of major depressive disorder poses a major clinical challenge, impacting long-term patient management. Identifying risk factors can enhance preventive interventions and therapeutic follow-up, while an integrative approach considering sociodemographic and psychological factors may help reduce relapse rates. These findings underscore the need for further research into the mechanisms of recurrence in major depressive disorder.

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Eating disorders, in particular Anorexia Nervosa (AN), are serious psychiatric disorders with a chronic course and high levels of disability and mortality. These disorders are characterized by a misrepresentation of body image and intense fear of putting on weight, leading to cognitive distortions related to food and weight control, as well as dysfunctional behaviors aimed at weight loss.

The aims of this paper are to provide a summary of the current literature concerning involuntary treatment in patients with eating disorders and to assess whether there is a difference in terms of baseline characteristics and treatment outcomes between patients treated both voluntarily or involuntarily.

Relevant articles were identified by searching the following terms: “treatment refusal”, “involuntary/compulsory/coercive/forced treatment/admission”, “eating disorders”, “anorexia nervosa”, “bulimia nervosa”. Research was restricted to articles concerning humans and published between 2014 and 2024 in English.

The treatment of eating disorders consists in a combination of weight control/weight gain methods and psychotherapy, as well as the treatment of organic complications associated with starvation and low body weight.

Involuntary treatment is usually intended for patients having worse baseline conditions. Factors associated with increased involuntary treatment utilization were female sex, lower age, psychiatric comorbidities, more severe disease with lower weight at admission and a longer course.

Concerning short term outcomes, the involuntary treatment can be life saving and half of these patients accept the treatment in 2 weeks time. Studies show that the involuntary treatment did not have a significant negative impact in the doctor-patient therapeutic relation. In terms of long term outcomes, patients treated involuntarily had similar outcomes to those treated voluntarily, having better outcomes in some domains, including menstruation, number of admissions and functionality.

The denial of the illness and lack of insight in AN raise practical and ethical questions relating to the autonomy of the patient and the responsibility of the family and health care practitioners. The involuntary treatment of eating disorders is a complex area and further research including quantitative and qualitative studies is needed.

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In forensic psychiatry, the most common diagnoses among the affected population are mood and psychotic disorders, personality disorders, or other conditions including intellectual disabilities. These individuals are either offenders or victims in criminal cases. Moreover, the tendency towards criminal behavior, disinhibition, agitation and aggression may also be associated with a neurocognitive disorder. Criminal behavior has been detected in 37.4% of frontotemporal dementia, 7.7% of Alzheimer’s disease, and 20% of Huntington’s disease patients.

Raising awareness on the potential presentations of disinhibited behaviors through three case reports and on the importance of detailed clinical evaluation to differentially diagnose and appropriately manage forensic referrals.

Each case was evaluated based on a predefined procedure comprising the anamnesis, mental status examination, review of previous medical and forensic records, neurological consultation including neuropsychiatric battery, social investigation and any other relevant information. Informed consent was obtained from all patients before presentation.

Case 1

A 63-year-old male, presented with a legal request of determining the need for a legal representative. The patient, who previously showed no similar behavior, repeatedly took loans under his own name, sold his assets at undervalued prices, experienced difficulties managing money, and was easily deceived. The patient was determined to exhibit frontal-type memory impairment, consistent with behavioral variant FTD (bvFTD), and it was deemed appropriate to appoint him a legal representative.

Case 2

A 52-year-old male, presented to assess his criminal responsibility regarding a theft offense. Anamnesis revealed forgetfulness, difficulties in managing money, tendency to take items from stores without paying, and repetitive behavior of cooking. Detailed examination and tests conducted led to a diagnosis of anxiety disorder, with a conclusion indicating full criminal responsibility.

Case 3

A 72-year-old male was hospitalized regarding an insult towards legal authorities. During the observation period in the inpatient ward, he exhibited similar behaviors. However, the final diagnosis was consistent with no significant psychopathology, and the patient was deemed criminally fully responsible for this act.

In cases where behavioral disturbances predominate, the possibility of frontal lobe dysfunction should be considered. Nevertheless, temporality relationships in symptomatology and the course of the disease, as well as where, when, and how the criminal act happened should also be taken into account. Cases which have similar initial presentations may finally lead to unrelated diagnoses. Systematic evaluations are necessary to accurately guide the legal authorities as well as planning treatment.

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Impairments in theory of mind, which influence the ability to accurately perceive and comprehend the mental states of oneself and others, play a pivotal role in psychiatric diseases. Understanding these cognitive aspects is crucial for developing targeted interventions and improving overall patient outcomes.

The purpose of this study is to examine theory of mind in individuals at risk for bipolar disorder and in the early stages of the disorder.

Sixty-two individuals with first-episode bipolar disorder (FE-BD) (mean age 21.92±4.58), seventy-eight individuals at ultra-high risk for bipolar disorder (UHR-BD) (mean age 20.5±3.93), and seventy-four healthy controls (HC) (mean age 23.36±5.28) were included in this study. The Hinting Task (HT) and the Reading the Mind in the Eyes Test (RMET) were applied to assess theory of mind.

The groups differed significantly in RMET positive (F(2-200)=5.087, p=0.007), neutral (F(2-200)=4.777, p=0.009) subscores, and total score (F(2-200)=11.267, p=0.000). Similarly, differences were found among the groups in terms of hypomentalization (F(2-174)=5.251, p=0.006), hypermentalization (F(2-174)=4.786, p=0.009), and total scores (F(2-174)=13.292, p=0.000) on the Hinting Task. No significant differences were observed in RMET negative scores among the groups (p>0.05). Both the FE-BD and UHR-BD groups exhibited significantly lower scores than the healthy controls across positive, neutral, and total RMET scores, as well as in total Hinting Task scores (p<0.05). Hypomentalization and hypermentalization errors were higher in the FE-BD and UHR-BD groups than in the HC group (p<0.05).

The results revealed significant differences in theory of mind performance between groups, including RMET scores and Hinting Task results. Individuals with first episode bipolar disorder (FE-BD) and those at ultra high risk for bipolar disorder (UHR-BD) consistently scored lower than healthy controls, emphasizing the need for targeted, early interventions in theory of mind and related cognitive processes. Future studies investigating clinical and neurobiological correlates of theory of mind across different stages of bipolar disorder are needed.

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Aging well in a cross-cultural perspective may encompass pertinent challenges in terms of adjustment, sexual well-being and satisfaction with life in the late years.

Considering the paucity of empirical data concerning cultural diversity of experiencing aging, this study aims to help fill this gap by assessing the specific patterns of sexual satisfaction, adjustment to aging (AtA), and life satisfaction with life (SwL) of older adults in Portugal and Spain.

This cross-national study included 443 older adults, aged 65 and older, from Portugal and Spain. Five instruments were applied: (a) Adjustment to Aging Scale (ATAS); (b) Satisfaction with Life Scale (SwLS); (c) New Sexual Satisfaction Scale - Short (NSSS-S); (d) Mini-Mental State Exam; and (e) Sociodemographic, health and lifestyle questionnaire. K-means cluster analysis was employed to identify and characterize the clusters considering adjustment to aging, sexual satisfaction and life satisfaction. One-way ANOVAs were conducted to analyze differences for sexual-well-being among clusters.

Findings indicated three clusters, which explained 79.3% (R-sq = 0.793) of the total variance: Cluster #1: “Well Adapted” (n = 37, 8.8%), Cluster #2: “Struggling to Adapt” (n = 141, 31.8%), and Cluster #3: “Active Agers” (n = 265, 59.8%). Participants in Cluster #1 were mostly Portuguese, with high levels of AtA, sexual satisfaction, and SWL. Conversely, Cluster #2 integrated mostly Portuguese participants with moderate sexual satisfaction, and lower levels of AtA and SwL. Participants from Cluster #3 were mostly Spanish with moderate levels of AtA and reduced sexual satisfaction and SwL.

This study innovates by exploring the elaborate interplay among sexual satisfaction, AtA, and SwL in a cross-cultural perspective, with implications for tailoring interventions, service planning, development and evaluation of culturally-diverse older populations.

Adjustment to aging; cluster analysis; older adults; satisfaction with life; sexual satisfaction.

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Nomophobia among university students is recognized as an addictive issue, as their attention is often difficult to divert from smartphones, especially during class. This issue is increasingly evident among nursing students, who frequently check their smartphones during class (p < 0.001), making nomophobia an important concern.

We conducted an umbrella review aimed at assessing the prevalence of different psychological and behavioral symptoms among nursing students, including nomophobia, anxiety, sleep disturbances, fear, and stress.

This meta-synthesis combined evidence from 20 systematic reviews and meta-analyses, incorporating 354 primary studies. Publication records were retrieved from PubMed, CINAHL, PsycINFO, and Scopus. The methodological quality of each meta-analysis was assessed using the AMSTAR-2 tool. Reporting followed the PRISMA guideline checklist.

Our synthesis revealed that 28% (95% CI: 24%–33%) of nursing students experience psychological and behavioral symptoms. Nomophobia/smartphone addiction was observed at 30% (95% CI: 12%–49%). Other prevalent symptoms included anxiety at 29% (95% CI: 17%–40%), sleep disturbances at 48% (95% CI: 5%–91%), stress at 27% (95% CI: 17%–37%), and fear at 41% (95% CI: 7%–75%).

Our findings suggest that nursing students are increasingly involved in nomophobia. As smartphones play a central role in daily life, digital detoxification is not easy. Although our research did not explore the relationship between nomophobia and other symptoms, the presence of issues such as anxiety, sleep disturbances, fear, and stress in nursing students warrants further investigation.

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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.

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Social deficits are a significant impairment in adult ASD, leading to difficulties in socio-emotional cognition, communication, and relationships. Effective social skills interventions are crucial during the transition to adulthood. The UCLA PEERS® (Program for the Education and Enrichment of Relational Skills) for young adults is a prominent and well-researched intervention, implemented in over eighty countries and translated into numerous languages. This program includes concurrent sessions for young adults and their parents, aiming to improve social skills and reduce ASD-related social issues

The current study aimed to test the effectiveness of a culturally adapted Persian -translated version of PEERS® for young adults with ASD without intellectual disabilities.

Three psychiatrists and two psychologists underwent PEERS® training and translated the manual into Farsi, adapting it culturally for Iran. Twenty-four young adults with ASD and their parents participated in the study, randomly assigned to a treatment group or a control group. Inclusion criteria were males aged 18-30 years with an ASD diagnosis, predominant social difficulties, motivation to participate, and a family member acting as a social coach. Exclusion criteria included intellectual disability, major psychiatric conditions, and significant verbal or literacy difficulties.

Participants attended 16 weekly 90-minute group sessions, covering topics like conversations, humor, electronic communication, dating etiquette, conflict management, and bullying. Sessions were led by a PEERS-certified psychologist and an assistant behavioral coach. Weekly meetings were held to align session content and address potential issues.

The culturally adapted Persian -translated version of PEERS® was perceived as beneficial by young adults with ASD and their caregivers, improving social skills and quality of life. However, quantitative measures did not show significant changes, indicating a need for further refinement and investigation to achieve measurable improvements in social functioning.

While qualitative feedback indicates that both young adults with ASD and their caregivers found the caregiver-assisted social skills intervention to be beneficial in improving social skills and overall quality of life, the quantitative measures did not show significant changes. This suggests that while the intervention may have positive perceptual impacts, further refinement and investigation are needed to achieve measurable improvements in social functioning.

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The Pain Catastrophizing Scale (PCS) is a widely used self-report tool for evaluating pain-related catastrophizing. In response to the need for more efficient diagnostic tools in clinical environments, the PCS has been shortened from 13 to 4 items in developing the brief version.

The objectives of this study were: (1) to examine the factor structure of a Korean-language version of the brief K-PCS and (2) to assess the reliability and validity of the brief K-PCS.

A total of 131 patients seeking treatment at a tertiary pain center in Daejeon, Korea, participated. Confirmatory factor analysis (CFA) with maximum-likelihood estimation was performed to evaluate the adequacy of the one-factor model. Cronbach’s alpha coefficients and Pearson correlations were calculated to investigate internal consistency and 2-week test-retest stability of the brief K-PCS, respectively. For concurrent validity, Pearson correlations were also calculated to examine the relationships between the brief K-PCS and various outcome measures.

The confirmatory factor analysis confirmed the adequacy of the brief K-PCS’s unifactor structure, indicated by excellent fit indices (CFI = .999, TLI = .996, SRMR = .039). The brief K-PCS exhibited high internal consistency (Cronbach’s α = .83). Test-retest correlations over a 2-week interval was .744 (p < .001), indicating high stability. For concurrent validity, the brief K-PCS showed significant positive correlations with measures of depression, fearful thinking, physical response, avoidance, and pain-related anxiety (p < .001), and significant negative correlations with quality of life measures, including physical, psychological, social relationships, environmental, and general quality of life (p < .001).

The brief K-PCS is a reliable and valid tool for assessing pain catastrophizing in a Korean patient sample with chronic pain.

H. Yang Grant / Research support from: National Research Foundation of Korea Grant funded by the Korean Government(NRF-2022S1A5A2A03050752), J. M. Park Grant / Research support from: National Research Foundation of Korea Grant funded by the Korean Government (NRF-2022S1A5A2A03050752), S. B. Cho Grant / Research support from: National Research Foundation of Korea Grant funded by the Korean Government (NRF-2022S1A5A2A03050752), S. Y. Lee Grant / Research support from: National Research Foundation of Korea Grant funded by the Korean Government (NRF-2022S1A5A2A03050752), C. Noh Grant / Research support from: National Research Foundation of Korea Grant funded by the Korean Government (NRF-2022S1A5A2A03050752), C. Roh Grant / Research support from: National Research Foundation of Korea Grant funded by the Korean Government (NRF-2022S1A5A2A03050752), S. Cho Grant / Research support from: National Research Foundation of Korea Grant funded by the Korean Government (NRF-2022S1A5A2A03050752)

The role of emotional regulation (ER) has emerged as a key mechanism associated with psychosis with important implications for its onset and maintenance. However, knowledge about ER in psychosis has been predominantly quantitative, often neglecting patients’ own perceptions of the difficulties they experience when dealing with their emotions.

To address this gap, we have undertaken a qualitative study to investigate ER in individuals with schizophrenia and schizoaffective disorder using semi-structured interviews. Given the qualitative nature of the study, we have no specific hypotheses. Instead, we aim to explore the stages of emotional regulation and the factors that influence ER in people with schizophrenia and schizoaffective disorder, aligning our investigation with existing theoretical models.

Patient recruitment and data collection are in progress. Thematic analyses will be carried out.

Results will be presented during the European Congress of Psychiatry.

We expect that this study will provide a deeper understanding of ER from the individuals’ perspectives and enrich ER literature and theoretical models related to clinical populations. Ultimately, this research aims to contribute to the development of quantitative studies to test new hypotheses and design individual-tailored psychological interventions aimed at improving ER in patients with schizophrenia and schizoaffective disorder.

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Physician Assisted Death (PAD) has been legalized or decriminalized in over a dozen jurisdictions around the world, and many other jurisdictions are considering assisted dying laws. Most jurisdictions only allow PAD in terminal conditions while a minority allow PAD outside end-of-life situations, with a small number allowing PAD for sole mental illness conditions. A key element in assessments of PAD requests is whether those assessments can filter out traditional suicidality, for which suicide prevention is provided, from other motivations for assisted death, for which PAD may be provided.

1. 1. To recognize the range of factors that may motivate assisted dying requests.

2. 2. To understand the factors that inform assisted dying assessments, specifically how the assessments attempt to identify suicidality.

3. 3. To appreciate the degree of certainty or uncertainty that assisted dying assessments actually identify suicidality in different patient populations.

This presentation briefly reviews evidence related to motivations leading to assisted dying requests in different populations, and then focuses on reviewing guidelines PAD assessors use to attempt to identify traditional suicidality, and to distinguish that from other motivations leading to PAD requests. These guidelines are compared to established evidence and factors related to suicide risk and suicide prevention.

1. 1. Different factors motivate different populations to seek assisted death, with those making PAD requests in terminal situations frequently seeking PAD in efforts to preserve dignity, and those seeking PAD outside terminal conditions or for sole mental illness citing feeling a burden, or an accumulation of multiple life stressors, as fueling their PAD requests.

2. 2. Most of the factors presented in guidance on distinguishing and separating suicidality from PAD requests equally apply to traditionally suicidal individuals and to those requesting PAD.

3. 3. Evidence shows that the few distinguishing factors used to attempt to separate suicidality from PAD requests, specifically impulsivity and acting on one’s own, do not actually filter out suicidality.

While a key goal of physician assisted death assessments is to identify and separate traditionally suicidal individuals from those seeking and receiving assisted death, current assessment techniques are unable to filter out suicidal individuals in an unknown number of cases.

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Parkinson’s Disease is associated with depigmentation of the substantia nigra and locus coeruleus, with specific pathophysiological alterations. It is characterized by tremor at rest, bradykinesia, postural instability and rigidity. But there are also other comorbid psychiatric disorders that accompany it, such as cognitive impairment, psychotic symptoms (hallucinations and delusions), mood disorders and sleep disorders, among others.

The main objective of this work is to review the current scientific evidence on the management of depression in Parkinson’s Disease.

The case of a 75-year-old man with a neurological history and a diagnosis of depression with a poor evolution is presented. A detailed search was performed on UpToDate using the search terms “Parkinson’s Disease” and “Depression”.

This is a 70-year-old man with a history of Parkinson’s disease and comorbid depression with a poor evolution. A multitude of therapeutic options have been tried, such as SSRIs, SNRIs, antipsychotics, tricyclic antidepressants and an intensive psychotherapeutic approach. Despite what has been described, the expected improvement is not obtained and, given the difficulties in the treatment of his Parkinson’s Disease, an update is necessary according to the scientific evidence collected.

According to the scientific evidence consulted, among the antidepressants most studied in Parkinson’s Disease are SSRIs, SNRIs and tricyclic antidepressants. The choice of antidepressant treatment will depend on the patient’s main symptoms and the risk-benefit assessment of starting treatment. The importance of cognitive-behavioral treatment is also highlighted.

Depression is one of the most common psychiatric disorders seen in PD. Depressive symptoms in PD are associated with increased motor disability and decreased quality of life. It is estimated that up to 50% of patients have depressive symptoms.

In conclusion, the approach to depression in Parkinson’s Disease must be multidisciplinary and comprehensive, with both psychopharmacological and psychotherapeutic treatment.

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Healthcare workers (HCW) face a growing crisis marked by high burnout levels (40-60%) and a rising intent to leave the profession. Current interventions focus mainly on individual resilience but have limited collective impact. Emerging evidence suggests that “Moral Injury” (MI)—a deep discord between HCW values and their practice, often worsened by organizational and economic constraints—may play a key role in this crisis.

The primary aim of this study was to describe the manifestations of MI among HCW in France, with a healthcare system characterized by universal health coverage. Secondary objectives included the psychometric validation of the Moral Injury Inventory (MII) for HCW, analysis of organizational determinants of MI, and modeling of the underlying mechanisms of this phenomenon.

This cross-sectional, observational study was conducted nationally via an online survey. Measures included the MII, the Moral Injury Events Scale (MIES), the PHQ-9 for depression, the GAD-7 for anxiety, the Maslach Burnout Inventory (MBI), and the EuroQol 5-Dimensions (EQ-5D) for quality of life. Item Response Theory (IRT) was used to test the MII, including assessments of construct validity, and reliability. Structural equation modeling (SEM) was used to explore complex interactions between MI and other variables, including burnout, depression, and anxiety.

Nearly 3,000 HCW participated in the survey. Psychometric analysis confirmed that the MII met IRT model assumptions, including unidimensionality, local independence, and monotonicity, with fit indices indicating adequate model fit (RMSEA ≤ 0.08, CFI, TLI ≥ 0.95, and infit mean square statistic ranging between 0.7 and 1.0). Differential Item Functioning analysis revealed no item biases. Over 50% of HCW reported experiencing MI, with notable variability across structural/organizational characteristics. MI and burnout emerged as distinct yet frequently associated constructs, with moderate to strong correlations observed between them. Their combined presence had a cumulative negative impact on health outcomes, with affected HCW showing higher levels of depression, anxiety.

This study highlights the high prevalence of MI among HCW in France, even within a robust healthcare system with universal coverage, and confirms that MI is distinct from burnout. These findings underscore the need for systemic interventions that address organizational factors, beyond the current individual-focused approaches used for burnout. Such a shift in focus would also help move away from the current tendency to over-burden and even blame HCW for systemic issues beyond their control. Given the global nature of the healthcare crisis, an international study is essential to identify systemic factors across healthcare settings, paving the way for a holistic, worldwide approach to supporting the healthcare workforce.

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Therapeutic Drug Monitoring (TDM) plays a crucial role in optimizing treatment for patients with psychiatric disorders and comorbid medical conditions, particularly in the elderly. This talk will focus on the practical application of TDM in managing polypharmacy and drug-drug interactions in a geriatric patient with mood disorders. Using a case-based approach, the discussion will highlight how TDM can guide dose adjustments, improve treatment efficacy, and minimize adverse effects in patients with multiple comorbidities.

Emphasizing real-world clinical challenges, this session will provide practical insights into integrating TDM into psychiatric practice, ensuring safer and more effective pharmacotherapy. Audience interaction will be encouraged through live voting and discussion to enhance learning and application in daily clinical settings.

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Knowledge of the prenatal predictors of postpartum depressive symptoms is of fundamental importance in preventing them.

This study aimed to examine whether first trimester maternal hair cortisol influenced maternal postpartum depressive symptoms.

The women (N = 75) were tested twice: in the first trimester of pregnancy and within three months after delivery. In the first trimester, they had hair samples taken and were examined using a sociodemographic survey and questionnaires: the Edinburgh Postnatal Depression Scale (EPDS), the Perceived Stress Scale (PSS-10), and the Zimbardo Time Perspective Inventory (ZTPI). After delivery, women completed a survey about the course of delivery and their child’s health, EPDS, PSS-10, and ZTPI.

A multiple hierarchical regression analysis was conducted to identify the predictors of postpartum depressive symptoms. In the first step, presence of maternal chronic illness and birth length were added, since these variables were associated with postpartum stress in our study. In the second step, we added the scores on depressive symptoms (EPDS) and stress (PSS-10) in the first trimester. After including hair cortisol concentration in the third step, depressive symptoms, stress, and hair cortisol concentration in the first trimester turned out to be predictors of postpartum depressive symptoms. The results showed that higher levels of depressive symptoms and stress and a lower level of hair cortisol concentration in the first trimester were associated with higher levels of postpartum depressive symptoms. We conducted mediation analyses to test time perspective as a mediator in the relationship of hair cortisol concentration in the first trimester to postpartum depressive symptoms.The results suggested that fatalistic time perspective mediated the relationship between hair cortisol concentration in the first trimester and postpartum depressive symptoms. In other words, women with lower hair cortisol concentration in the first trimester were more likely to develop postpartum depressive symptoms, and this relationship was explained by fatalistic time perspective.

The results of our study indicate that women with very low hair cortisol concentration in the first trimester are at greater risk for postpartum depression. These are the first data to show that low level of cortisol in the first trimester can be a predictor of maternal postpartum depressive symptoms. The results of our study suggest that examining hair samples in the first trimester of pregnancy may be a valuable method for identifying women at risk of developing postpartum depression.

None Declared

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

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

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

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

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

Exclusion criteria: intellectual disability.

Schizophrenia, mother-child relationship, emotions, patients.

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

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

None Declared