Electrodermal activity (EDA) measures the skin’s electrical properties. It varies according to the sweat gland’s activity which responds to the sympathetic nervous system (Boucsein W. Electrodermal Activity. Berlin: Plenum Press; 2012). Previous literature has reported lower EDA during bipolar and unipolar depressive episodes (Sarchiapone M, et al. BMC Psychiatry 2018; 18: 22 & Valenzuela-Pascual C, et al. Acta Psychiatr Scand 2024). Historically, heightened anxiety has been correlated with increased EDA, although findings in this area have been inconsistent (Naveteur J, et al. Int J Psychophysiol 2005; 56(3): 261–269).

This study aimed to determine whether significant differences in EDA exist among depressed patients based on their levels of anxiety.

We analysed EDA recordings from an E4 wearable device utilised by 29 depressed patients with bipolar disorder. They wore the device for a period of 48 hours without altering their daily routines. The tonic mean and phasic peaks parameters of EDA were extracted and analysed via a mixed-effects model for repeated measures, incorporating sleep state and anxiety level as variables. Anxiety levels were assessed based on the scores from item 10 on the Hamilton Rating Scale for depression, which reflects psychic anxiety.

The results indicated that anxiety levels did not significantly influence any of the models examined. However, in the phasic peaks model, there is a noteworthy interaction between anxiety level and sleep status (p < 0.01). Both models demonstrated a tendency towards increased EDA values in the high anxiety group although these findings did not reach statistical significance. This trend was consistent across both sleep states for the tonic mean model (Image 1). In contrast, the high anxiety group exhibited higher phasic peaks values (M [SD] = 2.33 [0.80-3.86]) compared to the low anxiety group (M [SD] = 2.33 [0.80-3.86]) only during wakefulness, although this difference was not statistically significant (p > 0.05) (Image 2).

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These findings should be interpreted with caution due to the small sample size and the imbalance in the distribution of low (17%) versus high anxiety (83%) participants. Furthermore, anxiety is a multifaceted symptom that should be evaluated using a more comprehensive assessment tool. To validate these preliminary observations, it is essential to increase the sample size and use a more precise measure of anxiety.

None Declared

It is well established that user behavior does not align with clinical recommendations regarding using medication in psychotic disorders, particularly bipolar disorder (BD). Nonadherence to treatment carries a high risk of relapse due to the recurrent nature of the illness and is influenced by multiple factors

The aim of this study is to investigate the prevalence of medication adherence among BD patients and to explore the various factors contributing to poor adherence.

This cross-sectional, descriptive, and analytical study was conducted with patient diagnosed with bipolar disorder at the Psychiatry “A” Department of Hedi Chaker University Hospital. Data on clinical and sociodemographic variables were collected between March and September 2023 using a questionnaire, alongside the Medication Adherence Rating Scale (MARS) to evaluate treatment adherence.

A total of 37 patients with BD completed the questionnaire. The mean age was 45.4 ± 13.9 years, with a sex ratio (M/F) of 1.46.

In this study, 73 % of patients had BD type I and 27% had BD type II.

The mean MARS score was 7.14 ± 2.13 and 62.2% were adherent to their treatment.

Only 16.2% of bipolar patients discontinued their medication due to side effects, while 51.4% present unintentional poor adherence.

A significant association was found between treatment adherence and socio-economic status (p = 0.05).

The MARS score was negatively correlated with the number of hospitalizations (p = 0.05, r = -0.315)

This study highlights that treatment adherence in bipolar disorder is influenced by various factors, with socio-economic status being a significant determinant. The negative correlation between MARS scores and the number of hospitalizations suggests that better adherence is associated with fewer hospitalizations. Improving treatment compliance is crucial to reducing the risk of recurrence and hospitalization in BD.

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Eating disorders (EDs) are complex conditions with significant impacts on physical and mental health. This study investigates hospital admissions and resource utilization for EDs among pediatric patients in Spain over a seven-year period, emphasizing the effects of the COVID-19 pandemic.

To analyze the epidemiological trends, prevalence, and hospital resource use for pediatric ED admissions in Spain from 2016 to 2022.

A retrospective analysis was conducted using data from Spain’s Minimum Basic Data Set of acute hospitals (CMBD-H) for patients aged 10–19 years with an ED diagnosis (ICD-10-CM code F50) between January 1, 2016, and December 31, 2022. Trends in hospitalization rates, types of EDs, comorbidities, and resource utilization were assessed.

The study identified 8,275 pediatric ED admissions, comprising 17% of all mental disorder admissions. Table 1 summarizes the characteristics of hospital admissions by age group (10-14 years and 15-19 years). Hospitalization rates increased from 19.4 per 100,000 in 2016 to 32.7 in 2022, with a notable rise in the 10–14-year age group post-pandemic. Anorexia Nervosa (AN) was the predominant diagnosis (71.6%). Psychiatric comorbidities were present in 35.6% of cases. The average length of stay was 24 days, with annual direct medical costs totaling €3 million and a median cost per admission of €11,580. AN patients had longer hospital stays (median 28 days) compared to other disorders, while Bulimia Nervosa (BN) patients had shorter stays (median 14 days) but higher average costs (€12,300). Table 2 details the average hospital length of stay and average cost of hospital admissions for EDs among adolescents in Spain.

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There was a 70% increase in pediatric ED admissions in Spain from 2016 to 2022, with a significant post-pandemic rise in younger patients. This underscores the need for improved early detection and intervention strategies, as well as enhanced screening for comorbid mental health conditions to manage the growing hospital demand effectively.

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

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

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

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

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

None Declared

Alexithymia, the limited ability to recognize and describe emotions, reflects impairments in emotional awareness and is a prevalent dysfunctional trait in individuals with addiction. Pain is an interoceptive feeling processed through interoceptive pathways and serves as a homeostatic emotion that can motivate behavior. Pain sensitivity may play a role in the development and progression of alcohol use disorder (AUD). Interoceptive awareness (IA) refers to the ability to perceive the internal state of the body. Both interoceptive accuracy (IAc) and interoceptive sensibility (IS), the objective and subjective dimensions of IA, have been shown to be implicated in individuals with AUD.

Our objective was to compare alexithymia, pain sensitivity, IAc, and IS levels between abstinent patients with AUD and healthy controls. Additionally, we aimed to investigate the potential associations between the dimensions of IA and both alexithymia and pain sensitivity.

The study comprised 52 abstinent patients with AUD and 52 healthy control subjects. 92.3% (n=48) of the participants in each group were male, and 7.7% (n=4) were female. Alexithymia was assessed using the 20-item Toronto Alexithymia Scale (TAS-20). Pain sensitivity was measured with the Pain Sensitivity Questionnaire (PSQ). IAc was assessed using the heart rate tracking task, which measured participants’ awareness of their own heartbeat by comparing the number of heartbeats they perceived with an objective heart rate measurement. IS was evaluated using the Multidimensional Assessment of Interoceptive Awareness Version 2 (MAIA-2). The study included patients who had completed detoxification and been abstinent for at least three weeks while participating in or undergoing a 28-day abstinence-based inpatient treatment program.

Individuals with AUD scored significantly higher on self-reported measures of alexithymia (AUD group: 53.35 ± 11.83; control group: 44.63 ± 6.43; p < 0.001, F = 21.768) and significantly lower on the heart rate tracking task (IAc) (AUD group: 0.65 ± 0.15; control group: 0.84 ± 0.13; p < 0.001, F = 43.615). No significant difference was found in self-reported IS scores (AUD group: 114.06 ± 21.38; control group: 113.37 ± 13.52; p = 0.844, F = 0.039) or pain sensitivity scores (AUD group: 5.22 ± 1.67; control group: 5.18 ± 1.06; p = 0.892, F = 0.018). Alexithymia scores showed significant negative correlations with IAc scores (r = -0.256, p = 0.009) and IS scores (r = -0.361, p < 0.001). However, pain sensitivity scores did not significantly correlate with alexithymia (r = 0.083, p = 0.402), IAc (r = -0.103, p = 0.299), or IS scores (r = 0.136, p = 0.169).

Our findings support the hypothesis that alexithymia, which is linked to the development and progression of AUD, is associated with the dimensions of IA.

None Declared

Autism spectrum disorders (ASD) are developmental deviations that cause social, communication and behavioral problems. Valproic acid (VPA) works as an inhibitor of histone deacetylases. One of the presumed causes of ASD development is neuroinflammation. A low-grade inflammatory process in nervous tissue can cause serious disorders, leading to the death of neurons, impaired myelination and anatomical and biochemical changes in brain structures. Currently, there are known inflammatory markers that are detected in the blood and used to assess the level of inflammation in the brain, for example, leukocyte elastase.

To investigate the effect of postnatal administration of VPA on the behavioral manifestations of ASD and the activity of leukocyte elastase in blood serum in male white rats.

The study was performed on male rat pups. The conditions for keeping animals and the experimental procedures used were approved by the Bioethics Commission of Moscow State University (registration No. 12.3 of 17.11.2022). The animals were administrated intraperitoneally with water (H2O) or VPA at a dose of 150 mg/kg from the 6th to the 12th day of life. The study used standard behavioral tests: weight monitoring from 6-12 days of life, “Social behavior” in the sibling/stranger modification on 55 day. The animals were decapitated on the 57th day. Blood was collected into tubes with serum separating gel (BD Vacutainer® SST™II Advance), centrifuged at 2000 g, serum was frozen -78°C. The activity of leukocyte elastase in blood serum was measured spectrophotometrically by the rate of hydrolysis of the substrate BOC-Ala- ONp (Biomedical, Inc.).

An important physiological indicator for ASD in the model used is a slowdown in weight gain. As a result of the study, it was revealed that the weight of males after 6 days of VPA administration was lower compared to control individuals (p = 0.003). In the “Social Behavior” test, in males who received VPA, the latent period for leaving the starting compartment was significantly longer than in the control (p = 0.019); also, experienced males later approached a stranger as if they were a stranger (p = 0.037), compared to controls. In this study, the activity of leukocyte elastase in the rat’s blood serum receiving VPA was significantly higher than in control individuals (p = 0.04). Similar deviations are observed in patients with ASD.

These results allow us to conclude that the administration of valproic acid to rats in the early postnatal period causes changes in physiological and behavioral characteristic typical for ASD. This confirms the validity of the created experimental model. The increase of leukocyte elastase activity in the rat receiving VPA indicate the role of inflammation in pathogenesis of ASD.

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Methamphetamine (MA) is one of the most addictive drugs globally. Among its harmful consequences, methamphetamine use disorder (MUD) and methamphetamine-induced psychosis (MAP) are prevalent and increase the burden of mental health worldwide. Recent studies highlighted the relationship of the disorders and various factors including patterns of MA consumption and adverse childhood experiences (ACEs). Understanding the association between these factors and MUD and MAP is essential for advancing our knowledge and improving healthcare for our patients.

To investigate the association of MA use patterns, ACEs and the development of MUD and MAP.

This study analyzed data from a survey using the ThaiMIND questionnaire (September 2023 – June 2024). We collected participants’ socio-demographic details (including gender, age, income, employment, marital status, education), mental health history, other substances use, MA use patterns, ACEs, psychotic symptoms and their onset. The diagnosis of MUD and MAP were based on DSM-5 criteria. Univariate logistic regression was employed to examine the relationships, adjusting for socio-demographics and mental health history for MUD models, and adding other substances use and MUD diagnosis for MAP models.

In this study of 2,524 participants, 1,987 (78.72%) met the criteria for MUD, and 876 (34.71%) met the criteria for MAP. The use of yaba (MA or speed pill) reduced the risk of MAP compared to ice (crystalline MA)(OR = 0.32 [0.12 – 0.85]) while combining two types of MA raised the risk of MAP compared to ice alone (OR = 1.96 [1.37 – 2.81]). For MUD, more frequent MA use, compared to monthly or less, increased the risk with OR = 1.81 [1.34 – 2.43] (2-4 times/month), 2.27 [1.58 – 3.27] (2-3 times/week), and 4.00 [2.87 – 5.59] (4 or more times/week). Similarly, for MAP, using MA 2-3 times/week raised the risk (OR = 1.59 [1.14 – 2.22]), and using it more than 4 times/week further increased the risk (OR = 2.16 [1.62 – 2.87]). Additionally, MA injection significantly heightened the risk of MUD (OR = 6.29 [3.28 – 12.04]). Emotional abuse (OR = 1.84 [1.36 – 2.47]) and physical abuse (OR = 1.71 [1.29 – 2.27]) were linked to a higher risk of developing MUD. In addition, physical neglect (OR = 1.29 [1.02 – 1.65]), emotional neglect (OR = 1.47 [1.13 – 1.90]), and sexual abuse (OR = 1.46 [1.05 – 2.03]) were associated with an increased risk of MAP. The total number of ACEs also increased the risk of both MUD (OR = 1.28 [1.17 – 1.40]) and MAP (OR = 1.14 [1.05 – 1.24]).

The study demonstrates that MA use patterns and adverse childhood experiences significantly impact the risk of developing MA use disorder and MA-induced psychosis.

None Declared

Psychiatry faces numerous challenges that significantly affect mental health of people in Europe, from climate change, wars, migration, pandemics, to rapid advance of artificial intelligence. Among the most pressing issues are deteriorating mental health of children and adolescents and the lack of trained professionals. At the same time, progress in neuroscientific research contributes to the development of new effective treatments, e.g., monoclonal antibodies for Alzheimer’s disease; repurposing of drugs for psychiatric disorders, such as GLP-1 agonists, showed potential in treatment of alcohol addiction. There is also a renewed interest in psychedelics, recent studies verified their therapeutic efficacy in treatment of several mental disorders. Neurostimulation methods (rTMS, tDSC) are recognized non-pharmacological interventions; utilization of new technologies (AI, virtual reality, mobile apps, etc.) can help us in treatment and prevention of mental disorders.

None Declared

Depression is a chronic and recurrent mental condition, causing a high burden of disease, functional impairment, and significant economic costs worldwide.

To compare the neuropsychological profile, inflammation, and functionality in patients with a major depressive episode before and after treatment.

A longitudinal study was conducted, recruiting a total of 39 subjects, with a mean age of 42 years (12 men - 30.8% and 27 women - 69.2%) diagnosed with major depressive disorder (MDD). The neuropsychological profile was measured using the Screening of Cognitive Impairment in Psychiatry (SCIP) and the level of functionality with the Brief Assessment of Functioning (FAST) test. Both total scores and subscales were used, along with inflammatory biomarkers (IL-6, IL-1ß, TNF-α, PGE2) and oxidative stress markers (TAS, GSHtot, GSHfree, GSSG, CAT, SOD, GPx, and BDNF).

The paired t-test was used through the statistical program SPSS. A unilateral p-value less than 0.05 was considered statistically significant.

Significant differences were observed in both the Hamilton Depression Rating Scale (p < 0.001) and in the biomarkers total GSH (p < 0.15), GSH free (p < 0.029), and GSSG (p < 0.027) of patients at three months from the start of pharmacological treatment compared to baseline (Table 1). Differences were also observed at 3 months of treatment in the SCIP scale (p < 0.001) as well as in its subscales: Immediate verbal learning (p < 0.001), Working memory (p < 0.001), Verbal fluency (p = 0.007), and Delayed verbal learning (p < 0.001), and in the FAST scale (p < 0.001) and its subscales: Autonomy (p = 0.002), Cognitive (p = 0.004), Finances (p = 0.004), and Relationships (p < 0.001) (Table 2).

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Our results indicate that there are improvements at the cognitive and functional level in subjects taking antidepressant treatment. Changes in GSH and GSSG biomarkers were also observed, whose antioxidant function is crucial for protecting cells from oxidative damage. The findings suggest that oxidative stress is a crucial factor in the pathophysiology of MDD. The study highlights the potential of these biomarkers to guide therapeutic strategies and improve the management of depression.

None Declared

Women with a history of major depression are at risk of perinatal depression (PND). The associations between PND and other types of psychiatric disorders are less clear, although a recent GWAS revealed genetic correlations with almost all psychiatric disorders.

The aim of this study was to examine the association between PND and overall, and 17 type-specific, psychiatric disorders in a life course approach.

Leveraging Swedish nationwide health register and primary care data, we included all birthing women diagnosed with depression or prescribed for antidepressants during pregnancy or within a year postpartum, i.e., women with PND (n=122,720), during 2001-2022. Using incidence density sampling, we matched each case to 10 unaffected birthing women. We ascertained any diagnosis of psychiatric disorder over the lifetime from the National Patient Register. Using multivariable conditional logistic regressions, we estimated the association between PND and any, or subtypes of, psychiatric disorders dated before or after the PND diagnosis in a liftecourse approach. Moreover, we conducted a nested case control study to investigate the association of psychiatric disorders and subsequent PND, and a matched cohort study to investigate PND and subsequent psychiatric disorders.

In preliminary results, at a mean age of 31.0, we found that PND was highly associated with any other psychiatric disorders (adjusted odds ratio (aOR)=9.02, 95%CI 8.9-9.2). The association remained when excluding depression (aOR=6.2, 95%CI 6.1-6.3), and was comparable for psychiatric disorders dated before PND diagnosis (aOR = 9.0), whereas attenuated for diagnoses dated after PND (OR= 3.9). Most pronounced association was noted for bipolar, personality disorders, depression, and anxiety. The association was stronger in primiparous women and in women born ourside of Europe (p-for interaction <0.001).

Throughout life course, PND is associated with psychiatric disorders, particularly with bipolar disorder, personality disorder, depression and anxiety. These findings may shed light on shared genetic/risk factors between PND and other psychiatric disorders.

None Declared

Vitamin D deficiency is a significant problem that affects the population living in most countries. This issue is independent of place of residence, gender, age or skin color. It is mainly influenced by the climate we live in and anti-healthy lifestyle, including bad eating habits.

The aim of the study was to evaluate lipid profile, glucose level, vitamin D level, taking into account sociodemographic variables, smoking and alcohol consumption. The study also included assessment of depression taking into account sociodemographic variables and vitamin D levels in perimenopausal women.

The study was conducted in a group of 191 women. The study consisted of two stages. The first part was carried out by means of a diagnostic survey with the use of questionnaire technique. The survey form consisted of two parts: a questionnaire that included questions about sociodemographic data and selected medical information, and the Beck Depression Inventory. The second stage of the study involved the collection of peripheral blood from each respondent in order to determine lipid profile, glycemia and serum vitamin D levels.

The age of the female respondents ranged from 45 to 65 years, mean age was 53.1±5.37 years, median 53 years. Vitamin D result was below normal in 78%. 77% had elevated total cholesterol levels. 91.6% of the respondents had HDL fraction cholesterol levels within the normal range. On the other hand, 64.4% were characterized by too high LDL fraction cholesterol and 84.8% of women showed normal triglyceride levels. Among the respondents, 91.1% had normal glycemic levels. Analysis of collected data showed a weak negative correlation between serum vitamin D concentration and concentrations of: total cholesterol (rho=-0.14; p=0.05), LDL fraction cholesterol (rho=-0.16; p=0.026) and triglycerides (rho=-0.22; p=0.002) of the examined women. Only in the case of HDL fraction cholesterol (p=0.067) there was no statistically significant correlation. There was also no statistically significant correlation between serum vitamin D levels and glycemia and severity of depression (p=0.152).

Most of the women studied did not manifest depressive disorders. Of the various factors affecting the severity of depression, only education was associated with depression severity.

Smoking adversely affects serum vitamin D concentration in the examined women.

Cessation of menstruation influenced carbohydrate metabolism and vitamin D concentration. Blood glucose concentration increased with the age of the studied women.

There was a relationship between vitamin D concentration and values of total cholesterol, LDL fraction cholesterol and triglycerides. Therefore, considering the biological functioning of the studied women, it is important to maintain normal vitamin D levels.

None Declared

The early stages after the onset of a first episode of psychosis (FEP) are crucial for the long-term outcome of the disease. Good outcome can be expected in <50% of patients, but three-quarters of all patients who experience a remission from a first episode of psychosis will have a recurrence of psychotic symptoms within a year of treatment discontinuation. Relapse prevention is key to preventing disease progression and further deterioration. Considerable number of patients experiencing a first episode of psychosis, will eventually transition to a diagnosis of Schizophrenia, so maintenance treatment should be the preferred option even in stable patients after a first episode of psychosis to remain in recovery. There is scarce information about differential effectiveness of antipsycotics in the long term. In such an atmosphere, the idea of polypharmacy with antipsychotics arises and may gain more supporters. Despite its obsolence, and unclear therapeutic benefits, as well as significant health risks, polypharmacy with antipsychotics is relatively common. This practice, due to unwanted effects, can lead to the arbitrary discontinuation of medication, and the consequent relapse of psychosis.

To determine the association of transition to schiyophrenia after the first episode of psychosis with a monotherapeutic or polypharmacy approach to the use of antipsychotics.

A retrospective analysis of all hospitalized patients (87 patients, 65.5% were women), diagnosed with first episode of psychosis during a five-year period was conducted. The rate of relapse, and conversion to schizophrenia was analyzed in relation to the therapeutic approach (monotherapy vs polypharmacy with antipsychotics), within one year after the end of hospitalization due to the first episode of psychosis.

35.6% (31) of the subjects were treated with monotherapy. 25% (8) of them relapsed within a one-year period. 64.4% (56) of patients were treated with polypharmacy. 55.2% (48) of patients were treated with two antipsychotics, and 9.2% (8) with three. 75% (24) of subjects treated with polypharmacy had a relapse of psychosis within a year after discharge. There is a statistically significant difference between the groups of patients (p˂ 0.05).

A significantly higher rate of relapse, and conversion to schizophrenia within a year after the end of hospitalization due to the first psychotic episode exists in subjects who were treated with two or more antipsychotics compared to subjects treated with monotherapy. The practice of polypharmacy with antipsychotics should remain reserved for individual, specially selected patients.

None Declared

A multi-site randomized controlled study demonstrated that the community mental health intervention GBV, when combined with standard care in the German healthcare system, led to greater improvements in empowerment, quality of life, and needs-orientation for people living with severe mental illness. However, to gain a comprehensive understanding, it is essential to include service users’ perspectives alongside effectiveness data.

This study aimed to assess the implementation of GBV from the service users’ viewpoint, providing a holistic evaluation of the intervention beyond randomized trial results.

A mixed-methods approach was used to evaluate the service users’ experiences with GBV. Semi-structured interviews were conducted, transcribed, and analysed using thematic content analysis. Additionally, fidelity ratings were collected after 12 months of intervention, based on a scale developed from GBV quality standards, focusing on needs orientation, relationship building, and service availability.

The process evaluation revealed a greater increase in empowerment, subjective quality of life and treatment satisfaction as well as a greater reduction in unmet needs with a subjectively higher perceived manual fidelity. Qualitative interviews supported these findings, emphasizing the critical role of strong relationships with GBV staff, personalized care tailored to individual needs, and adherence to GBV’s quality criteria.

While the effectiveness of GBV has been established, ensuring fidelity to the intervention’s manual is crucial for large-scale implementation. Key factors for success include a focus on relationship building and needs-orientation, ensuring that service delivery aligns with the predefined GBV quality standards.

None Declared

As a result of crises such as the Covid-19 pandemic, depressive symptoms are increasing in the European population (Arias-de la Torre et al. Lancet PH 2023; 8: e889-98), with depression being one of the most common illnesses anyway and are even at the highest level ever measured in some countries, like in Germany (Mauz et al. Front PH 2023; 11: 106). Various treatment options are available, depending on the severity and individual preference of patients, but treatment-resistant depression in particular can pose major challenges for patients and clinicians. Transcranial pulse stimulation (TPS), an alternative NIBS method based on shock waves, has been available for several years and is CE-certified for the treatment of Alzheimer’s dementia (Chen et al. CNS Nsc 2023; 00:1-10). It enables, for the first time, a precise and non-invasive modulation of subcortical brain regions where previously surgical intervention was necessary (Legon et al. Hum. Brain Mapp 2018; 39:1995-2006).

The aim of this case series is to examine safety and effectiveness of TPS in patients with treatment-resistant depression.

In the present study, 5 patients (gender ratio female/male 3:2) who met the criteria for treatment-resistant depression underwent a total of 6 treatments within 14 days (each session with 6000 pulses, energy level 0.25 mJ/mm² and frequency 4 Hz). With the help of neuro-navigation using individual MRI scans, pulses were applied bilaterally in the frontal and parietal lobe as well as the precuneus area (Figure 1). Additionally the shell region of the nucleus accumbens was targeted with 300 pulses on both sides due to its involvement in the pathophysiology of depression. Written consent and the approval of an ethics committee were obtained for all patients. Before, during and immediately after the TPS intervention, the antidepressant medication of all patients remained unchanged. The Beck Depression Inventory (BDI-II) was used to assess the severity of depressive symptoms before the first and after the last treatment session.

Apart from a temporary feeling of pressure in the area of the temples in one patient, none of the patients experienced any side effects during and after the treatment. All patients showed a reduction in the BDI-II total score in the pre-post comparison: the mean value decreased from 41 to 26 (Figure 2).

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The results of this case series show that a significant improvement in depressive symptoms is possible using TPS as a potentially well-tolerated treatment option, even in cases of treatment-resistant depression. Sham-controlled studies with large numbers of patients are required to prove its long-term effectiveness and safety.

None Declared

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.

None Declared

One of the main mechanisms of action of LSD in psychedelic-assisted psychotherapy (PAP) is the activation of 5HT2A receptors. This triggers a cascade of neurochemical processes with the release of neurotransmitters and neurohormonal substances. The release of oxytocin in this process is well documented in pre-clinical studies, with recent evidence in healthy subjects. We have no data on oxytocin reactivity during LSD treatment in patients with psychiatric problems. It would be of great scientific interest to identify treatment biomarkers in this field.

The main objective of this pilot study is to obtain preliminary data on the reactivity of salivary oxytocin during a single LSD intake as part of PAP for anxiety disorders or depression. The secondary objective is to establish preliminary correlations between variations in oxytocin levels, intensity of perceived effects, intensity of psychedelic mystical experience, and the overall clinical response to treatment (anxiety-depression symptoms).

Participants are recruited among patients with resistant anxiety-depressive disorders enrolled in the psychedelic-assisted psychotherapy (PAP) program of the Division of Addictology, Department of Psychiatry (Geneva University Hospital). Salivary oxytocin is measured at four different time-points: before LSD intake, then 60, 90 and 180 minutes after intake. Self-perceived intensity of effects is also measured at these time points and a self-report questionnaire of mystical experience (MEQ-30) is administered at the end of the LSD session. Of note, self-reported symptoms of depression (BDI-II) and anxiety (SATI-T) are measured when participants enroll the PAP program, then a few months later right before the treatment and three weeks after treatment. ClinicalTrials.gov:NCT06557239

Six participants (out of 10 planned) have completed the entire protocol. Four additional participants will receive treatment within the next two weeks. Saliva samples are stored at -20.C and will be sent for analysis once recruitment will be over (November 2024). A significant effect of time (P= 0.02) of perceived intensity effects is observed across different time-points (30, 60, 90, 180, 360 minutes after treatment), with a peak effect at 180 minutes. We also observe a significant interaction (P=0.03) between self-perceived intensity of effects and the intensity of mystical experience measured with the MEQ-30. BECK and STAI-T scores will be analysed after post-treatment assessment.

Our preliminary data show a clear effect of self-perceived treatment intensity and a relation between this effect and self-reported mystical experience. It will be of great interest to include oxytocin data in this analysis as well as the evolution of self-reported symptoms of anxiety and depression. With the successful recruitment and easy adherence to the protocol, we will certainly have all data available by the end of 2024.

None Declared

Marriage is widely regarded as an important part of social life, providing emotional support and stability. However, public perceptions of marriages involving individuals with psychiatric conditions like schizophrenia and bipolar disorder are not well understood. Stigma likely plays a crucial role in shaping these perceptions and affects societal attitudes toward such unions.

This study aimed to explore and compare public perceptions of marriage in individuals with schizophrenia and in individuals with bipolar disorder, and to examine how these views affect their marital prospects.

A cross-sectional survey was conducted using an online form to gather data from the general population. It covered socio-demographic and clinical variables, as well as detailed descriptions of schizophrenia and bipolar disorder symptoms and outcomes. The survey also included questions on public attitudes toward marriage involving individuals with schizophrenia and bipolar disorder. Participants answered 13 questions about the right of individuals with these conditions to marry, their capacity to maintain a stable relationship, and whether they would personally consider or recommend marrying someone with these disorders. This study was inspired by the article of Kumar et al., 2019).

The study involved 304 participants, mostly young adults, with 246 being women. Around 35.6% had a family history of psychiatric illness, and 23.35% lived with someone with a psychiatric disorder. The findings revealed significant differences in public perceptions of marriage for individuals with schizophrenia versus bipolar disorder. Participants were more strongly opposed to marriage as a cure, especially for schizophrenia (p<10^-3), and more had never considered finding a partner for someone with schizophrenia compared to bipolar disorder (p<10^-3). Reluctance to marry someone with schizophrenia was also significantly higher, even if compatibility was present (p<10^-3).

Regarding bipolar disorder, concerns about marriage exacerbating symptoms were more prevalent compared to schizophrenia (p=0.001). Despite these concerns, the stigma around marriage with individuals affected by bipolar disorder appeared less severe, as indicated by participants’ greater openness toward the possibility of such a union in individuals with schizophrenia (p<10^-3).

Results emphasize the need for targeted awareness and educational initiatives to address misunderstandings and support the marriage goals of individuals with mental health conditions. Future studies should examine the factors shaping these perceptions and develop approaches to promote a more inclusive perspective on marriage and mental health, tackling stigma and challenging widespread stereotypes.

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Humor is widely recognized for its potential to improve psychosomatic health, enhancing both physical and mental well-being.

To investigate the correlation between humor styles and psychosomatic health in older adults.

A cross-sectional study was conducted with 83 older adults (41 females, 42 males), aged 65 to 94 years (mean age: 74.1, SD = 8.1). Participants completed a sociodemographic questionnaire, the 32-item Humor Styles Questionnaire, and the 36-Item Short Form Survey (SF-36). Linear regression analysis was used to examine the relationship between humor styles and psychosomatic health outcomes.

Self-Enhancing Humor. For Aggressive Humor, the mean was 22.7 (SD = 7.95), and for Self-Defeating Humor, 26.3 (SD = 8.70). The mean scores for Physical Health and Mental Health were 277 (SD = 84.5) and 272 (SD = 70.6), respectively. Self-Enhancing Humor had a significant positive effect on Mental Health (B = 3.458, SE = 0.893, p < 0.001), RF (B = 0.7659, SE = 0.375, p = 0.044), GH (B = 0.7113, SE = 0.234, p = 0.003), MH (B = 0.9711, SE = 0.228, p < 0.001), and SF (B = 0.7165, SE = 0.329, p = 0.033). Additionally, Self-Defeating Humor showed a significant negative effect on RE (B = -1.093, SE = 0.474, p = 0.024).

The findings suggest that positive humor styles, particularly Self-Enhancing Humor, are strongly associated with better psychosomatic health in older adults. Incorporating humor-based interventions could be a valuable approach to enhancing psychosomatic health in this population.

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Burnout is an occupational phenomenon that may be a risk factor for several mental health disorders. It is defined by three dimensions namely emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). The nursing workforce experiences high levels of burnout taking a toll not only on their mental state but also their intent to stay leading to issues on shortage.

This study aims to assess association of burnout and its dimensions to intent to stay of medical nurses working in a private tertiary hospital in the Philippines.

Analytical cross-sectional study using secondary data conducted by the Nursing Services Group of the private tertiary hospital last March 2023. A survey was done on nurses’ perceptions of their working condition using Maslach Burnout Inventory and McCain’s Intent to Stay tools. Variables were assessed through simple and multiple linear regression analyses.

On simple linear regression, burnout, civil status, years of experience, and years of tenure revealed significance in their respective categories. EE and DP dimensions showed negative association to intent to stay. On multiple linear regression, only burnout (p< 0.000 and -0.028) and those married with children (p< 0.000 and -0.028) had significant association. EE consistently showed negative association however, DP and PA had positive association to intent to stay. In most literatures, DP is associated to lower intent to stay as it is equated to cynicism or detachment in interpersonal relations which can manifest as negative or inappropriate attitudes towards clients, irritability, loss of idealism, and withdrawal (Maslach et al. World Psychiatry 2016; 15 103-11). However, in this study, nurses who were more detached had surprisingly higher intent to stay which may show how cynicism can be protective. It is a cognitive method of creating a protective distance to prevent them from letting their job performance suffer especially when dealing with the physical and emotional exhaustion, and feelings of ineffectiveness caused by excessive and prolonged stress (Akyurt et al. Medical Science and Discover 2023; 10 918-928).

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Consistent with global studies, burnout is associated to lower intent to stay among nurses. However, it is beneficial to have more research looking further into the comprehensive role of cynicism in burnout. In this study, nurses have built some level of cynicism that is able to preserve themselves in negative situations. However, with no proper management, depersonalization can aggravate ultimately leading to feelings of inadequacy and lower intent to stay. A deeper and more contextualized understanding about this phenomenon may help administrators improve existing operations and policies that can help foster a healthier working environment for the nurses.

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Individuals at Clinical High Risk of Psychosis (CHR-P) show increased risk for developing psychotic disorders. The relationship between the risk of developing psychosis and urbanicity has been previously described; however, there are divergent results regarding the relationship between positive psychotic symptoms and urbanicity.

The present study aims to analyze the clinical and sociodemographic differences between an urban and a rural population of youth with CHR-P.

The characteristics of the CHR-P program at La Fe Hospital (Valencia) are described and compared for the two populations in the study: a rural area comprising 10 towns with populations ranging from 200 to 29,000 inhabitants each, with an average of 12,600 inhabitants, and an urban area corresponding to the northern metropolitan area of Valencia. An analysis and comparison of the sociodemographic and clinical characteristics of the general population in both areas is also conducted.

Preliminary results are provided: The sample consists of 46 patients, 21 from the rural area and 25 from the urban area. The average follow-up for both groups was 8 months, with a transition rate to psychosis during this period of 19% (n=4) for the rural area group compared to 0% for the urban area group (p=0.04). Patients in the rural area group exhibited greater severity of positive psychotic symptoms with a higher positive PANSS score (14.19 ± 4.32) compared to the urban area group (11.12 ± 3.67), and this difference was significant (p=0.032). No statistically significant differences were found between the two groups for the rest of the variables.

The preliminary results of our study show greater symptom severity in individuals from rural areas. Demographic factors, resource provision, or delays in care might be related to this finding.

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