When an adolescent or young adult is diagnosed with cancer, they’re frequently accompanied by their caregiver. Literature shows that caregivers of adolescents and young adult cancer survivors (AYACS) frequently experience high anxiety and depressive symptoms. Being these caregivers an important source of support to AYACS during this challenging journey, one question emerges: does caregivers’ mental health impact AYACS’ quality of life (QoL)?

Considering this, this study examined the associations between caregivers’ mental health and AYACS’ QoL.

Forty-eight dyads were recruited in four hospitals and one association in Portugal. AYACS were mostly women (62.5%) and off-treatment (62.5%). They were, on average, diagnosed at 18.9 years (range: 15-25) and currently 21.98 (range: 15-38). Their caregivers were mostly women (77.1%) and, on average, 47.02 years (range: 19-76). Parent-child dyads were the most frequent. The Quality of Life Questionnaire Core-30 assessed the AYACS’ QoL. Caregivers’ mental health, the Hospital Anxiety and Depression Scale, and the FCR7 scale assessed caregivers’ anxiety and depressive symptoms and fear of cancer recurrence, respectively.

Preliminary results show that among AYACS’ QoL, only low social functioning was significantly related to high anxiety and depression in caregivers. Treatment status was also significantly positively related to AYAs’ social functioning and negatively to caregivers’ anxiety and depression. AYAs and caregivers’ ages at recruitment were also negatively correlated with caregivers’ anxiety. Age of AYACS at diagnosis, living with caregiver, and type of caregiver were not related to AYACS social functioning nor caregiver anxiety and depression. A model was tested, showing that caregivers’ anxiety and depression predict AYAs’ social functioning, having treatment status as covariable.

Caregivers’ mental health and treatment status were shown to be important for AYACS’ QoL, especially social functioning. This supports the need to assess how caregivers are adapting to this new stage of life and provide specialized support when needed. This could indirectly have a positive impact on the QoL of AYACS. It’s important that the support provided considers the diverse challenges these caregivers face, which can differ from other caregiver groups.

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There has been an increasing socio-medical discourse on the humanitarian approach to the use of restraint in psychiatric inpatient units.

It is necessary to investigate the attitudes of psychiatric hospital staff toward the use of restraint in psychiatric inpatient units and to identify the factors influencing these attitudes.

This study examined the attitudes of psychiatric hospital staff toward the use of restraint in situations involving physical violence toward other patients, verbal violence toward other patients, physical violence toward staff, verbal violence toward staff, and disruption of the treatment environment. The study also investigated factors related to the considerations and perceived burdens (both legal and medical) associated with the use of restraint, comparing these findings with data from a survey conducted 10 years ago.Attitudes toward restraint were not significantly associated with gender, age, or years of service. However, staffs who exhibited less prejudice toward mental illness-related crime were less likely to find restraint necessary. Compared to 10 years ago, there was little change in the need for restraint in cases of physical violence (both toward patients and staff), but the need for restraint in response to verbal violence (toward both patients and staff) had decreased. The perceived burden, both legal and medical, associated with the use of restraint had increased.

Attitudes toward restraint were not significantly associated with gender, age, or years of service. However, staff who exhibited less prejudice toward mental illness-related crime were less likely to find restraint necessary. Compared to 10 years ago, there was little change in the need for restraint in cases of physical violence (both toward patients and staff), but the need for restraint in response to verbal violence (toward both patients and staff) had decreased. The perceived burden, both legal and medical, associated with the use of restraint had increased.

Psychiatric hospital staffs with less prejudice toward mental illness-related crime were less likely to perceive a need for the use of restraint. Compared to 10 years ago, the necessity of restraint in cases of verbal violence has decreased, which may be attributed to ongoing human rights education and increased legal and medical concerns. These findings provide important insights for future policy development aimed at promoting humanitarian approaches, such as non-restraint treatments.

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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.

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Adjustment Disorder (AD), introduced in DSM-III-R, is an emotional or behavioral reaction to a psychosocial stressor that causes significant distress and impairment. Symptoms include excessive worry, sadness, anxiety, and sleep disturbances. U.S. prevalence ranges from 11.5% to 21.5%, higher in those with suicide attempts and twice as common in women. Diagnostic criteria include symptom onset within 1-3 months, significant distress or impairment, and resolution within 6 months after the stressor or its consequences. Subgroups are based on predominant symptoms of anxiety, depression, or behavior (DSM-5).

Analysis of Adjustment Disorder cases in patients admitted to medical-surgical Units in 2023 at Hospital de Matosinhos.

Review of Clinical Records of all internal consultation requests made to the Liaison Psychiatry Team during 2023 at Matosinhos Hospital. Demographic data, psychiatric history, medical-surgical history, multidisciplinary intervention, and post-discharge guidance were obtained.

Out of the 420 patients observed in internal consultation in 2023, 67 were diagnosed with AD, representing 15.9%.

53% were men and 47% women.

The age distribution is represented in figure 1. Most of patients have an age gap between 50-70 years old. 58% is married, 9% single, 9% divorced and 22% widower.

79.1% of the patients live with their family and 20.9% lives alone.

All comorbidities found in patints with adjustment disorder is represented in figure 2. We can see that metabolic diseases and cardiovascular events are the most common comorbidities associated with AD.

Only 32% had seen a psyhiatrist before, while 68% had never contacted with a psychiatrist.

75% of the requests were made by internal medicine and general surgery.

According with the results of figure 3 we can tell that most of the patients started a new medication and just a few had psychological support.

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The diagnosis is subject to a degree of subjectivity and requires clinical judgment. There is a lack of clearly defined diagnostic criteria. It depends on a stressor and a reaction to the stressor that is considered excessive relative to what would be expected in the patient’s cultural and social context.

Treatment is underinvestigated. The basic pharmacological management consists of symptomatic treatment of insomnia, anxiety and panic attacks. The use of benzodiazepines to relieve these is common. In this study it is clear the need of giving medication to treat the symptoms even though we know that most of them would stop naturally. However, there is a lack of brief psycological interventions even though they are recommended.

It is now a critical time for advancing our knowledge of the disorder and further studies should be done.

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The COVID-19 pandemic has placed immense psychological pressure on healthcare workers (HCWs) worldwide. In addition to the physical risks of infection, HCWs have faced high levels of anxiety due to their proximity to the virus, overwork, and the challenges of providing care in an ever-evolving environment. These psychological effects are expected to persist well beyond the initial phase of the pandemic.

This study explores the long-term impact of COVID-19 on both anxiety and depression among HCWs and identifies the main contributing factors.

This cross-sectional study was conducted among HCWs infected with SARS Cov-2 between January and August 2022. Sociodemographic and professional data were extracted from participants’ medical records. Anxiety and depression were evaluated using the GAD-7 (Generalized Anxiety Disorder) and PHQ-9 (Patient Health Questionnaire) scales, respectively, through phone interviews conducted at least one year after their last COVID-19 infection

This study included a total of 184 healthcare workers (HCWs). The mean age of the participants was 41.93 years (± 8.6), with 95.1% being over 30 years old. Women comprised 81.4% of the cohort, and the majority of participants were nurses (45.7%), followed by administrative staff (20.1%). The median occupational seniority was 16 years. Notably, 28.3% of HCWs were employed in COVID-19 wards. Anxiety symptoms were reported by 92.9% of participants, with 17.3% experiencing mild anxiety, and 38.5% severe anxiety. Depression was prevalent in 69.1% of HCWs, with 27.2% presenting mild symptoms, and 24.5% experiencing moderate to severe depression. Female HCWs and those aged over 40 were significantly more likely to report symptoms of anxiety and depression (p < 0.001). Furthermore, HCWs with pre-existing conditions, such as diabetes, as well as those directly exposed to COVID-19 patients, exhibited significantly higher anxiety and depression scores. Nurses demonstrated particularly elevated levels of psychological distress, especially those working in COVID-19 wards.

The COVID-19 pandemic has had a profound and lasting psychological impact on healthcare workers, with anxiety and depression levels remaining elevated long after the acute phase of the crisis. This study emphasizes the need for targeted psychological support interventions. Addressing the mental health needs of HCWs is crucial not only for their well-being but also for ensuring the ongoing efficacy and resilience of the healthcare workforce in times of crisis. Further research is warranted to explore long-term impacts and effective strategies for mental health support in this population.

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Methylphenidate (MPH), a common stimulant medication for attention-deficit hyperactivity disorder (ADHD), has been shown to enhance both fine and gross motor skills in individuals with ADHD.

This study aims to assess the acute effects of a single dose of MPH on agility and balance motor tests, as well as physiological parameters such as heart rate (HR) and blood pressure (BP) at rest and after motor tests, in young healthy participants diagnosed with ADHD.

A randomized crossover design was employed to evaluate agility and balance motor performance with and without MPH treatment. The study included 35 physical education students (mean age 25.3±3.6 years) diagnosed with ADHD, 65.7% of whom were male. Each participant used their prescribed MPH medication. Motor tests included a zigzag agility test, with and without leading a ball, and a balance test. Physiological measurements, including HR, BP, and core temperature, were recorded at rest and after the motor tests. Subjective sense of effort was evaluated using the RPE scale.

The agility test without a ball showed a small but significant improvement following MPH treatment (without MPH 7.4±0.8, with MPH 7.4±0.8, p= 0.25) . No significant differences were found in the balance test or the agility drill with a ball, regardless of MPH treatment. Systolic blood pressure (SBP) at rest was significantly higher after MPH administration (without MPH 126.7±10.8, with MPH 131.9±12.7, p=.023). There were no significant differences in diastolic blood pressure (DBP), HR, or core temperature at rest or after the motor tests.

A single dose of MPH improved performance in the agility test without a ball but did not enhance balance or agility with a ball. These findings suggest that while MPH may enhance certain motor functions, its effects are selective and not universally beneficial across all motor tasks.

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Psychosis is a condition characterised by hallucinations or delusions, which can cause distress and burden for both the individuals experiencing it and their caregivers. Seeking help can reduce the distress and burden, improve symptoms, and prevent adverse outcomes. However, many people still do not seek help or delay help-seeking. The reasons for this are not yet fully understood, especially in South and Southeast Asian settings.

To explore the views and experiences of key stakeholders in South and Southeast Asia towards help-seeking for psychosis.

This systematic review included ‘views’ studies using qualitative, quantitative, and mixed-method designs. Systematic searches were conducted in several databases, including CINAHL, MEDLINE, PsycINFO, Embase, ASSIA, and Scopus from inception to September 2023. Each article was screened in duplicate by at least two independent reviewers. Popay et al.’s (2006) narrative synthesis was used to synthesise the data.

This review included 51 studies from 10 South and Southeast Asian countries. The synthesis revealed that people with psychosis and their caregivers sought help from various sources. Factors that facilitate or hinder help-seeking behaviours include the ability to recognise problems, the alignment between illness and treatment perceptions, the attainability of help providers, the roles of social networks and support systems, and perceived stigma. Further, people also considered the outcome of each help-seeking process to determine their subsequent behaviours.

Interventions to improve help-seeking behaviours among people with psychosis should consider these multiple factors and address not only the help-seekers but also a wider range of key stakeholders, including social networks and potential help providers.

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Sleep disorders are commonly reported among patients diagnosed with multiple sclerosis (MS), particularly in the period following the disclosure of the diagnosis. The combination of psychological stress and the chronic nature of the disease contributes to significant sleep disturbances. Understanding the prevalence, causes, and implications of these disorders is crucial for improving patient care.

The aim of this study is to evaluate the prevalence and characteristics of sleep disorders in MS patients following the announcement of the diagnosis and to explore the contributing factors, including psychological and physical symptoms.

A descriptive and analytical cross-sectional study was conducted from March 1, 2023, to January 30, 2024, involving patients diagnosed with multiple sclerosis (MS)who were observed in the neurology department at Habib Bourguiba University Hospital in Sfax. We evaluated sleep disorders using the insomnia severity index scale which included 7 items to investigate sleep disturbance.

A total of 100 patients, with a mean age of 38 years ± 10 years, were included, with a strong majority of women (73%). No psychiatric history was noted. The median disease duration was 7.38 years (3-10.75). Among our patients, 64(64%) had attained a university level of education. In addition, 40(40%) were married, and 60 (60%) were single, divorced, or widowed.

The median Insomnia Severity Index was 5 (1-10.75). More than half of our patients (62%) did not suffer from insomnia. However, 9% had a mild subclinical form of insomnia, 10% had moderate clinical insomnia, and 19% suffered from severe clinical insomnia.

Primary education level was correlated significantly with mild sleep disorders n=33.3 (33.3%), (p=0.044). On the other hand, those with a higher education level showed a lower prevalence of mild sleep disorders n=22.2(22.2%) (p=0.01). However, a lower prevalence of severe sleep disorders was noted among married individuals (10.5% p=0.004), while a higher frequency was observed in divorced individuals (15.8%, p=0.). Only refusal of the diagnosis upon its initial announcement was significantly associated with severe sleep disorders (63.2%, p=0.012).

Addressing sleep disorders in MS patients requires a holistic approach that incorporates both psychological and symptom management strategies. Early interventions targeting anxiety, depression, and physical discomfort are essential for improving sleep quality and overall well-being in this patient population. Further research is needed to develop tailored therapeutic approaches that address the unique challenges faced by MS patient’s post-diagnosis.

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Adolescent suicidal behaviors have seen a marked increase in incidence, particularly following the onset of the Covid-19 pandemic (Revet et al. Eur Child Adolesc Psychiatry 2023; 32 249–256). This surge has presented challenges for emergency and psychiatric services. It highlighted the need for improved understanding of predictive and protective factors linked to recurrent suicide attempts.

This study aims to analyze the clinical trajectories of adolescents admitted to emergency departments for suicide attempts between 2019 and 2021 and to identify predictors of recurrence, with a particular focus on conditions that may elevate the risk of repeat attempts (Tomaszek et al. Front Psychiatry 2024).

We conducted a retrospective cohort study at the Montpellier University Hospital, examining pediatric emergency visits related to suicide attempts over three consecutive years (2019–2021). The dataset included patient demographics, psychiatric diagnoses, treatments prescribed, and hospitalization metrics such as duration and readmission frequency. Statistical analyses employed a multivariate linear regression to identify significant predictors of recurrence.

The incidence of emergency visits for adolescent suicide attempts rose elevenfold from 2019 to 2021, reflecting the global trends in mental health deterioration post-Covid-19 (Lespes-Hislen et al. 2023). Recurrence rates were notably higher among patients initially admitted in 2021, with 54% of these adolescents re-presenting for subsequent suicide attempts, indicating a persistent crisis in mental health among this demographic. The selected model identified ADHD diagnosis, the use of mood stabilizers, and prolonged hospitalization as significant predictors of recurrence. In the regression model, each additional day of hospitalization was associated with an estimated increase in recurrence risk of 0.16 additional attempts per 1-day of hospital stay.

This study confirms an increase in suicidal behaviors after the pandemic and highlights the importance of personalized care, especially for adolescents with ADHD. The association between hospitalization duration and recurrence raises questions about the effectiveness of prolonged hospital stays in this population.

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The detection of electrophysiological markers to differentiate patients with suicide attempts could support the efforts of clinicians to provide proper diagnosis and treatment for them, and finally reduce the suicide mortality rate.

The objective of the current study was to investigate and compare cortical functional networks from resting-state electroencephalogram in patients with suicide attempts and suicidal ideation using source-level weighted network analysis. We also examined the possibility of network features serving as biomarkers by differentiation between suicide attempts and suicidal ideation using machine learning techniques.

This study investigated source-level cortical functional networks using resting-state electroencephalography in drug-naïve depressed patients with suicide attempt and suicidal ideation. Electroencephalogram was recorded in 55 patients with suicide attempts and in 54 patients with suicidal ideation. Graph-theory-based source-level weighted functional networks were assessed using strength, clustering coefficient (CC), and path length (PL) in seven frequency bands. Finally, we applied machine learning to differentiate between the two groups using source-level network features.

There were significant differences in the three global level indices of the high alpha band. The strength and CC of the high alpha band were significantly lower in patients with suicide attempts than in those with suicide attempts ideation. In contrast, the PL of the high alpha band was significantly higher in patients with suicide attempts than in those with suicide ideation. No significant differences in the other frequency bands were between the two groups.

The nodal CCs of patients with suicide attempts were significantly lower than those of patients with suicide ideation in most regions, except for three of the 68 regions.

The best classification performance between suicide attempts and suicide ideation was an accuracy of 73.39%, a sensitivity of 76.36%, and a specificity of 70.37% with 17 features. Three of these features were global-level network indices (strength, CC, and PL) in the high alpha band; the other 14 features were high alpha band nodal level CCs in limbic, frontal, temporal, parietal,and occipital area.

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This is the first study to use electroencephalogram source level network measures, revealing that network indices for high alpha band could be potential biomarkers to distinguish betweensuicide attempts and suicide ideation in patients with depression. Moreover, our study evaluated the electroencephalogram signals immediately after fatal suicide attempts in a relatively large number of un-medicated patients.

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Dementia is a progressive neurodegenerative disorder characterized by a gradual decline in cognitive functions, such as memory, reasoning, and communication, which places a significant burden on caregivers. Dementia caregiving presents unique challenges that contribute to elevated stress levels. Caregivers of dementia patients often face increased psychological and physical strain, exacerbated by the disease’s progressive nature and complex caregiving demands. This systematic review explores the perceived stress among dementia caregivers, highlighting the impact of caregiving responsibilities and identifying potential coping mechanisms. Our review seeks to offer evidence-based recommendations to support caregivers and improve their quality of life, thereby addressing a crucial gap in dementia care.

This systematic review aims to assess the extent of perceived stress among dementia caregivers, identify associated factors, and evaluate coping mechanisms. The goal is to highlight critical stressors and propose evidence-based strategies for improving caregiver support.

We systematically reviewed eighteen studies from PubMed using the terms “Perceived Stress Scale” and “Caregivers of Dementia Patients.” Our analysis included data from 3,385 caregivers, focusing on stress levels, cortisol measurements, and psychological impacts.

The review consistently identified high levels of perceived stress among dementia caregivers. Cortisol levels, assessed in three studies, were significantly elevated in caregivers compared to non-caregivers (Williams et al., 2021; Kim & Park, 2022; Nguyen et al., 2023). Perceived stress showed a significant correlation with cognitive decline and sundowning behaviors. Additionally, caregivers reported elevated depressive symptoms, with stress levels showing a direct association with these symptoms (Jones et al., 2021). The review also identified that higher education was associated with reduced anxiety and depression, while female caregivers reported higher stress levels compared to males (Miller et al., 2022). Effective coping strategies included seeking information, participating in culturally adapted interventions, and enhancing social support networks (Patel & Singh, 2023).

Dementia caregiving imposes considerable stress due to the demanding nature of the role and the complexities of patients’ conditions. Interventions should prioritize culturally sensitive support programs, expand educational opportunities for caregivers, and strengthen social support systems to alleviate caregiver stress. Future research should further investigate the influence of gender, social isolation, and healthcare access on caregiver stress, particularly in low- and middle-income countries (LMICs) and during global crises such as the COVID-19 pandemic. Addressing these factors will be crucial in developing comprehensive strategies to support dementia caregivers effectively.

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

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

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

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

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

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Autism Spectrum Disorder (ASD) is a developmental condition that modifies how a person perceives their surroundings, communicates and interacts with others. Autistic individuals often experience executive dysfunction, impaired social cognition, likewise differences in perception and information processing that can make it challenging to describe their internal sense of gender and gender-related needs. This case report presents the therapeutic journey of a young man diagnosed with Asperger Syndrome who entered dynamic supportive psychotherapy to address social and emotional challenges, likewise identity issues.

This poster aims to explore the clinical complexities arising from the presence of gender neurodivergence in individuals with ASD and its impact on their presentation, assessment and management. It seeks to highlight the unique challenges faced by autistic individuals in navigating gender identity, emphasizing the need for tailored clinical approaches.

A descriptive case report of a patient with ASD and gender neurodivergence, drawing on clinical records, patient interviews and psychotherapy sessions, psychological assessment and a non-systematic review of relevant literature.

A case report presentation of a 29-year-old man diagnosed with Asperger syndrome during adolescence. Due to adaptation difficulties and anxiety he started seeing a child’s psychiatrist and then transferred to an adult setting. He had intermittent visits to a community mental health service initially and, over the last two years, attended biweekly psychotherapy sessions at our hospital. Early psychological assessments revealed challenges with social interactions, confused and bizarre thinking patterns, identity diffusion, and a tendency for ruminative self-reflection. Treatment was interrupted at the end of 2023 due to a psychotic episode with dissociative phenomena, leading to the introduction of antipsychotics. After stabilization, psychotherapy resumed. During the course of therapy, conversations revealed a complex narrative around gender identity, including reflections on multiple genders and gender fluidity.

This case highlights the intersection of neurodiversity and gender identity, illustrating how individuals on the autism spectrum may experience and navigate gender in unique ways. The therapeutic process explored gender fluidity as an evolving self-concept, emphasizing the importance of inclusive approaches in psychotherapy. The report underscores the need for mental health professionals to be attuned to diverse expressions of gender identity within neurodivergent populations and advocates for flexible therapeutic frameworks that accommodate both neurodiversity and gender diversity.

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Since October 2004, antidepressants have had a black-box warning indicating that they are associated with an increased risk of suicidal thinking, feeling, and behavior in children and adolescents. On 2nd May 2007, the United States Food and Drug Administration ordered that all antidepressant medications carry an expanded black-box warning stating an increased risk of suicidal symptoms in young adults aged 18 – 24.

The initiation of antidepressants in the young adult population present unique patient safety considerations and medicolegal risks for physicians. Unlike the triadic doctor-parent-patient relationship in a child or adolescent patient, the doctor-patient realtionship in a young adult is a dyadic one. Hence, enlisting the help of a trusted adult to supervise the young person who has been newly initiated on antidepressants is more challenging.

In this poster, we explore the unique ethical considerations in initiating antidepressants in the young adult population and the steps clinicians may take to mitigate their medicolegal risk in treating this population. The ethical considerations of autonomy, beneficence and non-maleficence are analysed. The measures an individual clinician may take in clinical decision-making and follow-up to mitigate medicolegal risk are also discussed.

A literature search was conducted to determine the clinical considerations and prescription patterns in prescribing antidepressants to young adults. The legislation surrounding medication prescription in major jurisdictions were explored. Current literature on medicolegal risk management was studied to come up with recommendations on mitigating medicolegal risk when initiating antidepresants in young adults.

Initiating antidepressants in a young adult is a collaboratively undertaken medical decision. A thorough evaluation is required to determine if antidepressant initiation is warranted. Young adults initiated on antidepressants must be closely monitored for increased suicidality. The clinician should offer to psychoeducate a member of the young adult’s support network on his diagnosis and treatment, and apprise this person of the black box warning. . If there are imminent grave risks to the young person or others, confidentiality may have to be broken. Clear detailed documentation of the clinical considerations and discussion with the young person is essential.

Initiating antidepressants in young adults presents clinicians with unique patient safety and medicoleagl risk concerns. Steps in clinical decision-making and follow-up may be undertaken by clinicians to mitigate this risk.

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Adults with intellectual and developmental disabilities (IDD) often struggle to access suitable psychiatric care due to cognitive and communication challenges. Traditional mental health services are not always well-equipped for these needs, highlighting a critical need for evidence-based, IDD-specific guidelines. Expanding research, especially randomized controlled trials (RCTs), is essential to develop personalized, effective treatments for this population.

This poster aims to outline current gaps in psychiatric care for adults with IDD, propose strategies for treatment adaptation, and emphasize research priorities to advance evidence-based care for this underserved group.

A literature review assessed studies on treatment adaptations for IDD, focusing on the effectiveness of current interventions and limitations in existing research. Priority was given to innovative care approaches and adaptations in standard mental health treatments.

Psychiatric care for adults with IDD often involves adapting treatments like cognitive-behavioral therapy (CBT) and pharmacotherapy with simplified, patient-centered methods. For example, CBT adaptations may include breaking techniques into smaller steps, using visual aids, and shorter sessions, which accommodate cognitive limitations. Personalized care is essential due to varying abilities within this population. Pharmacological treatments also require careful titration and close monitoring, as the risk of side effects is higher among those with IDD. However, few RCTs assess the efficacy and safety of treatments for severe psychiatric disorders in the IDD population, underscoring the need for more rigorous research to support clinical guidelines. To overcome recruitment and follow-up barriers in RCTs, studies suggest alternative methods such as targeted outreach through day centers, provider organizations, and one-on-one approaches, which have been effective in reducing dropout rates. Furthermore, bipolar disorder treatment in IDD is particularly under-researched, despite its significant impact on quality of life, highlighting a need for focused studies in this area.

Enhancing psychiatric care for adults with IDD will require systemic changes, including increased research funding, IDD-specific clinical guidelines, and improved provider training. RCTs focused on adapted therapies and pharmacological interventions are crucial to build a strong evidence base. By promoting individualized, evidence-based approaches, the field can better meet the unique needs of adults with IDD, ultimately improving mental health outcomes and quality of life.

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Psychosis is characterized by hallucinatory and delusional experiences. Although, it was mostly considered to be present among clinical populations, there is strong evidence it can also be found in the general population. Limited reviews currently exist on the quality of the assessment methods designed to evaluate psychotic-like experiences in the general population. None of them assessed whether the existing instruments measure the same construct and, consequently, neglected problems associated with the “jingle-jangle fallacy” (Weidman et al., 2017; Flake and Fried, 2020). This fallacy might account for contradictions in the literature, as well as, issues with generalizability of the results.

The goal of our study is to better understand the agreement between various instruments used to assess hallucinations and paranoia-like experiences.

We conducted a systematic search of the scales assessing hallucinations and paranoia-like experiences among the general population. Labels for the content analysis were created based on their definition in literature by the first authors and revised by another researcher. Three researchers coded each item independently of each other. We then estimated to which extent any item overlaps with any item from the other scale included in the analysis. We used Jaccard index to assess similarities between sets (from 0 with no overlap among scales) to 1 (complete overlap). The analysis was done in R and Excel.

For 263 items from 11 hallucination scales, we estimated 38 labels with a mean overlap of 0.19 (very weak). CAPS demonstrated the highest mean overlap of 0.26. The highest overlaps were observed between MUSEQ and CAPS (0.5), MUSEQ and SPQ (0.4), and between LSHS-R and RHS (0.4). For the paranoia scales, the analysis of 183 items drawn from 12 scales resulted in 18 labels. The mean overlap across these labels was 0.30 - a weak association. The PIQ exhibited the highest mean overlap at 0.42, whereas the PSQ displayed the weakest overlap with a value of 0.17.

The overlap between hallucination scales was very weak. This disparity may be due to different instruments adopt varying interpretations of the hallucination continuum (Laroi, 2012). The weak overlap in paranoia scales may be less problematic, as theoretical models and empirical data suggest a more clear continuum of suspiciousness within the general population (Freeman et al., 2005) that maps our results. It is necessary to establish certain common grounds regarding what experiences represent which sides of the continuum, both in their variability, and severity in the field.

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The CLUMP (CLinical Utility of early intervention including the 5-Step Precision Medicine (5SPM) Method) project is a translational research initiative that aims to improve adherence to antipsychotic (AP) medications and therapeutic outcomes in patients with first-episode psychosis (FEP). CLUMP seeks to apply an early intervention model of Personalised Precision Psychiatry, based on pharmacogenetics, to this clinical group. In this specific analysis, we examine time to discontinuation of the first prescribed oral AP treatments before the implementation of the CLUMP project in Salamanca, Spain, in order to determine the impact the new Personalised Precision Psychiatry model might have on it. Indeed, given the high AP treatment discontinuation rates already identified in pragmatic, randomised controlled trials including FEP patients, these data would offer additional information about such rates in real-world clinical scenarios.

1. 1. To assess time to discontinuation for the first prescribed oral AP treatments in FEP.

2. 2. To identify specific AP with higher retention rates, which might reflect better tolerability and/or effectiveness.

This study includes a consecutive, retrospective cohort of 42 patients with FEP treated immediately before the CLUMP project implementation, who were followed for at least one year. Kaplan-Meier survival analysis was used to assess AP time to discontinuation during the first year post-treatment initiation.

Table 1 (Image 1) summarises median times to discontinuation and confidence intervals (CIs) for each AP. Survival curves (Image 2 and 3) depict treatment retention trends. The overall median time to discontinuation was 36 days (95% CI: 25-153 days), suggesting an overall high early AP treatment discontinuation. Results also showed very high variability across AP, with Paliperidone (264 days) and Risperidone (72 days) having longer retention times. However, most of the sample was initiated on Risperidone (71.2%), which affects the generalisability of these results.

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Concurring with previous randomised controlled trials, we identified a high rate of early AP treatment discontinuation in FEP treated in routine clinical practice. For most patients, the first prescribed AP was discontinued within the first month post-treatment initiation. These results emphasise the need for a more personalised AP treatment choice for patients with FEP.

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Vortioxetine is an antidepressant with multimodal action that exerts its numerous effects by modulating neurotransmission in multiple systems, achieving not only antidepressant effects but also procognitive ones, along with an appropriate tolerability profile. Currently, vortioxetine is only approved for the treatment of major depressive disorder (MDD) in adults. There is currently no unified consensus on the most appropriate pharmacotherapy for post-traumatic stress disorder (PTSD), so this clinical case raises the possibility of using drugs with multimodal action, such as vortioxetine, in patients with comorbid PTSD and MDD.

To describe a clinical case of comorbid PTSD with MDD, highlighting the use of drugs with multimodal action.

A 26-year-old woman began follow-up for an 8-month history of depressive mood, with apathy, anhedonia, and constant rumination about a significant life event, impacting her basic activities of daily living, along with death-related thoughts and fear of acting on them. She also presented with highly limiting tics, difficulty concentrating, mental blocks, slowed thinking, and mixed insomnia. The patient directly relates these symptoms to a traumatic event during her adolescence, which involved sexual abuse and threats during a conflicted romantic relationship. Over the years, she has experienced sequelae related to the traumatic event, such as avoidance behaviors regarding sexual matters, flashbacks with dissociative episodes during periods of heightened anxiety, difficulties in social relationships, and feelings of guilt, fear, and disgust. Treatment with Vortioxetine was prescribed, with progressively increasing doses over the following consultations until reaching 20 mg/day. After several visits to the emergency department during this time, the patient was referred to a psychiatric day hospital.

Thanks to this combined therapeutic plan, the patient has shown significant functional recovery, with marked improvement in the affective domain, regaining interest and enjoyment; and in the cognitive domain, demonstrating an increase in her ability to concentrate and in processing speed. Additionally, she has been able to maintain adequate sexual activity during this time.

Antidepressants with serotonergic action present sexual side effects, so treatment must be individualized in patients for whom this area is particularly relevant, considering drugs with a lower rate of side effects in this regard. The complete functional recovery of MDD includes cognitive symptoms as one of the primary therapeutic objectives, so it is important to consider using drugs that are effective in improving the affected cognitive domains. Post-traumatic stress disorder could benefit from the use of drugs with multimodal action, although more studies are needed in the future.

None Declared

Antipsychotic medications, particularly atypical antipsychotics, are commonly associated with metabolic side effects such as weight gain, dyslipidemia, and insulin resistance. These disturbances significantly increase the risk of cardiovascular disease and mortality, especially in patients treated with clozapine and olanzapine. It is not always feasible to discontinue these treatments, as the decision largely depends on the clinical context. Therefore, addressing these metabolic side effects requires specific pharmacological interventions to mitigate their impact.

This non-systematic review aims to assess the evidence supporting pharmacological interventions in managing antipsychotic-induced metabolic disturbances.

Relevant and recent studies or reviews were selected from the PubMed electronic database using search terms related to antipsychotic-induced metabolic disturbances and pharmacological interventions to manage them.

Current evidence suggests the need for early and aggressive pharmacological intervention in patients experiencing antipsychotic-induced weight gain. Non-pharmacological interventions, such as physical activity and dietary changes, are often insufficient to mitigate these iatrogenic effects. Pharmacological interventions to reduce metabolic risk in individuals with severe mental illness may include the introduction of an antipsychotic with a more favourable metabolic profile, modification of antipsychotic therapy (dose adjustment, augmentation with another antipsychotic with a lower metabolic risk or switching to another antipsychotic with a lower metabolic risk) and treatment of medical conditions (through the use of drugs such as metformin, statins, among others). Based on updated scientific evidence, the most effective pharmacological treatments for reducing weight gain associated with second-generation antipsychotics are metformin, GLP-1 receptor agonists, topiramate, zonisamide, and nizatidine. The adjunctive use of aripiprazole also reduces lipid levels and weight and attenuates negative symptoms in patients with schizophrenia and metabolic syndrome. Metformin is considered the best-tolerated intervention, while topiramate is the least tolerated.

Pharmacological interventions, particularly the use of metformin and GLP-1 analogues, offer promising results in managing antipsychotic-induced metabolic disturbances. These interventions improve weight management, glucose levels, and lipid profiles. More large-scale randomized trials are needed to further validate these interventions and assess long-term safety and efficacy.

None Declared

The corpus callosum (CC) is essential for interhemispheric communication, and its abnormal integration is central to the neurobiology of schizophrenia (SCZ). SCZ patients have a 10-fold higher risk of cannabis use disorder (CUD) and about 20-35% show a lack or poor response to antipsychotics and are defined as treatment-resistant schizophrenia (TRS) Until now, no study has analyzed the morphology of the CC in TRS compared to healthy controls (HC) and non-TRS patients with and without CUD.

The aim of the study is to assess whether the diagnosis of psychosis, the response to antipsychotic treatment, and CUD can influence the volume of the CC. To achieve this, we used an innovative artificial intelligence program applied to MRI, which provides structural information on a single subject.

We included 20 HC and 48 SCZ patients, of whom 14 were affected by TRS and 34 were non-TRS. Among the non-TRS group, 20 had CUD comorbidity (non-TRS-CUD+) and 14 did not have CUD (non-TRS-CUD-). All were assessed cross-sectionally through the Neurological Evaluation Scale, the Brief Assessment of Cognition in Schizophrenia, the Positive And Negative Syndrome Scale. We assessed them cross-sectionally using psychometric tools, cognitive tests. All patients underwent a brain MRI 1.5 T, for white matter volume group analysis, and MRI applied to Artificial Intelligence (MRI-AI-Pixyl.Neuro) for single-subjects analysis.

TRS was associated with higher PANSS total score (fig. 1) and neurological soft signs (fig. 2) and lower negative symptoms (trend) than non-TRS groups. The TRS group performs worse in the Tower of London task compared to non-TRS and HC groups. Only the condition of TRS is associated with a significantly smaller CC volume (64.28%) compared to HCs and non-TRS patients (Fig. 3). Only one patient from the non-TRS-CUD- group showed a reduction in the volume of the CC like TRS patients.

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TRS is associated with more severe general and negative symptoms, NSS, and cognitive dysfunctions and with a significantly smaller CC volume, demonstrating the role of this structure in the pathogenesis of TRS and probably in executive function impairment. Is conceivable that TRS has unique evolution and course characteristics, and that continuous cannabis use for 6.95 years is probably not sufficient to cause the structural alterations typical of TRS.

The MRI-AI applied to a single subject has shown reliable results, confirmed by classical group analysis, and represents a revolutionary tool for identifying potential neuroradiological biomarkers of disease, enabling quick TRS diagnosis in clinical practice, faster clozapine treatment following TRIPP guidelines, and easy application using only a standard volumetric sequence without post-scan analysis.

None Declared