The digital age has transformed mental health support in Tunisia. This study explores how individuals seek assistance for mental health concerns online, considering their comfort levels, preferences, and decision-making factors.

This study aims to: Investigate the comfort levels of Tunisians when discussing mental health concerns online Identify preferred online sources for mental health support Explore factors influencing the choice between online sources and mental health professionals

To unearth these insights, an exhaustive online survey was meticulously conducted. This survey was posted online on different social media platforms and cast a wide net, drawing responses from an eclectic cross-section of Tunisian society. The survey methodically gathered data on participants’ demographics, their inclinations towards online avenues for seeking assistance, and the multifaceted factors that sway their choices in this digital age.

Intriguingly, the results of this study illuminate several key findings:

Comfort Levels: A striking 47% of respondents expressed their unease about discussing their mental health concerns online. This statistic vividly underscores the intricate interplay between digital platforms and the persistent social stigma surrounding mental health issues.

Preferences for Online Sources: The study notably revealed that mental health apps and online counseling websites are emerging as the favored choices among those seeking support. This underscores the surging significance of digital mental health solutions tailored to individual needs.

Factors Influencing Preferences: An array of factors sways the preference for online sources. Among them, the allure of anonymity, the appeal of convenience, and the perception of limited access to in-person mental health professionals were prevalent. Additionally, financial constraints emerged as a notable consideration in the decision-making process.

Trust in Online Information: In contrast, individuals who leaned toward seeking assistance from mental health professionals stressed the pivotal importance of professional expertise, personalized guidance, and a comprehensive understanding of their concerns. Importantly, 38% expressed reservations about the reliability of online mental health information, underscoring the critical role of trust in the process.

This study sheds light on the nuanced process of seeking mental health assistance in the digital age. It emphasizes the need to address mental health stigma and improve online resource credibility. The findings highlight the importance of comprehensive mental health strategies that integrate digital solutions and traditional professional care, catering to diverse preferences and needs in Tunisia.

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Paliperidone Palmitate (PP) is an atypical antipsychotic, approved by the FDA for acute and maintenance treatment of schizophrenia and schizoaffective disorder.

It has a relatively safety profile, and reported cases of paliperidone palmitate-induced angioedema or anaphylaxis are uncommon.

We intend to present a case of paliperidone palmitate-induced anaphylaxis to alert clinicians regarding this rare, but possible complication.

Non-systematic review of the literature and report of a case study.

Long-acting injectable Paliperidone Palmitate (LAIPP) is a safe and effective alternative to oral Paliperidone, with less incidence of disease relapse related to medication non-compliance.

Substance use disorder (SUD) is highly prevalent in first-episode psychosis (FEP), and it is associated to decreased treatment compliance, which impairs the outcomes of these patients. Therefore, several authors have been recommended long-acting injectable antipsychotics (LAI-AP), such the LAIPP, as a first line for treatment of FEP-SUD patients.

The most common side effects associated with LAIPP are injection site reactions, extrapyramidal symptoms, hyperprolactinemia, sedation, hypersalivation, orthostatic hypotension, tachycardia, and weight gain. Hypersensitivity reactions have rarely been reported and may be dose-dependent.

We report a case of a 20-year-old female, without medical history and no history of allergies, who was medicated with once-monthly LAIPP at dose 100 mg for the maintenance treatment of a first psychotic episode associated with cannabis abuse.

Approximately 24 hours after the first monthly injection dose, she was admitted in the emergency room (ER) presenting an increasing angioedema associated with stridor, requiring endotracheal intubation and administration of adrenaline, clemastine and hydrocortisone during the assessment in the ER.

After clinical stabilization, she was transferred to the internal medicine ward, and following a full recovery, she was discharged 6 days later while being medicated with Olanzapine 15 mg/day, Lorazepam 3 mg/day and Sertraline 50 mg/day. LAIPP was suspected as the etiology of the anaphylaxis reaction due to temporal relationship of its onset with therapy administration and by the exclusion of other potential causes. Consequently, LAIPP was discontinued at discharge.

This report shows the possibility of a late and potentially life-threatening anaphylactic reaction to LAIPP. So, all physicians should be aware of this potential complication, which requires timely recognition and management.

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Hundreds of fires have been burning from coast to coast across the country since March 2023, putting Canada on track to experience the worst wildfire season ever. From East to West, provinces such as Quebec, Ontario, Nova Scotia, Alberta, and British Columbia have been particularly affected by large and uncontrollable wildfires.

This study aimed to determine the prevalence and predictors of depression symptoms among residents of Alberta and Nova Scotia during the Canadian wildfires of 2023.

This study conducted a cross-sectional quantitative survey for data collection. In the period between 14th May and 23rd June 2023, an online survey was administered using REDCap. Through the Text4Hope program, participants subscribe to receive supportive SMS messages daily. After the first message, participants were invited to complete an online questionnaire, containing demographic information, wildfire-related information, and responses to the Patient Health Questionnaire-9 (PHQ-9) for depression assessment. SPSS version 25 was used to analyze the data. Descriptive, univariate, and multivariate regression analyses were employed.

A total of 298 respondents completed the online survey out of 1802 who accessed it, resulting in a response rate of 16.54 %. Most of the respondents were females (85.2%, 253), below 40 years of age (28.3%, 84), employed (63.6%, 189), and in a relationship (56.4%, 167). A historical depression diagnosis (OR = 3.15; 95% CI: 1.39–7.14) was a significant predictor of moderate to severe MDD in our study. While employment status did not significantly predict MDD, unemployed individuals were two times more likely to report moderate-to-severe symptoms of MDD than employed individuals (OR = 2.46; 95% CI: 1.06–5.67). Among the total sample population, the moderate to severe MDD prevalence was 50.4%, whereas it was 56.1% among those living in wildfire-affected areas.

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As a result of our study, the development of moderate to severe MDD symptoms during wildfire disasters was significantly associated with a history of depression diagnosis. Although employment status did not significantly predict MDD, unemployed individuals had a greater likelihood of experiencing moderate-to-severe symptoms than employed individuals. Further research is necessary to ascertain reliable predictors of mental health issues among those who have experienced disasters, as well as to offer appropriate interventions and treatment options to the communities and individuals who are most vulnerable.

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ADHD medication prescribing trends are increasing in North America and both Northern and Western Europe (Raman, Sudha R et al. Lancet Psychiatry. 2018;5(10):824-835). Methylphenidate and atomoxetine are two substances available for use in ADHD in children and adolescents in Poland. To our knowledge, there is the lack of data on prescription trends for Poland and Middle-Eastern Europe.

The aim of the study is to estimate the increase in the total number of prescriptions for methylphenidate and atomoxetine and factors influencing it, like the impact of the proportion of prescriptions for women and for people aged 18-24 on.

Methylphenidate and atomoxetine prescription data for the period between 2012-2022 and for patients aged 5-59 were obtained from e-Health Centre, which contains data on prescribed medications in Poland. We conducted a series of linear regression models to explore the relationship between the number of prescriptions as the dependent variable and calendar year as the independent variable. Additionally, we considered two more variables: Percentage of prescriptions for women and percentage of prescriptions people aged 18 – 24. Further, we decided to run a mediation analysis to see whether the effect of calendar year was mediated by percentage of women.

We analyzed data on 925,536 prescriptions for methylphenidate and atomoxetine.

The model demonstrates a robust and statistically significant ability to explain the variance in the log-transformed dependent variable (R² = 0.98, F(2, 8) = 201.14, p < 0.001). The model’s intercept, corresponding to calendar year = 0 and percentage of prescriptions for women = 0, is estimated at -93.95, with a 95% confidence interval of [-152.74, -35.15]. The t-statistic for the intercept is -3.68, and the associated p-value is 0.006, demonstrating its statistical significance.

Within this model, the effects of the independent variables are as follows:

1. 1. Calendar year (β=0.05, t=4.07, IC95%: (0.02, 0.08), p<0,004)

2. 2. Percentage of prescriptions for women (β=0.06, t=4.18, IC95%: (0.02, 0.09), p<0,003)

The inclusion of the percentage of prescription for people aged 18-24 doesn’t improve the model’s ability to explain the variation in the number of prescriptions.

Mediation analysis showed that the indirect effect of percentage of prescriptions for women were significant.

These results provide robust evidence for the predictive power of the model, with both calendar year and percentage of women emerging as statistically significant and positively associated with the log- transformed dependent variable.

Between 2012 and 2022, the number of prescriptions for methylphenidate and atomoxetine increased exponentially in Poland. The percentage of prescriptions for women significantly contributed to the increase in the total number of prescriptions for methylphenidate and atomoxetine in Poland.

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Modern authors characterize hyperthymic individuals as eloquent, humorous, self-confident, optimistic, energetic, liberated, sexually active, constantly planning and implementing their plans. Four or more of the listed characteristics indicate the individual’s involvement in the circle of hyperthymic people. Statistical data on the prevalence of hyperthymic is scarce, which is due to rare requests for help and the diagnosis of this condition not as a disease, but within the framework of characterological traits. Attempts to classify hyperthymics have been made more than once, but previously none of the authors divided them according to the presence of side character traits in the personality structure.

To establish psychopathological types of hyperthymic individuals in whom affective states were formed.

The sample consisted of 50 patients (42 women, 8 men) who were on inpatient or outpatient treatment at the clinic since 2019 to 2022. Patients were examined by clinical-psychopathological, clinical-anamnestic methods due to the presence of a phase affective state.

Four types of hyperthymic personalities have been identified: anxious-hyperthymic, hysterical-hyperthymic, schizoid-hyperthymic and standard hyperthymic. Anxious-hyperthymic type, 20% (n=10) characterized by a combination of increased activity, sociability with such traits as suspiciousness, perfectionism, meticulousness, exactingness, concern for one’s health and the desire to maintain a healthy lifestyle. Hysterical-hyperthymic type, 46% (n=23) includes both hyperthymic and hysterical traits in the form of increased emotionality, egocentrism, drama, and desire for recognition from others. In addition, patients in this group are characterized by increased concern about their appearance (bright clothes, makeup, tattoos). Schizoid-hyperthymic type, 10% (n=5). In addition to increased activity and emancipation, patients in this group are prone to fantasizing, overvalued hobbies, sthenicity, emotional poverty and rationalism. Standard type, 24% (n=12) are characterized by the presence of typical hyperthymic traits - optimism, energy, constant desire for productive activity, success in the chosen profession, rapid career growth, sociability, openness.

Hyperthymic individuals with the development of affective phases are heterogeneous in their psychopathological structure and have features of the pathocharacterological structure that make it possible to distinguish anxious-hyperthymic, hysterical-hyperthymic, schizoid-hyperthymic and standard types. The developed classification of hyperthymia reveals the predominance of the hysterical-hyperthymic type (46%).

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Cognitive impairment is the frequent symptom occurring in nonelderly patients with schizophrenia or other neurodegenerative disorders. Cognitive dysfunction in patients with schizophrenia was described by Kraepelin more than a century ago. Increased awareness and advancements in the area of neuropsychological assessment and neuroimaging techniques have now rendered cognitive impairment an important focus of theories on the etiology and treatment of schizophrenia. Cognitive enhancement still remains a clinically unresolved challenge. Till date, there is no effective treatment available for enhancing cognitive function in patients with schizophrenia

This e-poster aimed to summarize evidence regarding clinical data on the nonpharmacologic and pharmacologic management of cognitive symptoms of schizophrenia, also known as cognitive impairment associated with schizophrenia (CIAS), and highlight the selection of appropriate treatment options.

A bibliopgraphical review was performed using PubMed platform. All relevant articles were found using the keywords: schizophrenia, cognitive symptoms, menagement.

Many different drug targets and strategies for drug development have been employed for enhancement of cognition in schizophrenia. Receptor targets have been identified on the basis of pharmacologic challenges that mimic schizophrenia (e.g., dopamine agonists and NMDA receptor antagonists), receptor abnormalities found on postmortem analysis of schizophrenia brain, and genetic linkage studies. Treatment with a D1 agonist was shown to “sensitize” D1 receptors and improve memory in both aged and antipsychotic-treated monkeys. Clinical trials of D1 agonists in schizophrenia have been delayed due to poor tolerability related to orthostatic hypotension and nausea. The glycine-site agonists, glycine, D-serine, and D-alanine, produced improvement in negative symptoms in small trials and some improvement in measures of cognition, although formal cognitive testing was not performed.

Although the evidence supporting cognitive remediation has not yet achieved the level necessary to merit inclusion in evidence-based treatment guidelines, this approach, combined with other psychosocial interventions, is promising. Several pharmacologic approaches are currently under study to facilitate neuroplasticity.

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Dementia is one of the greatest health challenges worldwide. According to the World Health Organisation (WHO) factsheet, currently more than 55 million people worldwide have dementia, with over 60% living in low- and middle-income countries. Every year, there are nearly 10 million new cases of dementia. WHO Global Status Report 2021 estimated growth of 139 million people with dementia by 2050. The estimated total global cost of dementia is likely to surpass US$ 2.8 trillion by 2030. As one grows older, the risk of developing dementia, particularly Alzheimer’s Disease, progressively increases. The Lancet Commission Reports 2017 and 2020 on dementia prevention, intervention, and care identified 12 modifiable risk factors, including physical inactivity, obesity, midlife hypertension, and diabetes. Addressing these lifestyle factors may significantly reduce the risk of dementia and its progression. While no curative or disease-modifying treatment is available for dementia at his stage, addressing modifiable risk factors may have a preventive role in reducing the risk of dementia.

The objective of the literature review is to explore current evidence on Physical Activity (PA) in reducing the risk of developing dementia and its progression. The focus is also to see the association of different forms and intensities of PA and their intensities, including aerobic, strength-based, and leisure, with the risk and progression of dementia.

Narrative review

Results from the reviewed studies showed that PA was found to be associated with a reduced risk of dementia, particularly Alzheimer’s Disease. Studies comparing different intensities of PA indicate though all levels of PA decrease the risk of dementia, there is a linear relationship between the higher intensity PA and the increased beneficial effect in terms of reduced risk of dementia. Leisure-time PA also has a protective role against dementia in longitudinal studies. There is more consistent evidence in favour of aerobic PA; however, it has a ceiling effect. The combination of aerobic and strength-based experience provides optimum beneficial effects. The elderly population who started physical activity in their 80s experienced the beneficial effects of PA in reducing the risk of dementia. There is mixed evidence of the protective effect of PA on the population who have already developed cognitive impairment or have genetic vulnerabilities. The author will also include the results of any relevant study published by 31 March 2024.

The details of the literature results and conclusions will be discussed at the conference.

I. Singh Consultant of: The author declare that the review was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., R. Chandra: None Declared

Health science students in post-secondary institutions experience high levels of depression and anxiety due to increased stress levels, workload, low socioeconomic status, and history of family mental illness, among other factors. Given the significant negative impact that depression and anxiety can have on undergraduate health science students, it is essential to understand the prevalence and correlation of these conditions in this population.

This scoping review aims to identify, document and analyze the literature on the prevalence and determinants of anxiety and depression among undergraduate health sciences students and identify gaps in knowledge for future research.

The scoping review was planned and executed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the Scoping Reviews statement. A comprehensive and systematic search was carried out for five databases, namely MEDLINE, Scopus, EMBASE, CINAHL and PubMed.

From the literature identified by our search strategy, the lowest prevalence for anxiety was 5.8%, and the highest was 82.6%, with a median of 44.25%. The prevalence of depression ranged from a high of 88.8% to a low of 2.1%, with a median value of 34.8%. Our analysis revealed that correlates of anxiety and depression among health science students include sociodemographic factors such as age, sex, gender, relationships, ethnicity and family history, personal health conditions, and academic and socioeconomic issues.

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With the high incidence of anxiety and depression among health science students, there is an increasing need to find practical remedies to support these students. It is also essential for policymakers and university authorities to implement interventions such as supportive text messages and other strategies geared toward providing support and improving the psychological well-being of health science students.

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Ethnicity and migration have an impact on illness models and consequently how, when and where people seek and obtain care. Early Intervention Psychosis (EIP) teams attend high rates of migrant and ethnic diverse populations but the study of ethnic differences in pathways to obtain and maintain care is still scarce . The most consistent findings are that minorities are less involved with primary services, have a higher risk of being treated in a coercive way and are at higher risk of early disengagement. Despite the increasing migration rates there has been very little investigation in Spain.

To investigate ethno-racial differences in pathways to obtain care, adherence and engagement during their first year of follow-up of subjects who start treatment at EIP of Reus, Catalonia, Spain

Participants

This is an observational 12 months follow-up retrospective study including all consecutively subjects with First Episode of Psychosis (FEP) referred to the EIP from January 2015 to January 2019. Visible ethno-racial status was self-reported being grouped as belonging to minority ethno-racial group if they were coded “any other than White regardless of country of origin”. ‘White’ was the majority group

Study variables:

At program entry:

Source of referral

At 12- months:

Adherence to the service:

Admissions to in-patient unit

Disengagement

184 FEP subjects (mean age 22.8 years and 66.1% of males) were included. Nearly 31% belonged to a minority ethno-racial group being the Maghrebi (60.4%) followed by the Latin-American (20.1%) the most frequent minority groups. The 81.2% of the minority group were first-generation migrants and 7.5% second generation migrants. The 52.2 % were referred from community services, 18.5% from emergency unit and 29.3% from inpatient unit. At follow up 64.5%, were highly adherent to EIP (> 75% of attended appointments), 16.7% required hospitalization and 11% disengaged. Multivariate analysis showed that the minority group was 2.19 times more likely to be low adherent [(95% CI 0.78-3.17; p=0.03], 2.89 times more likely to be hospitalised [(95% CI 1.20-6.98); p=0.01], and 4 times more likely to disengage from the EIP [(95% CI 1.35-11.90); p= 0.01] during follow-up than the majority group. No group differences were found in pathways to obtain care or in causes of disengagement.

In agreement with previous studies from other countries we found high rates of ethno-racial diversity in the EIP of Reus. In addition, we also found inequalities in the use of services, being minorities more likely to disengage, to be low adherent to the program and at greater risk of hospitalization. On contrary to other studies we did not find significant differences between groups in the source of referral to EIP

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In clinical practice, significant delays in requesting help are observed in patients with depressive symptoms and suicidal ideation.

The objective of this study was to determine factors associated with the time of untreated illness in a population with depressive disorder attending mental health for the first time in the area of Hospital Clínico Universitario de Valladolid (HCUV).

Methods: This is an observational study including adult patients of both sexes, referred to their first mental health consultation from their Primary Care Physician, with a picture of depressive symptomatology associated with an identifiable stressor. Informed consent was obtained from the patients and authorized by the Ethics Committee of the HCUV. R Studio ® statistical analysis.

The degree of emotional confusion was quantified with item 1 (“I am often confused about the emotions I feel”) of the Toronto Alexithymia Scale (TAS). This item is scored ( 1-5 )from most severe (1) to least (5). On the other hand, the time in weeks between symptom onset to referral, age and symptom severity according to the Montgomery Scale (MADRS) were recorded.

Results: We present data collected in an initial sample of 278 treated patients, with a female predominance (68%), a MADRS severity score (18.05 ± 5.01) and a calculated time without treatment of 59.66 ± 62.26 weeks (Tables 1,2,3).

A subsample of 72 patients with death ideation was studied, with a female predominance (75%) compared to the overall sample (X2 =1.99, p = 0.1585) (Table 4).

It was also observed that death ideation was higher in younger patients (t = 3.18, p = 0.001907) and with a severe MADRS depression score (t = -7.92, p < 0.0001), however they took a similar length of time to receive mental health treatment (T student t = -1.6605, p = 0.099); (Table 5).

There is no previous published evidence that considers the timing of untreated symptoms. According to test statistics, there are differences in untreated symptom time considering gender and TAS score (Table 6).

Death ideation is a current health problem that deserves attention. In multivariate analysis models, an association with clinical and demographic factors has been found; however, there is up to 20% of the variation in prevalence that is not explained by the aforementioned factors. The factors that determine the time delay in seeking help (treatment delays) have not been studied so far.

In this study we observe how a single variable doesn’t explain the delay in the first visit. The interaction between age, gender, alexithymia and hypoprosexia explains the delay in seeking help, although symptom severity doesn’t seem to be related. These data suggest that unexplained causality in multivariate studies may be related to the interaction between clinical and neuropsychological factors.

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Substance use disorders (SUD) affect differentially women and men. Although the prevalence has been reported higher in men, those women with addictive disorders present a more vulnerable profile and are less likely to enter treatment than men. The aim of this presentation is to present an overview of how gonadal hormones may influence in response to substances, clinical differences in the addictive disorders and implications in treatment response.Ovarian steroid hormones (estrogen, progesterone), the metabolites of progesterone, and negative allosteric modulators of the gamma-aminobutyric acid A (GABA-A) receptor, such as dehydroepiandrostenedione (DHEA) may influence the behavioral effects of drugs.

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Psychedelics are substances consumed for recreational use, the majority of these psychoactive substances are illegal and hard to obtain. Therefore, there is a demand for psychedelics legal and easier to access, these types of drugs are called ‘legal highs’. LSA (lysergic acid amide) is one of these new psychoactive substances, this drug is searched because it is known to have an effect similar to LSD. LSA has negative effects on body functioning not fully understood by the medical field.

This project aims to conduct a systematic review of the scientific health literature on LSA.

The following information was included in this review: articles reporting original data on physical effects, neurobiological effects, various bodily symptoms, social and cultural aspects in humans related to LSA, published in English, Portuguese, Spanish, Italian, and French. Studies involving animals, in vitro research, botanical studies, and non-original research were excluded. The following keywords were searched in the PubMed, Google Scholar, and Web of Science databases: (ergine or d-lysergic acid amide or LSA or d-lysergamide or lysergic acid amide). This study followed the PRISMA statement for systematic reviews and PRISMA checklist. The resulting data were tabulated and analyzed according to relevance.

LSA, also known as ergine, is an ergot alkaloid with a chemical formula very similar to LSD. Ergine is found in plants of the Convolvulaceae family and is primarily consumed through chewing the seeds of these plants, soaking them in alcohol, or preparing an extract. The amount of LSA in each seed is inconsistent, making it unpredictable how much will be consumed, and these seeds may contain other harmful compounds.

LSA is a partial agonist and antagonist of serotonergic receptors, with a preference for 5-HT1A and 5-HT2, and stimulation of D2 is related to nausea. It can cause symptoms including euphoria, hallucinations, anxiety, nausea, weakness, fatigue, tremors, and elevated blood pressure. In some cases, the use of LSA is associated with the use of other drugs, and there are case reports of LSA-induced PRES (Posterior Reversible Encephalopathy Syndrome), post-use suicides and the need for hospitalization due to psychosis-like states.

Studies conducted on the quality of information about LSA on digital platforms indicate misinformation with incorrect data that can be harmful to those who ingest the drug. Additionally, there are studies suggesting that LSA may improve symptoms of cluster headaches.

LSA is a legal drug in most countries, with widespread misinformation on the internet and limited control over its use. There are potential serious adverse effects caused by the drug, and it is often associated with other psychoactive substances. Greater knowledge about the drug is needed for diagnosing its use and abuse, as well as for educating the public.

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Nowadays children and adolescents are exposed to cyber victimization.This modern form of aggressive behavior has a negative impact on the psychological of victims,self esteem, and social interaction

To investigate the relation between cybervictimization and depression in tunisian preadolescents and adolescents

The Arabic validated version of the “cyberbullying assessment instrument” was distributed through social media groups of preadolescent and adolescents in Tunisia.The participants were also invited to answer items about social and demographic characteristics.The participation was voluntary,without confidential data.

Fifty four preadolescent and adolescent aged between 9 and 16 years old have participated. The average age was 12.4 years old. 64% of participants were girls.More than 80% of children have their own smartphone and a personal count on social media.Among those respondents,12 (22.2%) reported being cyberbullied at least once in the year.the children most likely to be bullied were girl aged between 9 and 12 years old with a poor socioeconomic level.low self esteem, depressive symptoms, anxiety symptoms are associated with cyber victimization.

The level of cyber victimization among preadolescents and adolescents is underestimated. Psychiatric disorder associated to this phenomena have to be considered in order to develop strategies and intervention to reduce the cyberbullying among vulnerable population.

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Pregnancy and the postpartum period involve several physiological adaptations crucial for offspring care. Recent research has highlighted reproduction-related brain plasticity in human mothers. Associations with aspects of maternal caregiving suggest adaptive changes that facilitate a woman’s transition to motherhood. However, the dynamic changes that affect a woman’s brain are not merely adaptive, and they likely confer a vulnerability for the mental disorders. To elucidate the pathophysiology of psychiatric problems that occur during the perinatal period, gaining insights into the physiological changes in brain function due to pregnancy is crucial.

Although it has been hypothesized that pregnancy enhances social cognitive functions in mothers to adapt to the offspring care, there are few reports to support this hypothesis. This study aims to investigate whether social cognitive functions change during the first pregnancy, with a focus on maternal adaptation to offspring care.

The study included a first pregnancy group and a never-pregnant control group. We conducted a prospective study comparing pregnant women between two-time points (T1, T2); at less than 21 weeks of gestation [T1] and those after 30 weeks of gestation [T2]. To assess the effects of pregnancy and gestational age (< 21 weeks or 30 weeks or more), both the control (never-pregnant) group and pregnant group were evaluated at two time points with similar intervals. The Emotion Recognition Task [ERT] of the Cambridge Neuropsychological Test Automated Battery (CANTAB) was performed to examine the emotion recognition of six basic emotions in facial expressions. We analyzed a cohort of 26 participants in the pregnant group and 25 in the control group. We performed a two-way repeated measures analysis of variance with pregnancy status and gestational period (T1, T2) as independent variables.

Significant interactions between group and time points (T1, T2) were observed only for Unbiased Hit Rate Anger (p<0.01); facial recognition accuracy for anger increased with the progression of pregnancy. There were no significant interactions for Unbiased Hit Rate Sadness, Happiness, Fear, Disgust, or Surprise.

This is the first study to demonstrate that facial recognition of anger enhances with the progression of pregnancy, utilizing never-pregnant women as a never-pregnant control group. The results of this study contribute to the physiological effects of pregnancy on the brain and cognitive function and have potential for further study of perinatal mental health problems.

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Several studies have demonstrated the unfavorable and neurotoxic effects of untreated psychosis (UP) on the brain. An estimated 10 to 12 cc of brain tissue could be potentially damaged due to neuroinflammation and oxidative stress when a first episode of psychosis goes untreated. Other studies have found a correlation between the duration of untreated psychosis (DUP) and treatment resistance or nonresponse. Evidence-based schizophrenia treatment mainly relies upon the use of first and second-generation antipsychotics, without solid evidence that the former is superior to the latter regarding the treatment of negative symptoms. Both groups, however, can come with a risk of side effects. Cariprazine, a third-generation antipsychotic, represents a safe and effective treatment, targeting both the positive and negative symptoms of schizophrenia.

To report a clinical case of a woman with an extreme DUP with predominantly negative symptoms of schizophrenia and highlight the favorable outcome cariprazine monotherapy had on her global functioning.

We report a clinical case of a 58-year-old woman with a history of a 40-year UP successfully treated with 4,5mg of cariprazine. The woman was brought involuntarily for psychiatric assessment at the emergency department with a clinical image of catatonic stupor and predominantly negative symptoms of psychosis. Her total PANSS score at admission was 129. The negative subscale score was 49. She was initially treated with 3mg cariprazine and 10mg olanzapine and was gradually left on 4,5mg cariprazine monotherapy with an adjunctive 30mg mirtazapine.

The patient was dismissed after 47 days of hospitalization. Cariprazine was effective in targeting both the cognitive and affective symptoms of long-standing UP. In the long-term, cariprazine also improved remnant delusional ideas of somatic and persecutory types, enhancing the patient’s social life, ensuring her support network, and assisting her integration into the community. The patient did not report any side effects, and her blood test results were within the normal range.

Not all cases of schizophrenia are dramatic at presentation - some can have a chronic and insidious course predominated by negative symptoms. UP can lead to disastrous consequences for the patient’s biopsychosocial well-being, leading to future treatment resistance and disability. Although such cases of untreated psychosis seem to be from the past, we should be conscious of their existence and treat them with a patient-personalized and symptom-centered approach. Cariprazine was successful and effective in treating this patient with a remarkable course of UP.

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According to the World Health Organization, around 2 billion people worldwide are estimated to drink. Alcohol intake results in 25% of the 3.8% of worldwide fatalities and 4.6% of global disability-adjusted life years that may be attributed to alcohol

This review seeks to synthesize data on psychological and pharmacological treatments for Alcohol Use Disorder (AUD) available in the inpatient setting.

A comprehensive and narrative review of studies and research on psychological and pharmacological interventions for patients with alcohol use disorders in inpatient treatment units was performed. Data was extracted from electronic bibliographic databases, including Medline, EMBASE, PsycINFO, Global Health, HealthSTAR, and Cumulative Index for Nursing and Allied Health Literature (CINAHL) via EBSCOhost. This review included both qualitative and quantitative studies

Overall, after an initial title, abstract screening, and subsequent full-text screening, seven out of 1245 extracted studies met the eligibility criteria and were included in the review. This review suggests that a combination of pharmacological interventions such as naltrexone, nalmefene, acamprosate and brief psychological interventions were effective in treating AUD.

This review suggests that pharmacological and psychological approaches, when used together, are efficacious in treating AUD. There is a need to adopt both pharmacological and psychological interventions in the treatment of AUD.

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In this section, the speaker will present the results from a recent longitudinal study performed by the work group, in which a cohort of 265 patients admitted with a manic episode were followed up during three years after hospital discharge to identify acute readmissions due to affective relapses. The study of different sociodemographic and clinical variables potentially implicated in a higher risk of readmission over three years is presented, including adherence to treatment, substance use, number of previous episodes, family history, predominant polarity, treatments used and number of visits to the Emergency Department.

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Cameroon’s eastern region faces numerous security challenges linked to successive crises in the Central African Republic, particularly with the massive influx of refugees especially since 2013. Official UNHCR figures speak of 349,409 Central African refugees present on Cameroonian soil. These are both refugees already well established in their host communities, and new arrivals. Since the post-electoral crisis in CAR at the end of 2020, the situation has gradually stabilized in the Kadey department, but remains volatile due to daily insecurity in the northern regions of the Central African Republic.

With a view to meeting the mental health and psychosocial support needs of the region’s population and better integrating refugees into their host communities, it was necessary to obtain a more exhaustive picture of the population’s perception of mental health, to understand the mechanisms of psychosocial support at community level and any differences between refugees and the indigenous population.

A mixed methodology with quantitative and qualitative data was chosen for a more detailed analysis. The survey was carried out in two communes in the Kadey department: Kentzou and Kette. The sample was disaggregated to take account of the socio-demographic characteristics and to enable to make comparisons between the situations of host communities, living in refugee sites and outside sites. For quantitative data, 205 the individuals responded to a questionnaire. 12 individual interviews and 12 Focus Group Discussions (involving 60 participants ) guided by semi-structured questions were used to collect qualitative data from key members of the community.

Analysis of quantitative and qualitative data has confirmed the successful integration of Central African refugees into the host community. Nevertheless, there is a difference between these two groups in terms of their perception and understanding of the definition of mental health, mental health disorders and treatment options. Thus, there was a clear difference in training and awareness needs between the host and refugee communities.

Based on the qualitative and quantitative results of our assessment, a number of recommendations have been drawn up. It would be interesting to find a balance in the definition, attribution of causes and treatment of mental disorders between the traditional, mystical and cultural vision and the psychological and psychiatric one. It would be important to encourage refugee communities to return to some of their traditional practices, and to allow several visions of the human being to coexist between a traditional and a more medical vision.

To address the lack of resources for mental health care in the Kadey area, more training in mental health and psychosocial support is needed for health and social workers in the area.

None Declared

After judgment of the Constitutional Tribunal of 22.10.2020, there are two premises for abortion: when pregnancy was caused by rape or pregnancy is the threat for health and life of a mother. Then some people indicated that the latter should be interpreted more broadly. So far, jurisprudence has interpreted health threats only in relation to physical health, currently – cases classified as mental health threats are included.

The aim of this paper is first to analyze different aspects of this phenomenon: clinical, philosophical, including ethical and legal. The second goal is to point out the best actions for psychiatrists.

The methodology of this paper corresponds to the pastoral paradigm: diagnosis, reflection, action. At first, the arguments of opponents and proponents of the concept of psychiatric premises for abortion were extracted. Then they were assessed from a logical and essential point of view. Finally, some conclusions and guides were included to enable psychiatrists to act appropriately, including ethical, clinical and legal aspects.

Statements and letters from various institutions and societies were analyzed, including the Presidium of the Supreme Medical Council, Polish Pediatrics Society, the Expert Team on Bioethics of the Polish Bishops’ Conference, the Bioethics Committee of the Polish Academy of Sciences, Patient’s Rights Ombudsman, Commissioner for Human Rights. The key arguments for psychiatric premises are presented in the Table 1.Table 1.

According to opponents, using the premise of mental health risks to terminate a pregnancy would be an example of the psychiatrization of life and the abuse of psychiatry for political purposes. There would be a danger of associating psychiatry as a tool for performing abortions, which would perpetuate the phenomenon of stigmatization – of both doctors and patients. Each of the arguments for this has been negated.

This problem illustrates an attempt to replace the paradigm of traditional personalistic ethics with utilitarianism. The concept of psychiatric premises for abortion is contrary to the principles of double effect and proportionality. It is also against the Polish Code of Medical Ethics: art. 39 and art. 54.

None Declared