Immunoassays such as enzyme-linked immunosorbent assays (ELISAs) provide precise measurements of class-specific antibodies to infectious agents. The application of these assays to blood and cerebrospinal fluid from individuals with psychiatric disorders has supported a role for microbial agents in these conditions. However, standard immunoassays are limited by their capacity to measure antibodies to only a single or a small number of infectious agents and epitopes, restricting the ability to identify differential immune responses.

Recent technological advances now allow for comprehensive profiling of immune responses to multiple infectious agents and their specific antigenic epitopes. These methods enable the investigation of differential immune responses as potential modulators of psychiatric disease risk.

We applied two novel serological platforms to analyze immune responses in blood samples from individuals with various psychiatric disorders and suicidal behaviors, as well as healthy controls. The first method assessed antibodies to >4200 peptides derived from >80 infectious agents immobilized onto a solid-phase surface. These peptides were incubated with small blood volumes, and antibody binding was detected via secondary reactions.

Results demonstrated significant differences in immune responses to Toxoplasma gondii and Epstein-Barr virus (EBV) in individuals with schizophrenia and other severe psychiatric disorders. Responses to T. gondii were primarily directed at dense granule (GRA) proteins, with multiple GRA peptide reactivities detected even in individuals classified as “seronegative” by standard immunoassays. For EBV, differential responses were observed to ZEBRA and other latency-associated proteins. Findings were corroborated using a phage display system, where peptides derived from viral proteins were expressed on the phage surface.

Interestingly, immune reactivity was not uniformly increased or decreased but varied depending on the specific antigen. These findings suggest that psychiatric disorder-associated immune alterations may not merely reflect pathogen exposure but also differences in immune response patterns. Further investigation of these differential responses could inform novel diagnostic, preventive, and therapeutic strategies for severe psychiatric disorders.

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Antidepressants are essential in managing depression, including treatment-resistant cases. Public perceptions of these medications, shaped by social media platforms like X (formerly Twitter), can influence treatment adherence and outcomes. This study explores public attitudes toward antidepressants through sentiment and topic modeling analysis of tweets in English and Spanish from 2007 to 2022.

Tweets mentioning antidepressants approved for depression were collected. The analysis focused on selective serotonin reuptake inhibitors (SSRIs) and glutamatergic drugs. Sentiment analysis and topic modeling were conducted to identify trends, concerns, and emotions in discussions across both languages.

A total of 1,448,674 tweets were analyzed (1,013,128 in English and 435,546 in Spanish). SSRIs were the most mentioned antidepressants (27.9% in English, 58.91% in Spanish). Pricing and availability were key concerns in English tweets, while Spanish tweets highlighted availability, efficacy, and sexual side effects. Glutamatergic drugs, especially esketamine, gained attention (15.61% in English, 25.23% in Spanish), evoking emotions such as fear, sadness, and anger. Temporal analysis showed significant increases in discussions, with peaks in 2012 and 2021 for SSRIs in Spanish, and exponential growth from 2018 to 2021 for glutamatergic drugs. Emotional tones varied across languages, reflecting cultural differences.

Social media platforms like X provide valuable insights into public perceptions of antidepressants, highlighting cultural variations in attitudes. Understanding these perceptions can help clinicians address concerns and misconceptions, fostering informed treatment decisions. The limitations of social media data call for careful interpretation, emphasizing the need for continued research to improve pharmacovigilance and public health strategies.

Infectious diseases are known to significantly increase the risk for later development of a mental disorder. Nonetheless, only few studies utilized big-data strategies to evaluate whether cumulative viral infection increases the risk of a subsequent mental illness, and whether risk and resilience factors a likely to modify theses associations. Methods: This study assessed the likelihood of mental illness development among individuals with recurrent exposure to pre-determined viruses (n = 53,416). The viral blood tests included in the analysis was based on consensus agreement of the VIRAL-MI consortium members, and was based on test validity, mandatory vaccination profiles, and the test’s ability to detect acute infection. Broadly, these tests included positivity to the following viral infections: Cytomegalovirus, Epstein-Barr virus, Hepatitis, Herpes, Toxoplasma and Influenza. Data was obtained through the Clalit Health Services, the largest healthcare organization in Israel. Results: Overall, 663,231 tests were obtained from the cohort of 53,416 cases. Kaplan-Meier analyses indicated that individuals infected with more than three viruses were significantly more likely to develop a mental disorder (Log rank 14.55, p<.001). Of the investigated disorders, only anxiety disorders presented a significantly differential pattern of cumulative risk, in the same direction (Log rank 10.06, p = .007). Conclusions: Cumulative viral infections may have significant contribution to the development of a mental disorder. Limitations and integration with previous research will be discussed.

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Unhealthy lifestyle behaviors are prevalent among people with mental illness (MI), affecting their physical and mental health. Most research has focused on the isolated effects of lifestyle behaviors, leaving the interconnectedness between these behaviors and health outcomes unexplored. This study aimed to examine these relationships and identify the most strongly connected lifestyle behavior or health outcome within a network.

We conducted a cross-sectional study with 423 inpatients with MI, receiving care as usual. Lifestyle behaviors, physical and mental health outcomes were assessed through questionnaires and routine data. A Gaussian Graphical Model was estimated, and strength centrality was calculated to identify the most influential nodes.

Mean age was 55.5 years, 42% were female, and 41% were diagnosed with schizophrenia. Psychological and physical quality of life (QoL), nighttime sleep problems, and overall sleep quality were the most strongly connected nodes. Sleep was strongly associated with physical QoL. Furthermore, there were negative associations between healthy food intake and cholesterol ratio, and positive associations between daily doses of antipsychotics and length of hospital stay. Node strength was stable (CS(cor = 0.7) = 0.75). No clear pattern emerged among other lifestyle behaviors and health outcomes.

This study offers insights into the interrelatedness of lifestyle behaviors and health outcomes. Addressing sleep problems could enhance QoL and potentially influence other health outcomes. Psychological and physical QoL were also strongly associated, emphasizing the importance of perceived well-being in health outcomes. Future research could explore causal pathways to identify treatment targets to improve care.

The recent development of the socalled “psychedelics” reminds us that unfortunately some medications which we used in psychiatry have a large burden of side effects, like the anticholinerg side effects of the older tricyclic antidepressants as well as the extrapyramidal motoric side effects of socalled typical neuroleptics. These side effects were sometimes also related to the efficacy of these medications. Interestingly, it seems that the neglection of side effects is still an unresolved issue in clinical psychopharmacology, since there are researchers and clinicians who argue that the psychedelic experience induced with psychedelics are associated with therapeutic efficacy. Furthermore, studies in this field not even mention these side effects as such and argue, when confronted with the issue, that these are necessary for the therapeutic outcome. Even more so, there are researchers and clinicians who think that these side effects allow the patients to understand their unconscious, like in the early days of psychoanalysis. However, recent preclinical animal models demonstrated antidepressant-like behavioral effects and synaptic actions that are not only linked to the serotonergic activation (mainly via the 5HT2A receptor), but also via opioid and glutamatergic pathways which share neurobiological mechanisms of network reconfiguration likely by intracellular plasticity cascades. It seems to be important from my point of view to develop antidepressant medications devoid of the side effect of psychedelic experience in order to produce a safer, non-hallucinogenic medication that has therapeutic potential for depressed patients.

S. Kasper Consultant of: In the past 3 years Dr Kasper served as a consultant or on advisory boards for Angelini, Biogen, Boehringer, Esai, Janssen, IQVIA, Mylan, Recordati, Rovi, and Schwabe; , Speakers bureau of: In the past 3 years Dr. Kasper served on speakers bureaus for Angelini, Aspen Farmaceutica S.A., Biogen, Janssen, Recordati, Schwabe, Servier, and Sothema.

Ketamine has been established as a rapid and potent antidepressant. However, despite its groundbreaking efficacy, it has several limitations, including the transient nature of its antidepressant effects following a single infusion, as well as the phenomenology of acute intoxication. This state is characterized by altered consciousness, manifesting as dissociative or psychotomimetic phenomena, along with cardiovascular changes, such as fluctuations in systolic and diastolic blood pressure.

The presentation explores whether these phenomena should be regarded as mere side effects or if they might play a role in ketamine’s antidepressant mechanisms. Furthermore, it addresses the ongoing challenge of identifying clinical and phenomenological predictors of a better antidepressant response.

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Medical students are persistently exposed to specific conditions that may have detrimental effects on mental health, such as stressful academic routine, demanding and heterogeneous curriculum, sense of competition and daily exposure to illness and death. Accumulating evidence highlights high levels of cynicism and emotional exhaustion among these subjects. Indeed, the prevalence of burnout syndrome in medical students may reach peaks up to 88% in some studies. Thoughts of stopping medical education, negative life events, lack of support, dissatisfaction, and poor motivation represent the main predictors of burnout in this group. Such findings highlight the need to develop prevention initiatives targeting the future generation of medical doctors. Moreover, implementation of psychosocial interventions delivered from medical schools could be helpful to improve coping strategies and resilience styles of students.

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Schizophrenia is a multifactorial disorder with a range of risk factors. Dysregulation in the systems involved in the stress response is a key component of its pathophysiology. Individuals at risk of developing schizophrenia exhibit hyperreactivity to stress and altered cognitive performance, both known as vulnerability markers. This study aims to determine whether stimulation of the prefrontal cortex can reduce reactivity to stress in unaffected siblings of patients with schizophrenia.

In a randomized, sham-controlled trial, 27 participants were assigned to receive either active (n = 14) or sham (n = 13) transcranial direct current stimulation (tDCS) over the prefrontal cortex for 30 min during exposure to an acute stressor. The stress response was measured biologically, via salivary cortisol levels, and cognitively, through a reality monitoring task, which serves as an intermediate cognitive vulnerability marker.

In contrast to the sham condition, active stimulation significantly reduced cortisol release in response to stress (F(9,216) = 1.972; p = 0.04) and prevented stress-induced impairment in reality monitoring (F(1,23) = 9.954; p = 0.004).

These findings suggest that tDCS should be a promising tool for reducing stress-induced biological and cognitive reactivity in a population at risk of schizophrenia.

Suicide remains a major risk factor for individuals suffering from schizophrenia and its prodromal state (i.e., Ultra-High Risk for Psychosis). However, less is known about the prevalence of suicidal behaviour among the adolescent and youth UHR population, a demographic vulnerable to the psychosocial and environmental risk factors of suicide. This review aims to synthesise existing literature on the prevalence of suicidal ideation and behaviour in the adolescent and youth at Ultra-High Risk for Psychosis (UHR), and the associations between suicidal behaviour and its correlates.

The databases PsycINFO, PubMed, Embase, Cochrane Library, Web of Science, and Scopus were accessed up to July 2024. A meta-analysis of prevalence was subsequently performed for lifetime suicidal ideation, lifetime non-suicidal self-injury, lifetime suicidal attempt, and current suicidal ideation. A narrative review was also carried out for the correlates of suicidal behaviour amongst adolescents and youth in the UHR population.

Studies were included in this meta-analysis. Meta-analysis revealed a high prevalence of lifetime suicidal ideation (58%), lifetime non-suicidal self-injury (37%), lifetime suicidal attempt (25%), and current (2 week) suicidal ideation (56%). The narrative review revealed that a personal transition to psychosis and a positive family history of psychosis were associated with suicidal attempts, while depression was associated with both suicidal attempts and suicidal ideation.

The prevalence of suicidal ideation and behaviour among UHR adolescents and youth is high and comparable to that of the general UHR population. Existing measures that mitigate suicide risk in the general UHR population should be adopted for the youth context.

Professionals’ attitudes, cultural background, and previous experiences are relatively stable and organized features of their backgrounds. They can affect the therapeutic process and provision of health care to LGBTIQ+ clients in both directions- affirmative and oppressive. Healthy development of sexual orientation and gender identity and their integration is one obvious prerequisite for healthy psycho-sexual and psychological development. Mental health care professionals should be aware of their attitudes, and cultural background, and how they can influence the therapeutic process with and provision of health care to LGBTIQ+ clients to provide culturally sensitive and LGBTIQ+ affirmative practice.

LGBTIQ+ affirmative health care can include any single or combination of several social, psychological, behavioral, or medical interventions designed to support and affirm an individual’s sexual orientation and/or gender identity.

Stigma-related stressors experienced by LGBTIQ+ people across these levels can take the form of relational trauma, and thus compound general life stressors that represent an additional risk for different stress-related outcomes including poor mental health and health-risk behaviors.

Expectations of rejection might be particularly frequent experiences among transgender and gender-diverse people. Existing data depict LGBTIQ+ populations to be at a greater risk for poor health outcomes and a plethora of risk behaviors.

Transgender and gender diverse (TGD) people most often perceive available healthcare to be of inadequate quality and potentially unsafe. However, up to now healthcare systems across Europe fail to provide equal access for TGD compared to cisgender people It has been estimated that at least 27% of TGD people in Europe fail to access TGD care. Compared to cisgender people and compared to lesbian, gay, bisexual, or intersex people, TGD people are most affected by not having access to appropriate care, and they are among those reporting the highest rates of experiencing bad health.

Access to the highest standard of LGBTIQ+ affirmative health care, including LGBTIQ+ affirmative approach within psychotherapeutic practice, that respects dignity and right of self-determination, personal, physical, and psychological integrity, autonomy, and wellbeing of LGBTIQ+ people, and that relies on evidence-based practice, clinical guidelines and standards of care should be a priority across European health care systems and psychotherapeutic modalities. Education and sensitization of medical, and mental health professionals, psychotherapists, and other health care professionals on sexuality, sexual orientations, gender identities, and diversities should be implemented as core intercultural competencies through the obligatory curriculum courses of health and mental health professionals.

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There is increasing emphasis on reducing the use and improving the safety of mechanical restraint (MR) in psychiatric settings, and on improving the quality of evidence for outcomes. To date, however, a systematic appraisal of evidence has been lacking.

We included studies of adults (aged 18–65) admitted to inpatient psychiatric settings. We included primary randomised or observational studies from 1990 onwards that reported patterns of MR and/or outcomes associated with MR, and qualitative studies referring to an index admission or MR episode. We presented prevalence data only for studies from 2010 onwards. The risk of bias was assessed using an adapted checklist for randomised/observational studies and the Newcastle-Ottawa scale for interventional studies.

We included 83 articles on 73 studies from 1990–2022, from 22 countries. Twenty-six studies, from 11 countries, 2010 onwards, presented data from on proportions of patients/admissions affected by MR. There was wide variation in prevalence (<1–51%). This appeared to be mostly due to variations in standard protocols between countries and regions, which dictated use compared to other restrictive practices such as seclusion. Indications for MR were typically broad (violence/aggression, danger to self or property). The most consistently associated factors were the early phase of admission, male sex, and younger age. Ward and staff factors were inconsistently examined. There was limited reporting of patient experience or positive effects.

MR remains widely practiced in psychiatric settings internationally, with considerable variation in rates, but few high-quality studies of outcomes. There was a notable lack of studies investigating different types of restraint, indications, clinical factors associated with use, the impact of ethnicity and language, and evidence for outcomes. Studies examining these factors are crucial areas for future research. In limiting the use of MR, some ward-level interventions show promise, however, wider contextual factors are often overlooked.

This presentation will serve as an overview of LGBTQ+ Clinical Care in the United States and throughout the world. Using the specific example of the Los Angeles LGBT Center, Dr. Ahuja will discuss the need for an LGBTQ+-specific mental health clinic. The reasons for having specialized care are numerous, but boil down to several significant areas.

First, the LGBTQ+ community suffers from large health disparities. This often results from lack of specialized knowledge by providers and health advocates. An LGBTQ+ specific center allows for experts to exchgange and enhance information, incerased research into this population which results in better standars of care, and a chance to educate others regarding LGBTQ+ care. They can serve as a model for other clinics or any other health settings where practitioners can implement LGBTQ+-specific practices that work for them and their patients and on a scale that makes sense.

Second, there is much evidence of discrimination by healthcare providers and insurance companies regarding the LGBTQ+ community, particularly when it comes to the Transgender population. This can include rude behavior by providers, missed screenings due to not paying attention to patient anatomy or LGBTQ+ status, misgendering, harrasment, and lack of insurance coverage for procedures. An LGBTQ+ center allows for patients to have healthcare advocates who can fight for approval and ensures that patients are not harrassed for being LGBTQ+ which results in many patients forgoing necessary care. Further, screenings and patient education regarding things like Pre-Exposure Prophylaxis and Hormone Therapy are much improved as the center and its providers have the knowledge and mission to carry out large-scale educaton efforts.

Finally, an LGBTQ+ center like the Los Angeles LGBT Center inevitably becomes a community hub. These centers function to not just provide medical care but also to advocate for LGBTQ+ issues, coordinate with other centers to manage population disease outbreaks, fight misinformation and disinformation with accurate research, and provide many ancillary services including housing and social community spaces.

Select Sources

James, S.E., Herman, J.L., Durso, L.E., & Heng-Lehtinen, R. (2024). Early Insights: A Report of the 2022 U.S. Transgender Survey. National Center for Transgender Equality, Washington, DC.

Holt S, Ahuja A (2025). LGBTQ+ Intimate Partner Violence: A Guide for Mental Health Practitioners. Routledge.

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People within LGBTIQ+ are significantly more likely to suffer a mental health disorder and substance use disorder compared to heterosexual persons. Stigma, discrimination, and lack of social support are considered as some of the contributing factors to the higher incidence of psychiatric morbidity in this group. Simultaneously, the group’s rights vary around the world, and example being that for example homosexuality is criminalized in many countries and sometimes punishable by death.

Even in countries where homosexuality and belonging to LGBTIQ+ community is not criminalized or is well accepted in the society; the studies show increased odds of poor mental health in this group. For example, a study conducted in Sweden, where same – sex marriage is legal, comparing suicide risk between heterosexual and same-sex married couples showed that same-sex married men had a was nearly three-fold greater suicide risk in comparison to their heterosexual counterparts. Accessible and evidence – based LGBTIQ+ affirmative psychiatric services are crucial for addressing the mental health care needs of the group. These services can be supported by well-structured and efficient training of mental health care professionals.

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Exposure to Adverse Childhood Experiences (ACEs) might increase the risk of suicide behaviors in the general adult population, while this association in individuals with affective disorders remains less characterized.

A comprehensive search was conducted in MEDLINE, PsycINFO, CINAHL, Web of Science, Scopus, and PubMed up to July 10th, 2024. Observational studies that compared the risk of suicide behaviors in individuals exposed and unexposed to ACEs were included. Pairwise random-effects meta-analyses were conducted, and the certainty of evidence was assessed with validated criteria.

A total of 41 studies from 17 countries, comprising 19,588 participants, were analyzed. The main findings indicated a significant association between ACEs and suicidal behaviors, with an odds ratio (OR) of 1.98 (95% confidence interval [CI] 1.74–2.26), and a “highly suggestive” strength of association. This was consistent across diagnostic subgroups (i.e., Major Depressive Disorders, Bipolar Disorders, and mixed diagnoses). The association was confirmed for any ACE, with sexual abuse being the most frequently reported and showing the highest risk (OR 2.24; 95% CI 1.90–2.64), for suicidal ideation (OR 2.16; 95% CI 1.42–3.29), and for suicide attempts (OR 1.95; 95% CI 1.70–2.25), while death by suicide and non-suicidal self-injury were underreported. Meta-regression analyses did not suggest potential moderators, though underreporting was noted.

This meta-analysis shows that exposure to ACEs nearly doubles the risk of suicide behaviors in individuals with affective disorders, warranting the targeted clinical, research, and policy measures to timely address this global mental health issue.

Studies examining age-stratified risk factors for suicide among individuals with bipolar disorder in different stages of life are scant, possibly because of the insufficient number of suicide cases.

This study investigated suicide mortality rates and risk profiles of suicide mortality stratified by five age groups in individuals with bipolar disorder.

This study identified patients with a diagnosis of bipolar disorder between January 1, 2000, and December 31, 2021, from Taiwan’s National Health Insurance Research Database. The study population comprised 45,211 inpatients diagnosed with bipolar disorder, with 1,370 suicide cases during the study period. We calculated the standardized mortality ratio (SMR) of the bipolar cohort relative to the general population. In the age-stratified nested case–control study, risk set sampling was performed to match 1 suicide case with 10 living controls by age, sex, and the year of first diagnosis. The age-stratified risk associated with demographic characteristics, psychiatric and physical comorbidities was estimated using multivariable conditional logistic regression.

The highest SMR (47.0) for suicide was observed in individuals with bipolar disorder aged <30 years. SMR decreased with age; patients aged >60 years had an SMR of 9.5. Among those younger than 40 years, a higher percentage of unemployment was noted among suicide cases than among controls. A significantly increased risk of the depressive phase of bipolar disorder was noted shortly before suicide mortality among patients with bipolar disorder in all age groups. Drug-induced and alcohol-induced mental disorders were associated with suicide and were highly prevalent in patients aged <30 years. Other forms of heart disease were identified in patients aged <40 years, and pneumonia was detected in the 50–59 years age group.

These findings aid the development of health-care intervention strategies for preventing suicide among patients with bipolar disorder in various stages of life.

Postpartum stress and mental disorders have a high prevalence in the population. Postpartum depressed states, for example, potentially threaten care of and bonding with the children. Although mothers face specific needs, specialized treatment options are scarce. Online programs to inform on and treat postpartum stress and depression are, to present, not widely available, but have the potential to overcome some of the obstacles of postpartum women finding treatment.

To identify needs of this specific group, we conducted an online survey on women after childbirth, asking for acceptance of e-health programs, sociodemographic, medical and psychometric data.

In a large, anonymized online survey, 453 women have participated. We investigated 1) the acceptance of tailored e-mental health programs according to the UTAUT model in the respective women and 2) characteristics and needs of the specific populations. Based on our findings, we developed an online tool for stress reduction after child-birth based on relevant topics indicated by and data from the literature on specific needs of post-partum women.

In this talk, motivation for this project, research results and ongoing research will be highlighted and discussed.

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Informal caregivers are essential in supporting individuals facing mental health challenges, yet the demanding nature of their role can lead to significant distress and long-term psychological strain. International guidelines consistently highlight the critical importance of early caregiver support and identify psychoeducation for caregivers as one of the most effective interventions to support them. However, psychoeducational programmes for caregivers remain significantly underutilised. To address this pressing gap in mental health support, Rey et al. (2020), in collaboration with Unafam, the French national family association, developed the BREF programme. This innovative psychoeducational intervention is designed to provide early and systematic support for caregivers of people with severe mental disorders.

This study investigated the impact of the BREF programme, focusing on its potential to mitigate depressive symptoms and alleviate the psychological burden experienced by caregivers.

This study used a single-group pre-post design. It included family caregivers who participated in the BREF programme from November 2020 to March 2022. Changes in caregiver depressive symptoms (CES-D) and burden (ZBI) measured pre-, post- and 3 months after intervention. Caregivers’ satisfaction and perceived usefulness were also assessed.

Data from 206 family caregivers were analysed. The depression and burden scores significantly decreased immediately after the intervention (p<0.001) and at the 3-month follow-up (p<0.05). Additionally, 98% of participants reported being satisfied to very satisfied, 95% of them deemed it very to extremely useful.

The BREF programme demonstrated significant benefits, notably reducing caregivers’ depressive symptoms and burden. Designed for early systematic implementation this standardized, time- and resource- efficient intervention, offers à promising foundation for a structured and graduated support pathway for caregivers.

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