Decision-making is a complex process, and little is known about the various elements that comprise it. Recent literature on neurocognitive deficits in patients with a history of suicidality has highlighted that impaired (non-adaptive) decision-making is one of the most consistent deficits in individuals with a history of suicidality.

This study aims to systematically review the available evidence on decision- making capacity in depressed patients with a history of suicide attempts.

A systematic search was conducted in PubMed, Psycnet, Elsevier and Scopus with additional searching through bibliographic references. This search was performed until the 31st of August 2022 and provided information on decision-making capacity in relation to suicidality and depression.

The literature review provided 377 references, the titles and abstracts of which were reviewed for relevance to this study and the entry criteria set. The review of the title and abstract of these studies resulted in 50 articles that were potentially relevant to the study topic and a further review was then conducted to re-examine the selected studies and articles, which resulted in the final selection of 20 studies. The outcome measure used by the majority of studies as a measure of decision-making ability was the IOWA Gambling Task (IGT), in which the performance of patients with a history of depression and self-harm in most studies was significantly worse than that of healthy controls. Some methodological characteristics of the studies included in this review complicated the interpretation of the results, such as the sample size and characteristics of each study.

Decision-making ability shows alterations in patients with a history of suicidality and depression, confirming the findings of previous studies. Furthermore, an impaired or dysfunctional decision-making ability may potentially be a predictor of suicidal behaviour in patients with depression, a possibility that could be a reason for further research in this field, both in the context of investigating predictors and in developing appropriate treatments for these patients.

None Declared

Resilience is defined as the process and outcome of successfully adapting to difficult or challenging life experiences, and adjustment to external and internal demands, including challenges in family or relationship dynamics, serious health concerns, financial pressure or work-related stress. Employees’ creative self-sufficiency, work environment, as well as the interpersonal relationships developing in the workplace which constitute basic parameters of professional satisfaction can potentially affect both psychosomatic resilience of the employees as well as their performance at work. Exploring the available bibliography, it was revealed that the mental health professionals’ community has not been sufficiently examined in terms of emotional resilience.

To examine the dimensions of psychological resilience among mental health professionals.

In the context of a postdoctoral research which is conducted on a sample of the Greek population- personnel working in mental health hospital and community-based settings -a review of 35 articles from 1985 to 2023 on PubMed and Google Scholar was proceeded regarding psychological resilience among mental health professionals.

Creative self-sufficiency and professional satisfaction were found to be positively correlated with resilience among mental health professionals. Additional factors have been found to influence mental resilience among mental health professionals, such as individual personality traits, coping style, perceived social support, a sense of security, and organizational support.

This review contributes to the evolving understanding of resilience, particularly regarding mental health prοviders. The positive correlation between creative self-sufficiency and professional satisfaction highlights the importance of fostering these dimensions to enhance mental resilience through implementing emotional capacity-building practices, social skills counseling, as well as mindfulness-based interventions.

None Declared

Knowledge of sex differences in risk factors for posttraumatic stress disorder (PTSD) can contribute to the development of refined preventive interventions. Therefore, the aim of this study was to examine if women and men differ in their vulnerability to risk factors for PTSD.

As part of the longitudinal AURORA study, 2924 patients seeking emergency department (ED) treatment in the acute aftermath of trauma provided self-report assessments of pre- peri- and post-traumatic risk factors, as well as 3-month PTSD severity. We systematically examined sex-dependent effects of 16 risk factors that have previously been hypothesized to show different associations with PTSD severity in women and men.

Women reported higher PTSD severity at 3-months post-trauma. Z-score comparisons indicated that for five of the 16 examined risk factors the association with 3-month PTSD severity was stronger in men than in women. In multivariable models, interaction effects with sex were observed for pre-traumatic anxiety symptoms, and acute dissociative symptoms; both showed stronger associations with PTSD in men than in women. Subgroup analyses suggested trauma type-conditional effects.

Our findings indicate mechanisms to which men might be particularly vulnerable, demonstrating that known PTSD risk factors might behave differently in women and men. Analyses did not identify any risk factors to which women were more vulnerable than men, pointing toward further mechanisms to explain women's higher PTSD risk. Our study illustrates the need for a more systematic examination of sex differences in contributors to PTSD severity after trauma, which may inform refined preventive interventions.

Binge eating behaviors are associated with psychological, social, and biological factors, while it is suggested that they may be triggered by negative emotions, including depression and anxiety, and provide relief from them, which in turn may lead to reinforcement of such behaviors.

This study aimed to examine the eating habits and in particular the binge eating behaviors of a sample of adults during the COVID-19 pandemic, an unprecedented challenge for public health and communities worldwide with multi-level consequences on people’s lives.

The sample consisted of 196 individuals residing in Greece aged 18 to 64 years (76.5% women), who completed an anonymous questionnaire from June to July 2021. This included the following psychometric instruments: Fear of COVID-19 Scale to assess the fear related to COVID-19, Rosenberg Self-esteem Scale to assess self-esteem, Depression Anxiety Stress Scale-21 to assess anxiety, depression and stress, Binge Eating Scale to assess binge eating behaviors, UCLA Loneliness Scale for the evaluation of the perceived feeling of loneliness and Reflective Functioning Questionnaire for the assessment of reflective functioning (i.e., the ability to understand human behavior in terms of underlying mental states).

The majority of participants (86.7%) reported that during the pandemic their diet was less healthy than before the pandemic onset, while almost half (46.4%) of the participants stated that they had experiences an episode of binge eating during the past 6 months, and 36.2% that they had used self-induced vomiting in order to control their weight. Of note, the results of a multiple regression analysis revealed that higher levels of fear of the pandemic as well as of depression were independently associated with higher binge eating, with women presenting higher mean scores in the Binge Eating Scale than men. Conversely, higher self-esteem appeared to be independently associated with lower binge eating levels, thus acting as a protective factor, whereas the remaining psychometric factors were not found statistically significantly related.

In conclusion, the findings of the present study highlight the importance of identifying dysfunctional eating behaviors and related psychological factors that may potentially act as risk or protective factors, especially during the pandemic.

None Declared

Racial and ethnic groups in the USA differ in the prevalence of posttraumatic stress disorder (PTSD). Recent research however has not observed consistent racial/ethnic differences in posttraumatic stress in the early aftermath of trauma, suggesting that such differences in chronic PTSD rates may be related to differences in recovery over time.

As part of the multisite, longitudinal AURORA study, we investigated racial/ethnic differences in PTSD and related outcomes within 3 months after trauma. Participants (n = 930) were recruited from emergency departments across the USA and provided periodic (2 weeks, 8 weeks, and 3 months after trauma) self-report assessments of PTSD, depression, dissociation, anxiety, and resilience. Linear models were completed to investigate racial/ethnic differences in posttraumatic dysfunction with subsequent follow-up models assessing potential effects of prior life stressors.

Racial/ethnic groups did not differ in symptoms over time; however, Black participants showed reduced posttraumatic depression and anxiety symptoms overall compared to Hispanic participants and White participants. Racial/ethnic differences were not attenuated after accounting for differences in sociodemographic factors. However, racial/ethnic differences in depression and anxiety were no longer significant after accounting for greater prior trauma exposure and childhood emotional abuse in White participants.

The present findings suggest prior differences in previous trauma exposure partially mediate the observed racial/ethnic differences in posttraumatic depression and anxiety symptoms following a recent trauma. Our findings further demonstrate that racial/ethnic groups show similar rates of symptom recovery over time. Future work utilizing longer time-scale data is needed to elucidate potential racial/ethnic differences in long-term symptom trajectories.

Suicide is the second most common cause of adolescent mortality worldwide.

To study the characteristics of a sample of adolescents (<18years of age) who died by suicide in Greece.

We investigated all suicides that took place within the area of the Piraeus Department of Forensic Medicine (population covered ~700,000) for the period 1992-2016, based on the victims’ forensic records.

During the 25-year period, 16 adolescents (and 1162 adults) died by suicide. They were mostly males (11/68.75%) and of Greek Nationality (14/87.5%). The mean age was 15.56 years (range: 12-17, standard deviation: 1.46). Two (12.5%) were under psychiatric medication (an antipsychotic and an antidepressant, respectively); none was receiving a benzodiazepine or a mood-stabilizing antiepileptic. None had used amphetamine, cannabis, cocaine or heroin. Two (12.5%) -one girl one boy- had consumed alcohol. The suicides took place primarily at home (12/75%), followed by outdoors (3/18.75%); one (6.25%) took place in a correctional facility. Hanging was the most prevalent method (6/37.5), followed by jumping (5/31.25%), shooting by a firearm (2/12.5%), drowning (1/6.25%), medication overdose (1/6.25% -amitriptyline poisoning) and a case of suffocating death (1/6.25%). Most suicides happened in September (5/31.25%) and April (3/18.75%). No significant differences were noted with the adult sample.

The methods chosen by the adolescents who died by suicide in our sample differ strikingly from those of usual suicide attempts at that age (medication overdose/self-cutting). The periods when the suicides took place may imply a role for school stress. Our study was retrospective and focused primarily on a large urban area.

We recently demonstrated that patients with major depression (MDD) with and without electroconvulsive therapy referral (ECTs vs. NECTs) qualitatively differ in neuropsychological profile. ECTs presented severe executive but minor visuospatial memory deficits, suggesting mainly frontostriatal involvement; NECTs presented the opposite pattern, compatible with temporohippocampal involvement. Here we follow up on ECT treatment effects on both cognitive domains.

15 ECTs were assessed with Hamilton Depression (HAMD-24), Hamilton Anxiety (HAMA) and Mini-Mental State Examination (MMSE) scales and 5 tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) at hospitalisation (PRE-ECT), immediately after ECT (POST-ECT) and 2 months later (FOLLOW-UP). ECTs at FOLLOW-UP were also compared to 15 matched non-psychiatric CONTROLS who underwent neuropsychological testing once.

There was significant clinical improvement (reflected by reduced HAMD-24 and HAMA scores: p < 0.001) between PRE-ECT and FOLLOW-UP. After a minor decline POST-ECT, MMSE scores showed significant increase at FOLLOW-UP (p < 0.02). At FOLLOW-UP, Paired Associates Learning (PAL) showed significant improvement (p < 0.001). Stockings of Cambridge (SOC) performance also improved (decrease in early abandonments, p < 0.04) POST-ECT and at FOLLOW-UP. However, clinical improvement did not result in improvement in Intra / Extradimensional Shift (IED): at FOLLOW-UP, ECT patients were indistinguishable from CONTROLS in all neuropsychological measures except IED (p < 0.04).

Clinically successful ECT treatment was accompanied by improved global cognitive functioning, visuospatial memory and spatial planning, but offered no benefit in attentional flexibility. This residual deficit suggests ‘trait’ frontostriatal involvement in this patient group.

The pretreatment neuropsychological profile of drug-resistant patients with major depressive disorder (MDD) referred for electroconvulsive therapy (ECT) may differ from that of their drug-respondent MDD counterparts. Such differences could help in identifying distinct MDD subtypes, thus offering insights into the neuropathology underlying differential treatment responses.

Depressed patients with ECT referral (ECTs), depressed patients with no ECT referral (NECTs) and nonpsychiatric Controls (matched groups, n = 15) were assessed with memory and executive function tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB).

ECTs scored significantly lower than NECTs in the Mini-Mental State Examination (MMSE; p = 0.01). NECTs performed worse than Controls in the Paired Associates Learning (PAL) task (p < 0.03 ; Control/NECT p < 0.01) and the Spatial Recognition Memory (SRM) task (p < 0.05 ; Controls/NECTs p < 0.05) ; ECTs performed between Controls and NECTs, not differing from either. In the Intra/Extradimensional (IED) set-shifting task, ECTs performed worse that Controls and NECTS (IED: p < 0.01 ; Controls/ECTs p < 0.01), particularly in the shift phases, which suggests reduced attentional flexibility. In Stockings of Cambridge (SOC), ECTs abandoned the test early more often than Controls and NECTs (H = 11, p < 0.01) but ECTs who completed SOC performed comparably to the other two groups.

A double dissociation emerged from the comparison of cognitive profiles of ECT and NECT patients. ECTs showed executive deficits, particularly in attentional flexibility, but mild deficits in tests of visuospatial memory. NECTs presented the opposite pattern. This suggests predominantly frontostriatal involvement in ECT versus temporal involvement in NECT dépressives.

The pretreatment neuropsychological profile of drug-resistant patients with major depressive disorder (MDD) referred for electroconvulsive therapy (ECT) may differ from that of their drug-respondent MDD counterparts. Such differences could help in identifying distinct MDD subtypes, thus offering insights into the neuropathology underlying differential treatment responses.

Depressed patients with ECT referral (ECTs), depressed patients with no ECT referral (NECTs) and non-psychiatric Controls (matched groups, n=15) were assessed with memory and executive function tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB).

ECTs scored significantly lower than NECTs in the Mini-Mental State Examination (MMSE; p=0.01). NECTs performed worse than Controls in the Paired Associates Learning (PAL) task (p<0.03; Control/NECT p<0.01) and the Spatial Recognition Memory (SRM) task (p<0.05; Controls/NECTs p<0.05); ECTs performed between Controls and NECTs, not differing from either. In the Intra/Extradimensional (IED) set-shifting task, ECTs performed worse that Controls and NECTS (IED: p<0.01; Controls/ECTs p<0.01), particularly in the shift phases, which suggests reduced attentional flexibility. In Stockings of Cambridge (SOC), ECTs abandoned the test early more often than Controls and NECTs (H=11, p<0.01) but ECTs who completed SOC performed comparably to the other two groups.

A double dissociation emerged from the comparison of cognitive profiles of ECT and NECT patients. ECTs showed executive deficits, particularly in attentional flexibility, but mild deficits in tests of visuospatial memory. NECTs presented the opposite pattern. This suggests predominantly frontostriatal involvement in ECT versus temporal involvement in NECT depressives.