Major depressive disorder (MDD) is associated with high rates of incomplete response during treatment, with only one-third of the patients reaching remission after the first trial of antidepressants, according to the STAR*D trial. Based on the results of the same study, only 67% of the patients with MDD obtained remission after four trials of antidepressants, including a monoamine oxidase inhibitor, i.e., tranylcypromine, and various augmenting strategies. However, in STAR*D, no atypical antipsychotics (AAPs) were used, which is an important shortcoming of this trial. Exploring the efficacy of AAPs as add-on agents to antidepressants in the case of MDD with partial responsiveness may improve the prognosis of patients who did not remit during either antidepressant monotherapy or antidepressant therapy augmented with other psychotropic agents.

To assess the available data on the efficacy and tolerability of atypical antipsychotic augmentation in patients with MDD who obtained only partial response to antidepressants.

This review included three databases (Google Scholar, PubMed, and EMBASE) that were searched from their inception until June 2024 for papers published in English corresponding to the keywords “major depressive disorder,” and “partial response” and “atypical antipsychotics”. Both primary and secondary reports were included.

Systematic reviews dedicated to this topic reported significantly superior responses to placebo for ziprasidone, risperidone, aripiprazole, brexpiprazole, cariprazine, and quetiapine when added to antidepressants. The tolerability of these augmenting agents was low, with high rates of early treatment discontinuation reported. Only risperidone was reported in a systematic review as similar to placebo in terms of tolerability for this population. Network meta-analyses showed positive results for quetiapine, olanzapine, aripiprazole and brexpiprazole in terms of efficacy, but in terms of acceptability, no difference between these four antipsychotics and between each of them and placebo were found; tolerability was low for all antipsychotics vs. placebo, but the certainty of most evidence was evaluated as low and very low. Aripiprazole, quetiapine, olanzapine, brexpiprazole and cariprazine are approved by the FDA for the adjunctive treatment of MDD that does not respond to antidepressant monotherapy.

AAPs are an efficient option for augmenting antidepressants when MDD is only partially responsive to antidepressants, but careful monitoring of this strategy’s tolerability is needed, and high rates of treatment discontinuation are reported.

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As a complementary or stand-alone treatment, sport and exercise therapy (SET) can have a therapeutic effect on the symptoms of mental illness as well as having a therapeutic or preventive effect on physical comorbidities. Therefore, treatment guidelines recommend the integration of exercise therapy as a complementary approach in a multimodal treatment. In a clinical inpatient setting SET are supervised by specialised professionals and conducted in an individual or group setting. Low level of participation in SET during treatment points to the need for research into influencing factors. One study suggests, that SET during mental health treatment increases the likelihood of meeting the physical activity recommendations.

The purpose of the study is to investigate the extent to which SET can increase patients’ levels of physical activity during inpatient treatment and, in particular, promote a physically active lifestyle after inpatient treatment, thereby supporting long-term stabilisation. In order to gain further insight into the factors that influence participation in SET during treatment, this study analyses both intrapersonal and interindividual factors.

Patients (age ≥ 18 years, all genders) in partial- or full-time inpatient treatment at a psychotherapeutic and psychosomatic specialist clinic in Lower Saxony, Germany are examined by online self-report questionnaire. It’s a longitudinal study design with 3 time points (start of treatment, end of treatment, 12 weeks after the end of treatment). Patients participate in SET as part of their treatment. Physical activity in minutes per week and the therapeutic alliance between exercise therapists and patients are measured. In addition, self-efficacy expectations, sport- and exercise-related self-concordance and the subjectively perceived effectiveness of SET are assessed as further factors influencing physical activity.

The results of the inferential-static data analysis will be reported.

Based on the results, possible implications for the focus of SET and the role of exercise therapists are discussed. Conclusions based on motivational aspects of maintaining a physically active lifestyle after the end of treatment are considered.

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The impact of bipolar disorder on occupational health and work ability has garnered increasing attention, as it significantly influences individuals’ professional functioning

To examine the socio-professional characteristics of workers diagnosed with bipolar disorder and evaluate their fitness for work.

Retrospective descriptive study of patients with psychiatric disorders seeking medical assessments at the occupational pathology department between January 2011 and January 2024.

A total of 17 patients with bipolar disorder were included, with a mean age of 36.3±8.6 years and a sex ratio of 0.42. The average professional seniority was 10.8±7.7 years. In terms of marital status, 37.5% were married, and 62.5% were single. Regarding educational level, 37.5% had completed secondary education, while 58.8% had a higher education degree, and 50% reported a family history of psychiatric disorders. Concerning lifestyle habits, 37.5% of patients were smokers, and 6.3% consumed alcohol. The most common sectors of activity were telecommunications (31.3%), transportation (18.8%), healthcare (18.8%), and cleaning and maintenance (12.5%). Workplace exposures included solvents (12.5%), noise (43.8%), imposed work pace (35.3%), lack of autonomy (35.3%), and conflicts with hierarchical superiors (62.5%). Work schedules varied, with night shifts (43.8%), alternating shifts (24.9%), and fixed hours (31.3%). Reported challenges included irritability (94.1%), sadness (93.8%), sleep disturbances (81.3%), appetite changes (43.8%), concentration difficulties (31.3%), and suicidal thoughts (25%). The disorder impacted work performance in 66.7% of cases, and 53% of patients required sick leave with an average duration of 7.4 months; 75% reported improvement under treatment. Medical assessments for work ability found that 18.8% were fit for work, 12.5% were permanently unfit, and 6.3% were temporarily unfit, while 56.3% required workplace adjustments, including avoidance of answering phone calls (12.7%), fixed work hours (23.5%), exclusion from night shifts (11.8%), and avoidance of public contact (17.6%); 6.3% underwent job reassignment.

Bipolar disorder has a substantial impact on work ability, highlighting the need for customized interventions and job accommodations to ensure that workers can maintain their roles and productivity.

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Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that begins in childhood and persists into adulthood in 35-50% of cases, resulting in a prevalence of 2-4% in the adult population. The core symptoms are inattention, hyperactivity, and impulsivity, while emotional dysregulation is considered an associated symptom. Several lines of evidence support structural and functional brain imaging alterations in ADHD. Decreased volume of the accumbens and amygdala persist from childhood into adulthood, and several resting-state and task-related functional alterations have also been reported.

To investigate differential brain activation patterns in adults diagnosed with ADHD as compared to healthy controls (HC) during an affective Go/NoGo task, to understand the neural background of selective inhibition in emotionally demanding situations.

Data of 61 subjects were analyzed: 34 adult ADHD patients meeting DSM-IV diagnostic criteria (17 women, 17 men, mean age 37.3 years) and 19 HCs (10 women, 9 men, mean age 30.2 years). HCs were screened using the 90-item Symptom Checklist to exclude current psychiatric comorbidity. Symptom severity was assessed using the Conners’ Adult ADHD Rating Scale (CAARS). During the MRI scan in a Philips Achieva 3.0T scanner, we used a block design delivering positive, negative and neutral stimuli from the IAPS System applying a Go/NoGo paradigm. The fMRI analysis focused on contrasts between task and rest, emotional and neutral, and Go and NoGo conditions (activation or deactivation). Contrast between activation and deactivation in the ADHD and HC groups were tested.

Based on the pooled data from both groups, we found significant contrasts between the task and rest conditions, including an activation of primary and secondary visual cortex, frontal areas, corresponding to the Visual Network (VN), the Dorsal- and Ventral- Attention Networks (DAN, VAN), and the Central Executive Network; and a deactivation of the anterior cingulate, precuneus and parietal areas, corresponding to the Default Mode Network (DMN). During emotional vs neutral conditions, we detected activation of the secondary visual cortex, while contrasts between NoGo vs Go conditions manifested as activation of ACC and insular regions. ADHD subjects showed increased BOLD activation in the DAN and VAN areas. In all conditions, DMN areas showed higher deactivation in the ADHD group.

Here, we report differences in VN, DAN and VAN brain regions and the DMN in adult ADHD patients suggestive of distinctive pattern of activation and deactivation during an emotional Go/NoGo task. The results have clinical implications for understanding ADHD patients under in emotionally demanding situations.

Funding: Hungarian Brain Research Program, grants 2017-1.2.1-NKP-2017-00001 ans #NAP2022-I-4/2022 to JMR and PC.

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Social media has become a powerful influence on adolescent body image. Platforms like Instagram and TikTok, which focus on appearance, often promote idealized body standards, leading young users to internalize unrealistic beauty ideals. This has resulted in increasing body dissatisfaction and negative mental health outcomes, as adolescents seek validation through likes and comments.

This review examines how social media exposure affects body image and emotional wellbeing in adolescents, particularly whether it contributes to negative outcomes like low self-esteem, body dissatisfaction, and mental health issues.

A review of international studies published in the last five years was conducted using PubMed and Google Scholar. Search terms included “social media,” “body image dissatisfaction,” “mental health,” and “adolescents.” A total of 26 studies that met the criteria were analyzed.

social media, body image dissatisfaction, adolescents, mental health, eating disorders, self-esteem, COVID-19

The studies consistently revealed a strong link between frequent social media use and negative body image. Both male and female adolescents reported increased body dissatisfaction, though most studies focused on females. Social media exposure was also linked to higher risks of eating disorders and a drive for thinness.

Frequent users of appearance-focused platforms experienced reduced self-esteem and heightened levels of anxiety and depression, with social comparison behavior worsening these effects. Adolescents’ body image was further influenced by peer and parental validation, with peer approval playing a critical role in shaping their self-perception. The negative impacts of social media were particularly exacerbated during the COVID-19 lockdown due to increased isolation.

Social media platforms centered on appearance have a significant negative impact on adolescents’ body image and mental health. These findings highlight the need for interventions promoting media literacy, critical social media engagement, and support from parents and educators to mitigate these effects.

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Attitudes toward people with mental illness change. We present evidence of attitude change from different contries, with regard to different mental health conditions. While attitudes towads mental health problems in general, and towards depression, seem to soften, there is little positive change with regard to people with substance use disorders, and attitudes have even worsened towards people with schizophrenia. We discuss possible explanations for these diverging trends, and hypothesize on potential remedies.

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The consumption of pornographic products is a phenomenon that continues to increase considerably, especially among young people. It is encouraged by easier access to the Internet. On the other hand the concept of sexual self-esteem is a relatively new and little explored subject in the literature. It has emerged across a range of areas such as weight, sexual trauma and physical satisfaction.

The aim of our study is to evaluate the impact of pornography consumption on sexual self-esteem in a population of Tunisian women and to determine the associated factors influencing this relationship.

This is a cross-sectional, descriptive, and analytical study conducted among 107 Tunisian women.

Data were collected using an anonymous self-questionnaire in French, using Google Forms, distributed across various Facebook platforms. It explored sociodemographic data, medical history and sexual health characteristics, sexual behavior, and pornography consumption along with its impact.

For the evaluation of sexual self-esteem, we used the “Sexual Self-Esteem Inventory for Women - Short Form” (SSEI-W-SF) in French language. (Hannier, S et al. Translation and validation study of the French version of the “SSEI-W-SF”. Sexologies. 2022;31.)

The majority of women (76%) are aged between 18 and 30 years, primarily from urban backgrounds (89%), professionally active (81%). In terms of marital status, 43% are single. Most women (60%) have no psychiatric history, 25% are being treated for anxiety disorders, and 20% for mood disorders. More than a quarter (28%) reported experiencing sexual abuse. Regarding sexual education, majority of women (94%) consider its learning essential, although only 11% received structured education at school. Consequently, 80% of women indicated that their main source of sexual education was online. In the studied population, 60% of women reported consuming pornography, primarily in the form of videos (79%). The evaluation of sexual self-esteem using the SSEI-W-SF revealed an average total score of 61.66, ranging from 26 to 82, with a median of 63 and a standard deviation of 10.887. Women with the lowest scores were particularly affected in terms of adaptability and control. We observed a significant correlation between pornography consumption and the absence of sexual education during childhood (p = 0.009). Women who deemed sexual education essential showed lower consumption of pornography (p = 0.027).

Regarding sexual self-esteem, no statistically significant correlation was found between sexual self-esteem and pornography consumption, either for the global sexual self-esteem score (p = 0.809) or for the five spheres of sexual self-esteem assessed separately.

In conclusion, the influence of pornography on sexual self-esteem warrants careful examination, requiring a balanced perspective that addresses both its positive and negative effects on individuals’ well-being.

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Mindfulness involves being aware of both your thoughts and emotions as well as your surroundings. Regular practice of mindful self-care can enhance the overall well-being. For university staff, these practices can help counteract negative effects on mental health.

Our study aims to evaluate the practice of mindful self-care and its impact on the psychological health of university staff.

We conducted a descriptive, analytical and cross-sectional survey among university staff. The survey was carried out during a one-day training session on mental health promotion using a self-administrated questionnaire. We collected socio-professional data. We assessed psychological health using the depression anxiety and stress scale (DASS 21) and self-care behaviours using Mindful Self-Care Scale (MSCS).

Our study included 65 participants, 67.7% of whom were female. The average age was 53±6.8 years, and the average job tenure was 21.3±8 years. We found that 36.9% of participants experienced mild to moderate stress, 35.4% had mild to moderate depression, 7.7% had severe to extremely severe depression, and 23.1% had severe to extremely severe anxiety.

The average mindful self-care score was 102.8±26.3. The means for specific aspects of mindful self-care were: mindful relaxation 12.6±4.5, physical care 19.9±5.6, self-compassion and purpose 20.7±7.6, supportive relationships 15.4±5.6, supportive structure 13.4±4.6, and mindful awareness 14.5±4.8.

We found a negative correlation between anxiety and depression and mindful self-care (p = 0.02, r = -0.2). In female participants, stress was also negatively correlated with mindful self-care (p = 0.02, r = -0.3).

According to our findings, mindful self-care may be a potential strategy for anxiety, depression and stress management available to university staff. Given the considerably poor psychological health in the study population, we recommend to increase awareness of mindful self-care in university staff.

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Despite the crucial need for objective diagnostic procedures in psychiatry, the research of the quantitative neural bases of mental disorders is in its infancy, and currently there are no well-validated markers that could be translated into clinical practice. Candidate brain markers for neurodevelopmental, psychotic, and mood disorders have been proposed, but confounding factors and low statistical power leave most of these markers at the very early stage of development. Increasing evidence suggests a crucial role of biological, especially including sex, and environmental factors in shaping behavioral development and psychopathological risk. Moreover, such risk seems associated with greater susceptibility to cardiovascular problems, possibly mediated by alterations in the brain-heart axis. In this context, the study of brain maturation trajectories and brain-heart interactions in relation to sex and environment can provide key insights on the etiology of complex mental illnesses.

This lecture will provide an overview of our recent research on the interactions among biological factors, in particular sex, environmental risk, brain morphology and function, and cardiac autonomic regulation in affective and psychotic disorders using multivariate analysis approaches. Evidence obtained from juvenile cohorts, including samples of twins, will be presented to provide useful information on the genetic and environmental determinants of behavioral developmental trajectories, and on sex differences in these trajectories. The complex relationships among sex, environmental risk, autonomic regulation, brain morphology and connectivity, and mental and physical health will be explored in transdiagnostic samples of young adults and elders. Special focus will be given to sex-shared and sex-specific brain and autonomic mechanisms affected by social stressors, including discrimination, bullyism, and chronic stress, and their possible role in determining the heterogeneous clinical dimensions of psychotic and affective disorders.

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The widespread use of electronic cigarettes (e-cigarettes) among adolescents and young adults has become a significant public health concern. With the rise of social media, exposure to content promoting e-cigarette use, including endorsements by influencers, has become increasingly pervasive. This overlap between social media and vaping culture may contribute to the normalization and growing use of e-cigarettes among this vulnerable population.

This article aims to systematically examine the influence of social media use and endorsements by influencers on e-cigarette use among adolescents and young adults, identifying patterns of exposure and consumption across various platforms and providing insights for future prevention and intervention strategies.

This systematic review aims to explore the impact of social media use and influencers on e-cigarette use among adolescents and young adults. A PRISMA model review was conducted across four databases: PubMed, Science Direct, Google Scholar, and Scopus. Medical Subject Heading (MeSH) terms and keywords (vape, e-cigarette, smoking, social media, influencer, adolescent) were used to search for full-text studies published in English from the last five years. The studies included focused on human subjects aged 10-21 and met predefined eligibility criteria.

Of the 1,064 articles initially identified, 37 were included after screening and removing duplicates.

Thirty-seven articles met the eligibility criteria. The analysis focused on five key social media platforms: TikTok, Instagram, YouTube, Twitter, and Facebook. However, significant methodological limitations were noted in the studies.

The research highlights a strong link between social media use and youth e-cigarette consumption. Exposure to vaping content, ads, and peer influence on social media increases the risk, particularly among younger and vulnerable groups. Social media enables both direct marketing and peer-to-peer promotion. Stricter regulations on online ads and enhanced parental controls are necessary to mitigate these risks and reduce youth vaping rates.

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A case series of patients diagnosed with comorbid ASD and ADHD in adulthood is presented.

To make a comparison between the situation and social difficulties before and after specific ADHD treatment, in order to reinforce that it is not only a treatment for academic functioning, but also helps social interaction and therefore general functioning.

Four clinical cases are presented, three females and one male, with a mean age of 45 years. All of them were diagnosed with ASD and comorbid ADHD, with a predominance of impulsive component, in 2023.

All of them, prior to the diagnosis of ASD, were diagnosed with GAD, social phobia or even avoidant personality disorder. For these diagnoses, from a very early age, they received different SSRIs and benzodiazepines with little response.

In the consultation, after taking a complete clinical history, and fundamentally a biographical history, the examination was complemented with ADOS and CPT.

Due to the results obtained in CPT, it was decided to start treatment with lisafentamine between 50 and 70mg DMD.

CPT was performed again, obtaining better results in all cases, with a decrease in impulsivity and attention, mainly. At a subjective level, patients reported a substantial improvement, especially at a social level, which favoured their functioning in basic activities of daily living.

In adults, a correct diagnosis is important given that many of them present symptoms compatible with one or more neurodevelopmental disorders not diagnosed in childhood. Likewise, treatment in accordance with these disorders improves functionality and avoids polypharmacy and side effects of unnecessary treatments.

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In the present era, technology and medicine have become deeply intertwined, forming inseparable scientific disciplines. The mobile phone has become an omnipresent device, serving functions such as financial management, job organization, social networking, and internet access. While its benefits are undeniable, there is growing evidence of its potential pathological effects. One of the most recently identified issues is nomophobia—a term combining “no mobile,” “phone,” and “phobia,” which refers to the fear or anxiety of being without one’s mobile phone.

Nomophobia is considered a situational phobia of the contemporary era. Its symptoms include excessive reliance on mobile phones and pervasive anxiety about losing internet connectivity. Related conditions include “Ringxiety” and “phantom vibration syndrome,” where individuals perceive false notifications from their devices.

This study aims to assess the relationship between eating disorders (ED) and nomophobia. Additionally, it seeks to analyze the psychopathological components of nomophobia and evaluate the characteristics of the Nomophobia Questionnaire (NMP-Q), currently used for its assessment.

A questionnaire was administered at the Study and Care Unit for ED in Bologna, Italy, between January 2023 and May 2024. Alongside tests evaluating the social and psychopathological characteristics of the outpatients (including the STAI-Y for anxiety assessment), the Italian version of the NMP-Q was employed.

The study included 104 patients (97 females and 7 males) with an average age of 21.8 years (range 18-44). The results showed that 100% of the subjects exhibited symptoms of nomophobia, with 21.3% displaying severe nomophobia. Among these, 94.4% tested positive for state anxiety, and 100% for clinically significant trait anxiety. This suggests that nomophobia may reflect not only current anxiety symptoms but also an anxious trait, indicating a predisposition to heightened reactivity and anxiety in response to environmental stimuli.

The data highlight the alarming pervasiveness of internet addiction in contemporary society, with nomophobia being a significant manifestation. Given its substantial consequences, it is crucial to deepen our understanding of this condition and its underlying psychosocial determinants. This will enhance our knowledge and aid in developing more effective prevention strategies. However, a paradox arises: if nearly everyone is affected by nomophobia, it challenges the traditional definition of a disease. Further research into the NMP-Q test’s structure and specificity is necessary, as high prevalence rates may question its current measurement validity.

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Depressive disorders and anxiety disorders are typical comorbidities in autism spectrum disorder (ASD), with a reported prevalence of 20% and 9%, respectively (Lai, 2019). Autistic subjects are more at risk for suicidal thoughts and behaviors compared to typically developing peers; moreover, depressive symptoms are often resistant to both pharmacological and psychotherapeutic treatments. In 2019 intranasal esketamine was approved in Italy for treatment-resistent depression (TRD). We observed two young outpatients affected by autism (diagnosis made by “Lab-Aut”, a specialized mental health service in Pavia) treated with esketamine in our ambulatory for TRD. Clinical information and personal details were summarized in Image 1.

To evaluate the clinical response to intranasal esketamine in subjects with major depression in ASD and to compare the outcome with neurotypical patients.

Autism diagnosis wase made according to ADOS-2 and ADI-R scores, confirmed by a clinical judgment of senior psychiatrist. Our follow-up protocol during esketamine treatment consists in the following scales: MADRS, C-SSRS, DES-II, Psychace Scale, Reading the Mind in the Eyes Test, HAM-A, HAM-D, BDI, PANSS. Psychometric evaluation was performed at T0 (before esketamine), T1 (one week of pharmacotherapy), T2 (one month), T3 (2 months) T4 (3 months) and T5 (6 months). We collected results from neurotypical patients (n=12) and autistic patients (n=2) between 2022 and 2024.

Both in autistic patients and in neurotypical ones we noticed a premature decrease in depressive symptoms and a reduction of suicidal thoughts. This improvement was testified by a reduction from T0 to T1 in MADRS total score and in C-SSRS sub-score focused on intensity of suicidal ideation. The reduction was maintained during the observation period (Image 2). Due to the small sample size of autistic patients, we couldn’t reach the statistical significance threshold for this population. Considering the entire sample (n=14) we obtained significant results (T0-T1: MADRS decrease p=0,00006, C-SSRS decrease p=0,00009. T0-T5 MADRS and C-SSRS variations p<0,00001). Comparing our sub-samples, it’s possible to notice a similar trend in follow-up between autistic and neurotypical patients. (Image 3).

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Image 2:

Image 3:

Our preliminary data coming from clinical experience suggest the efficacy of intranasal esketamine in depressive episodes occurring in autistic patients. A larger sample size of autistic patients will be necessary to set a comparative study and to give significance to these results. Esketamine could represent an important therapeutic option in depressed patients with ASD comorbidity.

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Alcohol withdrawal syndrome is a significant challenge in the management of alcohol use disorder, with traditional treatments often relying heavily on benzodiazepines like diazepam. This study aimed to explore the efficacy and safety of incorporating baclofen (30 mg/day) alongside minimal, tailored diazepam doses—adjusted according to alcohol intake and CIWA-Ar scores—to manage withdrawal symptoms more effectively than conventional diazepam protocols. By reducing the total diazepam needed and shortening detoxification time, the study highlights the potential of baclofen to offer a faster, safer approach to alcohol withdrawal treatment.

To evaluate the efficacy and safety of combining baclofen (30 mg/day) with minimal diazepam doses—calculated based on alcohol consumption and adjusted by CIWA-Ar scores—in managing alcohol withdrawal symptoms more rapidly than standard diazepam protocols.

Sixty-nine patients with alcohol use disorder were enrolled and randomized into two groups. The baclofen group (n = 32) received baclofen 30 mg/day plus minimal diazepam, with initial diazepam doses based on average daily alcohol units consumed (1 mg diazepam per unit) and adjusted using CIWA-Ar scores. The standard group (n = 37) received a conventional diazepam-based detoxification regimen with fixed starting doses adjusted by withdrawal symptoms. Primary outcomes were the total diazepam dosage required and the duration of detoxification. Secondary outcomes included daily CIWA-Ar scores and incidence of adverse effects. Statistical analyses employed independent t-tests and chi-square tests, with p < 0.05 considered significant.

The baclofen group required significantly less diazepam compared to the standard group (mean total dose: 30 ± 10 mg vs. 50 ± 15 mg; p < 0.001). They also experienced a shorter detoxification duration (mean: 15 ± 1 days vs. 19 ± 1 days; p = 0.01), indicating a faster withdrawal process. CIWA-Ar scores were consistently lower in the baclofen group throughout detoxification (mean: 6 ± 2 vs. 10 ± 3; p < 0.001), reflecting milder withdrawal symptoms. No significant adverse effects were observed in either group, including over-sedation, respiratory depression, or hallucinations.

Combining baclofen (30 mg/day) with minimal diazepam—calculated based on alcohol consumption and adjusted by CIWA-Ar scores—effectively controlled alcohol withdrawal, reduced diazepam use by 40%, and shortened detoxification by about four days. The protocol was well-tolerated and may benefit patients at risk from high benzodiazepine doses or in settings aiming to limit benzodiazepine use. These findings suggest baclofen can reduce medication needs and speed up recovery. Larger trials are needed to confirm these results and evaluate long-term outcomes like relapse rates and sustained abstinence.

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The high prevalence of mental health disorders makes investigating their etiology a fundamental activity. Factors influencing their physiology include genetic predisposition, substance use, environmental factors, etc. Among these, weather and atmospheric pollutants are two of the least studied. The biologically active agents in the atmosphere interact with living beings, disrupting their homeostasis and leading to alterations in both physical and mental health. This interaction was already noted in the Corpus Hippocraticum in the 4th century BC.

The objective is to analyze the impact of various environmental factors and atmospheric pollutants on daily emergency hospital admissions for mental disorders in the healthcare area of the province of León from 2011 to 2022.

An observational, retrospective, ecological, longitudinal, and time series study is conducted. Admission data is sourced from the coding office at the Complejo Asistencial Universitario de León, meteorological data from the Agencia Estatal de Meteorología, and pollutant data from the Junta de Castilla y León. A combined database in Excel is created for statistical analysis, both descriptive and analytical (Poisson regression), using the SPSS statistical package.

It was observed that hospital admissions for mental disorders are significantly related to sunlight hours, ozone, precipitation, average wind speed, CO, NO2, maximum atmospheric pressure, NO, and PM10.

The findings of this study show that meteorological factors and atmospheric pollutants are related to hospital admissions for mental disorders. Applying this information in psychiatric emergencies could improve forecasting and resource management during periods of higher demand.

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Impairments in theory of mind, which influence the ability to accurately perceive and comprehend the mental states of oneself and others, play a pivotal role in psychiatric diseases. Understanding these cognitive aspects is crucial for developing targeted interventions and improving overall patient outcomes.

The purpose of this study is to examine theory of mind in individuals at risk for bipolar disorder and in the early stages of the disorder.

Sixty-two individuals with first-episode bipolar disorder (FE-BD) (mean age 21.92±4.58), seventy-eight individuals at ultra-high risk for bipolar disorder (UHR-BD) (mean age 20.5±3.93), and seventy-four healthy controls (HC) (mean age 23.36±5.28) were included in this study. The Hinting Task (HT) and the Reading the Mind in the Eyes Test (RMET) were applied to assess theory of mind.

The groups differed significantly in RMET positive (F(2-200)=5.087, p=0.007), neutral (F(2-200)=4.777, p=0.009) subscores, and total score (F(2-200)=11.267, p=0.000). Similarly, differences were found among the groups in terms of hypomentalization (F(2-174)=5.251, p=0.006), hypermentalization (F(2-174)=4.786, p=0.009), and total scores (F(2-174)=13.292, p=0.000) on the Hinting Task. No significant differences were observed in RMET negative scores among the groups (p>0.05). Both the FE-BD and UHR-BD groups exhibited significantly lower scores than the healthy controls across positive, neutral, and total RMET scores, as well as in total Hinting Task scores (p<0.05). Hypomentalization and hypermentalization errors were higher in the FE-BD and UHR-BD groups than in the HC group (p<0.05).

The results revealed significant differences in theory of mind performance between groups, including RMET scores and Hinting Task results. Individuals with first episode bipolar disorder (FE-BD) and those at ultra high risk for bipolar disorder (UHR-BD) consistently scored lower than healthy controls, emphasizing the need for targeted, early interventions in theory of mind and related cognitive processes. Future studies investigating clinical and neurobiological correlates of theory of mind across different stages of bipolar disorder are needed.

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Open access to psychological treatment manuals is critical for advancing research and clinical practice, particularly in low- and middle-income countries, where access to mental health care is scarce. Despite growing recognition of the need for freely available manuals to ensure replicability, transparency, and wider dissemination of evidence-based interventions, open and free access to intervention manuals remains limited.

We aimed to quantify the availability of protocols and manuals for psychological interventions used in randomized clinical trials (RCTs) for severe mental disorders. This research is part of the broader European Research Council – funded project DECOMPOSE, in which we employ a systematic and reproducible approach for decoding, classifying, and evaluating the active ingredients of psychological interventions.

Using recent network meta-analyses of RCTs, we collected psychological interventions for psychotic, bipolar, substance use, eating, and borderline personality disorders. We attempted to retrieve intervention protocols and manuals directly from trial publications or their published protocols and referenced manuals. If the protocols or manuals were not accessible, we contacted the study authors to request the materials.

We identified a total of 259 RCTs, but only 18 had published protocols. Of the 71 RCTs pre-registered on platforms such as ClinicalTrials.gov, only 5 provided an adequate description of the psychological treatment components, all of which overlapped with already published protocols. To retrieve missing materials, we contacted 450 authors from 241 RCTs. We received positive responses from 75 RCTs, negative responses from 55 RCTs, and no replies from 100 RCTs. We were not able to retrieve contact information for the authors of 11 RCTs.

Of the 75 positive responses, we obtained the complete requested materials for only 47 trials. In the remaining cases, we were instructed to purchase the manuals (n=11), provided with only partial materials (n=4), or given additional references that were not the full intervention manual (n=13). Negative responses included the trial being too old or no authors’ access to the materials (n=22), commitment to send the materials without further follow-up (n=8), suggesting the paper as the sole available resource (n=11), and various other reasons (n=14)

Our findings reveal a significant lack of freely available intervention manuals, limiting the implementation and replicability of psychological treatments. Coordinated action is needed to ensure open access to these materials for more replicable research, wider dissemination of results, and improved access to evidence-based mental health care.

None Declared

COVID-19 wreaked havoc across the world killing millions along its path. All attempts were made to lower and eventually control the death toll from the pandemic. The “trace, test and treat” approach had its limits since the latter were not developed fast enough. Vaccines were seen as the best hope to protect individuals from the coronavirus and COVID-19. Thus, vaccination was encouraged and promoted widely. Aside from vaccines, interventions emphasised non-pharmaceutical self-protective behaviours to protect against coronavirus infection. Subsequently, there were various levels of compliance and observance of self-protection within nations. Yet studies have not attempted to explore the research implications of compliance patterns.

The present study’s aim was to (i) identify latent classes of individuals’ varying levels of compliance with COVID-19 self-protective behaviours; and (ii) explore the capacity of the latent classes to separate individuals according to their levels of Perceived Infectability, Germ Aversion and Fear of COVID-19.

Data for the current study was extracted from a cross-district COVID-19 study conducted among high school level learners (N = 1609; girls = 59%; rural areas = 43%) in South Africa. Latent classes were derived based on the scores obtained by learners on a self-developed index of non-pharmaceutical self-protective behaviours. Three classes were identified, and they were compared against their obtained Perceived Infectability, Germ Aversion and Fear of COVID-19 scores.

Scores of all three knowledge groups did not differ on Perceived Infectability (p > .05), but the highest scorers, the “knowledgeable group”, scored higher than the “moderately knowledgeable group” and the “relatively low knowledge group” on Germ Aversion and Fear of COVID-19. The scores of the “moderately knowledgeable group” and the “relatively low knowledge group” did not differ on the Fear of COVID-19.

The study supports an approach where learners are classified according to their knowledge of COVID-19 self-protective behaviours, and their motivation for self-protection established according to the classification.

None Declared

Mobile phone addiction is a behavioral disorder characterized by the inability to function in daily life without a smartphone, most often with unlimited access to the internet. “Phone addicts” perceive their mobile phone as the most important tool for daily contact with others.

The aim of our study was to examine internet and mobile phone addiction in individuals aged 15-50 years.

The study involved 107 participants who regularly use mobile phones and access the internet. The participants completed an online survey as part of the study. The Kimberly Young test was used to assess internet addiction. The test consisted of 7 questions with “yes” or “no” responses. A score of ≥4 points was considered indicative of addiction. To assess mobile phone addiction, a test consisting of 10 questions was used. The questions concerned attitudes towards SMS messages, phone calls, mobile network operator promotions, and mobile phone use. Each question had 3 possible answers. Providing answers marked with point “c” to 5 or more questions was considered indicative of mobile phone addiction. The only inclusion criteria were: being over 14 years old and owning a mobile phone with internet access.

The study involved 71 women, accounting for 66.4% of the respondents, and 36 men, accounting for 33.6% of the respondents. The age of the participants ranged from 16 to 50 years, with the average age being approximately 22.8 years. Among the study participants, 35.5% had higher education, 43.9% had secondary education, and 20.6% had primary education. 54.2% of the respondents lived in urban areas, while 45.8% lived in rural areas.

The questionnaire included a question regarding the amount of time spent online each day. According to the respondents’ answers, the average time spent online was approximately 358 minutes. The next question concerned the time spent on phone calls or text messages. The average time spent on this was approximately 75 minutes.

The results of the study indicated that 20 individuals, or 18.7% of the respondents, were addicted to the internet. Six individuals, or 5.6%, were addicted to their phones. Two respondents, or 1.9%, were addicted to both the internet and their phones. The data obtained were subjected to statistical analysis using Statistica software.

A statistically significant correlation was found between the degree of mobile phone addiction and the amount of time spent using the phone. The longer the time spent on the phone, the greater the degree of mobile phone addiction.

Age significantly affects the degree of internet addiction. Among older individuals, the level of internet addiction is lower. The amount of time spent using the internet does not affect the degree of addiction. As the duration of mobile phone use increases, the intensity of mobile phone addiction also increases. Age does not affect the degree of mobile phone addiction.

None Declared

Physician Assisted Death (PAD) has been legalized or decriminalized in over a dozen jurisdictions around the world, and many other jurisdictions are considering assisted dying laws. Most jurisdictions only allow PAD in terminal conditions while a minority allow PAD outside end-of-life situations, with a small number allowing PAD for sole mental illness conditions. A key element in assessments of PAD requests is whether those assessments can filter out traditional suicidality, for which suicide prevention is provided, from other motivations for assisted death, for which PAD may be provided.

1. 1. To recognize the range of factors that may motivate assisted dying requests.

2. 2. To understand the factors that inform assisted dying assessments, specifically how the assessments attempt to identify suicidality.

3. 3. To appreciate the degree of certainty or uncertainty that assisted dying assessments actually identify suicidality in different patient populations.

This presentation briefly reviews evidence related to motivations leading to assisted dying requests in different populations, and then focuses on reviewing guidelines PAD assessors use to attempt to identify traditional suicidality, and to distinguish that from other motivations leading to PAD requests. These guidelines are compared to established evidence and factors related to suicide risk and suicide prevention.

1. 1. Different factors motivate different populations to seek assisted death, with those making PAD requests in terminal situations frequently seeking PAD in efforts to preserve dignity, and those seeking PAD outside terminal conditions or for sole mental illness citing feeling a burden, or an accumulation of multiple life stressors, as fueling their PAD requests.

2. 2. Most of the factors presented in guidance on distinguishing and separating suicidality from PAD requests equally apply to traditionally suicidal individuals and to those requesting PAD.

3. 3. Evidence shows that the few distinguishing factors used to attempt to separate suicidality from PAD requests, specifically impulsivity and acting on one’s own, do not actually filter out suicidality.

While a key goal of physician assisted death assessments is to identify and separate traditionally suicidal individuals from those seeking and receiving assisted death, current assessment techniques are unable to filter out suicidal individuals in an unknown number of cases.

None Declared