Progressive supranuclear palsy (PSP) is a neurodegenerative disorder characterised by supranuclear ophthalmoplegia (SNO), parkinsonism, and postural instability. Overlap with frontotemporal dementia (FTD) has been suggested, with PSP-FTD considered a specific phenotype. Common psychiatric symptoms include apathy and depression, while hallucinations and delusions are rare. Hallucinatory palinopsia is the persistence or recurrence of vivid visual images after the stimulus has been removed. It results from aberrant activation of visual memory circuits, and, while uncommon, is typically seen in conditions such as strokes, space-occupying lesions and seizures.

To present a case highlighting unique psychopathology in a patient with PSP-FTD phenotype.

Clinical case description and literature review.

An 80-year-old male with a 6-year history of progressive behavioural changes, memory disturbances, and motor dysfunction presented initially with apathy and social withdrawal. Memory impairment and gait difficulties followed, along with irritability, aggression, and hypersexual behaviours like inappropriate touching or gesturing towards family members or masturbating in public. Asymmetric intention tremors (left > right) and stereotypic hand movements developed over time. In the past year, the patient began experiencing visual hallucinations, particularly hallucinatory palinopsia, where he persistently saw objects like lizards or water bottles that had been removed from view. These occurred in clear consciousness, were not perceived by others, and would typically last for about an hour. By a multidisciplinary approach, the possibility of delirium was ruled out. A diagnosis of PSP with FTD phenotype was made based on clinical evaluation, including SNO, and neuroimaging. The patient was started on Syndopa and Donepezil. Psychiatric evaluation revealed high scores in domains of Apathy, Disinhibition, Agitation, and Hallucinations on the Neuropsychiatric Inventory (NPI). Psychoeducation was provided, and Quetiapine 12.5 mg was initiated, leading to mild improvement in behavioural symptoms. The patient remains under regular follow-up with plans for medication optimization and physiotherapy inclusion.

Behavioural symptoms in PSP are prevalent and challenging to manage. This case highlights the importance of distinguishing between apathy and depression, as misdiagnosis can lead to unnecessary antidepressant use. The patient’s presentation, including disinhibition, hypersexuality, and less commonly reported visual hallucinations, emphasises the need for comprehensive evaluation and a multidisciplinary approach to management in PSP-FTD cases.

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The birth of a child is a joyous event that can be accompanied by major challenges for women’s mental health. It is marked by physical, hormonal, psychological, family and social upheavals. It can also be associated with an increased risk of incidence or decompensation of psychiatric disorders.

The aim of this study is to describe the trends and characteristics of post-partum mental disorders in the Orientale region of Morocco.

36 files of patients hospitalised or having consulted for a post-partum psychological disorder at the Mental Health and Psychiatric Diseases Hospital of the Mohammed-VI University Hospital Centre in Oujda were examined using a data collection form.

The main disorders identified were post-partum depression and puerperal psychosis, with rates of 62% and 38%, respectively. 32% of them have attempted suicide, 14% have suicidal thoughts, 32% have committed infanticide, and 21% have rejected their baby. With regard to pregnancy and childbirth, a third of the women had a caesarean section, with primiparous women predominating. 57% of the women described their childbirth experience as long and painful. Similarly, the use of addictive substances was mentioned in 44% of cases.

It is true to say that measures need to be put in place to improve conditions for women and to raise awareness among those around them of the need for early detection of these disorders. These proposals underline the importance of taking concrete steps to support the women concerned and promote their mental well-being.

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Mood disorders (MD) have been consistently associated with alterations in the immune system. Evidence suggests a condition of systemic low-grade inflammation with abnormally decreased adaptive, increased innate immunity, and with higher levels of circulating cytokines, higher macrophage/monocyte inflammatory activation patterns, and higher neutrophils to lymphocyte counts. A dynamic pattern of premature immunosenescence and partial T cell defect starting early in adolescence, involving a reduction of naïve T cells and an expansion of memory and senescent T cells, parallels lifetime recurrence of illness episodes, worsening outcomes and fostering chronicity. Consistent systematic reviews and meta-analyses affirm that COVID-19 survivors show persistent psychopathology and neurocognitive impairment, with clinical significant depressive psychopathology being reported in around 31% of patients. Psychopathological features are the same observed in MD, along the same gradient of severity, and including a typically melancholic cognitive vulnerability. Neurocognitive impairment could possibly separate from depression in the long term, but not in the first year after infection, and it is largely overlapping with persistent cognitive deficits described in MD. We will discuss pathogenetic mechanisms shared by both, MD and post-COVID depression, with a specific emphasis on: (i) spread disruption of white matter microstructure, reduced grey matter volumes in anterior cingulate cortex, and abnormal functional connectivity in the cortico-limbic circuitries; (ii) abnormal cell trafficking across the blood brain barrier, essential for brain maintenance and repair in healthy conditions; (iii) altered immuno-inflammatory setpoints as observed in the peripheral blood, known to parallel white and grey matter abnormalities in the brain, and recently shown to disrupt neurovascular coupling and spontaneous neural activity. We suggest that post viral depression provides an invaluable model illness for the study of immune-inflammatory mechanisms involved in the pathogenesis of mood disorders, to identify new targets for treatment, with the aim of restoring mental health and brain homeostasis.

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Contemporary global crises, including Climate Change/CC, has increased the interest in Future Anxiety/FA. As an emotional response to the anticipation of threats in the distant rather than proximal future, FA is broader than worry, which generally focuses on particular issues and fluctuates depending on specific circumstances.

To analyze the psychometric properties of the Portuguese versions of Dark Future Scale (DFS; Zaleski et al. 2019), composed of 5 items to evaluate FA; and Climate Change Worry Scale (CCWS; Stewart 2021), a 10-items measure of proximal worry about CC; to explore whether they evaluate distinct or overlapping constructs.

590 adults (64.6% women; mean age=34.40±16.18) answered DFS, CCWS (preliminary), Climate Change Distress and Impairment Scale/CC-DIS and Pro-Environmental Behaviours Scale/PEBS. Exploratory Factor Analysis (EFA; with a subsample of n=290) and Confirmatory Factor Analysis (CFA; n=300) were performed. DFS and CCWS structures tested with CFA were based on previous EFA results, including a model combining items from both scales.

DFS: CFA evidenced the good fit of the unidimensional model, χ2/df=3.314, CFI=.995, TLI=.990, GFI=.989, RMSEA=.060, p<.001; alfa=.91.

the unidimensional model (similar to the one found in the original version) (χ2/df=2.076; CFI=.982; TLI=.970; GFI=.965; RMSEA=.0590; p<.001; a=.90) and the two-factors model, with F1 composed of 6 items related to CC concerns and F2 of 4 items related to perceived interference (χ2/df=2.561; CFI=.973; TLI=.956; GFI=.956; RMSEA=.0611; p<.001; aF1=.75, aF2= .89) presented good fit.

the 2-factor model, with each scale being one factor (χ2/df=2.312; CFI=.962; TLI=.951; GFI=.928; RMSEA=.065; p<.001) and the 3-factor model, where CCWS divides into 2 factors (χ2/df=2.248; CFI=.964; TLI=.954; GFI=.926; RMSEA=.063; p<.001) resulted in good fit. FA correlated with CCWSTotal/F1/ F2 (r>.25). Correlations with CCDIS were r=.36 for FA and r<.55 for CCWSTotal/F1/F2; only CCWS total and dimensional scores correlated with PEB (r>.45) (all p<.001). When predicting CCDIS, FA adds 4% (R change, p<.001) to the variance explained by CCWS dimensions (R2=49.7%). Only CCWSConcerns (b=.345) but not CCWSInterference predicted PEB.

DFS and CCWS Portuguese versions have adequate validity and reliability. Their moderate correlation and the validity of the measurement models tested suggest that they evaluate distinct constructs. FA seems more maladaptive than CCW: although it increments CC-DIS prediction, it does not correlate with PEBS. The same applies to CCWSInterference, which emphasizes that the CCWS two-factor structure may be useful to delimit CCW’s normal/pathological nature. We intend to use these scales in an ongoing research project on psychological factors associated with CC mitigation and adaptation.

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Drug-induced movement disorders are a rare side effect of which some cases have been reported and published. It may be due to antidepressants, antipsychotics or other drugs. In these cases it is important to realize differential diagnosis, identify the medication that may have caused it and implement appropriate management to solve it.

To present the case of a 16-year-old adolescent diagnosed with major depressive disorder with movement disorders after treatment with escitalopram.

A literature review was conducted on movement disorders and treatment with antidepressants in child-adolescent population.

Our case is about a 16-year-old adolescent who is living with his family and he is studying at the high school. The patient has no personal psychiatric history and in his family only his father has an adaptive disorder treatment. The first time he comes to consultation, he said that in the last few weeks he has anxiety attacks in different environments and an increase in basal anxiety. He has been in a low mood for about two years with apathy, which has increased in recent weeks. He is diagnosed of major depressive disorder and we decided to continue with escitalopram 10 mg and chlorazepate dipotassium prescribed a week ago by his family doctor. After one month, he goes to the second consultation with difficulty in walking, stiffness and instability that is related to the introduction of treatment. In addition, he comments on mild improvement of anxiety and mood. Due to the timing of the onset of movement disorder and the onset of escitalopram, it is decided to suspend it. Chlorazepam dipotassium is maintained and short-term for evaluation of evolution. In the following consultation, no movement disorder symptoms are seen and the onset of another antidepressant with a different course of action is assessed.

Drug-induced movement disorders as in the case described are a rare side effect of which some cases have been reported and published. Different studies reveal the different behavior of antidepressants in the adult and child-adolescent population. In a meta-analysis on antidepressants and depression in the child-and-youth population (1), the results indicated that sertraline, escitalopram, duloxetine and fluoxetine could be considered as the first option although cases with associated extrapyramidal symptoms (EPS) were reported. According to a study on the association of antipsychotics, antidepressants with movement disorders in children and adolescents (2), the risk-benefit profile of antipsychotic use should be considered as an adjuvant to reduce EPS. In addition, in a post-marketing study (3), a potentially harmful association was found between movement disorders and the use of antidepressants mirtazapine, vortioxetine, fluvoxamine, citalopram, paroxetine, duloxetine, escitalopram, fluoxetine, sertraline, venlafaxine, among others.

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Emotional awareness and emotion regulation are essential skills for psychological well-being, especially in college students, who frequently experience stressful situations and emotional challenges. Therefore, interventions aimed at developing skills such as stress management and frustration tolerance can be important to enhance emotional awareness and regulation, contributing to the promotion of mental health in this population.

This study aimed to evaluate the effectiveness of a mental health promotion program, focusing on the development of emotional awareness and regulation in college students.

This study employed a pretest-posttest design, and nonparametric tests were used. Measures:

1. 1) Depression Anxiety and Stress Scale (DASS-21); 2) Difficulties in Emotion Regulation Scale (DERS) and an interview with six open questions to evaluated the individual perception of the impact of the intervention. Participants: nine Portuguese female college students, with an average age of 19,77 years (SD=1.48). The intervention consisted of six face-to-face sessions, lasting 60 minutes each, with theoretical and practical aspects for skill training of stress management, emotional regulation, and frustration tolerance.

The results suggested a decrease in levels of anxiety (p=.07), depression (p=.03), and stress (p=.07) after the intervention. There was also a decrease in emotional regulation difficulties for the participants (p=.01), notably in difficulties regarding strategies (p=.02), impulses (p=.03), and non-acceptance (p=.05). For the subscales of awareness, goals, and clarity, although the results showed a decrease, there was no statistical significance. It stands out from the analysis of the students’ answers to the open questions, that they developed their emotional regulation skills and they also highlighted the importance of the close supervision and support throughout the process, as well as the practical nature of the sessions.

The results suggest that the intervention program can contribute to enhance emotion regulation and promoting mental health of college students. Suggestions for future studies would be to replicate the intervention with a larger sample and with group control.

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Early diagnosis and intervention are essential for managing and improving long-term outcomes of severe mental illness, highlighting the need for reliable early biomarkers. This longitudinal study explores whether there are sex differences in the development of the brain during childhood and adolescence differs between offspring of parents with and without a diagnosis in the mood-psychosis spectrum.

We obtained 286 T1-weighted and diffusion weighted MRI scans of 184 offspring (aged 8–18 years at baseline) of at least one parent diagnosed with bipolar disorder (n=78) or schizophrenia (n=52) and offspring of parents without severe mental illness (n=54); 102 offspring underwent a follow-up scan (on average 3.9 years between scans). Global brain measures, regional cortical thickness and surface area, gyrification and sulcul morphology were computed. Anatomical brain networks were reconstructed into structural connectivity matrices. Network analysis was performed to investigate anatomical brain connectivity. Group comparisons and the interaction with age were analysed with (non)linear mixed-effects models. Explorative analyses will be done on the interaction with sex. To correct for multiple comparisons, we applied a Benjamini-Hochberg false discovery rate (FDR) correction (q=0.05).

A significant effect of age was found on most of the included brain features, with suggestive evidence for subtle deviations in trajectories in the cortical thickness and network metrics, but not in the gyrification index and sulcul morpholoy in offspring of parents with schizophrenia. Sex effects will be discussed during the meeting.

Our findings suggest the brain development in familial high-risk youngsters is associated with being at familial risk for schizophrenia.

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Artificial intelligence (AI) and -omics techniques (genomics, proteomics, metabolomics) represent two rapidly evolving fields that are increasingly intersecting to transform clinical research and healthcare.

AI, aiming to mimic human intelligence through computational modelling, possesses extraordinary capabilities for big data analysis. -Omics, offering quantifiable and dynamic readouts of the molecular state of the subject, can generate large databases covering hundreds to thousands of molecules with complex relationships.

Combining AI-driven insights with the wealth of data generated by genomics, transcriptomics, proteomics, and metabolomics can help uncovering complex biological networks, with the potential to revolutionize our understanding of disease mechanisms, improve patient stratification, and optimize therapeutic interventions.

In this presentation, the concepts of AI and -omics and their combined application to clinical research will be discussed, summarizing the strengths and limitations of these approaches. Studies leveraging AI across various -omics domains will be presented. Key advances, ongoing challenges, and future perspectives in this rapidly evolving field will be debated.

While still in the early stages, the synergistic partnership between metabolomics and AI represents an exciting frontier that holds great promises for groundbreaking advancements in clinical research and human health, paving the way toward a new era of precision medicine.

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Research underlay various results concerning the differences focusing on gender in smartphone use and mental issues. Some find no difference, but assessing mental factors reveals the influence of social interactivity, low emotional understanding, and perceived social support variations according to problematic smartphone use.

Our research aims to investigate problematic smartphone use, mental well-being, emotional regulation, and social anxiety as a function of gender to explore specific ways of functioning in the addiction process.

The study participants were 400 young adults, of whom 104 were men (26%), 293 were women (73.2%), and three individuals (0.8%) were of another gender. The mean age of the participants was 25.9 years (SD 10.9). Registered answers refer to demographic data (gender, age, smartphone usage habits) as well as psychological measures: a Smartphone Application-Based Addiction Scale (SABAS), a Mental Health Continuum Scale (MHC), an Assessing Emotions Scale (AES), and Fear of Negative Perception Questionnaire (FNPQ).

The results showed that gender showed significant differences in the mediating factors that affect problematic smartphone use. In the mediation model, gender relates significantly related to time spent with smartphones (p=.001) and fear of negative perception (p=.001). The statistical mediation model highlighted the gender-depending significant role of the mediating factors (time of use per day, MHC, AES, FNPQ) in problematic smartphone use.

Our research highlights gender differences in excessive smartphone use, such as higher social anxiety, which is a higher predisposing factor in women than in men. Gender is a significant indirect determinant of problematic smartphone use.

None Declared

Schizophrenia is a severe mental disorder often diagnosed in early adulthood, significantly impacting quality of life and increasing mortality risk. Xanomeline-trospium (KarXT), a combination of a muscarinic cholinergic receptor agonist and a peripheral antagonist, offers a potential new approach.

We aimed to perform a systematic review and meta-analysis to assess the efficacy of KarXT compared to placebo in reducing the symptoms of schizophrenia.

We systematically searched PubMed, Embase, and Cochrane for randomized controlled trials (RCTs) enrolling patients with schizophrenia treated with KarXT versus placebo. Our outcomes included the overall improvement in schizophrenia symptoms, measured by the Positive and Negative Syndrome Scale (PANSS) total score, as well as specific symptom domains assessed by the PANSS positive and PANSS negative subscales. Additionally, the Clinical Global Impressions-Severity (CGI-S) score was used to measure the overall severity of the disorder. We computed mean difference (MD) with 95% confidence intervals (CIs) using R version 4.3.2. Heterogeneity was assessed using I² statistics.

Three RCTs were included with 640 patients, of whom 314 (49.1%) received KarXT. There were 509 males (79.5%) and 131 females (20.5%). The average body mass index (BMI) was slightly higher in the KarXT group (29.1) compared to the placebo (28.8). KarXT resulted in a greater decrease in the PANSS total score (MD: -9.74; 95% CI -12.40, -7.08; p<0.001; I²=0%; Figure 1A), PANSS positive (MD: -3.20; 95% CI -4.04, -2.36; p<0.001; I²=0%; Figure 1B), PANSS negative (MD: -1.55; 95% CI -2.28, -0.81; p<0.001; I²=22%; Figure 1C) and CGI-S score (MD: –0.60; 95% CI -0.75, -0.45; p<0.001; I²=24% Figure 2).

Image 1:

Image 2:

Our systematic review and meta-analysis of RCTs showed that KarXT is significantly more effective than placebo in reducing schizophrenia symptoms.

None Declared

A migrant is any person who moves or has moved across an international border regardless of the legal status of the person, whether the movement is voluntary or not, the reasons for the movement or the length of stay. In recent decades, migratory flows have increased significantly also in Italy. The migration process has highlighted the need to explore the potential challenges within the local multicultural context, as well as the difficulties that migrant patients with mental health issues may face. The assistance, diagnosis, and treatment of patients of foreign origin have become essential aspects of the pursuit of overall well-being within the community.

According to the literature, migration can represent a stress factor that leads to an increased risk of developing psychiatric symptoms or disorders. It should be emphasized that, although the organization of mental health services in Italy is strongly based on territorial outpatient services, the first contact of migrants with psychiatry occurs through the emergency room and the psychiatric wards of hospitals that usually admit patients with disorders in the acute phase.

It becomes necessary to learn more about this topic, given the limited or insufficient national and international studies on these issues.

This study aims to investigate and describe the characteristics of migrants admitted to three Emergency and Acceptance Departments (DEA) in Northern Italy: Novara, Alessandria, and Borgomanero in comparison with natives, to investigate any differences between the two populations regarding the variables described above.

Through an electronic data acquisition research software solution (REDCap), the clinical and socio-demographic characteristics of migrants hospitalized at the three DEA will be collected. The data of migrants who received psychiatric consultation (PC) from January 2020 to December 2024 will be compared with those of natives. Data will include socio-demographic and clinical aspects, with a specific focus on mental health disorders (such as suicidal behaviours), type of intervention and outcome of the consultation. The only inclusion criterion used was the presence of PC after triage while no exclusion criteria were used except for age under 16.

Ongoing analyzes will provide an in-depth description of the correlation between migrant status and the mental well-being of patients accessing the DEA who have received a PC. Particularly, the analyzes will allow us to outline the risk factors for psychiatric diagnosis and the choice of treatment strategies.

The data could suggest the need for prevention and intervention programs aimed at the migrant population, oriented towards cultural differences in the expression of discomfort, linguistic difficulties and/or mutual understanding between healthcare personnel and patients.

None Declared

I will present data from a range of Danish studies on both cannabis-induced psychosis and Danish epidemiological studies on the association between cannabis and psychotic disorders such as schizophrenia. A deeper understanding of these associations is important. If the consistent association that we have observed for many decades is indeed causal, then cannabis is perhaps the single most important preventable risk factor for schizophrenia that we have identified to date. The development over time of the population attributable risk fraction, gender differences, and other novel areas will be covered in the presentation.

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Xp11.22 duplication syndrome, a rare genetic condition first identified in 2009, has fewer than 100 documented cases in the literature. To date, little is known about the genotype-phenotype relationship in this rare genetic syndrome and there is a paucity of data specifically regarding catatonia in this condition.

The primary aim of this case report is to provide a comprehensive description of the clinical presentation, diagnostic approach, and management strategies employed in a case of catatonia occurring in the context of Xp11.22 duplication syndrome and ASD.

Methods of this case report include assessment of the patient via thorough psychiatric and medical evaluation, as well as additional information obtained through chart review and collateral sources.

Our patient, a 15-year-old Caucasian male, was diagnosed with Xp11.22 duplication syndrome at age 3 due to speech and motor delays. At 14, he experienced sudden behavioral and motor changes, including withdrawal, repetitive speech, slowed gait, and repetitive motor behaviors like “rewind” actions. Over 3 months, symptoms included emotional lability, self-injurious behaviors, and significant disruption to daily functioning. Outpatient management with olanzapine and quetiapine worsened agitation. Referred to a specialist, he was started on lorazepam up to 12 mg daily for suspected catatonia. ECT was considered, but further workup ruled out seizure disorder and autoimmune encephalitis. Pediatric neurology found no alternative etiology and recommended ECT. On admission, BFCRS score was 14, showing catatonic symptoms like automatic obedience, mutism, and immobility. Lorazepam was reduced to 2 mg three times daily, and amantadine 100 mg twice daily was continued. An acute ECT course of 12 bilateral treatments over four weeks reduced catatonic symptoms, improving mutism, motor speed, and daily activities. During a 56-day hospitalization, he received 7 maintenance treatments. Upon discharge, BFCRS decreased to 7, and he continued lorazepam and amantadine.

This case report underscores the complexity of managing catatonia in patients with Xp11.22 duplication syndrome and ASD, highlighting the potential need for multimodal treatment approaches. The significant improvement observed with the addition of ECT to the treatment regimen emphasizes the importance of considering this option in cases of refractory catatonia, even in patients with complex genetic and neurodevelopmental backgrounds. This case raises important questions about the underlying neurobiological mechanisms of catatonia in the context of Xp11.22 duplication syndrome and ASD.

None Declared

The relevance of studying late-life depression is determined by the increase in its prevalence, difficulties in diagnosis and therapy. Depression in old age aggravates the course of comorbid somatic pathology, leads to a deterioration in the quality of life of the elderly, the development of mental insolvency and social maladjustment. In addition, depression accelerates the aging process, accompanied by an increased risk of mortality and the development of dementia.

To study the clinical features of late-life depression in patients of a gerontopsychiatric hospital.

Patients with depressive disorders who were treated in the conditions of the gerontopsychiatric hospital. The study used clinical, psychopathological and statistical methods. A total of 333 patients were examined: 87 men (26.1%) and 246 women (73.39%) aged 60 and older (average age 69.05±6.66). According to the ICD-10 classification, all patients were diagnosed with a depressive episode of various etiologies: in 20 patients (6.0%) - a single DE, in 86 patients- a depressive phase within the framework of the BAR(25.9%)and in most patients–227people– a depressive phase within the framework of DDR. According to the ICD-10criteria, depression corresponded to a moderate depressive episode in 246 patients (73.9%), a mild depressive episode in 64 (19.2%)and a severe depressive episode in 23 patients (6.9%).

Analysis of the psychopathological structure of the examined inpatient patients with late-age depression revealed the predominance of psychopathological conditions characteristic of late age, in the structure of which anxiety and anxiety-melancholy disorders dominated (152people-45.7% of cases), depression with the dominance of apathetic and adynamic disorders, which were observed in 135people (40.5%), were somewhat less common. Complex psychopathological depressions with a predominance of senesto-hypochondriac disorders, as well as delusional depressions, were less common – in 39 people–11.7% and 7 people-2.1% of cases, respectively. A characteristic feature of late-age depressions was the presence in their structure of dissomnic, anxiety and hypochondriac disorders, which were noted, respectively, in100%, 94.6% and 93.1% of cases, as well as subclinical cognitive disorders: subjective cognitive impairment (complaints of memory loss)- in 64.3% of patients.

The study shows the polymorphism of psychopathological symptoms of endogenous depression in late life, the presence of anxiety, senesto-hypochondriac, dissomnic and cognitive disorders in the structure of depression.

None Declared

In recent years, scientific literature has focused on the study of neurophysiological indices, including parameters derived from electroencephalography (EEG), electrocardiography (ECG), and electrodermal activity (EDA), in order to identify potential biomarkers that could be useful in the assessment, monitoring, and prevention of psychiatric disorders.

The aim of this work is to investigate whether some neurophysiological indices are able to predict the symptomatic improvement and the socio-relational functioning of people hospitalized in acute psychopathological conditions at the Psychiatric Unit of the Bufalini hospital in Cesena, in a transversal manner in regard to the diagnostic category and the symptomatic severity of the psychiatric disorder.

To assess treatment outcomes from both a psychopathological and functional perspective, the Health of the Nation Outcome Scales (HoNOS) and Brief Psychiatric Rating Scale (BPRS) were administered at the start and end of hospitalization. Neurophysiological parameters were measured using the Rehacor-T device, which recorded frontocentral cerebral oscillations in Delta, Theta, Alpha, and Beta frequency bands, as well as heart rate and skin conductance. Data collection involved two phases: initially, participants viewed a calming landscape with eyes open, followed by a phase with eyes closed where they aimed to maintain tranquility. The Stroop test was then conducted. Statistical analyses were performed using JASP software.

The sample includes 112 patients (M = 57; F = 55), the average age of the participants is 44 years (SD = 16), while the average level of education is 11 years (SD =3).

The Beta frequency band in the eyes closed condition and the Delta frequency band in the eyes open condition show a positive regression with the changes in the HoNOS scale scores, indicating that an increase in Beta and Delta oscillations corresponds to an improvement in socio-relational functioning.

A positive regression was found between Delta oscillations in the Stroop test phase and changes in BPRS scores, suggesting that an increase in oscillations corresponds to an improvement in clinical symptoms.

Although several autonomic abnormalities are known in psychiatric disorders, our results did not show any prognostic ability from the ECG and EDA indices recorded in the sample.

In conclusion, in line with what has already been demonstrated in the literature, it is possible to confirm that EEG indices can reflect the adaptive resources of the person affected by psychiatric disorders in terms of the possibility of responding to treatment.

Deepen the research in this field could lead to the identification of new and more specific biomarkers for the prevention, diagnosis and treatment of psychiatric disorders.

None Declared

Doctors Without Borders works in humanitarian settings. In these settings, we have observed a notable movement away from first generation medications such as haloperidol towards second-generation antipsychotics, where these medications are available. We began to question whether the evidence clearly justified this and decided to contribute to the evidence.

To assess the clinical benefits and harms of haloperidol compared to olanzapine for people with schizophrenia and schizophreniaspectrum disorders.

Searched the Cochrane Schizophrenia study-based register of trials, screened the references of all included studies. We contacted relevant authors of trials for additional information where clarification was required or where data were incomplete. The register was last searched on 14 January 2023.

We didn’t find a statistically significant difference between haloperidol and olanzapine in global state (RR 0.84, 95% CI 0.69 to 1.02), nor in relapse (RR 1.42, 95% CI 1.00 to 2.02). Haloperidol resulted in an increase of extrapyramidal side effects compared to olanzapine (RR 3.38, 95% CI 2.28 to 5.02). For weight gain, there may be a large reduction in the risk with haloperidol compared to olanzapine (RR 0.47, 95% CI 0.35 to 0.61). Haloperidol may result in an increase of leaving the study early compared to olanzapine (RR 1.99, 95% CI 1.60 to 2.47).

Overall, the certainty of the evidence was low to very low for the main outcomes in this review, making it difficult to draw reliable conclusions. There is no clear difference between haloperidol and olanzapine in terms of global state and relapse. Different side effect profiles were noted. These findings should contribute to continue using haloperidol and olanzapine.

Many studies did not use equivalent doses of the two medications when they were compared. Most studies used comparatively higher doses of haloperidol compared to olanzapine.

None Declared

Subutex abuse in Tunisia is a phenomenon that is becoming more and more frequent and the management of which is not obvious due to the development of this substance in parallel markets.

Our objective was to assess the patient’s Subutex use and initially assist with withdrawal, followed by achieving abstinence.

We followed the case of a patient in the psychiatric unit B at the Razi hospital, for depressive symptoms and having a problem of misuse of Subutex for 4 years, in a difficult family and social context.

Patient follow-up was done over a one-year period with weekly consultation sessions at the beginning to assess the situation. Although withdrawal was done after a few weeks, it was essential to maintain this abstinence, using psychotherapy based on CBT done over 7 sessions.

During the study period, the patient violated abstinence only once in a family conflict.

The patient’s response to our management has reinforced the hope of being able to treat addiction to Subutex despite the severity of his condition and family and social instability.

None Declared

Bipolar Disorder (BD) is a severe and chronic psychiatric condition, with complicated course and substantially reduce psychosocial functioning. Alterations in immune response are considered to be one of the major factors underlying the etiopathogenesis of BD, causing alterations in neurotransmitter systems, neuroendocrine systems, neurotrophic factors, and producing oxidative stress. Inflammatory cytokines have potential value for the clinical diagnosis and prognosis of BD.

The primary aim of the study was to assess the effect of disease course and clinical-characteristics on alterations of transforming growth factor-beta (TGF-beta), in BD.

This cross-sectional study included 82 patients with BD in remission. Multivariate linear regression with TGF-beta value as an outcome, and duration of illness, number of hospitalizations, residual symptoms estimated as Brief Psychiatric Rating Scale (BPRS) score, gender, and age, was used to produce the model.

The explored linear regression model was significant, explaining 39.4% of the variance (p<0.001). Higher TGF-beta was predicted by less previous hospitalizations (p<0.001) and lower BPRS score (0.034), while longer duration of illness was almost significant predictor (p=0.054). Age and gender showed no predictive effect in the model.

The study points out to the better course of BD characterized by less episodes and less residual symptoms in determining the TGF-beta levels, potentially creating a more favorable immunological state. The importance of neuroprotective and neurodegenerative balance of immune mediators, their interplay and relation to chronicity and severity of BD should be further explored.

None Declared

Ehlers-Danlos Syndrome (EDS) is a group of hereditary connective tissue disorders that primarily involve skin hyperelasticity, hypermobility of joints and fragility of blood vessels.This syndrome shows heterogeneous features.Recent studies have shown that patients with EDS have a higher risk of psychiatric conditions such as depression, suicide and schizophrenia.The existing literature on safe administration of ECT defines several case reports which incorporates connective tissue disorders.

This case report aims to define a rare case of EDS related psychosis including the clinical presentation and management.Furthermore, to show the administration of ECT in patients suffer from this medical condition after their assessment.

Comprehensive presentation of patient’s case and review of systematic literature using database, in regards to connective tissue disorders and psychiatric conditions.

A 42-year-old female patient,diagnosed with anxiety disorder 7 years prior, who has shown no remission and has experienced multiple hospital admissions over the past year due to various psychotic and depressive episodes, presented to our hospital with complaints that a “sorcerer” had cast spells on her.She reported delusions of mystical and somatic nature, describing that as a result of these spells, supernatural entities had caused her teeth to shrink, her skull to shift, the brightness in her eyes to diminish, her internal organs to decay and her physical presence to fade away.Additionally, she expressed paranoid-persecutory delusions that these entities would ultimately lead to her death.Treatment history included multiple SSRIs, antipsychotics and 6 sessions of TMS therapy, all with limited response.Her family history revealed that her father had died by suicide and her siblings were also diagnosed with depression/anxiety disorders.

The patient was admitted with a preliminary diagnosis of psychotic depression.Physical examination findings included hyperflexibility and hyperlaxity, suggestive of EDS.As the patient was at increased theoretical risk for complications; several consultations were requested to assess fitness for treatment prior to ECT.Based on these evaluations, ECT was deemed safe to proceed.Bifrontal ECT was successfully administered, resulting in marked improvement in the patient’s psychotic symptoms.

Even delusions are remarkably indicative for psychosis, it is crucial to recognize the underlying medical conditions may contribute to its onset and/or exacerbation.Psychiatric evaluations should be performed during EDS patients’ routine follow-ups.Additionally, as is already shown in other case reports, administration of ECT in patients with EDS should be considered.However, further research is required to understand the eligibility of ECT on connective tissue disorders also to expand our repertoire in the treatment.

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“Psychosurgery” is defined as the human brain surgery to treat psychiatric symptoms.

This study aims to portray psychosurgery’s historical evolution.

A review of 35 articles from 2000 to 2024 on PubMed and Google Scholar, regarding psychosurgery.

The initial phase of psychosurgery dated in 1888, when Swiss psychiatrist Gottlieb Burckhardt, in en effort to control the symptoms of psychiatric patients, he performed the very first brain topectomies. Later on, in 1936, Portuguese neurologist Egas Moniz and neurosurgeon Almeida Lima, collaborated on performing the first lobotomy. After achieving 20 lobotomies, Moniz reported that 35% of patients showed complete remission of psychiatric symptoms, 35% of patients showed a mild improvement, and 30% of patients showed no improvement. It was Freeman’s (a neurologist) and Watts’s (a neurosurgeon) turn to perform in 1936 the first lobotomy on the USA ground, on a woman suffering from depression; Alice Hammatt. Unfortunately, six days post-operation, Hammatt experienced language difficulties, disorientation and agitation. However, the surgery was still considered a success. By 1942, Freeman and Watts had performed 200 lobotomies, declaring that 63% of patients improved, 23% of patients showed no relief, while 14% of patients suffered complications, including death. Freeman pursued with the development of a transorbital method which he tended to perform in outpatient departments, without any neurosurgical assistance, having patients anesthesized with a portable electroshock machine. Profoundly disapproving this method, Watts, decided to end their partnership. Further unsatisfactory outcomes like the lobotomy of Rosemary Kennedy (sister of President John F. Kennedy) shaped an additional negative image of Freeman’s work. Rosemary who initially was subjected to lobotomy due to mild developmental delays, anxiety and epilepsy, was postoperatively left severely disabled, without autonomy, being institutionalized for the rest of her life. Finally, the approval of chlorpromazine’s use in the US (1955) alongside public awareness over psychosurgery’s complications, such as the “post-leucotomy syndrome” causing disinhibition as well as “lobotomy criteria” which included female gender, non-obeidance, hospitalization in overcrowed institutions, opposite political opinion, leaded to psychosurgery’s dowfall.

Considering the dark history of psychosurgery, it is imperative to proceed to such treatments exclusively to diseases with a well decoded neurophysiology, always respecting human rights and protecting patients’ dignity and self-will.

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