Effective discharge management is essential for psychiatric inpatient care, significantly impacting patient outcomes during and after the transition from inpatient to outpatient settings. A well-coordinated discharge process ensures continuity of care, reduces readmission risks, and supports long-term recovery. However, there is a notable lack of comprehensive data on discharge practices across European countries, impeding the evaluation of their effectiveness and the development of informed improvements.

The present study has two primary objectives: first, to systematically review current practices, challenges, and outcomes related to psychiatric discharge management across European countries. Second, to evaluate and compare existing discharge guidelines, protocols, and toolkits. By synthesizing these findings, we aim to identify best practices, highlight gaps, and offer recommendations for optimizing discharge procedures. Additionally, we will briefly present a current mixed-method research project from Germany, titled “Evaluation of Discharge Management in Psychiatric Care,” which aims to assess discharge management practices for psychiatric inpatients. These insights will supplement the broader European review by offering a focused perspective on the practical considerations and challenges of discharge management practices within a specific national context.

We will conduct a systematic search and review by exploring multiple electronic databases (MEDLINE, Embase, Cochrane Library and PsycINFO) and grey literature sources (Google and Google Scholar) for both quantitative (observational studies, reports) and qualitative (clinical guidelines, protocols, interviews, focus groups) data related to psychiatric discharge management. Additionally, we will hand-search the references of key papers, including existing systematic reviews and included articles. The search will include documents published from 2000 to December 31, 2024.

The presentation will provide an overview of the current research and literature on psychiatric discharge management practices in Europe. The review is expected to provide critical insights into advancing psychiatric care standards. Additionally, the presentation aims to engage researchers and clinical practitioners attending EPA25 by providing a platform for knowledge exchange on psychiatric discharge management, facilitating networking opportunities and fostering potential collaborations for future research in this vital field.

Discharge management is a critical aspect of psychiatric care that requires meticulous planning and coordination. The insights gained from this review will contribute to the development of evidence-based discharge protocols that are adaptable to diverse patient populations and healthcare settings, ultimately leading to more effective and cohesive care strategies across Europe.

None Declared

The abrupt occurrence of neuropsychiatric symptoms in patients with alcohol-related cirrhosis requires detailed evaluation not only for hepatic encephalopathy but also for other etiologies like Wernicke-Korsakoff Syndrome. In this case, we present a patient with alcohol-related cirrhosis who was initially admitted to gastroenterology unit with a preliminary diagnosis of hepatic encephalopathy but was ultimately diagnosed with Korsakoff Syndrome.

This case highlights the critical need for comprehensive neuropsychiatric assessment in patients with alcohol-related cirrhosis and offers a review of the current literature on the definition and clinical presentation of confabulation.

Description of a clinical case and literature review

45-year-old male with a history of alcohol-related cirrhosis was admitted to gastroenterology unit with symptoms suggestive of hepatic encephalopathy. On hospital day two, he was consulted to consultation-liaison psychiatry unit with the complaints of sleep disturbances and meaningless talking. In his story; over the past 3 months, he was talking about unrealistic events, having anger outbursts and disrupted sleep cycle, although his total sleep duration remained normal. Aside from grandiosity, mild irritability and disruptions in thought content, there were no signs of manic episode, such as euphoria, distractibility or reduced sleep. In mental state examination, he was alert, oriented in time, place and person, displaying normal psychomotor activity, speech, and impulsivity with euthymic mood. Neurological examination revealed no signs of Wernicke encephalopathy, such as nystagmus, ataxia or confusion. Subsequent psychiatric evaluations revealed fluctuations in narrative, lack of insight, mild memory impairment, and grandiose thought content suggestive of momentary confabulation, all indicative of Korsakoff Syndrome. He was transferred to the psychiatry inpatient unit and treatment with amisulpride at 200 mg daily and thiamin at 300 mg per day were initiated. Following treatment, there was a gradual improvement in aggression; however, no significant enhancement in confabulations or memory function was observed.

To our knowledge, this is the first case report of Korsakoff Syndrome presenting with a preliminary diagnosis of hepatic encephalopathy. The neuropsychiatric components of hepatic encephalopathy can manifest with a variety of symptoms, posing a challenge in differentiation from psychiatric disorders, such as mania or Korsakoff Syndrome. This report highlights the importance of a collaborative evaluation for patients presenting with neuropsychiatric symptoms and a history of alcohol-related cirrhosis.

None Declared

Multiple sclerosis (MS) is a chronic neurological disorder that can profoundly affect patients’ quality of life due to its diverse symptoms and disease progression. MRI findings are critical in assessing the extent of neurological damage and may correlate with various aspects of patients’ health and well-being.

identify the relationship between MRI findings and quality of life in individuals with MS.

A cross-sectional study was conducted in the neurology department of Razi University Hospital (Tunisia) between October 2023 and June 2024. Patients with a diagnosis of MS based on the 2017 McDonald criteria were recruited, excluding those with active disease relapses. Participants completed questionnaires covering sociodemographic data, medical history, disability status, clinical and radiological characteristics. Quality of life was assessed using the SF-36 and the Multiple Sclerosis Quality of Life (MSQoL-54) scales.

A total of 83 patients with MS were recruited, with ages ranging from 19 to 66 years. The study population had a predominantly female sex ratio of 3.4. The majority of participants (75.9%) were from urban areas, and 74.7% had a university-level education. Moreover, 49.1% were married, and 60.2% were employed. Regarding medical history, 40.3% had a comorbid condition, and 30.1% had a psychiatric history. The mean age at disease onset was 26 ± 10 years.First-line treatments were prescribed to 27.7% of patients. Second-line treatments were prescribed to 69.9% of patients.

The mean overall score on the SF-36 scale was 53.56. According to MSQ ol54, the most affected domains were sexual function, physical health limitations, and sleep. The least affected domains were pain, social function, and sexual satisfaction.The SF-36 mean score decreased from 50.59 in patients with more than 10 lesions to 21.37 in those with fewer than 10 lesions, with a statistically significant difference (p = 0.012). We found a significant relationship between a higher number of lesions (>10) and the dimensions of physical health (p = 0.007), emotional well-being (p = 0.027), perception of health (p = 0.025), social function (p = 0.017), distress (p = 0.049), cognitive function (p = 0.038), and overall quality of life (p = 0.029). Thalamic lesions were associated with the dimension of distress (p = 0.048). The presence of new lesions in the most recent follow-up MRI was associated with emotional well-being (p=0.018).

The study highlights a significant correlation between MRI findings and quality of life inpatients with MS. Understanding this relationship is crucial for developing targeted treatment strategies that address both the physical and psychological aspects of the disease. By integrating MRI assessments into routine care, healthcare providers can better support the well-being of individuals living with MS and tailor interventions to their specific needs.

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Domestic violence against women has increasingly been recognized nationally and internationally as a serious problem. Violence against women is a troubling phenomenon in Russia. Meanwhile, domestic abuse against women often results in severe psychological and mental health problems, including but not limited to depression, anxiety, and post-traumatic stress disorder.

The main aim of the study was to find out the psychological and psychiatric consequences of intrafamily violence against women.

A cohort of 18 females turned to psychologists and psychiatrists and was examined. Details of background, as well as psychological and mental problems, were extracted. Each item was assessed with the help of descriptive statistics.

Research has been carried out on the basis of psychological and psychiatric assessment of women who had a long history of violence by their husbands or partners, including sexual violence and maltreatment. Clinical assessment has revealed depression, anxiety, and adaptation disorders, accompanied by acute and chronic somatic diseases, low self-esteem, post-traumatic stress disorder, and drug abuse.

The research shows the high social and clinical significance of the consequences of abuse against women and also the necessity of domestic violence prevention by legal provisions and multidisciplinary research with the participation of psychiatrists, psychologists, and specialists in the fields of primary healthcare, education, and social protection.

None Declared

In the last decennium there is an explosion of medical devices to help patients in their fight against their psychiatric disorder and if possible to take more control and responsibilities over their own lives. In our research on measurement instruments it was doubted that patients were able to use computers and apps. Happell, 2009, addressed that psychiatric patients were very interested in using apps and also were positive being partners in the development of apps that could enhance their quality of life. Their attitude towards apps in clinical practice was more positive than their clinicians who were afraid of being judged on their performance and are more hesitant (Buwalda, et al., 2015). 10-15 years later millions of patients and clinicians are using applications and other medical devices to enlighten their lives.

But what about the most vulnerable citizens, our patients, in the cities in the context of urbanisation. In Amsterdam the public mental health services developed the self-sufficiency matrix (SSM) to gain insight in the peoples individual possibilities. A measure that insights the adaptation to the complex city life and how they can take care of themselves in this ever changing world. How do they feel about using apps or their professionals in daily clinical practice?

This presentation is about the history of the development of a mental health app for psychiatric patients in the city to be used by the professionals. Through a small pilot the presenter will a show the process of development of the SSM-app that gives insight in the wellbeing of the most vulnerable and their needs. We will also discuss the challenges and user-friendliness of the SSM- app in our PMH to make our work more digital proof.

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Cognitive function, particularly verbal memory, is often compromised in Bipolar Disorder (BD). While studying risk factors for cognitive deficits has not identified causal factors, focusing on protective factors that support verbal memory can help tailor interventions for individuals with BD.

Investigate associations between daily rhythms and verbal memory in people with BD in full or partial remission.

This is a cross-sectional study. Participants were included if their Montgomery Asberg Depression Rating Scale (MADRS) score was ≤16 and Young Mania Rating Scale (YMRS) score was ≤8. Daily rhythms were assessed by self-report using the BRIAN scale, as was chronotype. Regularity and intensity of physical activity were measured with actigraphy, with devices worn on the wrist for up to ten days. Variables of interest included mean time per day in moderate to vigorous physical activity (MVPA), intensity and timing of the most active five hours per day (M5), and total intensity per 24 hours over the assessment period. Cognitive function was assessed using a validated, self-administered, web-based test platform for Norwegian-speaking participants, which included a verbal memory test. Actigraphy data were processed using specialized software to extract relevant metrics. Correlational analysis was conducted to evaluate the relationships between daily rhythms and verbal memory.

A total of 87 participants were included, comprising 30 men and 57 women, aged between 18 and 64 years. Among them, 57 had bipolar disorder type 2, and 30 had bipolar disorder type 1. The analysis revealed a significant positive correlation between verbal learning and the timing of the most active five hours, with better verbal learning observed for M5 timing later in the day. There was also a moderate positive correlation between better delayed verbal recall and the amount of time spent in moderate to vigorous physical activity.

Our findings suggest that modifiable factors, such as later timing of the most active five hours and amount of time spent in moderate to vigorous physical activity, are associated with better verbal learning and memory in individuals with bipolar disorder. These insights could inform interventions aimed at improving cognitive outcomes in this population.

None Declared

The growing need for effective solutions to bridge the mental health treatment gap is particularly critical in countries where economic and political crises have exacerbated existing mental health challenges. In this context, the urgency for scalable and accessible interventions is evident. Step-by-Step (SbS), a guided digital self-help program developed by the World Health Organization (WHO), has been implemented as a promising approach to alleviate depressive symptoms and improve functionality in vulnerable populations.

This meta-analysis aims to evaluate the findings of studies that examined the efficacy of SbS, compared with enhanced care as usual (ECAU), in reducing depressive symptoms and functional impairment.

We systematically searched PubMed, Cochrane, and Scopus for randomized controlled trials (RCTs) comparing SbS with ECAU. The pooled outcomes were the overall improvement in depressive symptoms, measured by the Patient Health Questionnaire (PHQ-9), as well as functional impairment measured by the WHO Disability Assessment Schedule-12 (WHODAS). We calculated the mean difference (MD) for the outcomes, with 95% confidence intervals (CIs). Statistical analysis was performed using Review Manager (RevMan) 8.1.1 with a fixed-effect model. Heterogeneity was assessed using the I² statistic.

Three RCTs were included, encompassing 604 patients, of whom 263 (43.5%) participated in SbS. The population consisted of 35.1% males and 64.9% females. The mean age was 28.8 years, with a standard deviation of 8.7. SbS reduced PHQ-9 scores (MD = -3.48; 95% CI [-4.44, -2.52]; P < 0.00001; I² = 3%; Figure 1) and WHODAS scores (MD = -3.37; 95% CI [-4.84, -1.90]; P < 0.00001; I² = 0%; Figure 2) compared with ECAU.

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Image 2:

This meta-analysis of RCTs suggests that SbS has a positive effect in reducing depressive symptoms and functional impairment compared with ECAU.

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Adolescents are at increased risk of developing suicide-related behaviour (SRB). Varying contributing factors may play an important role across the different forms of SRB. Perfectionistic concerns may become a cognitive moderator influencing volitional moderators (e.g., non-suicidal self-harm, NSSH) and suicidal ideation escalation.

To identify profiles of perfectionistic concerns in a community sample of adolescents. Also, to study the relationship between suicide-related outcomes and NSSH, according to perfectionism profile.

A sample of 1,526 adolescents (54.3% female; M= 13.81 years, SD= 1.28) participated in our study. A wide range of SRB and motivational and volitional risk factors were evaluated in school settings. Six types of perfectionistic concerns, assessed by the Frost Multidimensional Perfectionism Scale (FMPS), were used to identify perfectionism profiles, through latent profile analysis.

Almost one in five adolescents (19.5%) showed SRB risk and more than one in three adolescents (35.1%) engaged in NSSH in the last year. Five profiles of perfectionism were identified (Figure 1). The profile featured by higher concerns across perfectionistic domains (7.2% of participants) showed significant relationship with SRB risk (OR = 2.84) and suicidal ideation (OR = 1.22), in comparison to the minimal concern profile. On the other hand, the profile featured by high parental concerns (18.2% of adolescents) was associated with increased risk of ideation (OR = 2.75) and NSSH (OR = 1.51).

Image 1:

Perfectionism may constitute a key risk factor for NSSH and SRB development. The promotion of prevention programmes to enhance cognitive regulation skills may help prevent suicide in adolescents.

None Declared

This study focused on one of the key components of mental healthcare provision: waiting lists in the community mental health service in County Louth and Meath, Ireland. The background context addresses the increasing demand for healthcare, shortage of resources, administrative hindrances, and the impact of waiting time on patient outcomes and satisfaction.

The objectives of the research were to Identify the primary causes of waiting lists in the community mental health services of County Louth and Meath in healthcare provider’s opinions and their views on potential solutions to reduce waiting lists and improve service delivery.

A mixed-methods approach was applied to conduct a comprehensive assessment of waiting list causes and potential solutions based on the combination of qualitative and quantitative methods. The main qualitative methods encompassed semi-structured interviews with healthcare professionals and thematic analysis of their perceptions. The quantitative part of the study consisted of a survey distributed among members of the multidisciplinary mental health teams to collect information regarding perceptions, challenges, and potential solutions to the waiting list problems.

The study showed a variety of issues in the human factor of waiting lists, including insufficient staffing, high demand for services, administrative delays, limited resources, and communication failures between mental health and primary care teams. The mental healthcare professionals in County Louth and Meath voiced their apprehensions concerning patients’ wait times, resource scarcity, and the effect of these problems on the performance of services and patient outcomes. The general findings uncovered that 89.3% of respondents recognized insufficient staffing as the essential challenge in waiting list management, with 82.1% likewise featuring the higher demand for services as a significant variable adding to waiting lists.

Carefully assessing these issues is vital, and evidence-based steps are to be employed in managing the waiting lists in the community mental health services in County Louth and Meath, Ireland. Suggestions on increased staffing, resource investment, technology leveraging, process optimization, and enhanced communication between primary care and psychiatry are the essence of potential solutions. Undertaking these suggestions will enable mental health services to increase efficiency, provide a better patient experience, and subsequently improve overall service delivery while reducing the consequences of long waiting times.

None Declared

Fibromyalgia is not a primarily psychogenic disorder, however due to high levels of comorbidity with psychiatric disorders and shared therapeutic targets, psychiatrists can play an important role in the diagnosis and treatment of fibromyalgia.

Fibromyalgia is a chronic pain syndrome affecting around 2-5% of the general population. Fibromyalgia’s core symptom is the persistent generalized pain, its other symptoms include fatigue, stiffness, depressed mood, anxiety and sleep disturbance. Although some psychiatric symptoms are an integral part of fibromyalgia clinical presentation, in a significant part of patients their severity warrants a specific psychiatric diagnosis and management. Available data shows high rates of psychiatric comorbidity in fibromyalgia, with lifetime prevalence reaching 9-33% for anxiety disorders, 16% for post traumatic stress disorder, 63% for depression, 26% for bipolar disorders. Psychiatric comorbidity in fibromyalgia is associated with the severity of fibromyalgia, its impact on patients functioning, quality of life and socioeconomic status. Moreover, the works of our team have also shown that some psychopathological symptoms such as depression, anxiety, anhedonia, chronobiological preferences and circadian rhythm disruptions as well as some psychological traits are linked to lack of response to pharmacological treatment in fibromyalgia.

The current knowledge on fibromyalgia etiopathogenesis is incomplete and does not warrant a comprehensive description. There are no biomarkers or objective tests, which would verify the fibromyalgia diagnosis, which is therefore based primarily on the physician’s history-taking and fulfillment of criteria. In effect, the group of patients diagnosed with fibromyalgia is most likely heterogeneous, regarding the biological basis of its symptoms, clinical presentation and susceptibility to treatment. This also means treatment is symptomatic and characterized by limited effects.

Fibromyalgia management requires a multidisciplinary approach, with emphasis on non-pharmacological interventions such as physical activity, cognitive–behavioral/mindfulness psychotherapy, physical therapies. For a large number of fibromyalgia patients these interventions are not sufficiently effective and there is a need for pharmacotherapy. The use of selective serotonin and noradrenaline reuptake inhibitors (SNRI) and pregabalin, which are commonly used to manage depression and anxiety, is supported by best scientific evidence. Also other drugs used for psychiatric disorders such as amitriptyline, gabapentin, quetiapine or naltrexone (in low doses) were proven useful in fibromyalgia management.

This presentation will sum up current knowledge on psychiatric comorbidity in fibromyalgia and treatments which psychiatrists can offer to fibromyalgia patients.

None Declared

A compatriot who is declared insane and ends up chained in a mental institution is a new and unexpected character that appeared in Russian fiction during its heyday in the first half of the 19th century. The theme of “madness” followed by “chaining” is repeated in the influential works of Alexander Pushkin, Alexander Griboyedov, Alexander Voeikov and other outstanding writers of this period.

Find out: (1) How historically accurate was this persistent artistic image — was it merely a literary convention or a true reflection of the status quo? (2) Was the shackling of patients “the standard of care” in psychiatric institutions in Russia and Europe in the late 18th and first half of the 19th centuries?

A historiographical and comparative analysis was conducted, which allowed us to compare historical evidence and manuals on mental illness published in Europe in the period 1782-1845, as well as Russian professional literature on the history of psychiatry in Russia.

The artistic image of the “madman on a chain” largely corresponded to reality; moreover, in a number of cases, the horror of reality exceeded the artistic image.

By bringing the image of the patient in chains to the forefront, Russian fiction attracted public attention to the topic, which was one of the factors that contributed to the opening of a significant number of new psychiatric hospitals in Russia in the second half of the 19th century, with a more humane attitude towards psychiatric patients.

None Declared

The main contributions of Spanish and Hispano-American authors to the study of basic symptoms, either published in Spanish and English, will be briefly presented. Former publications mainly included translation and validation of different versions of the Frankfurt Complaint Questionnaire, transversal and longitudinal studies, and their role for psychosocial rehabilitation, also in a Penitentiary Psychiatric Hospital. More recent research includes the network analysis of basic, attenuated, and frank psychotic symptoms on 460 subjects attending a German early detection service, where disorganized communication, delusions and hallucinations were the most central symptoms. Interestingly, cognitive and perceptual disturbances, included in basic symptom criteria, appeared to develop across attenuated symptoms to frank positive psychotic symptoms. Concerning the finding of three clusters of symptoms, “subjective disturbances”, “positive symptoms and behaviors”, and “negative and anxious-depressive symptoms”, the predominately attenuated hallucinations of both SIPS and PANSS joined the basic symptoms in “subjective disturbances”, therefore underlining the importance of insight in separating true psychotic hallucinations from other hallucinatory experiences and not justifying antipsychotic medication.

None Declared

Cannabis legalisation has undergone a rapid global transformation, with varying policy approaches and public health implications across different geographic areas and social contexts.

Several arguments have been proposed to support cannabis legalisation, ranging from control of the quality and potency of the market products, harm reduction, addressing the black market activities, reducing crime, and economic benefit. However, cannabis use has been associated with public health concerns, and it has been established as the most preventable risk factor for psychotic disorders.

This work aims to dissect the key arguments supporting cannabis legalisation through the following objectives: 1) reviewing the relationship between cannabis legalisation and the incidence and prevalence of psychotic disorders in countries where cannabis has been legalised, as well as changes in incidence rates over time in those countries where legalization is currently under debate; 2) examining the relationship between cannabis use and psychopathological outcomes using a syndemic approach; and 3) presenting original data from the epidemiological branch of the EC-1 study, aiming to identify risk factors for psychopathology, violence, and aggression in South London.

None Declared

Patients with mental disorders often engage in extreme and unpredictable violent behaviors that seriously endanger the public security and stability of the society. Violence risk is commonly assessed by subjective judgement, which may lead to bias and uncertainty in the appraisal results. Existing expression recognition and analysis techniques have limitations in identifying the emotional states of patients with mental disorders.

The study aimed to explore the association between violent behaviors and facial expression in patients with mental disorders by machine learning algorithm, to evaluate the application value of facial expression analysis system in violence risk assessment of individuals with mental disorders.

Thirty-nine patients with mental disorders were enrolled and assessed by using Modified Overt Aggression Scale (MOAS), positive and negative syndrome scale (PANSS) and brief psychiatric rating scale (BPRS). An emotional arousal paradigm was performed and the intensity of baisc emotions and expression action units was recorded before, during and after the paradigm. The processed quantitative data was used to generate one-dimensional waveform maps and two-dimensional time-frequency maps and then quantized feature data were extracted. A machine learning model with high accuracy was trained using these feature data, which can accurately determine the violence risk states of patients and output the probability. All individuals participated voluntarily and provided informed consent. This study was approved by the ethics committee of the Academy of Forensic Science.

The intensity difference of sadness, surprise and fear in different time periods was statistically significant. The intensity of the left medial eyebrow lift action unit was found significantly different before and after the emotional arousal. The intensity of anger and disgust was positively correlated with the MOAS scores, PANSS scores and BPRS scores. The features of time-frequency diagrams of 5 expression action units (medial eyebrow raise, eyebrow lowering, slightly open lips, chin drop and eye closure) and 8 basic emotions were selected and then support vector machine was used for triple classification, which is a classifier that can well distinguish the three stages of non-violence risk period, violence risk period, and post-violence risk period. In the 4:1 training-testing grouping, the classification accuracy reaches 91.2%.

Featured expressive action units and various baisc emotions might be used to capture information associated with violent behaviors. The facial expression analysis system mentioned above can be used as an auxiliary tool to assess the potential risk of violence in patients with mental disorders.

X. Ling: None Declared, S. Wang: None Declared, X. Zhou: None Declared, N. Li: None Declared, W. Cai: None Declared, H. Li Grant / Research support from: This study was supported by National Key R & D Program of China [grant number 2022YFC3302001], National Natural Science Foundation of China [grant number 81801881], Science and Technology Committee of Shanghai Municipality [grant numbers 20DZ1200300, 21DZ2270800, 19DZ2292700].

Neurodegenerative disease prevalence is high in the elderly, as aged brains accumulate molecular and cellular damage. Protein misfolding and aggregation are pathological processes underlying neurodegeneration, as seen in dementia. This coupled with oxidative stress, disrupted ubiquitin-proteosome system and neuroinflammation may contribute to neuronal damage. Lewy body dementia (LBD) collectively refers to Parkinson’s disease (PD), Parkinson-disease dementia and dementia with Lewy bodies (DLB) (Delenclos, Moussaud, & McLean, 2017). It is characterised by Lewy body (LB) deposits in the CNS, predominantly compromised of misfolded α-synuclein protein. Disease-modifying therapy (DMT) targets underlying protein misfolding and promotes LB clearance.

• - To review international trial data on DMT safety, tolerability and efficacy in DLB.

• - To consider molecular basis for protein misfolding and DMT in DLB.

Two international registries (ClinicalTrials.gov; EU clinical trials register) were consulted to identify agents being tested in completed, ongoing and recruiting trials. Both databases were searched by disease “Lewy body dementia” or “LBD” or “alpha-synuclein pathology” and study type “interventional” for phase I-III trials. Trials solely investigating diagnostic biomarkers, approved symptomatic DLB treatment or PD without dementia symptoms were excluded from final analysis.

11 trials were found studying DMTs for DLB. 10 out of the 11 trials were in phase II and one in phase I. The main agents investigated were tyrosine-kinase inhibitors (TKIs), phosphodiesterase-9 inhibitors, β-adrenergic agonists, and β-GCase chaperones. Primary and secondary outcome measures were “safety/tolerability of agent”, “changes in cognitive function” or “changes in serum/CSF α-synuclein”. Results from a phase I trial demonstrated a 3.85 and 3.5-point increase in mini-mental state examination scores at 6 months with nilotinib doses 300mg and 150mg, respectively (Pagan et al., 2016). Slight reduction was observed in CSF/plasma α-synuclein levels. Phase II trials for bosutinib versus placebo showed no significant difference in cognitive function (Pagan et al., 2022). Ambroxol trials, a β-GCase enzyme enhancing inhibitory chaperone, remain in recruiting stages but have proven drug tolerability. Data on CSF biomarker changes in DLB was unavailable.

Current understanding of protein misfolding in α-synucleinopathies suggests that a single DMT may be insufficient in mixed pathology. Cocktail therapy targeting various misfolded proteins may be necessary for a cure. DMTs have limited use as most patients are diagnosed with advanced DLB. Sensitive diagnostic biomarkers with high specificity are required for accurate DLB diagnosis in the prodromal phase, a critical window for protein misfolding reversal with DMT. TKI cardiotoxicity may also limit clinical use of this DMT, especially in the elderly.

None Declared

Access to employment is a significant challenge in adulthood, particularly for autistic individuals. Accommodations, both in the workplace and during selection processes, are essential to support the inclusion of this population in the labor market. Given the dynamic nature of support needs, understanding the specific characteristics and needs of autistic individuals is necessary to provide reasonable adjustments. However, this process becomes more complex when individuals do not disclose their autism diagnosis, hindering organizations’ ability to identify and address their needs.

To identify accommodations that support the employment of autistic young adults in Chile.

Semi-structured interviews were conducted with 12 autistic young adults with job interview experience in Chile. Participants, residing across five regions, were selected through theoretical sampling. Data were analyzed using content analysis in alignment with the principles of Grounded Theory by Glaser and Strauss. Ethical approval was obtained from the Universidad de O’Higgins Ethics Committee, and all participants provided informed consent.

While accommodations are deemed necessary by autistic individuals, they are seldom requested due to concerns that such requests may imply reduced competence, potentially lowering employment prospects. Participants in this study highlighted key dimensions essential for support, including procedural adjustments (advance preparation, privacy, and flexibility), interpersonal approaches (empathy and respect for diversity), and sensory accommodations (specific sensory considerations and clear, literal communication). Additionally, virtual interview formats were viewed positively, as they facilitate the fulfillment of certain sensory needs.

This study reveals a tendency among autistic individuals not to request accommodations during job-seeking processes, despite recognizing their necessity. Promoting professional practices based on updated, inclusive knowledge is essential for developing employment processes that effectively support autistic individuals.

None Declared

A 43-year-old male with a diagnosis of Bipolar Disorder associated with substance use is admitted to the mental health unit due to a psychotic decompensation. The patient has had an unfavorable progression requiring multiple admissions to mental health services. He suffers from dyslipidemia, hypertension, and poorly controlled diabetes. He has had some occasional work but is currently unemployed. He does not engage in leisure or sports activities, which he attributes to being highly sedated by the medication. He is currently being treated with clozapine, valproic acid, quetiapine, and various benzodiazepines.

Achieve stabilization of the psychopathological condition without producing additional side effects such as sedation.

During the hospital stay, Quetiapina is slowly reduced over one week, and Aripiprazole is introduced at a moderate oral dose (Aripiprazole 10 mg). It is then gradually increased to 30 mg/day. After 3 weeks, it is switched to Aripiprazole 400 mg /28 days intramuscularly. At the start of Aripiprazole introduction, there is a good response and a tolerance.

With the combination of Clozapine and Aripirazole 400 mg/28 days intramuscularly, there is a noticeable reduction in psychotic symptoms, allowing for the discontinuation of both Quetiapine and benzodiazepines from the patient’s treatment.

At present, reviewing the outpatient follow-ups the patient has had after hospital discharge, he continues with Aripiprazole 400 mg /28 days intramuscularly, showing overall improvement in functioning. Due to the reduction in sedation, the patient has begun participating in sports and educational activities, which provide him significant personal satisfaction.

Introducing Aripiprazole in combination with Clozapine significantly reduces psychotic symptoms by controlling positive symptoms, which means the patient does not need to rely on benzodiazepines, allowing for their discontinuation. The reduced level of sedation has enabled the patient to engage in sports and other activities that he previously felt hindered from due to medication. It is indeed very important for any patient to resume leisure and sports activities, but in this specific case, the patient had grade III obesity with associated dyslipidemia.

None Declared

Postpartum psychosis (PPP) is a psychiatric condition that arises shortly after childbirth. Electroconvulsive therapy (ECT) offers rapid symptom relief, particularly in severe cases. Despite reports of ECT effectiveness in PPP, its use remains limited and unstandardized.

This systematic review aims to evaluate the clinical effectiveness of ECT in treating PPP.

The electronic databases PubMed/MEDLINE, Cochrane, SciELO, SCOPUS, and WOS were screened for studies reporting ECT outcomes in PPP following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published between 2004 and 2024, written in English, and focused on subjects up to 12 months postpartum were included. All studies were vetted by ≥ 2 reviewers. Bias was assessed with the JBI Critical Appraisal Tool.

A total of 255 studies were identified and 7 met the inclusion criteria. ECT was exclusively used in severe PPP refractory to pharmacological intervention. Symptom improvement was reported in 100% of cases and most achieved total remission. Total ECT sessions ranged from 5 to 15, with symptom improvement after 1-6 sessions and remission after 5-11 sessions. ECT side effects were transient and included memory loss, mild cognitive deficit, and pain.

High remission rates on ECT were demonstrated where pharmacological intervention was insufficient, highlighting its effectiveness as a rapid and safe intervention for PPP. Adverse effects were transient and manageable, underscoring ECT safety. Small sample sizes and variability in ECT protocols limit the generalizability of the findings. Further evidence from prospective studies is needed to consider ECT as a first line treatment for PPP.

None Declared

Military personnel are exposed to intense stress and potentially traumatic environments, making them particularly vulnerable to psychiatric disorders. These pathologies can lead to prolonged periods of convalescence, affecting not only the health of individuals, but also the operational readiness of the armed forces.

To identify the most common psychiatric causes of convalescence in military personnel and assess their impact on the operational readiness of the armed forces.

This was a retrospective study of a descriptive nature, from January 1, 2023 to August 30, 2024, which focused on military personnel who presented a request for convalescence to the occupational pathology consultation at the Military Center for Occupational Medicine and Professional Safety in Tunis.

During the study period, 275 patients were included in the sample, with a mean age of 40.83 ± 9.93 years and a sex ratio of 2.77. Their average length of service was 15.62 ± 11.87 years. Depression was the most frequent psychiatric pathology, accounting for 70.9% of convalescence causes, followed by anxiety disorder at 8.7%. The most affected category was non-commissioned officers, accounting for 54.7% of cases. The ranks most affected were warrant officer in 12% of cases, chief sergeant in 11.6% of cases and head warrant officer in 10.9% of cases. Military healthcare and administration were the most represented specialties, in 17.5% and 14.2% of cases respectively. The most common workstations were nurses (15.6% of cases), administrative officers (12.4%) and infantrymen (6.2%). The average length of convalescence was 74.78 ± 88.77 days. Convalescence lasting more than 180 days accounted for 10.3% of cases.

Our study shows that psychiatric pathologies have a significant impact on operational readiness. The often prolonged periods of convalescence highlight the importance of implementing effective prevention and management strategies to mitigate the impact of psychiatric disorders within the armed forces.

None Declared