Adolescence and motherhood are transitional phases, moving from childhood to adulthood and from womanhood to motherhood. These processes involve significant psychological conflicts, where childhood narcissistic vulnerabilities risk being exposed.

The study aims to describe the mother-infant bond and the management of adolescent motherhood. This case informs the psychopathological and therapeutic reflections throughout the study.

This study examines a clinical vignette of a 16-year-old adolescent followed in the Perinatal Department at Rouen University Hospital, alongside a literature review. Semi-structured interviews were conducted with the adolescent mother and her family from July 2019 to April 2020, covering sociodemographic data, pregnancy experiences and consequences, the adolescent’s baby, the baby’s father, and the adolescent’s family. Written consent was obtained from the mother at the study’s outset.

The case involves M.D, a 16-year-old at 16 weeks gestation, is the youngest of two siblings and is in a relationship with a 25-year-old man. Her family history includes maternal depression, and her personal history includes ADHD with irregular follow-up, behavioral hospitalization at age 7, and a pregnancy termination in 2018. She was referred by a midwife due to challenges in envisioning her pregnancy. M.D. lives in a disrupted family dynamic marked by intrafamilial violence, conflicts with her brother, and repeated runaways. She was placed under social services following a report from her mother concerning behavioral issues. Her pregnancy was marked by anxiety over a potential forced termination, conflicts between adolescence and motherhood, and worries about childbirth. Motherhood posed additional challenges, such as infantile regression, irritability, impulsivity, difficulty caring for the baby, emotional immaturity, and ambivalence toward her pregnancy and motherhood. Her interactions and emotional attunement with the baby were inadequate. M.D. received multidisciplinary support (gynecologist, pediatrician, social worker, psychiatrist, child psychiatrist, psychologist, childcare provider) with extensive family and partner involvement. Improvements were noted in mother-infant bonding, reduced impulsivity, and decreased marital conflicts with Methylphenidate.

A collaborative care network is essential to support the bond between the adolescent mother and her child. The father’s role can serve as a separating third party, facilitating the child’s access to symbolic thinking. This role may also be filled temporarily by professionals who act as substitute third parties, supporting both the mother’s and child’s development.

None Declared

Negative symptoms are a key aspect of schizophrenia, significantly impacting a patient’s functioning and quality of life. Although hospitalizations are often associated with positive symptoms, negative symptoms can also dominate the clinical picture in in-patients. Female patients are usually underrepresented in schizophrenia studies.

To analyse the changes of negative symptoms in female in-patients.

This was an observational study with data recorded at hospital entry and release. Adult inpatients with a schizophrenia diagnosis according to the International Classification of Diseases 10th edition who exhibited predominant negative symptoms according to clinical judgement were included. Patients received pharmacological and some non-pharmacological treatment as usual.

The primary outcome measure was the modified Short Assessment of Negative Domains (m-SAND), an anamnesis-based scale that is composed of 7 items: two positive items (delusions and hallucinations) and five negative items (anhedonia, alogia, avolition, asociality and affective flattening). Each item is rated from 0 to 5 (not observed; mild; moderate; moderately severe; severe; and extreme). Other measurements included the Self-evaluation of Negative Symptoms (SNS).

Least squares (LS) means were calculated for the change from baseline to final visit using a mixed model for repeated measures (MMRM).

63 female patients were included in the study. The mean age was 41.6 years with 14.2 years of mean duration of illness. All patients had predominant negative symptoms, in fact, 65% of them was hospitalized because of it. 30% of the patients also had secondary negative symptoms, mainly due to positive symptoms. The mean duration of hospital stay was 38 days. All patients received pharmacotherapy. At baseline, 9.5% were on cariprazine monotherapy and 84.1% on cariprazine combined with another antipsychotic such as olanzapine (23.8%) or quetiapine (7.9%). By the end of the hospital stay, 14.3% of female patients received cariprazine monotherapy and 82.5% cariprazine combination treatment with olanzapine (30.2%) or clozapine (15.9%). Significant decrease was detected in m-SNAD total score (LS mean change from baseline: -10.95) and SNS total score (LS mean change from baseline: -9.74). Functioning increased from poor (76%) to ‘manifest disabilities’ according to PSP (81%).

In summary, female patients had significant improvement during their hospital stay in terms of negative symptoms. The most utilized pharmacotherapy during the hospital stay was cariprazine both in a form of mono- and polytherapy.

J. Dragasek: None Declared, Z. Dombi Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., P. Herman Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., V. Dzurilla Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., Á. Barabássy Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine.

A bill on euthanasia and assisted suicide is currently under discussion in France. It proposes that only competent adults suffering from a serious and incurable condition that threatens their life in the medium term, or who are in an advanced or terminal phase, and experiencing unbearable physical or psychological suffering—either refractory to treatment or considered unbearable in the absence of treatment—may request medical assistance in dying (MAiD). However, French psychiatrists have expressed concerns about the bill, as it does not mandate a psychiatric evaluation, despite the high prevalence of mental disorders, including depression, in the general population. These disorders are even more frequent in end-of-life conditions and can significantly impact decision-making capacity and the wish to die. Depression, a common comorbidity in cancer—the leading cause of MAiD requests—affects approximately 15% of cancer patients but is often underdiagnosed and undertreated. The bill also raises concerns regarding its implications for suicide prevention. Some MAiD requests may stem from treatable psychiatric conditions rather than a well-considered end-of-life choice. Furthermore, a proposed obstruction offense could potentially criminalize suicide prevention efforts, complicating the role of mental health professionals. Uniquely, the French bill allows a third party chosen by the patient to administer the lethal substance, a provision not found in any other country. This raises significant ethical and psychological concerns regarding the emotional burden on the designated individual, who may experience distress, guilt, or long-term psychological repercussions from actively participating in assisted dying. Finally, the possibility of future expansion to include psychiatric-only indications, as seen in other countries, remains a critical issue requiring careful ethical and medical scrutiny.

None Declared

Chronic pain is a debilitating condition affecting 20% to 30% of adults globally, with prevalence rates rising to 19% to 38% in Europe. It is often linked to self-medication, particularly through alcohol consumption, due to alcohol’s short-term analgesic properties, which act on the opioid system. However, continued alcohol use for pain relief can lead to alcohol use disorder (AUD), worsening the pain and causing physical and mental health issues.

This study explores the relationship between alcohol use in chronic pain management and the development of AUD through a literature review and a clinical case.

A narrative literature review was conducted using PubMed with the terms “alcohol use disorder” and “chronic pain.” English and Portuguese articles from the last 10 years were included, yielding 85 results. A clinical case involving a patient with chronic pain and alcohol dependence illustrates the issue.

The review shows that 28% to 35% of chronic pain patients use alcohol for symptomatic relief. While alcohol may provide initial pain relief, prolonged use leads to tolerance, increased consumption, and a significant risk of AUD. Approximately 18% to 25% of patients meet the criteria for AUD, with men being more commonly affected.

The clinical case describes a 56-year-old man with family history of AUD, who developed chronic pain after a work accident resulting in multiple trauma. The patient began consuming alcohol daily for pain relief, which escalated to an AUD diagnosis and worsened pain due to alcohol-induced hyperalgesia.

Alcohol use is prevalent among chronic pain patients, often as a form of self-medication. However, this practice is frequently counterproductive, as increased consumption to counteract tolerance can lead to serious complications, including hyperalgesia, psychiatric disorders, and significant difficulties in managing both pain and alcohol use disorder (AUD). The clinical case highlights these issues and reinforces the need for a multidisciplinary approach that addresses both pain management and alcohol dependence.

Early detection of problematic alcohol use is essential to prevent the development of AUD. A comprehensive treatment plan, incorporating strategies for pain control and addiction management, is crucial for improving the overall health and well-being of patients dealing with chronic pain.

None Declared

Schizophrenia and other psychotic disorders have a high social and economic cost. Antipsychotic drugs are the main approach to schizophrenia treatment. Drug adherence can be assessed with the Medication Possession Ratio (MPR), which means the days covered by the drugs purchased / 1 year.

The aim of this study was to investigate the effect of primary family factors and adverse childhood experiences (ACEs) on antipsychotic MPR among patients with schizophrenia spectrum disorder (SSD). Furthermore, we analyzed long-acting injectable antipsychotics (LAIs) and mood stabilizers separately.

We had access to a database of former adolescent psychiatric inpatients (n=508) treated during the years 2001-2006 in Oulu university hospital, Finland. Participants were followed for SSD diagnosis via National care register for healthcare (CRHC) and physician-prescribed antipsychotic drug purchases via Social Insurance Institute (SII) register up to June 2023.

The participants using clozapine (OR 5.26, 95%CI 1.79-15.39) or mood stabilizers (OR 5.34, 95%CI 1.37-20.83) were significantly more likely to have MPR > 80% compared to participants using other antipsychotics. Sibling position, the size of primary family or ACEs did not associate with MPR.

Clozapine and mood stabilizers increased the likelihood of higher antipsychotic MPRs among former adolescent psychiatric inpatients having SSD.

None Declared

In depressive disorders caused by chronic psychological stress, cognitive decline is produced by neuroinflammatory and neurodegenerative changes in the brain. M2-type macrophages possess high pronounced regenerative potential due to high production of neurotrophic, neuroprotective and angiogenic factors. We have previously shown that M2 macrophage-derived soluble factors (M2-SFs) edit stress-induced depressive-like behavior.

The aim of the study was to investigate the central effects of soluble factors derived from human macrophages, polarized to M2 phenotype (M2-SFs) involved in the mechanisms underlying the editing of depressive-like behavior.

Human macrophages were polarized polarised to M2 phenotype under serum deprivation conditions. Stress-induced depression-like male mice were undergoing intranasal administration of M2-SFs during 7 days. After which an immunohistochemical analysis was performed assessing the expression of the microglial marker Iba1. The levels of brain-derived neurotrophic factor (BDNF) and cytokines in separate structures of the brain were assessed by ELISA. For histological examination Nissl staining was applied.

Depressive-like behavior editing after the M2-SFs administration was registered against the background of some structural and functional changes in the brain. It was found an increase in the density of pyramidal neurons in the frontal cortex and augmented level of BDNF in this brain structure and also in the hippocampus. After the introduction of the M2-SFs in depressive-like mice the decreased expression of the microglial marker Iba1, accompanied with decreased levels of pro-inflammatory cytokines IL-1β, IL-6, TNF-α, INF-γ in pathogenetically significant structures of the brain was also observed.

The data obtained indicate that the depressive-like behavior-editing effect of M2 macrophage-derived soluble factors is mediated by stimulating neurogenesis, neuroplasticity and reducing neuroinflammation.

None Declared

Increasingly the collection and use of clinical data is considered as extremely important. These data may allow, among other targets, a better profiling of patients and as such help to develop better and more targeted care-pathways. Often these type of data collections are implemented on large, national levels. Although this already provides an important source of information, often the regional specifics are missed on these larger scales. Within the Antwerp region we developed a program allowing a deeper, smaller grained, level analyses of populations mental health care needs and their regional differences. The aim is to use these data to steer changes in the care pathways as offered by the different locally active care-providers.

None Declared

University hazing is a common practice that impacts students’ mental health and well-being, especially in medical schools. Despite its common occurrence, there is a lack of reliable tools to assess hazing experiences and perceptions among students.

This study aimed to evaluate hazing experiences, attitudes, and impacts and to develop and validate the University Hazing Self-Report Scale (UNI-Hazing) among Brazilian medical students.

This was a cross-sectional study conducted among Brazilian medical students. The UNI-Hazing scale was developed as a four-part questionnaire designed to assess personal experiences with hazing, students’ opinions, and its perceived impact on their well-being. Participants also completed a sociodemographic questionnaire and established scales including the Johns Hopkins Learning Environment Scale (JHLES), the Medical Student Stress Factor Scale (MSSF), the Generalized Anxiety Disorder 7-item (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9). We conducted exploratory factor analysis to uncover latent factors and assessed internal consistency, test-retest reliability, and convergent validity.

1,017 medical students from 74 universities across Brazil participated in the study. While the majority of students did not report being victims or witnesses of hazing, certain hazing behaviors, such as body painting and forced solicitation for money, were relatively common. Hazing incidents most frequently occurred at parties, followed by sports associations and fraternities, with fewer on-campus incidents. Students largely held negative views on hazing. Factor analysis revealed three subscales within UNI-Hazing: “Social Pressure and Institutional Responsibility”, “Emotional Harm and Ethical Concerns” and “Physical Hazing and Power Dynamics”. The scale demonstrated strong internal consistency (Cronbach’s alpha: 0.93, 95% CI: 0.92–0.93) and test-retest reliability (Pearson correlation coefficients: 0.44–0.84). Correlations with the external scales supported the scale’s validity, showing positive correlations with MSSF, GAD-7, and PHQ-9, reflecting the psychological impacts of hazing, and negative correlations with JHLES, indicating that as hazing experiences increase, positive life experiences may decrease.

The UNI-Hazing scale is a reliable and valid measure for assessing hazing experiences and perceptions among medical students in Brazil. The findings highlight the need for universities to implement anti-hazing policies and support systems for students impacted by hazing practices.

None Declared

Recent research suggests that psychological and personality factors, specifically affective temperaments, may influence adherence to prescribed pharmacotherapeutic interventions. However, this relationship has not yet been investigated in the context of infertility treatments.

Our prospective longitudinal study aimed to assess the impact of affective temperaments on medication adherence during infertility treatments.

Among women presenting for infertility treatment at the Semmelweis University Assisted Reproduction Centre, we administered the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-A) questionnaire before treatment to assess their affective temperament and the Morisky Medication Adherence Scale (MMAS) questionnaire six months after treatment initiation to measure their medication adherence during treatment. The effect of affective temperaments on medication adherence was analyzed using linear regression models. All statistical analyses were performed using R statistical software version v4.4.1.

In this paper, we present preliminary partial results. In our cohort of 121 women undergoing infertility treatment, higher hyperthymic affective temperament score predicted significantly higher adherence to pharmacotherapy recommendations (β = 0.11, p = 0. 042), while the other four dominant affective temperaments predicted significantly poorer medication adherence (cyclothymic: β =-0.15, p<0.001, depressive: β = -0.21, p=0.001, irritable: β =-0.14, p=0.004, anxious: β =-0.09, p=0.011).

The results suggest that affective temperaments may affect adherence to prescribed pharmacotherapeutic interventions among women undergoing infertility treatment, which may thereby influence the outcome of infertility treatment administered. By screening for affective temperament profiles, it would be possible to identify patient groups at high risk of drug non-adherence and then to aid adherence by applying patient-tailored treatment, including psychological interventions, which could increase the chances of successful pregnancy among women undergoing in vitro fertilization treatment.

None Declared

The aim of this study was to investigate the associations between smartphone and social media use and mental health outcomes among adolescents in Ireland.

This study aimed to fill a gap in the existing literature by examining specific types of online activity, such as cyberbullying and “sexting” (sending sexually explicit messages), and the independent associations of these activities with worse mental health.

This study is a cross-sectional analysis of secondary data from the 2023 Planet Youth Partner survey. The study population was 4,544 mostly 15- and 16-year olds from Cavan, Monaghan and North County Dublin. The dependent variable was the total Strengths and Difficulties Questionnaire (SDQ) score, a tool commonly used to assess mental health status. Independent variables included hours of social media use, experiences of cyberbullying, body image perceptions, and involvement in sexting. Multivariable logistic regression models were employed to determine the associations between these variables and mental health outcomes, controlling for potential confounders such as gender, sleep duration, and maternal education level.

The study found significant associations between several online activities and worse mental health. High use of social media (4 hours per day or more) was associated with a 62% greater risk compared to those who used it for about 1 hour or less.

Cyberbullying was a also strong predictor of poor mental health, with victims nearly twice as likely to have a high SDQ score. Negative perceptions of one’s own body image and participating in sexting were also significantly associated with worse mental health outcomes.

Gender differences were observed, with females more likely to be victims of cyberbullying, to be asked for and to send sexually explicit messages, and to have worse mental health outcomes when compared to males. Insufficient sleep was also a significant predictor, with those sleeping for 6 hours or less per night having more than twice the risk compared to those who slept for the recommended 8 hours or more.

The findings of this study suggest that specific aspects of smartphone and social media use, particularly high usage and negative online experiences, are independently associated with poorer mental health outcomes in adolescents. These results are consistent with international evidence and highlight the need for targeted public health interventions to mitigate the risks associated with this technology. The study recommends developing evidence-based guidelines for parents and teachers to promote healthier online behaviours among adolescents in Ireland. It also calls for a national Public Health campaign and policy measures to enforce stricter regulations on social media companies and protect young people from harmful online experiences.

None Declared

Affective disorders, including but not limited to major depressive disorder, bipolar disorder, and persistent depressive disorder, comprise a group of disorders characterized by clinically significant mood disturbances. Depression, which makes the most important contribution to the DALY index among all mental disorders, was the primary focus of this study. Physical activity, regardless of changes in body weight, has been shown to reduce symptoms of depression and the likelihood of a new episode of the disease.

This qualitative study aimed to explore the barriers to motivation for physical activity in patients with affective disorders.

This study comprised a qualitative investigation using semi-structured interviews with thematic analysis. Following ethical approval, a convenience sample of 10 participants with affective disorders was drawn: all of the sample were female, aged 18 years or older, with 69% falling into the 27–35 years age bracket. Diagnostic and clinical information were collected, and barriers to engagement in physical activity were explored. All interviews were recorded and transcribed verbatim.

Ten face-to-face qualitative interviews were completed and lasted between 30 and 60 min. The findings were summarized under the key thematic areas of Anhedonia, Fatigue, Lack of time, Fear of condemnation, and Embarrassment, illustrated by texts. The key thematic areas were further grouped under the overarching themes of 1. Personal characteristics and the influence of low mood: anhedonia and fatigue; 2. External factors: need more time; 3. Social factors: embarrassment and fear of condemnation. Then, the following barriers were identified: “Lack of Strength” barrier, “Lack of Time” barrier, and “Rejection of physical characteristics” (or self-stigma) barrier.

While small and exploratory, the study provides significant insights into the barriers to motivation for physical activity in patients with affective disorders. Although these findings are not generalizable to other populations or males with affective disorders, they offer valuable considerations for future research and interventions in this field. This study’s findings have profound implications for future psychosocial interventions for patients with affective disorders. By identifying and understanding the barriers to motivation for physical activity, it paves the way for more effective, individualized interventions, including those aimed at reducing self-stigma.

None Declared

Obesity is a growing problem in several developed countries and has a complex etiology in teenagers. Approximately one-third of children and adolescents in the United States are overweight or obese. However, it is not clear how depression and obesity are screened and treated in the primary care setting for adolescents.

This study aims to describe the prevalence, screening, and treatment rates for depression in adolescents in ambulatory settings in the United States.

Data on 444,080,295 male and female adolescents ages 13-18 were extracted from the 2008-2018 CDC National Ambulatory Medical Care Survey datasets. Adolescents were stratified by weight groups based on CDC guidelines (i.e., body mass index percentile).

Of the adolescents, 16.89% were obese, 13.81% were overweight, 43.39% were normal weight, and 25.91% were underweight. Depression screening rates in adolescents with obesity is 2.89%, overweight is 3.35%, normal weight 3.49%, and underweight is 2.83% (p=0.382). Prevalence of depression in adolescents with obesity is 7.17%, overweight is 6.04%, normal weight is 6.31%, and underweight is 12.14% (p<0.0001). Prevalence of counseling and psychotherapy in adolescents with obese status is 2.70%, overweight status is 2.89%, normal weight is 2.92%, and underweight is 11.27% (p<0.0001). Patients seen by primary care health workers, age, female gender, number of chronic conditions, and increased visits are significant predictors of depression diagnosis in adolescents.

Depression in adolescents who are overweight or obese is under-screened for, under-identified, and under-treated. More mental health counseling and psychotherapy must be offered to those with both depression and obesity.

None Declared

Recent evidence suggest the nosological entity called Schizo-Obsessive Disorder (SchizoOCD), similar to Schizoaffective Disorder. Some authors argued that obsessions and delusions would be on a continuum, which justify the difficulty in distinguishing obsessive from delusional thoughts, and compulsions from stereotypical behaviors. In order to assist in the screening, monitoring or treatment of such disorders, instruments as scales and questionnaires may be important tools in psychiatric practice.

This systematic review investigated the most frequent instrumentsused to assess SchizoOCD.

We systematically reviewed articles up to 2015 in English, Portuguese and Spanish at PubMed, Scielo and Embase databases. We included studies with humans, no age limitation, with OCS or diagnosis of OCD and schizophrenia or psychotic symptoms. Systematic review articles, meta-analysis, letters to the editor and case reports were excluded, as well as articles that did not use assessment instruments for the diagnosis of schizophrenia comorbid with OCD. The methodological and clinical data extracted from the articles are described at the results.

A total of 9,833 articles were selected, but 53 were read. Cross-sectional studies were the most frequent (n=39; 73.6%), followed by cohort studies (n=9; 17.0%).The total sample size of Schizo-OCD patients was 2,605 patients (in 44 studies), of which 44.7% (n=1,164) were female. The mean age and the age of onset of the disorders are described in Table 1. Only 23 (44.4%) of the studies described the psychiatric comorbidities (2 (3.8%) studies reported that the patients had no comorbidities). The most frequent comorbidities were Major Depression (n=18; 34%) and Substance Use Disorder (n=9; 17.0%). The used diagnostic instruments or interviews are listed in Table 2. Table 3 describes the scales used to assess the severity of Schizophrenia and/or OCD symptoms. From a psychopathological point of view, only 9 (17.0%) of the articles described psychotic symptoms in more detail. For OCD, 15 (28.3%) of the articles detailed the obsessive-compulsive symptoms.

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Few studies in the literature used scales to discriminate psychotic and obsessive-compulsive aspects in patients with the alleged diagnosis of Schizo-OCD. Scales for measuring symptom severity such as PANSS and YBOCS were widely used in the studies, indicating that their application in clinical practice can serve as an aid during treatment management. Specific scales and instruments for Schizo-OCD were not found and we suggest as a future perspective the development of a new tool to assess symptoms and to elucidate possible symptomatic confusions.

None Declared

Trichotillomania (TTM) and Major Depressive Disorder (MDD) are two psychiatric conditions that frequently co-occur, presenting a significant challenge for treatment due to their complex interplay. TTM involves repetitive hair-pulling, leading to noticeable hair loss and distress, while MDD is characterized by persistent low mood and loss of interest or pleasure leading to dysfunctionality.

This case report aims to discuss a case of a 21-year-old female with major depressive disorder and trichotillomania, management challenges, and the importance of a comprehensive, multifaceted therapeutic approach to address both disorders effectively.

A 21-year-old female college student and youth church leader presented with chronic hair-pulling and depressive symptoms. She had low self-esteem and a strong need for validation. Despite her responsibilities, she struggled with emotional distress exacerbated by family dynamics and her church role. Her symptoms were linked to self-esteem threats and feelings of inadequacy. She was diagnosed with Trichotillomania, Scalp, and Major Depressive Disorder.

Initial pharmacologic management was Fluoxetine 20mg/day up titrated to 40mg/day with no improvement hence shifted to Escitalopram 20mg/day and N-acetylcysteine 1200mg/day with noted significant improvement in symptoms. Non-pharmacologic strategies included supportive-expressive psychodynamic psychotherapy, cognitive-behavioral techniques, and family therapy. Psychoeducation, suicide safety planning, and an interprofessional approach with dermatology co-management were also integral.

Over the course of 15 therapy sessions, the patient demonstrated significant improvement in both her depressive symptoms and hair-pulling behavior. Her active engagement in therapy, combined with pharmacological support, facilitated better emotional regulation and a more cohesive sense of self. Her adherence to the treatment plan, along with the collaborative efforts of the interprofessional team, contributed to her positive outcomes.

This case highlights the significance of addressing both TTM and its comorbid conditions for effective treatment outcomes. The interplay between TTM and MDD underscores the need for comprehensive treatment plans incorporating pharmacological and psychotherapeutic approaches. Future practice should consider the benefits of an interprofessional approach for managing complex cases like this.

None Declared

Clozapine, traditionally prescribed for treatment-resistant schizophrenia, has shown potential for off-label use, particularly in affective and personality disorders characterized by severe impulsivity, nonsuicidal self-injury (NSSI), and suicidality (Delgado et al 2020, Journal of psychiatric research, 125, 21-27). Emerging evidence suggests that clozapine’s unique pharmacodynamic profile (serotonergic activity and high affinity for D4R, α1R, H1R) may contribute to reducing aggression and impulsivity and offer therapeutic benefits for borderline personality disorder (BPD). This is particularly relevant given the high suicide risk in BPD patients, with an estimated annual rate up to 10%, 50 times higher than the general population. Despite this, current treatment guidelines for BPD typically limit pharmacological interventions in favor of psychotherapeutic approaches (Pascual JC et al Int Clin Psychopharmacol. 2010, 25(6), 349-55). However, clozapine’s ability to modulate impulsivity and emotional dysregulation could provide a valuable adjunct in the treatment of this complex disorder.

To evaluate the efficacy of clozapine in reducing impulsivity, emotional dysregulation, and suicidality in patients with BPD.

The study cohort consisted of 47 patients (29 women) with a mean age of 28 years (IQR: 22-44), all diagnosed with BPD resistant to previous pharmacological treatments. Clozapine was introduced after a comprehensive risk-benefit assessment. At baseline, 96% of patients were taking mood stabilizers or anticonvulsants, 87% were taking SSRI/SNRI antidepressants, 81% were taking antipsychotics, and 66% were taking other medications such as benzodiazepines or gabapentinoids. Clinical assessments using the RIPoST-40, MOAS, and Columbia scales were administered at baseline, one week (T1), one month (T2), and three months (T3). Data were analyzed using repeated measures ANOVA and Friedman’s test with significance set at p<0.01 after Bonferroni correction.

Significant reductions in all scores were observed at T3: RIPoST-40 scores decreased by 40.15% (p<0.0001), MOAS by 58%(p<0.0001), Columbia Scale scores by 70.20% (p<0.0001). At month 3, clinical response, defined as a ≥50% reduction in scores, was achieved by 11% of patients on the RIPoST-40, 70% on the MOAS, and 94% on the Columbia Scale.

Clozapine demonstrated significant reductions in impulsivity, emotional dysregulation, and suicidality in patients with BPD, with rapid improvements observed within the first week and sustained through 3 months. These findings suggest that clozapine, in combination with psychotherapy, may be an effective treatment strategy for the most severe symptoms of BPD. Further prospective studies with larger cohorts are needed to validate these preliminary results and to assess the long-term safety and efficacy of clozapine in this population.

None Declared

Accidents, whether minor or severe, can have significant psychological impacts, especially in elderly populations. Stress related to accidents often exacerbates pre-existing conditions or leads to new mental health challenges such as anxiety, depression, or post-traumatic stress disorder (PTSD). The psychological impact of accidents on elderly individuals is often compounded by physical frailty, social isolation, and diminished coping mechanisms. Following an accident, elderly individuals may face prolonged recovery periods, limited mobility, and a reduced sense of independence, all of which can heighten stress levels. Additionally, the fear of future accidents may lead to avoidance behaviors, further isolating them from social interactions and routine activities, thus exacerbating anxiety and depression. Pre-existing mental health conditions, such as mild cognitive impairment or chronic illness, can worsen under accident-related stress.

This study aims to explore recent trends in understanding and addressing accident-related stress in elderly individuals, focusing on the psychological, social, and physiological factors contributing to their vulnerability. The primary objective of this study is to examine the psychological, social, and physiological factors that increase the vulnerability of elderly individuals to accident-related stress.

A mixed-methods approach was used, combining a systematic review of literature from 2015 to 2024 and interviews with mental health professionals. The sample consisted of 30 peer-reviewed studies and 25 elderly individuals aged 65 and above who had experienced accidents within the last year. Studies were selected based on relevance to accident-related stress in the elderly, with an emphasis on post-accident psychological outcomes and interventions.

Results indicated that the elderly are more susceptible to prolonged stress responses following accidents due to physical fragility, social isolation, and reduced coping mechanisms. The review also highlighted an underutilization of mental health services in this demographic, despite the availability of stress-reduction programs. Furthermore, findings showed that older adults who participated in targeted mental health interventions, such as cognitive-behavioral therapy and peer support groups, experienced better outcomes in managing stress compared to those who did not.

In conclusion, accident-related stress in the elderly presents unique challenges that require specialized attention. Healthcare providers should prioritize early identification and tailored interventions to mitigate the long-term psychological effects of accidents in this vulnerable population.

None Declared

Suicide remains a major cause of death in prison (Status report on prison health in the WHO European Region 2022). In comparison with adults from general population, incarcerated people are at increased risk of presenting suicide-related behaviours (Fazel S, et al. Lancet Psychiatry 2017; 4 946–52). Although certain studies have identified effective programs to reduce suicide in prison context (Carter A, et al. EClinicalMedicine 2022; 44 101-266), there is little evidence examining the relationship between moderators of effectiveness at individual and contextual levels.

This study aims to review empirical research on moderators of effectiveness of interventions in prison to reduce suicide, summarizing effect sizes across studies.

For this systematic review and meta-analysis, we searched EBSCOhost, ScienceDirect, PubMed and ProQuest for articles published from 1990 to 2024. Elegible studies included those evaluating the effect of psychological interventions, delivered to adults during incarceration, on suicidal prevention. The impact of moderators covering bibliometric features (i.e. year of publication, country), methodological features of the study (i.e. sample size, mean age of participants, sex ratio, study design, assessment type and tools), suicide-related features (main outcome, previous suicide history), and other relevant variables (prison type and location, type and length of sentence) as well as psychological traits (alcohol or drugs misuse or other treatments) were also included. This review was conducted in accordance with PRISMA guidelines. Meta-analyses using random-effect models were used to pool effect sizes for moderators’ outcomes. The protocol was pre-registered with PROSPERO, CRD42024538967.

Of 7728 articles retrieved, 18 studies (1695 participants, 330 [19.5%] females, 756 males [44.6%], and 609 [35.9%] unknown) met the inclusion criteria. Mean ages were 32·0 years, and ethnicity data was not sufficiently reported to be aggregated. Type of prison was mostly public sector and located in rural areas. Studies were frequently conducted in UK (n=8; 44%) and used varying study designs; most frequently pre-post with no control group (n=9; 50%). On average, prevention programs in prison context were effective in decreasing suicide deaths, suicidal ideation and self-harm (n=14; 78%).

Findings suggest that explanations for efficiency of psychological interventions to prevent suicide behaviour and self-harm in prison context, are moderated by physical environment, individual and psychosocial factors. Future research identifying what factors moderate treatment outcomes in suicide and self-harm prevention within prison environments could help elucidate associated factors of efficiency, helping develop potential therapeutic actions.

None Declared

Adults with intellectual and developmental disabilities (IDD) have higher rates of psychiatric disorders, such as depression, anxiety, and bipolar disorder, compared to the general population. Unique challenges, like cognitive impairments and communication barriers, require tailored treatments. This poster reviews strategies for managing these conditions in adults with IDD, focusing on adaptations in psychopharmacology and psychotherapy.

To outline treatment approaches for depression, anxiety, and bipolar disorder in adults with IDD, highlight limitations and necessary adaptations, and advocate for collaborative treatment models involving healthcare providers and caregivers.

A literature review identified studies and guidelines on psychopharmacologic and psychotherapeutic interventions tailored to adults with IDD, examining the effectiveness of pharmacological agents, cognitive behavioral therapy (CBT), and other adaptations.

Current treatments for depression, anxiety, and bipolar disorder in adults with intellectual and developmental disabilities (IDD) often deviate from standard protocols, requiring modifications in both pharmacological and therapeutic approaches. Depression management in IDD typically relies on selective serotonin reuptake inhibitors (SSRIs), adapted with gradual dose escalation and close monitoring due to limited data on their specific effects in this population. Psychotherapy, particularly group cognitive behavioral therapy (CBT), has shown notable efficacy, with studies reporting significant symptom reduction in treated groups. For anxiety disorders, low-dose SSRIs remain the primary pharmacological option, with cautious titration to minimize adverse effects, while benzodiazepines are generally avoided to prevent paradoxical responses and disinhibition. CBT-based interventions, including graduated exposure therapy customized for specific phobias or triggers, show promise, though further randomized trials are warranted. Managing bipolar disorder in IDD is particularly challenging due to the heightened risk of severe functional impairment and symptom overlap, with mood stabilizers like lithium and antipsychotics administered sparingly given potential metabolic and neurological side effects. Given limited research, clinical strategies often rely on individualized treatment plans informed by provider expertise and patient-specific needs.

Treatment for psychiatric disorders in adults with IDD requires significant adaptation, with careful dosing and monitoring of medications to minimize adverse effects. Evidence supports CBT as an effective option, yet there is a critical need for more research, especially randomized trials, to develop more robust guidelines specific to this population. Close collaboration between healthcare providers and caregivers is essential for successful outcomes.

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