Children born to mothers with mental health disorders are at a significantly increased risk of developing insecure attachment patterns.

Demonstrate with clinical case that mothers with schizotypal personality disorder tend to be less sensitive and responsive, and more intrusive in their interactions and caregiving (Høivik et al. BMC Psychiatry Int 2018; 18, 198; Willinger et al. ANZJP Int 2002, 36, 5; Vebeke et al. al. APA Int 2017, 8 54-63; Ripoll et al.).

The clinical case presented below highlights functional decline in a woman with schizotypal personality disorder during pregnancy and the transition to motherhood.

The 39-year-old mother of a 16-month-old son, employed as a saleswoman, has been in outpatient psychiatric treatment for 6 years. She has been hospitalized 6 times, 4 of which occurred in the year after childbirth.

Her psychiatric history began at age 33, when she was first admitted due to an impulsive outburst, involving aggression toward objects. Psychological evaluation revealed impulsivity alongside paranoid ideation. Treatment (aripiprazole, quetiapine, and paroxetine) led to clinical improvement, and she continued psychotherapy for psychosis. For 5 years, she maintained regular employment, entered a relationship, and became pregnant, at which point she discontinued pharmacotherapy.

At 32 weeks of pregnancy, she became disorganised, refusing food and gynecological examinations, leading to psychiatric hospitalization. A combination of haloperidol, quetiapine, and lorazepam stabilized her condition, although negative symptoms, cognitive impairments and schizotypal features persisted. She gave birth to a healthy son via planned cesarean section and continued postnatal care under a psychiatrist and clinical psychologist.

Within the year postpartum, she experienced 4 additional hospitalizations, primarily due to mood destabilization linked to non-adherence to oral and depot pharmacotherapy. Each time, her condition improved upon reintroduction of therapy. By her penultimate discharge, a social coordinator was appointed, as she struggled with childcare, expressing emotional detachment from her child. Her fourth hospitalization was characterized by disorganization and impulsivity, after which she ended her relationship with her partner. Currently, she resides with her mother and remains on quetiapine, clozapine, and aripiprazole. With her consent, her partner and his mother assumed childcare responsibilities. The patient reports feeling emotionally relieved and stable, and has agreed to resume depot pharmacotherapy.

This case underscores the importance of early identification and timely intervention in perinatal psychiatry. Effective treatment of maternal mental illness, doesn’t necessarily lead to secure attachment formation between mother and child, nor does it guarantee better cognitive or socio-emotional outcomes in the offspring.

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Military personnel, faced with stressful and often extreme situations, can develop psychiatric disorders which require specific management to maintain both their well-being and the operational effectiveness of units. These disorders pose significant challenges for the assessment of their fitness for military service.

To study the impact of psychiatric pathologies on fitness for military service.

This was a retrospective study of a descriptive nature, from January 1, 2023 to August 30, 2024, which was conducted among military personnel referred to the occupational pathology consultation at the Military Center for Occupational Medicine and Professional Safety in Tunis to assess their fitness for duty due to psychiatric disorders.

During the study period, 42 patients were included, with a mean age of 38 ± 10 years, all male. The study population was divided into non-commissioned officers (45.2%), unlisted men (40.5%) and officers (14.3%), 44.5% of whom belonged to the army, 19.4% to the navy, 11.1% to the air force and 25% to the joint services. The ranks most affected by psychiatric pathologies were the first-class soldier at 21.4%, the master corporal and the warrant officer at 16.7% each. The most common specialties were infantry and transport at 28.6% and 11.9% respectively. The most common work positions were administrative officer (19.1%) and infantryman (9.5%). The predominant pathologies were anxiety-depressive syndrome in 31% of cases, depression in 26.2%, anxiety disorder in 14.3% and post-traumatic stress disorder in 11.9%. Eighty-one percent were exempted from carrying weapons, 57.1% from guard duty and 2.4% from field trips, with an average exemption duration of 5 months. All requests for exemption were accepted, of which 22% led to a reform file, 14% to psychiatric care, and 5% to a notice of fitness for military service. A change of specialty was indicated in six cases, all of them to an administrative position.

Psychiatric disorders strongly affect fitness for military service, leading to exemptions and changes of specialty. Enhanced psychological care and rigorous follow-up are essential to preserve the operational effectiveness and well-being of military personnel.

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Bilateral pallidodentate calcinosis (BPC), also known as Fahr’s disease, is an uncommon neurodegenerative disorder that may be either genetic or sporadic. It is distinguished by bilateral and symmetrical deposits of calcium in the basal ganglia and occasionally in the cerebral cortex, impacting the regulation of motor and cognitive functions.

To underline the diagnostic pitfalls faced in Fahr’s disease when psychotic manifestations are predominant, thereby emphasizing the need to integrate neuroimaging and diagnostic assessments in differenciating this disease from a primary psychotic disorder.

We present a rare case of Fahr’s disease with an atypical initial presentation, where the condition was initially misdiagnosed due to predominant psychiatric symptoms.

The patient, a 34-year-old man, displayed significant behavioral disturbances and cognitive decline since the age of 30. Initial psychiatric assessments identified a delusional syndrome, hallucinatory episodes, and psychomotor agitation, leading to a provisional diagnosis of a primary psychotic disorder. However, neuroimaging subsequently revealed bipallidal calcifications characteristic of Fahr’s disease, and further diagnostic evaluations (neurological examinations, a determination of parathyroid hormone (PTH) levels along with a comprehensive calcium-phosphate evaluation) confirmed the condition.The patient was treated symptomatically with second-generation antipsychotics, alongside supportive therapy, resulting in partial symptom alleviation.

This case underscores the challenges of diagnosing Fahr’s disease when psychiatric manifestations predominate, which can delay appropriate diagnosis and treatment. Continuous, multidisciplinary follow-up is essential for optimal management of psychiatric symptoms.

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Physical and/or psychological trauma may contribute to the onset of type 1 diabetes. Forensic medicine experts recognize post-traumatic diabetes in rare cases that meet specific criteria, including the severity of the trauma, its occurrence within a short timeframe before diabetes onset, and the absence of prior diabetes indicators.

This study aims to describe the clinical and biological characteristics of post-traumatic diabetes, with particular emphasis on the psychiatric aspects.

This retrospective, cross-sectional study analyzed cases of patients hospitalized for acute diabetes following physical or psychological trauma. The diagnosis of post-traumatic diabetes was based on the criteria of French forensic experts: acute autoimmune diabetes, trauma occurring within six months before diagnosis, and no signs suggesting pre-existing diabetes. Autoimmune involvement was confirmed by the presence of anti-pancreatic antibodies, specifically anti-glutamic acid decarboxylase (GAD) and/or anti-tyrosine phosphatase IA2.

The study included 10 patients (8 men and 2 women) aged between 17 and 47 years (mean age 29.5±11 years). Family history of autoimmune disease was present in 40% of cases, and type 2 diabetes in 60%. The average body mass index was 24±6 kg/m², with obesity in 30% of cases. The mean blood glucose at admission was 14.54±3.48 mmol/L, and the average HbA1C was 6.51±0.56%. Anti-GAD antibodies were present in all patients, while anti-IA2 antibodies were detected in 20%. Clinically, 60% of patients presented with ketosis, and 40% with ketoacidosis. Psychiatric trauma, including grief in 3 patients and divorce in 2 patients, was the triggering factor in 50% of cases. All patients required insulin therapy upon admission, with obese patients receiving additional metformin.

This study supports the hypothesis of post-traumatic diabetes, particularly in cases of severe psychiatric trauma. Although scientific literature remains inconclusive, the role of stress in the onset of diabetes warrants further investigation due to the heterogeneity of findings regarding stress episodes preceding diabetes development.

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Borderline personality disorder (BPD) is characterized by important attachment issues and emotion dysregulation, particularly in response to psychosocial stressors. Emotions (mainly anger and sadness) may therefore be felt and expressed more intensively. Even though stress response is mainly regulated by cortisol, oxytocin is also involved in this response, and both hormones interact in a temporal dynamic. A previous pilot study carried-out by our group has shown that oxytocin displays less variation in naturalistic setting and lower reactivity during a stress task in patients with BPD when compared to healthy subjects.

We are now carrying out a larger-scale study to better understand the interplay between cortisol and oxytocin in every-day life and during stressful situations, but also which other factors may influence these hormonal changes like medication, hormonal contraceptives, childhood adverse events and other psychiatric comorbidities.

We aim to recruit 120 participants (60 per group). Each participant undergoes three visits. First visit: explanation of the global procedure and risks, signature of informed consent, as well as psychological screening and distribution of questionnaires and salivettes (to be returned during the second visit). Second visit: return of questionnaires and return of part of the salivettes collected during the morning + additional saliva sample and assessment of emotional state. Third visit: experimental procedures and return of remaining samples of salivettes collected in the previous days for circadian assessment (the afternoon of the second visit). Thus, the day of the third visit participants perform an experimental task, the Trier Social Stress Test (TSST), involving stress reactivity.

Currently, 28 BPD patients and 39 healthy controls completed protocol. We analyzed hormonal preliminary data of the first 20 participants of each group. Our initial analyses showed a hyporeactivity of cortisol during stress in BPD patients compared with healthy subjects (F= 5.27, p = .005).

Recruitment is still ongoing and further analyses will be conducted. Our study may offer a better understanding of the neurobiological underlying stress dysregulation in BPD, which may help to contribute to the development of new psychotherapeutic and pharmacological approaches.

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Schizophrenia and bipolar disorder are severe psychiatric disorders influenced by genetic and environmental factors, sharing clinical features, risk factors, and genetic predispositions. Cognitive impairment is a central aspect of both disorders, affecting various domains like memory, attention and executive function. Distinguishing disorder-specific cognitive impairments from those shared across psychoses is challenging. Research on Clinical High Risk (CHR) and Familial High Risk (FHR) populations is vital for identifying cognitive impairments related to vulnerability. CHR populations exhibit cognitive changes, but the evidence on FHR populations remains less clear, even though offspring of individuals with severe mental disorders face a high risk of developing these conditions.

This study aims to perform a meta-analysis of neurocognitive functioning in offspring of individuals with affective psychoes and non-affective psychoses, compared to healthy controls (HC-Off). This meta-analysis seeks to improve statistical power of individual studies and offer more reliable estimates of cognitive deficits related to genetic vulnerability to psychotic disorders.

Following PRISMA, MOOSE, and EQUATOR guidelines, a systematic literature search was conducted up to December 12th 2023. Articles were screened, and those relevant were assessed for eligibility. The inclusion criteria focused on original studies comparing neurocognitive performance between offspring of individuals with affective or non-affective psychoses and healthy controls. The primary outcome was the difference in performance across neurocognitive domains. Meta-analyses were conducted on the overall sample and separately for affective and non-affective offspring, using a random-effects model.

Within the analyzed domains, individuals with affected parents performed significantly worse in every domain in comparison with control group, except in Motor Functioning domain. When studied separatley, offspring of parents with affective psychosis showed significant cognitive impairments in visual and verbal learning, processing speed, and memory, with smaller deficits in other domains. In contrast, offspring of parents with non-affective psychosis exhibited more severe impairments. Social cognition and motor functioning were less affected in both groups.

Key deficits in learning, memory, and general intelligence highlight the potential for these cognitive domains to serve as markers of vulnerability to psychosis. While both groups of offsrping show impairments, the more pronounced deficits in the non-affective group indicate a distinct cognitive risk profile. These insights may inform early interventions tailored to the specific cognitive challenges faced by high-risk populations.

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Neurodevelopmental disorders are prevalent worldwide, with an increase in diagnoses in recent years (Faraone et al. Neurosci Biobehav Rev. 2021; 789-818; Russel et al. J Child Psychol Psychiatry 2022; 674-682). Individuals diagnosed with conditions such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Specific Learning Disorder (SLD) and Language Development Disorder (DLD) are considered neurodivergent and constitute the so-called neurominorities (Doyle, N. British medical bulletin 2020; 108-125). Studies have shown that adults with ADHD and ASD have lower scores when assessed for quality of life, compared to neurotypicals (Pinho et al, J Atten Disord 2019; 1736-1745; Sáez-Suanes & Álvarez-Couto, Rev J Autism Dev Disord 2022; 307-319).

The present study aims to describe the quality of life of neurodivergent students.

The research was cross-sectional, prospective and quantitative. The project was approved by the Research Ethics Committee. A total of 79 neurodivergent university students from public and private universities in the State of São Paulo participated in the research. The study was carried out remotely through the Google Forms platform with application of the TCLE and WHOQOL-DIS instruments.

It was observed that 30% of the participants had a diagnosis of ASD, while 48% had ADHD, 8% had ADD, 14% had ASD with ADHD and none had a diagnosis of DLD or SLD. It is worth mentioning that in the questions about quality of life and health, 18% were dissatisfied. Regarding the ability to perform tasks, 13% reported that physical pain prevented them and 70% reported needing medical treatment. Regarding levels of personal satisfaction, 37% said they were dissatisfied with their sleep, 20% were not satisfied as a person and 28% scored completely dissatisfied with access to health services. Regarding well-being and neurodivergence, 30% of the participants were completely unhappy and 15% stated that their limitation had a negative effect on their life. Regarding autonomy, belonging, and self-perception, 23% reported total dissatisfaction with their communication skills and 41% stated that they were completely dissatisfied with their involvement in social activities. Finally, regarding strengths and weaknesses, 32% of the subjects reported not being at all satisfied with their work opportunities, 29% were in the same situation regarding the adaptations of the environment to their limitations, and 14% reported dissatisfaction with study opportunities.

This study was able to analyze the perspective on the quality of life of neurodivergent university students. However, due to the various biases that involve this population, it is necessary to seek broader answers, looking at the national scope to provide a better understanding of quality of life, including in the academic environment.

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High-stress levels can be problematic for teachers and indirectly affect students. Knowledge about the prevalence and predictors of high-stress and low resilience will provide information about the extent of the problem among teachers in Canada.

To examine the prevalence and correlates of perceived stress and low resilience among Alberta, Nova Scotia, Newfoundland and Labrador teachers.

This is a cross-sectional study. Participants self-subscribed to the Wellness4Teachers text-messaging program and completed the online survey on enrollment. Data collection occurred from September 2022 to August 2023. Resilience and stress were respectively assessed using the Brief Resilience Scale (BRS) and the Perceived Stress Scale (PSS-10). Data was analyzed with SPSS version 28.

A total of 1912 teachers subscribed to the Wellness4Teachers program, and 810 completed the baseline survey, yielding a response rate of 42.40%. The prevalence of high stress and low resilience were respectively 26.3%, and 40.1%. Participants with low resilience were 3.10 times more likely to experience high-stress symptoms than those with normal to high resilience (OR = 3.10; 95% CI: 2.18–4.41). Conversely, participants who reported high stress were 3.13 times more likely to have low resilience than those with low to moderate stress (OR = 3.13; 95% CI: 2.20–4.44).

Our study findings infer there’s an incidence of high levels of stress and low resilience among teachers in the three Canadian provinces. Governments and policymakers in the education field should integrate stress management and resilient building strategies into teachers’ ongoing professional development programs to help prevent and address high stress.

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The life journeys of women who have experienced childhood violence are often marked by great complexity. This study aimed to better understand the links between childhood trauma and the development of substance use disorders, in order to propose therapeutic interventions tailored to the specific needs of these women

identify the most frequent types of trauma and their frequency in the studied sample. To describe the most commonly used substances, patterns of use, and the severity of substance use disorders.

sample of 53 women who frequented harm reduction centers participated in this study. The Childhood Trauma Questionnaire (CTQ) was employed to evaluate experiences of childhood trauma, while the Drug Use Disorder Identification Test (DUDIT) was utilized to assess the severity of substance use disorders. Data collection was conducted anonymously, and subsequent analysis was performed using statistical software spss.

In our study, 53 women consulting risk reduction centers met the inclusion criteria.

• - A history of childhood trauma (CTQ ≥ 35) was observed in 92.5% of cases (n=49). Severe trauma scores were found in:

• - 45% for emotional neglect

• - 23% for physical neglect

• - 51% for emotional abuse

• - 59% for physical abuse

• - 21% for sexual abuse

• - A drug dependence (DUDIT ≥ 2) was observed in 72% of cases (n=38), i.e., all women in the study who used psychoactive substances. The most frequent dependencies were related to cannabis (53%), followed by benzodiazepines (41%) and pregabalin (36%).

• - Injectable drug use was observed in 23% of cases, with Subutex being the most common (n=10; 5%). Two women used heroin (1%).

These results highlight the importance of integrating a trauma-informed approach into the care of women with substance use disorders. Specific therapies, such as trauma-focused cognitive-behavioral therapy (TF-CBT), can be particularly beneficial in helping these women manage their post-traumatic symptoms and reduce their substance use.

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The relation between thyroid function and depression has long been recognized. However, studies analyzing coexistence of thyroid dysfunction and suicidal behavior still offer contradictory results. Thyroid hormones that may play an important role in suicidal behavior have not been thoroughly investigated in the sample of individuals with comorbid anxiety and mood disorders (AMD).

The aim of this cross-sectional study was to identify potential associations between thyroid function and suicide attempts (SA) in individuals with AMD.

This study comprised 147 consecutive participants (mean age 42.4±13.1 years; 69% women). Thirty-five percent (n=51) of the sample was hospitalized after a suicidal attempt, 34 percent (n=50) patients with AMD and without a history of SA, and 31 percent (n=46) individuals without a life time history of mental disorders or suicidal attempt (control group). All participants were interviewed for current psychiatric diagnoses and suicidal behavior using the Mini International Neuropsychiatric Interview. The biochemical blood tests were performed for the concentrations of free thyroxine (FT4), free triiodothyronine (FT3) and thyroid stimulating hormone (TSH). All data were reported as means, standard deviations, or medians (interquartile range [IQR]). Analysis of variance (ANOVA), chi-square test, independent samples t-test, Kruskal-Wallis test, were used for the group comparisons. Multivariable logistic regression analyses were used to assess the associations between thyroid hormones parameters and SA.

All participants had serum FT4, FT3 and TSH level within normal range. Patients with AMD and SA were more likely to be younger than patients with AMD only and the control group (36.1 ± 13.6 vs. 41.5 ± 11.9 and 48.4±12.1 years; p<0.001). There were no significant differences according to gender, BMI, mean values of TSH and FT4 between groups. In our study, FT3, but not the other thyroid axis hormones, was independently associated with suicidal behavior. Patients with AMD and SA had lower FT3 levels in comparison to patients with AMD without SA and the control group (5.20 (0.65) pmol/L vs. 5.52 (0.62) and 5.65 (0.71, p=0.005)).

A multivariable logistic regression revealed that FT3 levels of female SA were significantly lower than non-attempters (4.92 (0.64) pmol/L vs. 5.42 (0.71), p=0.029) and significantly lower than male-attempters (5.61 (0.61), p<0.001). We not found any significant differences with regard to FT3 levels between male SA and non-attempters and controls.

Lower FT3 concentrations, even within the normal reference range, were related to SA in female gender, but not male. This finding supports the importance of evaluating FT3 levels in clinical decision-making on suicide risk of patients with AMD.

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Over the past 30 years, cytokines have been extensively studied in relation to neuroplasticity, modulation of neuro-signaling, and various psycho-immunological aspects of depression. Interferon gamma (INF-γ) is traditionally recognized for its pro-inflammatory role, but it also possesses regulatory functions by antagonizing Transforming Growth Factor beta (TGF-β). TGF-β acts as an anti-inflammatory and regulatory cytokine. The interaction between these cytokines remains inadequately explored in patients with depression.

The aim of our study was to analyze the differences in serum concentrations of INF-γ and TGF-β between patients with Major Depressive Disorder (MDD) and healthy controls.

Blood samples were obtained from 55 patients who met the DSM-IV-R criteria for a current MDD episode without psychotic symptoms, and from 45 healthy controls, matched for age and gender. Participants were assessed using the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HDRS). Serum concentrations of INF-γ and TGF-β were determined using enzyme-linked immunosorbent assays.

The concentration of TGF-β was significantly higher in patients compared to healthy controls, while no differences were observed for INF-γ between the groups. Moreover, INF-γ concentrations were statistically higher in patients with more severe depression, as measured by HDRS and BDI. TGF-β levels increased with severity only as assessed by HDRS. Among various factors (sociodemographic, clinical, and hereditary), INF-γ was positively correlated solely with the number of hospitalizations, whereas TGF-β levels correlated with the duration of treatment and symptoms.

The interplay between TGF-β and INF-γ is frequently considered a crucial component of the inflammatory hypothesis in depression. Further research is needed to understand why concentrations are elevated in patients with more severe forms of depression, yet show no correlation with other clinical or sociodemographic factors.

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Symptoms of schizophrenia are associated with dysregulation of the dopaminergic systems of the central nervous system. Negative symptoms, including those related to emotions and mood, result from reduced activity in the mesocortical system, while positive symptoms result from increased activity of the mesolimbic system. Disorders in the reward system, composed of dopaminergic neurons, play an important role in the pathogenesis of addiction development. Nicotine activates the presynaptic parts of the neurons that make up the system to secrete dopamine, which translates into a feeling of pleasure and stimulates the development of addiction.

The aim of the study was to demonstrate the relationship between the degree of development of nicotine and the severity of symptoms related to emotions and mood with patients suffering from schizophrenia.

The study involved 75 patients diagnosed with schizophrenia (F.20 according to ICD-10). The study was conducted from October 2023 to September 2024 in CZPiLU in Gliwice. During the study, the Frankfurter-Bejindlichkeits-Skala was used to assess the appearance and severity of symptoms related to emotions and mood. The analysis of the development of addiction was made possible by the Fagerström Test for Nicotine Dependence.

Based on statistical analysis, a significant relationship was noted between the severity of addiction to nicotine and the presence or absence of symptoms related to well-being. In addition, a correlation (p<0,001) was noted between the degree of nicotine and the severity of symptoms related to emotions and mood. Patients with strong negative symptoms of schizophrenia developed a high level of addiction to nicotine (p=0,001), while those with mild (p=0,001) or moderate symptoms (p=0,005) related to well-being achieved lower scores on individual addiction scales. All patients included in the study had at least a mild level of addiction to nicotine.

The presence of schizophrenia symptoms related to well-being has a significant impact on the initiation of addiction development to nicotine. Furthermore, the level of advancement of symptoms related to emotions and mood translates into the severity of nicotine, especially in the group of patients in whom strong negative symptoms translate into a high level of addiction advancement. Patients suffering from schizophrenia require psychological and psychiatric care and diagnostics for addictions and appropriate prevention before their development.

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Dissociative experiences are considered typical esketamione’s side effects. Several investigations have have shown that ketamine/esketamine-induced dissociation may be linked to improved responsiveness, although other studies have not supported this association. Despite these controversial findings, it’s possible that dissociative experiences are crucial to the antidepressant effects, at least in specific subtypes of depression. In fact, current understanding of the therapeutic potential of ketamine (the anaesthetic from which esketamine is derived) converges on the so-called “relaxed prior hypothesis”, suggesting that glutamatergic blockade up-weights bottom-up surprising somatosensory/affective states. Consequently, ketamine improves short-term plasticity in depression by enhancing sensitivity to interoceptive signals.

This study describes and discusses two case studies in which the experience of esketamine dissociation was particularly effective in enhancing antidepressant effects.

We selected 2 case studies for their paradigmatic description of “depersonalised depression” (Entfremdungsdepression). Patients were interviewed both 4 weeks before and at the peak of esketamine effects during a 6-month treatment. Following a neurophenomenological approach, we combined subjective reports from unstructured clinical interviews with review of previous objective neuroimaging results and neurocomputational models to elucidate the relationship between esketamine’s effects and interoceptive sensitivity. Patients were administered the HAM – D at T0 and T6 and the Dissociative Experience Scale (DES-II) and the Structured Clinical Interview for Depersonalization-Derealization Spectrum (SCI-DER) at T0.

According to our observations, esketamine-induced dissociation may be particularly effective in the depersonalised depression subtype, in which interoceptive awareness and interaffectivity are significantly impaired. In particular, disembodiment may suspend previously acquired patterns of feeling, perception and behaviour. As previously described by Richard Yansen, ketamine disrupts the assertion of bodily tensions so that they cannot tighten in the way they used to tighten, and they cannot hold back emotionally in the way they used to hold back: then many of the feelings behind the armour can pour out with a softening, cathartic release. Our patient D.P. sketches this phenomenon nicely when he says that “esketamine makes you change your own personal attitude, your own grammar”.

Consistent with previous findings, we suggest that esketamine-induced disembodiment allows for a temporary window of psychological plasticity and heightened sensitivity with the body regaining its permeability to affective affordances. Future research should address the relationship between esketamine-induced disembodiment, sensitivity to interoceptive signals, and depression outcomes.

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Physical activity can be therapeutically effective in the treatment of depressive disorders. There is a need for research in clinical practice both with regard to the framework conditions required for physical activity and whether the implementation of sports therapy under the conditions of everyday care can have an effect on physical fitness and depressive symptoms. This study therefore examines the effect of sports and exercise therapy in the day-care treatment of unipolar depression.

• - treatment of depressive disorders

• - implementation of sports therapy under the conditions of everyday care

Patients with a depressive disorder as their main clinical diagnosis (F32./F33.) who underwent day clinic treatment for 5-11 weeks were included. People in the intervention and control groups completed a minimum of 2.0 and a maximum of 0.5 exercise sessions per week respectively. To investigate the effect of sports and exercise therapy on aerobic performance, the intervention group completed a submaximal, bicycle ergometric step test (PWC test), whereby the heart rate was measured over the individual exercise levels in a pre-post comparison. Furthermore, the change in depression symptoms between the intervention and control group was recorded at admission and discharge from treatment using the BDI-II.

Patients in the intervention group (IG) showed a significantly greater reduction in depression symptoms compared to the control group (CG) (ΔBDI-II; M = - 8, p <.01).

In the pre-post comparison of PWC, IG achieved a significant increase in performance of 7 and 12 watts respectively (p <.05; t-test). Further inferential statistical results are reported.

Regular physical training can lead to a significant improvement in endurance performance and an improvement in depressive symptoms.

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Recovery-oriented care requires a paradigm shift from a vulnerability to a protection model. However, protective factors and resources to recovery in urban milieus remain poorly understood. Whether material, emotional or social, the identification of those resources calls for user-led initiatives and a more situated understanding of environments, where those recovery trajectories occur.

The Lausanne-based Urban Remediation program is a multi-stakeholder (service users, psychiatrists, geographers, community actors and public authorities) initiative, which aims to identify key elements of an ‘urban recovery milieu for psychosis’ and create such a milieu in the city of Lausanne (Switzerland). This talk describes the participatory methods used to create a strategy to foster recovery from psychosis in cities to better inform city’s mental health plan and policies.

We implement a living lab approach aimed at real-world experimentation in four phases: (i) exploration, (ii) co-creation, (iii) experimentation, and (iv) implementation. During phase one, we’ve used participatory mapping, go-along interviews and photovoice for an in-situ engagement with 10 young patients to ensure a systematic understanding of obstacles and resources for recovery. For phase 2, qualitative analysis and collective workshops with the various stakeholders were used to co-elaborate relevant urban interventions and identify partners for further implementation.

Introducing a Living Lab methodology to experiment the recovery-oriented strategy in a limited area in a real-world setting provides us with solutions, which can be further scaled up to inform the creation of a more inclusive city. Lessons learnt with early psychosis patients can benefit to the community as a whole, as high sensitivity of psychotic patients can teach us a great deal both regarding urban stressors and resources common to the general population.

Using real-world methodologies in cities allows to mobilize actors and resources beyond individual resilience to support recovery trajectories. Consistent transdisciplinary efforts are needed to involve all stakeholders (urban planners, mental health plan developers and society at large) for effective user-based changes and implementation of sustainable solutions.

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Mood disorders are among the most prevalent and debilitating mental conditions in worldwide populations. Non-adherence to treatment recommendations may have serious consequences for patients with mood disorders. There are several methods to show whether the patient cooperates with the doctor and follows his recommendations, or whether he or she skips the prescribed doses of medications. These include objective methods, such as detecting the drug in the blood, urine or saliva by analysis or special markers, pill counting, electronic monitoring, and an electronic record of filled prescriptions. Subjective methods involve assessment of the patient, medical staff, and those in the patient’s immediate environment. The most commonly used subjective methods are an interview, filling out a questionnaire, and assessment by health care professionals and the patient’s relatives The problem arises when the patient inadvertently skips medications, which makes it difficult to assess adherence. This may be due to the severity of the disease and poorer cognitive function, and sometimes a change in daily routine.

The aim of the study was to identify factors influencing life satisfaction, disease acceptance and therapeutic adherence among people with mood disorders.

This survey-based study included 103 people with mood disorders. It was performed using the author questionnaire, and standardized research tools, namely: the Adherence to Refills and Medication Scale (ARMS), the Acceptance of Illness Scale (AIS), the Beck Depression Inventory (BDI), and the Satisfaction with Life Scale (SWLS).

The level of life satisfaction decreased with an increase in the severity of depressive symptoms (βstd. = -0.665, p < 0.001). Mood disorder patients with more severe depressive symptoms had significantly higher scores on the adherence scale (βstd. = 0.290, p = 0.003). Patients with higher levels of depressive symptoms showed a lower level of acceptance of the disease (βstd. = -0.215, p < 0.001).

1. 1. The dosage of medications taken, and the severity of depressive symptoms determine life satisfaction of people with mood disorders.

2. 2. Respondents with greater severity of depressive symptoms scored higher on the adherence scale, which means that they were more likely to be non-adherent to treatment recommendations. The type of mood disorder may affect patient adherence. Subjects with bipolar disorder showed higher and those with anxiety-depressive disorder—lower adherence than patients with depression.

3. 3. Subjects with more severe depressive symptoms showed a lower degree of acceptance of the disease.

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Alzheimer’s disease (AD) is a very common cause of dementia and a common cause of death in elderly humans. No effective long-term treatment has been found so far. Recently developed treatments with antibodies have shown severe side effects of edema or intracerebral hemorrhage in a larger number of cases.

Neuronavigated transcranial pulse stimulation (TPS) as a new non-invasive therapy method could represent a current alternative to standard treatments. In contrast to ultrasound stimulation (tFUS) TPS uses shock waves with a mechanical transduction. These shock waves allow an application to superficial brain structures as well as into areas deep in the brain without the induction of any unwanted thermal side effects. The stimulation of the target areas can be MRI-navigated with nearly a similar precision as in stereotactical procedures.

85 out-patients with Alzheimer’s disease with light to moderate symptoms received TPS-treatments with 6.000 pulses each session bilaterally in 6 sessions over 2 weeks into the frontal, parietal and temporal cortex (0.2 mJ/mm2 4 Hz - Neurolith by Storz Medical). The treatment was repeated with a single booster session every 6 weeks. Pulses were inividually neuronavigated by current MRI-images. Executive functions were tested using the Stroop-Test (colour-word-interference-test). Patients with Alzheimer’s Disease normaly present only poor results in the Stroop-Test. We tested with a pre – post design (t0 pre stimulation : t1 after 6 sessions, two weeks later as well as t2 6 months later). The mood of the patients was measured using the BDI on t0, t1 and t2.

TPS-stimulation showed strong ameliorating effects on performance in the Stroop-Test. The mean-score of the Stroop-test was diminished significantly (pre vs. post ; p < 0.05 – paired T-test) in a comparison of t0 to t1. This effect was preserved during an interval of 6 months (t2). Single patients showed extraordinary improvements by shortening completer times in the Stroop-Test by half.

Depressive symptoms of the patients were also diminished by the treatment. The BDI score decreased from 20.1 ( t0 ) to 9.7 ( t1), and 9,1 (t2) respectively.

No significant side-effects occured during all the sessions in any of the patients.

The results of this trial show that cognitive impairments of executive functions and depressive symptoms in Alzheimer’s disease may be ameliorated using TPS as a noninvasive neuronavigated brain stimulation method. No severe side-effects were observed. In the meantime beneficial effects of shockwaves with low intensitiy have also been shown in the fields of dermatology, orthopedics and cardial surgery.

Different mechanisms of action of TPS are still under investigation.

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Numerous studies have revealed the association between deficit hyperactivity disorder (ADHD) and brain inflammation due to immune system response to congenital or perinatal human cytomegalovirus (CMV) infection.

The aim of study was to examine the impact of neuroinflammation caused by CMV infection on the development of ADHD in prematurely born children.

The medical records of 126 prematurely born children aged 7-11 were retrospectively analyzed. Participants were divided into two groups, the observed population of 56 children with ADHD and the control group without ADHD. Three parameters were observed, C-reactive protein (CRP) as an indicator of inflammation, IgM antibodies to CMV for etiological diagnosis of CMV infection and cranial ultrasound findings for the confirmation of structural changes in the brain.

Statistical analysis of our data showed the association between the onset of ADHD and the presence of congenital/perinatal CMV infection in prematurely born children (p<0.01). Nevertheless, these two variables had a very low positive correlation (phi coefficient 0.07173). The results did not show the association between elevated levels of CRP and presence of ADHD in prematurely born children (p>0.01), which confirmed that not every inflammation, regardless of the cause, was associated with ADHD. The analysis also confirmed the positive correlation between the variables listed in pairs: elevated levels of CRP and positive IgM on CMV, elevated levels of CRP and altered ultrasound neuroimaging findings, as well as positive IgM on CMV and altered ultrasound neuroimaging findings. All of these correlations speak in favor of the CMV caused neuroinflammation as etiopathogenetic basis in ADHD.

In our sample CMV-induced neuroinflammation was associated with the development of ADHD in prematurely born children.

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Adolescence in young people with autism spectrum disorder (ASD) is a special time of life, for them facing physical and mental changes, and for their parents who must cope with the new challenges associated with their child’s development. Research has shown that the severity, violence and behavioral disorders help to explain the major difficulties encountered by these families.

To cope with these difficulties, parents often use a variety of coping strategies. These coping strategies encompass all an individual’s cognitive and behavioral efforts, which are constantly evolving, to manage a situation perceived as stressful.

Our study aimed to assess the coping strategies adopted by parents of adolescents with ASD, their level of burden and to determine the relationship between these two variables

We conducted a descriptive and analytical cross sectional study among parents of adolescents with ASD followed at the “Erraihan” therapeutic farm in Sfax during the period of May 2024.

The hetero-questionnaire used a pre-established form for collecting data relating to parents and adolescents and two psychometric scales:

• - The BRIEF-COPE scale: to assess coping mechanisms in parents, of which there are four: problem-focused mechanisms, avoidance-focused mechanisms, social support-focused mechanisms and emotion-focused mechanisms.

• - The zarit Burden Inventory (ZBI): used to assess the level of burden.

Forty-three parents were enrolled. Their mean age was 50.6 ±7.93 years (min=36; max=81). The average age of the adolescents was 17.79 years, with extremes of 13 and 20 years.

Emotional focus (mean score=2.54) was the coping mechanism most used by parents, followed by problem focus (mean score=2.50) and social support (mean score=2.45).

Avoidance was the least-used coping mechanism (mean score=1.63). Assessment of parental burden showed that the mean Zarit score was 24.6±20.14, with extremes of 0 and 48. Twenty-seven parents (62.80%) felt a burden of severe intensity.

In our study, only the humor-based emotion-focused coping strategy was more important in parents with absent to moderate levels of burden (1.98 versus 1.41; p=0.02). For the other coping strategies, there was no significant association with level of burden. Social support scores between parents with absent to moderate and severe levels of burden were close.

Our results show that parents feel the heavy burden of caring for their sick adolescent. Indeed, ASD generates a great deal of stigmatization in the parent, who avoids discussing the illness with those around him, for fear of suffering further stigmatization. This vicious may explain the absence of a link between the level of burden and coping strategies centred on social support.

Thus, the question of the role of family support and associations for autistic families, proves crucial.

None Declared