Prementrual disorders (PMD) affect millions of women in reproductive age worldwide. Understanding the potential link between PMD and its comorbidities, including autoimmune disease (AD), is crucial for ultimately improving women’s health. Although hormonal fluctuations seem involved in the development of PMD and some AD, the relationship between PMD and AD remains unclear.

Hence, we aimed to investigate the bidirectional association between PMD and AD.

Leveraging Swedish nationwide and regional registers, we conducted a nested-case control study and a matched-cohort study. Among 3,630,028 eligible women of reproductive ages during 2001-2022, we identified 104,972 incident PMD, their unaffected full sisters, and 10 unaffected matched women per case. We extracted 41 types of AD diagnosis recorded in the registers. Using conditional logistic regression and Cox regression models, we estimated the odds ratio (OR) and hazard ratio (HR) with 95% confidence interval (CI).

Women with AD had a 12% increased risk of subsequent PMD (95% CI 1.10-1.15) compared to unaffected women, and a 6% increased risk compared to their unaffected full sisters (95% CI 1.01-1.11). Women with PMD had 23% (95% CI 1.20-1.26) and 17% (95% CI 1.10-1.24) elevated risks of subsequent AD compared to unaffected women and full sisters, respectively. Among parous women, a stronger bidirectional association was observed for those both exposed to PMD and perinatal depression (nested case-control OR:1.46, 95%CI 1.38-1.54; matched cohort HR:1.49, 95%CI 1.34-1.66) compared to only PMD (nested case-control OR:1.04, 95%CI 1.00-1.07; matched-cohort HR:1.14, 95%CI 1.07-1.21). The strongest bidirectional association with PMD was found for autoimmune thyroid disease and celiac disease.

Our findings illustrate a bidirectional association between PMD and AD, in particular among parous women with a history of perinatal depression. If confirmed in future studies, healthcare professionals need to be vigilant about the risk of AD in women with PMD and vice versa.

None Declared

War is the most powerful psychosocial stressor affecting all segments of modern Ukrainian society.

It was conducted a comprehensive examination of 176 patients of both sexes: Group I consisted of 101 military personnel; Group II - 97 volunteers; Group III - 95 IDPs in order to develop a system of personality-oriented treatment of stress-related disorders in persons affected by war.

Clinical and psychopathological examination, which included a structured interview and patient’s observation aimed at studying influence of socio-psychological and biological factors on development of post-stress disorders. Psychodiagnostic method include use: M-PTSD; HADS; HAM-A, HAM-D; Questionnaire of neuropsychological stress by T.A. Nemchin; State-Trait Anxiety Invertory; Methods of diagnosing coping behaviour in stressful situations; Impact of Event Scale-Revised; Clinical Administered PTSD Scale-CAPS; Traumatic Stress Questionnaire; Colombian Suicide Intentions Severity Scale; Methods for determining suicide risk and assessing self-awareness of death in patients with depressive disorder (Kozhyna H.M., Zelenska K.O., 2015); Methods for ‘Diagnosing the level of social frustration (Wasserman L.I., modified by Boyko V.V., 2002).

Clinical structure of stress-related disorders was presented by PTSD and adjustment disorders. Clinical structure of PTSD was represented by anxious, dysphoric, asthenic and somatoform syndromes. System of personality-oriented treatment was developed, including differentiated use of psychopharmacotherapy, psychotherapy and psychoeducation; creation of re-adaptive atmosphere; formation of health-centered lifestyle and based on a salutogenic approach. Pharmacotherapeutic component of developed program included differentiated, targeted use of SSRIs, SNRIs, antipsychotics, tranquilizers and anxiolytics. Psychotherapeutic program was based on identification of dominant resource channels for overcoming stress and finding inner stability using integrative model of psychological survival after severe stress, Basic Ph. Psychotherapeutic support included trauma-focused CBT for all patients, EMDR therapy with additional use of Pucelik Consulting Group’s PTSD Self-Management Program for servicemen patients in Group I; individual crisis therapy for patients in Group II; and interpersonal therapy for patients in Group III. For anxious depressive reactions, CBT and art therapy were used for all patients; with the additional use of problem-solving therapy for patients of Group I; Group II - individual crisis therapy; Group III - mindfulness techniques, relaxation training.

Effectiveness of developed system of personality-oriented treatment of stress-related disorders was proved, and positive dynamics of mental state, reduction of psychopathological symptoms, increased resistance, reduced levels of social and psychological frustration were established.

None Declared

Sibutramine is an anorexigenic drug that has been used to treat obesity. After its commercialization, FDA ordered the suspension of its prescription in USA because of the adverse effects. It has structural similarities to amphetamine and is a serotonin-noradrenaline reuptake inhibitor. The primary metabolites are responsible for the activity and inhibit the reuptake of noradrenalin and serotonin from the synaptic cleft. This substance can interfere with one of the known mechanisms of psychosis increasing dopaminergic transmission and leading to potential psychomimetic effects.

The main objective in this paper is to obtain a critical evaluation of the literature regarding psychosis and sibutramine. There has been done a bibliographic review in databases such us SCOPUS, Web of Science, UptoDate and PubMed. This review was realized under certain criteria and keywords. The motivations behind this research were generated after an unusual clinical case (in symptomatology’s presentation). Sibutramine is a compound, which is not commercialized in the UE, so the diagnosis of the toxic psychosis was more complicated than the average psychedelics drugs.

To develop this review, numerous databases were chosen: PubMed, Scopus, UpToDate and Web of Science. However, only in PubMed we have obtain relevant results. For descriptors we have used two terms: “psychosis” and “sibutramine”. In this database, 27 results were obtained. With the criteria previously designed, which were free text access and works published in the last 20 years, only ten of them met all the criteria. With these ten articles, a systematic and qualitative analysis has been done, focusing on the ones which described similar cases.

The sibutramine psychosis is difficult to identify. Frequently is mixed up with other substances in dietary supplements, which can appear as harmless. So, as clinics, we need to be careful, always considering this information in the clinical records. This case was peculiar; a 24 years old woman was consuming sibutramine as a compound in one supplement she was taken for losing weight. Three weeks prior to the consult the symptons started with an erotomaniac delusions, accompanied by disruptive behaviour, mood swings (dysphoria) and irritability. She was hospitalized and treated with antipsychotic medication (aripiprazole) showing a full recovery in five days.

Sibutramine can cause severe mental health disorders. As a compound of dietary supplements, can be easily acquired through online stores. Our work as clinics is to be vigilant of this kind of substances because of the danger that can generate. More studies should be done, to acquire knowledge of the psychobiological mechanisms involved in these cases. The prognosis seems to be positive, but there are certain risks in patients with unknown vulnerability factors.

None Declared

Adult patients with Autism Spectrum Disorder (ASD) exhibit a range of behaviours that can be disruptive to the medical care of themselves and other patients and as a result, are at higher risk of being sedated. Symptom severity is heterogenous. Some patients are completely non-verbal, some require assistance with basic activities of daily living, and others function independently with only mild difficulties. Roughly two thirds of patients with ASD have a comorbid psychiatric diagnosis, with the most frequent comorbidities being ADHD, anxiety and depressive disorders or intellectual disability. These comorbidities complicate the management of these patients, and may further increase their agitation and distress.

The present study aims to determine whether adult patients with ASD who present with acute psychiatric illnesses receive more sedatives in the emergency department.

43 adult patients with a previous diagnosis of ASD who were referred to the mental health team at a single, large emergency department in metropolitan Victoria over the year of 2021 were identified and matched with an equal number of controls within the same cohort. Sedative medications were converted to diazepam and chlorpromazine equivalent doses.

There were 41.9% female participants among cases and controls. The mean age of patients with ASD was 26.7 (SD = 7.9), which was similar to the mean age of controls of 27.4 (SD = 7.6). The mean hospital length of stay was 13.4 hours (SD 8.6) among cases and 14.0 (SD 7.0) among controls. A higher proportion of patients with ASD received benzodiazepines at 60.5% compared to 46.5% among controls, with a difference that was not statistically significant. A lower proportion of 30.2% of patients with ASD received antipsychotics compared to 44.1% among controls, with a difference that was not statistically significant.

This study shows evidence that patients with ASD are more heavily sedated in the emergency department compared to patients who present similarly but do not have a prior diagnosis of ASD. While the observed increased dose of benzodiazepines was modest, it does represent a potentially increased degree of harm to patients with ASD. We strongly recommends that every attempt should always be made to reduce the use of sedative medications in favour of other techniques for behavioural management. These include verbal de-escalation, reducing sensory stimuli, one-to-one nursing, prompt security presence and the involvement of family or friends. Since patients with ASD are at a higher risk of receiving sedatives, efforts should be made to recognise their patterns of behaviour and difficulty, to understand them and formulate constructive and safe ways to manage their behaviour.

None Declared

New antidepressant treatments are needed that not only demonstrate strong efficacy but also act quickly, are safe for long-term use, and are well-tolerated by patients. Accelerated intermittent Theta-Burst Stimulation (aiTBS) is a promising form of noninvasive brain stimulation in the treatment of depression (1). iTBS stimulation is a time saving and cost-effective technique, and could provide long-lasting improvement of treatment-resistant depression (TRD) (2). Currently, there is limited evidence regarding the role of aiTBS within treatment algorithms for TRD compared to placebo.

This is a single-center, double-blind, randomized, placebo-controlled pilot intervention study, designed to evaluate the efficacy and safety of aiTBS for TRD.

Stimulation will be administered in 10 daily sessions, one session every 50 minutes, over 5 days, for a total of 50 sessions. Each session will consist of 3 minutes of stimulation at a frequency of 50 Hz, delivering 600 stimuli per session, with an intensity of 120% of the motor threshold targeted at the left dorsolateral prefrontal cortex.

Participants must be adults aged 18 to 75 years (inclusive), and meet the criteria for TRD, unresponsive to two antidepressants at an adequate dose and for an adequate duration with a stable dose for at least 4 weeks. Assessments, including HDRS, PHQ-9, EQ-5D-5L, SDS, CGI-S, and MGH-ATRQ, will be conducted at the baseline visit, at the end of the treatment, one and three months after the treatment.

Accelerated protocols are an emerging area of interest in the treatment of TDR, but several issues remain to be clarified, including the durability of their effects, safety, and feasibility of implementing these protocols in outpatient settings in routine clinical practice.

None Declared

Six clinical cases of patients with premenstrual dysphoric syndrome treated in Mental Health with SSRIs are presented.

The aim is to briefly review the pharmacological approach to premenstrual dysphoric syndrome through the presentation of a series of cases.

Six cases of female patients are presented, with a mean age of 35.4 years, two of whom were nulliparous. All of them had no history of mental health problems. They had regular cycles and had no relevant medical or gynecological history. They reported that for the last three years they had been more irritable, emotionally labile, feeling apathetic and sad, with difficulties in concentration and a feeling of loss of self-control, which made interpersonal relationships difficult, especially at work.

The patients denied that they had previously experienced these symptoms throughout their lives.

Analyses were carried out, with estrogen and progesterone levels, without obtaining significant alterations.

The MADRS and HAMILTON scales were administered to all of them on the 14th day of the cycle, as well as on the 5th day of the cycle. A mean of 9.2 was obtained on the MADRS on the 5th day of the cycle, compared to 15.6 on the 14th day, while the HAMILTON obtained a score of null-mild anxiety on the 5th day and moderate anxiety on the 14th day.

After this comparison, treatment with fluoxetine at a dose of 20mg DMD was started only from the day of ovulation to menstruation, withdrawing this treatment for the rest of the cycle. Again, both scales were compared and the results obtained were more similar on the 5th and 14th day of the cycle.

To avoid hormonal treatment and thus the moderate side effects it presents, premenstrual dysphoric syndrome can be treated by taking SSRIs at low doses, only for 15 days of the cycle.

None Declared

Electroconvulsive therapy (ECT) is a widely recognized and effective treatment for severe psychiatric conditions, including major depressive disorder, treatment-resistant depression, and some psychotic disorders. Although ECT is highly effective, administering it to patients with cranial metal implants—such as plates, screws, clips, or electrodes—presents potential safety challenges. Metal implants, particularly those made of ferromagnetic materials, may interact with the electrical currents in ECT, which can lead to heating, shifting of the implant, or other adverse effects, thereby raising safety concerns.

To review the safety and clinical considerations of electroconvulsive therapy in patients with cranial metal implants. This literature search aims to identify evidence on risks, contraindications, and guidelines to support safe and effective treatment in this population.

We conducted a literature search on PubMed to investigate the application of ECT in patients with cranial metal implants. The search included keywords “electroconvulsive therapy” and “ECT” combined with the terms “cranial metal implants,” “head metal implants,” and “metallic skull plate” interchangeably. We included only case reports. We used this approach to gather relevant studies addressing the safety, efficacy, and considerations of electroconvulsive therapy in individuals with metal implants in or near the skull.

The literature search identified 11 case reports documenting the successful administration of ECT in patients with cranial metal implants. Across these cases, ECT was performed without adverse events related to the implants, and treatment outcomes were reported as effective in managing psychiatric symptoms. Most reports emphasized careful planning and individualized assessment to minimize risks, particularly regarding implant location and material composition. Safety measures included conducting pre-treatment imaging to evaluate implant positioning.

The connection between cranial metal implants and ECT necessitates careful consideration of safety protocols to prevent potentially hazardous interactions. While metals such as titanium are generally not problematic for this therapy, it is essential to consider the type of metal, its location, and its magnetic properties before applying this technique. Our clinical experience also shows positive outcomes in patients with cranial metal implants, demonstrating safe and effective administration with proper evaluation and precautions. Further research and establishing safety guidelines will be crucial for optimizing treatment and minimizing risks for patients with metal implants.

None Declared

Sleep disorders are very common in children with neurodevelopmental disorders such as autism. Poor sleep can have detrimental effects on cognitive processes, attention, memory, language, and regulation of mood and behavior. Many people with autism have difficulty correctly processing sensory information that reaches them from both the environment and their own body. Depending on how the person with autism perceives the sensations, these can impact on sleep, causing nighttime awakenings or poor sleep conciliation. It is vitally important to evaluate nighttime rest and have knowledge of appropriate tools to improve sleep in patients with ASD.

In this work we aim to evaluate, in a child-youth population diagnosed with ASD who have been admitted to our ASD Day Hospital during the year 2024, the prevalence of sleep disorders and their characteristics. As well as generating strategies to improve sleep conciliation and factors to take into account or avoid that may be affecting our patients.

A review is carried out of the clinical history of patients admitted to the TEA Day Hospital during the year 2024. Sleep problems are analyzed, as well as their relationship with stress. Results and measures to improve the quality of night rest in these patients are presented.

From January to September 2024, a total of 26 patients with autism have been treated at the ASD Day Hospital of the University Hospital of Mutua Terrasa, in the following programs: intensive, eating problems and low functionality. Of these, 32% were women, with an average age of 11.64 and an average stay of 40 days.

More than half of the patients had sleep problems, where the majority had more than one. Among the most frequent: difficulties falling asleep (12), maintenance insomnia (8), frequent awakenings (4), night terrors (6), and the need for the presence of parents and/or sensory interventions to be able to fall asleep (12).

The main interventions carried out have consisted of: establishing adequate sleeping habits, avoiding naps, avoiding highly stimulating activities, feeling tired beforehand, adapting environmental conditions to the needs of the child and giving proprioceptive information before sleeping.

Among the most commonly used drugs we found atypical antipsychotics: olanzapine, risperidone. Some antidepressants: mirtazapine and occasionally benzodiazepines. The vast majority of children took melatonin.

Sleep disorders are highly prevalent in patients with ASD, but correct intervention can improve comorbid symptoms such as anxiety, stress and discomfort, which are largely related to poor sleep.

Sensory-perceptive interventions are essential to improve nighttime rest in children with ASD

None Declared

Schizophrenia is a severe psychiatric disorder characterized by disturbances in perception, thinking, affect, behavior, and negative symptoms. Depression in patients with schizophrenia worsens disease outcomes by increasing suicide risk, complicating the clinical picture, and reducing social functioning quality. Treatment is challenging, as monotherapy with modern antipsychotics is not always successful. Adding antidepressants may improve outcomes, but the effectiveness of such augmentation often requires further evidence.

This study aimed to examine the effects of combining second-generation antipsychotics (SGA) with vortioxetine, a novel multimodal serotonergic antidepressant, on various aspects, including quality of life, anhedonia, cognitive function, and overall symptom improvement in schizophrenia patients.

We conducted a comprehensive search of PubMed, Embase, Cochrane and Web of Science databases up to September 2024 for studies using Vortioxetine with standard treatments for schizophrenia.

We screened 371 studies and our review included six studies gathering 508 patients. Study type, sample sizes, and follow-up time varied across studies (Figure 1). All studies involved adding Vortioxetine to existing antipsychotic treatments, with dosages ranging from 5-20 mg/day. Study durations varied from eight to 48 weeks. Common scales across multiple studies included: PANSS (Positive and Negative Syndrome Scale), WHOQOL-BREF (World Health Organization Quality of Life Assessment), CDSS (Calgary Depression Scale for Schizophrenia), and various cognitive function tests (e.g., WCST, Verbal Fluency Test, Stroop Task). Overall, the studies reported positive effects of vortioxetine in schizophrenia patients (Figure 2): Improved quality of life, Reduced anhedonia, Enhanced cognitive function, Improved depressive symptoms, Reduced negative symptoms. Most studies reported good tolerability of vortioxetine with minimal side effects.

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Image 2:

The findings suggest that Vortioxetine may be a promising adjunctive treatment for schizophrenia, potentially improving various domains including quality of life, cognitive function, negative symptoms, and depressive symptoms. However, larger and more robust studies are needed to confirm these findings.

None Declared

Negative consequences of acute and chronic stress caused by information overload, environmental problems, natural disasters, man-made disasters, military clashes, and acts of terrorism have become increasingly evident in recent decades. They can lead to a painful “breakdown” of socio-biological adaptation mechanisms, a decrease in adequacy in assessing the environment, and, as a consequence, the formation of disturbances in the psycho-emotional sphere, manifested in the development of behavioral disorders (aggression and depression). Therapy for behavioral disorders does not provide a complete cure, apparently due to the formation of a “vicious circle” that can only be broken by normalizing the regulatory relationship between the central nervous system and the immune system. One way to solve this problem is to develop new methods of therapy based on immunological approaches. The method of choice may obviously be immunotherapy with autologous immune cells with a certain, including in vitro modulated, functional activity.

The aim of the study was to investigate the possibility of obtaining a positive psychoneuroimmunomodulatory effect in aggressive and depressive-like animals by transplanting immune cells, the functional activity of which was in vitro modulated by a psychoactive substance (PAS).

Male (CBAxC57Bl/6)F1 mice aged, in which aggressive or depressive-like states were formed under the influence of long-term social stress, were used as donors and recipients in the experiments. Immune cells for transplantation were obtained from a suspension of donor’s splenocytes, cultured in vitro with PAS (chlorpromazine or caffeine, respectively) and then intravenously administered to syngeneic recipients. In the control group of animals, cell preparation and transplantation were carried out under similar conditions, except that the latter were cultured without the presence of PAS. In recipients the parameters of the nervous and immune systems functional activity were recorded.

Transplantation of in vitro PAS-modulated splenocytes to recipients with stress-induced behavior patterns resulted in targeted changes in their motor and exploratory activity in the Open field test, motor activity in the Porsolt test, and decreased anhedonia in recipients with a depressive-like phenotype, recorded against the background of changes in the content of a number of pro- and anti-inflammatory cytokines IL-1β, IL-2, IL-4, IL-6, IL-10, IFNγ, TNFα in pathogenetically significant brain structures. In recipients, a positive change in the parameters of the immune system functional activity were also revealed.

The possibility of immunoediting stress-induced forms of behavior by transplanting in vitro PAS-modulated immune cells, which have a positive psychoneuroimmunomodulatory effect in the body of syngeneic recipients, has been demonstrated.

None Declared

Worldwide, social media and touch screen device use has rapidly increased over the past decade and are particularly popular among young people. To obtain more insight in the potential negative associations with compulsive social media use and touch screen devices in Dutch children, we assessed its relation with self-reported well-being and cognitive function in primary school children. We found social media to be negatively associated with life satisfaction and increasing touch screen device use with increased reaction time. This suggests that the compulsive social media use and touch screen device use have negative consequences on mental well being and cognitive performance already at a young age. Therefore the use of social media in children under the age of 15 years should be restricted or forbidden.

None Declared

Depression in older adults may present itself as a recurring disorder originating from earlier life, as a new onset depression (late-onset depression, LOD), or as a depression due to organic diseases (e.g., vascular depression). An estimated 30% of all cases of depression in older adults are represented by LOD. Low tolerability due to the changes of the pharmacodynamic and pharmacokinetic profile (e.g., lower volume of distribution, reduction of renal clearence, longer half-time, different receptoral sensitivity and density), as well as low efficacy of antidepressants and high risk of completed suicide, have been reported in this population.

To explore the current state of evidence for the pharmacological treatment of LOD through a narrative literature review.

This review included three databases (Web of Science/Clarivate, PubMed, and Cochrane), explored from their inception to June 2024, for papers published in English using the keywords “late-onset depression,” “geriatric depression,” “old age depression,” and “antidepressants” or “treatment.”

Based on the results of 27 selected primary and secondary reports, selective serotonin reuptake inhibitors (SSRIs), especially escitalopram and sertraline, are considered the first line of treatment for LOD, with >50% rate of responsiveness being reported. SSRIs are followed by serotonin-norepinephrine reuptake inhibitors (SNRIs), and other new-generation antidepressants, mainly mirtazapine, vortioxetine, and bupropion. The therapeutic guidelines recommend the correct treatment of comorbid neurocognitive disorders; however, the available evidence shows that antidepressants have very limited efficacy in the presence of dementia. The number needed to treat (NNT) for LOD was between 6.7 and 14.4 (Alexopoulos Transl Psychiatry 2019;188 9). For treatment-refractory LOD (TRLOD), augmentation with lithium, aripiprazole, memantine, or methylphenidate, as well as switching to phenelzine, nortriptyline, desipramine, or a combination of antidepressants, such as bupropion and nortriptyline have been suggested as potential solutions, but the evidence to support such recommendations has low quality. Regarding the tolerability of antidepressants in this specific population, electrolyte imbalance, worsening of cognitive dysfunction, increased coagulation time, and falls should be considered.

SSRIs are the first-line pharmacological approach in LOD, with SNRIs and other new-generation antidepressants as the second-line. The pharmacological recommendations for TRLOD are based on low-quality data. Due to the tolerability and safety-specific aspects, special care should be given when monitoring these patients during the pharmacological treatment.

None Declared

India is facing a growing mental health burden, with significant disparities in access to services despite the introduction of the National Mental Health Program (NMHP) and the Mental Healthcare Act (MHA). While these policies aim to improve mental health care, their implementation remains inconsistent due to a range of challenges. Understanding these barriers is crucial to enhancing mental health services across the country.

This study aims to identify the key challenges impeding the effective implementation of existing mental health policies in India, with a focus on rural-urban disparities, resource constraints, and sociocultural factors.

A comprehensive literature review was conducted, examining peer-reviewed articles from databases such as PubMed, Scopus, and WHO policy documents, and reports from government and non-governmental organizations. Data was analysed to assess the primary obstacles related to funding, workforce shortages, stigma, policy integration, and infrastructure issues. Qualitative insights from key stakeholders in mental health services were also included.

The review revealed five primary challenges. Firstly, the insufficient financial allocation for mental health programs, leading to limited-service availability; secondly, a shortage of trained mental health professionals, particularly in rural areas; thirdly, a pervasive stigma surrounding mental health, hindering service uptake; fourthly, the poor integration of mental health care into primary health systems; and lastly, the bureaucratic inefficiencies and lack of infrastructure. These challenges disproportionately affect rural populations, exacerbating the urban-rural divide in mental health care delivery.

The effective implementation of mental health policies in India is undermined by systemic challenges such as inadequate resources, workforce gaps, and sociocultural barriers. Addressing these issues requires targeted interventions, including increased investment in mental health services, enhanced training programs, stigma reduction campaigns, and better integration of mental health care into general healthcare frameworks. A coordinated, multi-level approach is essential to overcoming these barriers and achieving meaningful improvements in mental health outcomes across India.

None Declared

Major Depressive Disorder (MDD) significantly impacts global disability and quality of life. Some variables such as the trait anxiety and experiencing stressful life events (SLEs) are usually related to the MDD. However, the relationship between these variables in depression needs further investigation. Emerging research suggests the STAI-trait could be a nonspecific measure of negative effect and increase susceptibility to stress-induced depression.

This study assesses the State-Trait Anxiety Inventory (STAI) trait scores and SLEs, depressive symptoms, outcomed and functionality in MDD patients, with the hypothesis that STAI-trait may predispose individuals to stress-induced depression.

A prospective observational study was conducted with 25 MDD patients recruited at Hospital Universitari de Bellvitge. The STAI-trait and SLE exposure were measured during the initial visit. Depression symptom and outcome variables were assessed in three sequential clinical evaluations.

Preliminary findings show a significant association between anxiety trait and SLEs, high STAI-trait scores correlated positively with increased SLEs. This, correlating with more severe MDD symptoms and a complex disease course.

These findings support the notion of the STAI-trait as a possible mediator between life stressors and depression.

They highlight that increased STAI-trait anxiety might lead to greater vulnerability to stress and its potentially depressive effects, underscoring the need to consider this trait in clinical practice and the development of preventive strategies.

None Declared

Organic solvent-induced psychosyndromes (OSP) constitute a major occupational health concern, particularly in industrial sectors involving frequent use of chemical products. This neurotoxic disorder can have significant consequences on workers’ health and their ability to maintain professional activity.

This study aims to analyze the epidemiological, clinical, and occupational characteristics of organic solvent-induced psychosyndromes diagnosed in the workplace, as well as to evaluate their impact on work fitness.

A retrospective study was conducted based on medical records collected at the Institute of Occupational Health and Safety (ISST) in Tunisia during a period of 5 years from 2019 until 2024. Socio-professional data, risk factors, diagnoses, progression, and fitness decisions were analyzed with a focus on OSP cases. The severity of the psychosyndrome was assessed using the Raleigh classification and the WHO criteria.

The study identified 11 cases of organic solvent-induced psychosyndromes. The average age of patients was 41 years. The gender distribution showed 6 women and 5 men.

The professional sectors were distributed as follows: chemical industry (n=4), textile industry (n=3), electronics (n=2), and other sectors (n=2).

The main solvents involved were xylene (n=7), toluene (n=6), hexane (n=5), and cyclohexane (n=4), with multiple exposures in 8 cases. The average duration of occupational exposure before diagnosis was 14 years ranging from 5 to 30 years. An ineffectiveness of protective measures was found in 6 patients.

The most frequently reported symptoms included memory disorders (n=9), attention disorders (n=8), and mood disorders (n=7).

The most common type of psychosyndrome was type 2B (n=8).

Regarding work fitness, nine cases required removal from solvent exposure, including six through job transfer and three through workplace accommodation. Two cases were declared unfit for their current position.

This study highlights the impact of organic solvent-induced psychosyndromes on workers’ health and emphasizes the need for better protective measures, early screening, and regular medical monitoring.

None Declared

Since the beginning of the health crisis caused by COVID-19, the impact of the pandemic context on the mental health of healthcare professionals has been widely studied. However, few studies have assessed psychological manifestations in healthcare workers affected by COVID-19.

Determine the prevalence and factors associated with depressive symptoms in healthcare workers with COVID-19.

This is a cross-sectional analytical study of health professionals at Farhat Hached University Hospital with COVID-19 over a 6-month period from September 2020 to February 2021. Depressive symptoms were screened using the Depression Subscale of Hospital Anxiety and Depression Scale (HADS-D).

Our study included 477 healthcare professionals. The mean age was 39.9 ±10.8 years, with a predominance of women (sex ratio =0.27). Almost a third of the participants were nurses (32.1%), followed by doctors (27.9% of cases). Most of the healthcare workers affected developed a pauci-symptomatic form of the infection (73.8%), with an average confinement time of 14.9±6.9 days. On returning to work, 74 staff (15.5%) noticed that their colleagues were withdrawing from work. According to the HADS-D scale, depressive symptoms were observed in 19.1% of cases. The predictive factors were gender (p<10-3), age (p=0.016), the symptomatic form of COVID-19 (p= 0 ,038), the duration of confinement (p<10-3) and the withdrawn attitude experienced by colleagues on returning to work (p<10-3).

Our results showed that psychological suffering, particularly depression, among care staff depended on several predictive factors. Psychological support during and even after the period of confinement is therefore necessary

None Declared

An increasing number of patients with treatment-resistant depression (TRD) are treated with a novel form of transcranial magnetic stimulation (TMS): the intermittent theta burst stimulation (iTBS). In this retrospective naturalistic study, we analyzed the outcome of iTBS treatment in patients with treatment-resistant depression.

To investigate the impact of history of esketamine treatment in the current depressive episode on response to iTBS.

In this study, we included 66 hospitalized patients (57.6% female; mean age, 52.7 years) from the University Department of Psychiatry, University of Münster. Prior to iTBS treatment, 10 patients were treated with esketamine (60% female; average age, 49.8 years) and 56 were not (57% female; average age, 53.25 years). A Chi-squared test was utilized to investigate the impact of history of esketamine treatment on response to iTBS.

The overall response rate was 51.5%. Prior to iTBS, 15% of the patients were treated with esketamine in the current episode. In the patient group with history of esketamine treatment (ESK+), 40% of the patients responded to iTBS. In the patients without history of esketamine treatment (ESK-) in the current episode, the response rate to iTBS was 53.6 %. However, history of esketamine treatment in the current episode had no significant impact on iTBS outcome (P = 0.505; χ2 = 0,626; df = 1). The difference in baseline disease severity between the groups was not statistically significant (CGI-S 6.3 (ESK+) vs 6.1 (ESK-), P = 0.281; F = 1.184; df = 64). The total rate of treatment dropouts was 3%.

History of esketamine treatment in the current episode was associated with worse outcome of iTBS. This finding was not statistically significant. iTBS may be an effective (40% response rate) and safe treatment for patients who did not respond to esketamine therapy.

M. Tonkul: None Declared, B. Baune Consultant of: Received speaker/consultation fees from AstraZeneca, Lundbeck, Pfizer, Takeda, Servier, Bristol Myers Squibb, Otsuka, LivaNova, Biogen, Angelini, and Janssen-Cilag., E. Kavakbasi Consultant of: Received speaker and advisor honoraria from LivaNova and Janssen-Cilag.

Bipolar disorder is a chronic mood disorder that often coexists with a range of psychiatric and physical comorbidities. Among these, eating disorders (ED) have emerged as a significant concern due to their impact on the course and prognosis of BD.

This study aims to investigate the prevalence of ED in stabilized bipolar patients and identify clinical and demographic factors associated with this comorbidity.

We conducted a cross-sectional, descriptive, and analytical study of patients followed for bipolar disorder at the psychiatry outpatient unit at the Hedi Chaker University Hospital in Sfax. The questionnaire included sociodemographic data, medical and psychiatric history, and anthropometric characteristics. Eating disorders were assessed using the Eating Attitude Test 40 (EAT-40).

Our study included 93 patients. The mean age was 41.49±12.33 years, with a M/F sex ratio of 2.58. Among the patients, 58.1% were married, 45.2% had secondary education, and 47.3% were unemployed. Personal somatic history was reported by 35.5% of participants, and 11.8% had psychiatric comorbidities alongside bipolar disorder.

The mean body mass index (BMI) was 27.4 kg/m² (SD=5.96). Of the patients, 29% were overweight, and 31.2% were obese. The prevalence of eating disorders was 18.3%.

EAT-40 scores were significantly associated with age (p=0.018), female gender (p<10⁻³), living alone (p=0.031), lack of formal education (p=0.009), history of medical comorbidities (p<10⁻³), weight (p=0.05), and BMI (p=0.003).

The significant associations between EAT-40 scores and sociodemographic factors underscore the need for targeted screening and interventions in this population. Early detection and management of eating disorders in bipolar patients are crucial to improving clinical outcomes and overall quality of life.

None Declared