Although criminal behavior is not expected in the elderly, especially those diagnosed with dementia, it is important to keep in mind the potential forensic significance of dementia. Also it is especially important to focus attention on the participation of people with dementia in the legal process, given that their cognitive impairments may impair their ability to participate in the judicial process, as well as their capacity to protect their rights and interests.

The aim of the study is to provide an overview of the forensic meaning of dementia and the assessment of persons with a diagnosis of dementia in a legal context.

For the purpose of the research, a review of relevant studies in the PubMed database was performed, related to the field of forensic psychiatry of offenders diagnosed with dementia and criminal behavior of the elderly.

During the forensic assessment of people with dementia, it is important to assess their cognitive impairment, for which purpose various psychological tests and diagnostic processing are applied in addition to diagnosing other comorbid diagnoses, especially depression or the existence of a psychotic disorder. In dementia, an important criminogenic factor can be the use of alcohol, along with the potential for committing violent crimes.

Depending on the severity of cognitive impairment and the existence of psychotic symptoms or a delirious state, the legal capacity of people with dementia can be significantly impaired. It is important to assess the need for security measures of psychiatric treatment, as well as the possibility of participating in the court process with regard to cognitive impairment. It is also necessary to pay attention to the protection of the rights and interests of people with dementia, as well as the ability to reason.

None Declared

Adolescence is a critical period for the development of substance use disorders (SUD), with psychoactive substance (PAS) use posing significant mental and physical health risks. In Slovenia, the absence of specific residential treatment options for adolescents has historically limited care mostly to outpatient settings, often inadequate for severe cases. In December 2023, the University Psychiatric Clinic Ljubljana opened Slovenia’s first inpatient ward for adolescents with SUD, offering a comprehensive, structured program addressing both the psychological and physiological aspects of addiction.

The primary objectives of this study are to present the inpatient ward for adolescents with SUD program in Slovenia and to conduct an analysis of data from the first six months of the program.

The program utilized a multidisciplinary approach, incorporating individual therapy, group therapy, psychoeducation, pharmacotherapy, family involvement and a range of structured therapeutic activities such as music therapy, film therapy and educational groups. A retrospective analysis of patient data from December 2023 to June 2024 was conducted. Key outcome measures included length of stay, abstinence rates, readmission rates and factors influencing premature discharge. Motivation and adherence to the therapeutic agreement were also assessed.

During the six-month period, 20 adolescents were admitted to the ward, resulting in a total of 32 hospitalizations, reflecting a significant rate of readmissions. The average age of the patients was 17.16 years. The length of stay varied considerably, with an average duration of 45 days. Readmissions accounted for 37.5% of total hospitalizations, often due to relapse or behavioral challenges. Motivation for treatment and adherence to the therapeutic agreement were critical factors affecting the length of hospitalization and the risk of early discharge.

The introduction of Slovenia’s first residential treatment program for adolescents with SUD marks a significant development in the country’s healthcare system. The program offers a structured environment conducive to improving abstinence rates and addressing the complexities of adolescent substance use. However, the high rate of readmissions and the ongoing challenge of maintaining abstinence post-discharge highlight the need for refined treatment strategies, particularly regarding patient motivation and long-term relapse prevention. Future efforts should focus on optimizing the length of stay and enhancing post-discharge support to improve long-term outcomes.

None Declared

The escalating burden of occupational stress and chronic health issues among healthcare professionals frequently culminates in burnout syndrome.

This study proposes the development of a prototype mobile recommendation system that utilizes the Internet of Medical Things (IoMT) for health monitoring and burnout assessment, while simultaneously offering coping strategies for healthcare professionals.

A digital framework was conceptualized using the Unified Modeling Language (UML), which outlined the system’s modules and graphical interfaces. The proposed system integrates a range of biometric sensors, including an electrocardiogram (ECG), a blood pressure monitor, a blood oxygen saturation monitor, and temperature sensors, complemented by a psychometric assessment tool to evaluate burnout syndrome.

The results of this study demonstrate that the proposed system can offer significant benefits in terms of promoting physical and mental well-being. By functioning as a continuous health monitoring tool and a preventive measure against stress and chronic illnesses, the proposed system can enhance the resilience of healthcare professionals.

The proposed system not only facilitates proactive health surveillance but also delivers targeted interventions to alleviate burnout effects. The implementation of this technology could revolutionize mental health management in the workplace, paving the way for robust health policy formulation within medical institutions.

None Declared

Climate change is the biggest threat of the 21st century and poses a significant risk to mental well-being by aggravating social injustice, by which children and adolescents are particularly affected. To avert the scenarios predicted by scientists, it is not only necessary for politicians to act quickly and thoroughly but also to rethink our self-understanding as those responsible for planetary health and to face this crisis with a fundamental rearrangement of priorities.

Highlighting and summarizing current knowledge on climate change and its effects on mental health were aimed.

To emphasize the global challenges related to mental health, facts and figures of climate change and the actual status quo of climate-related mental health were gathered through an online review of existing resources.

According to the Glasgow Climate Pact of the United Nations Framework Convention on Climate Change, the world is currently heading for a global warming of 2.7°C, accepting the destruction of habitats and ecosystems. The warnings regarding climate change from the scientific community are becoming increasingly clear. The Lancet Countdown, a review by scientists from 43 leading institutes around the world, shows visible impacts of climate change on human health. The Intergovernmental Panel on Climate Change report confirms a global increase in climate change-associated morbidity and mortality in 2023, as well as the impact on mental health. The climate crisis threatens mental health ubiquitously. In this context, new terms as “eco-anxiety”, “eco-paralysis”, and “solastalgia” are already being used. Eco-anxiety describes the fear of directly experiencing climate change. While this fear results in a change towards environmentally friendly behavior in some people, others fall into eco-paralysis. Knowledge about climate change can lead to paralysing fear and denial. Trauma from experiencing extreme weather events or forced relocation also trigger psychological distress in young people. In addition to eco-anxiety, the term solastalgia is increasingly used to describe the existential pain caused by experiencing irreversible climate-related changes in the environment. Surveys show that anxiety about the future has increased among young adults in recent years. The interconnections between climate change and mental health also include stress reactions and emotional suffering, strained social relationships, helplessness, grief, and increased risk of suicidal behavior.

Considering many health care professionals do not yet carry out any corresponding preventive measures regarding climate change and its effects on mental health, the self-image of physicians must be rethought and sharpened as communicators and ambassadors. To address this global topic, it is urgent to strengthen research, training, policies, advocacy, and data collection.

None Declared

Mental health is essential for overall well-being and resilience in facing life’s challenges. Self-esteem, a crucial mental health determinant, affects how individuals perceive and manage stress, and may be linked to worse health outcomes when conditions like anxiety and depression are concerned. Consequently, understanding the role of self-esteem in mental health is essential for developing effective preventive strategies and interventions.

In this study we aimed to investigate the relationship between self-esteem levels and anxiety, depression and stress, with a hypothesis that the presence of the aforementioned mental health challenges is significantly correlated with lower levels of self-esteem. We sought to explore the potential impact of self-esteem as both a risk factor and a target for interventions in mental health care.

A cross-sectional study design was employed, involving 100 participants based in the Republic of Croatia and divided equally into two groups: support-seeking individuals or patients from the daily clinical setting and a control group with no psychiatric treatment history. Participants completed the Rosenberg Self-Esteem Scale (RSE) and the Depression Anxiety Stress Scale (DASS-21). The self-esteem scores classified individuals into low, average or high self-esteem categories. Statistical analyses, including chi-square tests and Mann-Whitney U tests, assessed differences in DASS-21 scores between groups, with adjustments for sociodemographic factors.

Psychiatric patients showed significantly lower self-esteem (mean = 20.84, SD = 7.161) than the control group (mean = 29.84, SD = 7.709). Additionally, psychiatric patients experienced higher levels of anxiety (mean = 12.60, SD = 5.237), depression (mean = 12.04, SD = 5.595) and stress (mean = 14.06, SD = 4.433) when compared to the control group, which exhibited mild anxiety (mean = 5.14, SD = 5.018), low depression (mean = 4.90, SD = 5.296) and minimal stress levels (mean = 6.96, SD = 4.973). Statistical analysis revealed a statistically significant association between low self-esteem and support-seeking or patient status (p = 0.001). Additionally, low self-esteem was associated with more severe mental health symptoms across all categories (p < 0.05).

This study emphasizes the interconnectedness between self-esteem and mental health, demonstrating that lower self-esteem is associated with higher anxiety, depression and stress levels. Therefore, integrating self-esteem enhancement into therapeutic settings may be an effective strategy for mitigating mental health risks, providing a proactive approach to psychological care and prevention.

None Declared

For decades, the standards of gender-related healthcare provided to trans and gender-diverse people have been prepared by international professional associations. These standards are often expected to rely on research evidence, but when the research evidence is not conclusive, an expert consensus is sought. In addition to the standards and guidelines updated with intervals, such as the Standards of Care for the Health of Transgender and Gender Diverse People, Version 8, and the Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline of the Endocrine Society, there are several national guidelines developed by the professionals in some European countries. There are significant similarities among these care principles concerning practical recommendations. However, the practice may vary depending on the differences in healthcare delivery systems and, more importantly, legal regulations. In general, international guidelines provide room for flexibility in practical applications. Yet, in recent years, there has been a significant change in many European countries with respect to the public appreciation of gender diversity and gender-related healthcare, mainly resulting from a politicized debate triggered by more conservative arguments rather than evidence. This backlash, which has also had a profound impact on the medical professional sphere, is a cause for concern. In this climate, it is becoming more challenging to develop and implement the standards of care for trans and gender-diverse individuals in many countries. Similarities of challenges in the implementation of standards also exist in the means of handling these challenges.

None Declared

Treatment-resistant schizophrenia patients have the worst clinical outcomes and poor quality of life, despite the administration of clozapine. Currently, the definition of resistance is based on treatment response, but evidence differentiating resistance remains unclear. The dysconnectivity theory suggests that disrupted brain interactions contribute to schizophrenia pathology. Advances in functional and structural neuroimaging allow exploration of connectivity patterns that may characterize treatment-resistant schizophrenia.

This study aimed to describe functional and structural connectivity patterns in schizophrenia patients on clozapine.

Patients taking clozapine (CLZ) or other antipsychotic (nCLZ) were recruited from the Hospital of the Medical School of Ribeirão Preto. Healthy controls (HC) were recruited from the Hospital database. Seventy-seven participants were selected: CLZ = 35, nCLZ = 27, and HC = 27. Functional connectivity (FC) was assessed via resting-state functional magnetic resonance imaging (rs-fMRI) and ROI-to-ROI analysis using the CONN toolbox. Structural connectivity was analyzed with diffusion tensor imaging and tractography using TRACULA toolbox. ANOVA and Tukey test were used for three-group comparisons, and the t-tests for two-group comparisons. Functional analysis was performed with a significance threshold of p < 0.05 and false discovery rate (FDR) set to p < 0.01.

Reduced frontotemporal FC and increased FC in the frontal-occipital were common in CLZ and nCLZ compared to HC. An increased FC between sensorimotor and the cerebellum was notable in CLZ compared to HC. Structural findings included increased axial diffusivity (AD) and mean diffusivity (MD) in 8 of 10 tracts in CLZ compared to HC. The corticospinal tract and inferior longitudinal fasciculus exhibited increased AD and MD in CLZ compared to nCLZ. The cingulum angular bundle showed significantly altered diffusion measures in nCLZ: increased AD, MD, and radial diffusivity (RD), and reduced fractional anisotropy (FA).

This study described a widespread functional and structural dysconnectivity in CLZ, characterized by reduced frontotemporal FC and increased frontal-occipital and sensorimotor–cerebellum FC. Altered AD and MD measures in the corticospinal tract and inferior longitudinal fasciculus were observed in the CLZ. Alterations in AD, MD, RD, and FA measures in the cingulum angular bundle, particularly noted in nCLZ, may be associated with antipsychotic administration. Further studies are necessary to establish whether these dysconnectivity patterns consistently characterize these patient groups.

None Declared

The Lancet Commission on dementia prevention, intervention and care and the WHO Guidelines on risk reduction of cognitive decline and dementia provide evidence-based recommendations on lifestyle behaviours and interventions to delay or prevent cognitive decline and dementia. Due to demographic change and because new developments in pharmacotherapy are not suitable for all patients, there is a great need for non-pharmacological interventions. The MEMODIO app was developed to provide a multi-domain therapy for users with Mild Cognitive Impairment (MCI) and dementia. A screenshot of the app is shown in Image 1.

The aim of this study was the exploratory evaluation of whether an app-based therapy can improve cognitive function in patients with MCI and mild dementia. For the interim analysis as of October 2024, the results of the MCI study arm are reported (n=42).

One hundred forty patients with confirmed diagnosis of MCI [Montreal Cognitive Assessment (MoCA) score 21-25] or Mild Dementia (MoCA score 14-20) were randomized to an intervention (IG) or standard of care (SoC) group. IG patients received SoC plus the MEMODIO app, providing cognitive and physical exercises, as well as psychoeducation on a brain-healthy diet and risk factors for cognitive decline, for 12 weeks. MoCA, Amsterdam Instrumental Activity of Daily Living Questionnaire - Short version (A-IADL-Q-SV) Dementia-Related Quality of Life (DEMQOL) as well as Physical Activity Questionnaire (PAQ 50+) were collected at baseline and study end.

In the MCI group, the mean age was 71 years, 20 out of 42 patients were female. Preliminary outcomes are shown in Images 2 and 3.

The preliminary analysis on MCI patients (mean age: 71 y ±9,49 SD, 48% were female) showed statistically significant improvements in MoCA in the IG (-0.84±3.5 SoC vs. 1.96±2.7 IG, p=0.006). Quality of life, physical activity and activities of daily living at the time point of the interim evaluation were not significantly different from baseline, but the activity level measured by PAQ showed a non-significant improvement in the SoC group.

Image:

Image 2:

Image 3:

In this RCT, a significant improvement in cognition was shown in MCI-patients using the MEMODIO app compared to those receiving SoC alone. Further analyses are ongoing.

G. Nelles Grant / Research support from: PI of MEMODIO@APP_CARE, T. Steinmann Employee of: memodio GmbH, D. Stein Shareolder of: memodio GmbH, V. Weil Employee of: memodio GmbH, A. Bicu: None Declared, C. Polidori: None Declared

Behavioral variant frontotemporal dementia (bvFTD), characterized by profound personality changes, impulsivity, and disinhibition, is a neurodegenerative disorder that imposes a significant burden on caregivers. This condition is increasingly recognized as a standalone factor contributing to the onset of caregiver stress syndrome (CSS). This case explores the intricate interplay between bvFTD’s neurobehavioral manifestations, its effect on caregivers, and the systemic insufficiencies in offering support.

To highlight the correlation between behavioral variant frontotemporal dementia (bvFTD) and caregiver stress syndrome, emphasizing the systemic limitations in social and financial aid for caregivers.

A 68-year-old female presented with significant behavioral alterations, including disinhibition and impulsivity. These manifestations, coupled with frontal and temporal lobe atrophy confirmed via CT scan, pointed to a diagnosis of bvFTD. Her daughter, the primary caregiver, developed significant psychological distress in response to the escalating caregiving demands. The daughter’s request for caregiver status, and subsequent efforts to obtain financial and psychosocial support, were met with significant systemic barriers.

In line with broader data, caregivers of individuals with dementia—especially bvFTD—exhibit disproportionately high levels of psychological distress. The daughter’s subsequent psychological symptoms mirrored national trends of caregiver overload, exacerbated by insufficient systemic response and support. Studies show that caregiver burden tends to increase over time, with upward stress trajectories due to increased caregiving demands and reduced social support. This burden can precipitate mental health problems, such as mood disorders, and increase caregiver mortality risk significantly.

The behavioral disturbances characteristic of bvFTD intensify the psychological burden on caregivers, who must contend with the rapid cognitive and functional decline of their loved ones. The absence of sustained financial and psychosocial support exacerbates this strain, pointing to a critical need for reforms in caregiving policies. Understanding the clinical trajectory of bvFTD and its unique caregiver challenges is paramount for developing targeted interventions to prevent caregiver burnout, improve patient outcomes, and mitigate the psychosocial and health risks for caregivers.

None Declared

For patients with schizophrenia, effective treatment of early episodes may improve long-term outcomes, reduce the risk of relapse, and limit functional impairment.

To evaluate the efficacy and safety of brexpiprazole versus placebo in adult and adolescent patients with early-episode schizophrenia.

Data were analyzed from four Phase 3, 6-week, randomized, double-blind, placebo-controlled trials: three in adults (Clinical Trials.gov: NCT01396421 [Vector], NCT01393613 [Beacon], NCT01810380 [Lighthouse]), and one in adolescents (NCT03198078 [Study 331-10-234]). For the trials in adults, patients aged 18–65 were randomized to placebo (total N=531), brexpiprazole (total N=1,093; 0.25, 1, 2 or 4 mg/day, or 2–4 mg/day, depending on the trial), or quetiapine extended-release (N=154; active reference in one trial). For the trial in adolescents, patients aged 13–17 were randomized to placebo (N=104), brexpiprazole 2–4 mg/day (N=110), or aripiprazole (N=102; active reference). Mean baseline Positive and Negative Syndrome Scale (PANSS) Total scores indicated that adult and adolescent patients were of similar disease severity. In all four trials, the primary efficacy endpoint was change from baseline to Week 6 in PANSS Total score. In this post hoc analysis, early-episode schizophrenia was defined as age 13–35, and ≤5 years’ duration of illness. Data from the four trials were pooled and compared between brexpiprazole 2–4 mg/day (FDA-recommended target dose in adults and adolescents) and placebo. Efficacy outcomes were analyzed using least squares (LS) mean change from baseline (mixed model for repeated measures). Safety was also evaluated.

The post hoc early-episode schizophrenia sample comprised 292 patients treated with brexpiprazole 2–4 mg, and 190 treated with placebo (analyzed for safety), of whom 289 and 187 were analyzed for efficacy, respectively. The post hoc efficacy sample comprised 19.3% of the corresponding efficacy sample of the adult trials (pooled), and 98.1% of the corresponding efficacy sample of the adolescent trial. In the post hoc efficacy sample, mean (standard deviation) baseline age was 22.4 (6.6) in the brexpiprazole group and 20.5 (6.6) in the placebo group, and baseline PANSS Total scores were 97.9 (13.5) and 100.4 (14.2), respectively. The LS mean (standard error) change from baseline to Week 6 in PANSS Total score was -21.4 (1.1) with brexpiprazole, and -17.8 (1.4) with placebo (p=0.042). The overall incidence of treatment-emergent adverse events (TEAEs) was 50.7% with brexpiprazole, and 46.3% with placebo. The TEAE with the highest incidence in the brexpiprazole group was akathisia (6.5%; placebo, 2.1%).

Image 1:

In this post hoc analysis of patients with early-episode schizophrenia, brexpiprazole was associated with greater improvement in schizophrenia symptoms than placebo. No new safety observations were made.

None Declared

The mental health of medical students is a critical concern, as their well-being directly influences academic performance and the overall success of educational institutions. The high academic demands, heavy workload, and emotional stress encountered by medical students can lead to significant mental strain, potentially resulting in mental disorders. Understanding these factors is essential for developing effective support mechanisms.

This study aimed to investigate the mental well-being of medical students across the Visegrad Four countries (Hungary, Czech Republic, Poland, Slovakia) by identifying key predictors of well-being and categorizing students into well-being clusters based on psychological and physical health indicators.

A cross-sectional exploratory study was conducted using an anonymous, English-language online questionnaire. The survey gathered general demographic data, health-related information, and academic attitudes. Mental well-being was assessed using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), coping strategies were evaluated with the Brief COPE inventory, and somatic symptoms were measured using the Patient Health Questionnaire-15 (PHQ-15). Regression analysis was performed to identify predictors of mental well-being, and a two-step cluster analysis was employed to classify students into distinct well-being groups.

A total of 1,703 medical students (467 males) participated in the study. Regression analysis identified adaptive problem-focused and emotion-focused coping, social support, satisfaction with the university experience, healthy eating habits, and a sense of control over personal health as positive predictors of mental well-being. In contrast, maladaptive coping strategies (avoidant and passive) and frequent somatic symptoms were negative predictors. The cluster analysis revealed three distinct groups: (1) a stable group with high well-being and satisfaction, low somatic symptom frequency, and low incidence of mental disorders; (2) a risk group with moderate well-being, low satisfaction, higher somatic symptom frequency, and increased incidence of mental disorders; and (3) a problematic group characterized by low well-being, low satisfaction, high somatic symptom frequency, and frequent mental disorders.

The findings suggest that enhancing adaptive coping strategies, the sense of control, and perceived social support may significantly improve mental well-being of medical students. Furthermore, identifying risk and problematic groups can support the development of targeted interventions. These insights not only contribute to a better understanding of medical students’ mental well-being but also offer practical implications for designing preventive and supportive programs to address mental disorders.

None Declared

Adolescence is a crucial stage, during which sleep undergoes significant maturation. Among the sleep changes that characterise adolescence, sleep debt is particularly relevant. Although existing evidence indicates that sleep debt is very prevalent in adolescents, little is known about its impact on adolescents’ mental health.

To explore the cross-sectional and longitudinal associations between sleep debt in adolescence and depression in adolescence and young adulthood.

This study is based on the Avon Longitudinal Study of Parents and Children. Here, we used data from 4,993 participants with information on sleep and depression at 15-16 years, and 3,962 on depression at 24 years. Self-reported information on amount of sleep hours per night during weekdays and weekends (i.e., actual sleep) and amount of sleep hours per night they felt they needed (i.e., sleep need) was collected at 15-16 years. Sleep debt at 15-16 years was calculated as the difference between sleep need minus actual sleep, with higher scores indicating higher sleep debt. Depression symptoms at 15-16 years were self-reported using the Short Mood and Feelings Questionnaires and the cut-off of total scores ≥ 8 was used as a criterion for depression. Moderate depressive disorder at 24 years old was measured using the self-administered computerised version of the Clinical Interview Schedule revised. To test the cross-sectional and longitudinal associations between exposures and outcomes, a series of logistic regression analyses (unadjusted and adjusted) were conducted.

The results from the cross-sectional logistic regression analyses showed that the three measures of sleep debt (weekday, weekend and average) were significantly associated with the outcome, indicating that adolescents with higher sleep debt were at higher risk of concurrent depression at 15-16 years (weekday: OR=1.15, CI 95%=1.11-1.19, p<0.001; weekend: OR=1.04, CI 95%=1.01-1.07, p=0.010; average: OR=1.11, CI 95%=1.07-1.15, p<0.001). Regarding the longitudinal associations, only adolescents with higher sleep debt during weekdays were at higher risk of moderate depression at 24 years (OR=1.12, CI 95%=1.05-1.20, p<0.001), despite sleep debt on average being close to significant (OR=1.07, CI 95%=0.99-1.16, p=0.052).

Higher sleep debt is associated with higher risk of depression in adolescents and constitutes a risk factor for depression in young adulthood, particularly when the sleep debt occurs during weekdays. Our results contribute to the debate on early school times in adolescents and how these can impact their sleep patterns and consequently negatively affect their mental health. Further efforts to understand sleep debt in adolescence are needed, to prevent the development of future mental health problems.

None Declared

Inspired by discussions at the EPA Summer School 2024 on suicide prevention, this poster explores local strategies implemented across European nations. Emphasizing the importance of tailored approaches, the study analyses successful initiatives and community-based programs, and investigates how country-specific factors influence suicide rates. Key findings from research papers on innovative methodologies were also examined, offering insights to inform future practices in suicide prevention.

The poster aims to:

• - Present local strategies for suicide prevention across European countries, focusing on the contributions of clinicians who attended the EPA Summer School.

• - Highlight how knowledge of diverse strategies can impact clinical practice in mental health across Europe.

• - Categorization: European countries are grouped by suicide rates—high, medium, and low—using WHO and European CDC data.

• - Summarization: Local prevention strategies and programs in each group are summarized.

• - Analysis: Various socio-economic and cultural factors influencing suicide rates are discussed, including stigma, economic conditions, and access to healthcare.

• - Comparative Approach: Strategies are compared to identify common successful elements and contextual challenges.

None Declared

Healthcare workers, faced with increasingly demanding professional requirements, are particularly exposed to psychosocial risks. These psychosocial factors have direct repercussions on their work capacity, potentially compromising their professional performance and increasing the risk of medical errors.

To study the influence of psychosocial factors on the work capacity of healthcare workers.

This is an analytical cross-sectional study conducted among healthcare staff at Sahloul University Hospital in Sousse over a 3-month period. Our study was based on a questionnaire that included socio-professional characteristics, Karasek’s model, and the Work Ability Index (WAI).

One hundred and thirty-seven staff members were included in this study, with a response rate of 72.4%. The mean age was 48.7 years, with a sex ratio of 0.57. A low work ability (WAI) was reported in 37.1% of cases. A high psychological demand at work was noted in 24.8% of cases. Job strain was reported in 18.1% of cases. Low WAI scores were statistically associated with age (p<10-3), female gender (p<10-3), lack of physical activity (p = 0.03), professional seniority (p<10-3), and high psychological demand at work (p<10-3). No association was found between low decision latitude, low social support, and WAI scores.

The results of this study highlight the significant impact of psychosocial factors on the work capacity of healthcare staff. Preventive measures in healthcare settings to improve working conditions and preserve the mental health of caregivers are essential.

None Declared

Major depressive disorder (MDD) is a severe mental disorder with a prevalence rate of 10%. Approximately 30-40% of patients suffering from MDD show higher levels of proinflammatory cytokines, associated to low response to pharmacotherapy. Thus, modulation of immune system might have a key role in the management of MDD.

This study is aimed to: 1) assess the interrelation between immune hyperactivation and neuronal plasticity; 2) assess how non-pharmacological treatments impact on the immune hyperactivity in patients suffering from MDD; 3) identify biological makers able to predict the course of MDD and the effectiveness of treatments.

Immune4Plasticity is a longitudinal, multisite trial funded by Italian Ministry of Health. Preclinical analyses aimed at investigating the interrelation between immune hyperactivation and neuroplasticity as well as the identification of biological markers of MDD will be carried out at National Institute of Health in Rome. Clinical part of the study will be performed at the Department of Psychiatry of University of Campania, Naples, and at the Vita-Salute San Raffaele University, Milan. Seventy patients aging 18-65, with a diagnosis of MDD according to the DMS-5 criteria without psychotic symptoms, scoring more than 14 at the 17-item Hamilton Depression Rating Scale and able to release informed consent will be included. Thirty-five participants will attend a lifestyle psychosocial intervention in Naples; thirty-five will undergo light-therapy sessions in Milan. Assessments of both groups will be performed at recruitment (T0), after 3 months (T1) and after 6 months (T2), by using standardized psychometric tools and blood samples. The project will be carried out for 24 months.

This multidisciplinary, translational study will shed more light on the complex interrelationship between MDD, immune system and neuroplasticity by investigating the role of psychosocial intervention and light therapy as ‘modulators’. This will make it possible to develop innovative therapeutic strategies by integrating non-pharmacological approaches with anti-inflammatory drugs and to identify new peripheral markers to assess the response to treatment of patients with MDD.

MDD is a complex mental disorder associated with higher expression of inflammation. Sometimes, it is not adequately responsive to pharmacotherapy. Understanding the effect of non-pharmacological treatments as “modulators” of the inflammatory pattern of MDD may be an important strategy to optimize clinical management of this disorder.

None Declared

Studies that have investigated the relationship between testosterone and psychiatric disorders in women report inconsistent results. Some studies suggesting that female depression patients have lower serum testosterone levels than healthy controls while others report higher serum testosterone levels in female depression patients. Testosterone has also been found to modulate depression and anxiety symptoms. Social research suggests high androgen levels cause aggressive behavior in men and women and as a consequence may cause depression and possible results with more often hospitalization.

The purpose of this study was to determine whether there is a link between the intensity of psychological symptoms that required hospital psychiatric treatment and the level of testosterone in the blood.

The research is prospective and includes female patients with established diagnoses of depressive disorder, anxiety-depressive disorder, bipolar disorder (depressive episode) aged 18-65. The patients had their laboratory parameters determined, including sex hormones (testosteron, estrogen, progesterone, FSH, LH and prolactin), filled out a demographic questionnaire and questionnaires: The Suicide Behaviors Questionnaire-Revised (SBQ-R), Generalised Anxiety Disorder Assessment (GAD-7), Patient Health Questionnaire (PHQ-9), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), Matthey Generic Mood Question, Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HAMA) i Hamilton Depression Rating Scale (HAMD).

The preliminary data of the prospective study showed that there was a statistically significant proportion of patients in whom higher testosterone levels are linked with higher number of hospitalizations (rho=0.511, p=0.036).

Preliminary results show an association between testosterone levels and frequent psychiatric hospitalizations.

None Declared

Brain age gap estimation (BrainAGE) has demonstrated accelerated brain aging in mild cognitive impairment (MCI) and functional aging in patients with Alzheimer’s disease (AD). Nevertheless, the neuroanatomical aging characteristics of AD remain insufficiently understood. The present study aimed to investigate the neuroanatomical aging conditions of AD using the BrainAGE model.

Clinical profiles and T1 structural magnetic resonance imaging (MRI) data of 219 healthy controls (HCs) and 51 AD patients were collected. We extracted gray matter and white matter volumes from the structural MRI and used the BrainAGE model to evaluate aging characteristics in AD patients. Specifically, we configured a stacking model with two levels to predict brain age. The model was trained on the 219 HCs and tested on the AD patients to investigate whether AD could lead to different neuroanatomical aging conditions. In addition, we explored differences in voxel-wise gray matter, white matter patterns, and clinical profiles between AD patients with different neuroanatomical aging conditions.

The proposed machine learning algorithm could accurately estimate brain age in HCs. Application of the BrainAGE model to the AD group revealed three subgroups with advanced, typical, and delayed brain aging conditions. The three AD subgroups also differed in voxel-wise gray matter and white matter volumes. Furthermore, the three subgroups differed in age and genetic scores.

The BrainAGE model identified subtle deviations from age-related brain atrophy in the AD cohort with distinctive clinical manifestations, which contribute to the understanding of neuropathology of AD.

Test anxiety is a widespread issue affecting students’ academic performance and mental health. Students taking a gap year after failing the university entrance exam are particularly vulnerable to traumatic stress and future exam anxiety. An effective group intervention, such as the EMDR Flash Technique, can provide timely support to this group. This technique, an extension of EMDR, involves rapid eye blinking with relaxing imagery during dual stimulation sets, efficiently processing up to five memories per session.

The project’s primary objective is to examine how the EMDR Flash Group Technique addresses traumatic stress and exam-related anxiety in gap year students, while promoting adaptive coping strategies. By tackling anticipatory and future-focused stress, the intervention aims to lower the risk of developing mood and anxiety disorders.

This randomized controlled study will be conducted with a total of 300 students. Participants will be randomly assigned to one of three groups: the EMDR Flash Group Technique, a single-session psychoeducation seminar, and a waitlist control group. Symptoms will be measured at pre-treatment, post-treatment, and follow-up. The assessment tools include the Socio-demographics Scale, Test Anxiety Inventory, Coping with Stress Scale, and the Impact of Event Scale. This study will address the following hypotheses: H1: EMDR Flash Group Technique will decrease the level of test anxiety. H2: It will decrease traumatic stress based on previous test experiences. H3: It will develop functional coping mechanisms.

A significant reduction in exam anxiety levels is expected in the EMDR Flash Group participants, supporting its effectiveness in managing stressors and preventing the development of anxiety disorders. Additionally, there will be a decrease in traumatic stress symptoms (re-experiencing, avoidance, and hyperarousal), demonstrating its effectiveness as an early intervention for trauma-related disorders. Participants are expected to develop more functional stress management skills, emphasizing the technique’s role in reducing dysfunctional coping mechanisms and enhancing resilience. Overall, the EMDR Flash Group Technique will demonstrate its effectiveness as an early intervention model for managing anxiety and preventing the progression of related psychological issues.

Image 1:

Image 2:

Unlike traditional EMDR protocols that focus primarily on past traumas, our approach uniquely integrates past, present, and future-focused elements, creating a holistic framework for managing both past traumatic experiences and anticipatory anxiety about future challenges. By employing a group-based format, this protocol not only offers the potential for a more scalable and efficient intervention, but also provides a deeper understanding of how EMDR can be adapted to address psychiatric disorders in youth.

None Declared

A 26-year-old man presented with his first-episode psychosis (FEP) following a 15-month period marked by a progressive sense of estrangement from his surroundings, ideas of reference, persistent anxiety, difficulty focusing, and social withdrawal. Two years prior, he began stimulant treatment for suspected attention-deficit/hyperactivity disorder (ADHD), though he discontinued the medication shortly after, as he perceived no improvement. Over the past year, he became increasingly distant from friends and eventually resigned from his job. About three months before hospitalization, he began experiencing first-rank symptoms of schizophrenia. This case will serve as a starting point to discuss the complexities of diagnosing the prodromal phase of FEP.

This clinical review aims to examine the phenomenology of the prodromal phase of FEP and address the diagnostic challenges posed by symptom similarities between this phase and neurodevelopmental conditions like ADHD.

A literature review was conducted using the PubMed database, covering studies from the past 20 years. Studies were selected if they included phenomenological descriptions of the prodromal phase in FEP and/ or examined the impact of neurodevelopmental conditions on the emergence of psychosis.

The review identified several key phenomenological markers characterizing the prodromal phase of FEP, which can aid in distinguishing it from other psychiatric conditions. The prodromal phase of FEP is frequently marked by subtle but progressive alterations in cognition, perception, and affect, including experiences such as derealization-depersonalization, ideas of reference, paranoid ideation, and social withdrawal. Evidence suggests that prodromal symptoms intensify over time, evolving from vague unease to specific disruptions in reality testing. Although ADHD and the prodromal phase of a FEP may share some overlapping characteristics - particularly when symptoms are assessed in a cross-sectional manner - ADHD symptoms are generally regarded as stable traits that persist consistently into adulthood.

This case underscores the need for careful differential diagnosis, especially when evaluating individuals in high-risk age groups for psychosis who present with subtle symptoms that do not clearly fit a single diagnostic category. In such cases, clinicians should avoid premature conclusions and instead adopt a longitudinal and comprehensive approach, considering whether genetic, neurodevelopmental, or social risk factors may be contributing to the presentation. A phenomenological perspective can help clinicians detect subtle yet significant shifts in perception, cognition, and affect, enhancing diagnostic accuracy and enabling timely intervention.

None Declared