Sexual minority individuals face unique challenges in mental and sexual health, emotion regulation, and well-being. Although understanding the complex dynamics among these variables in the context of diverse sexual orientations and gender identities is crucial to supporting and tailoring comprehensive interventions, limited research has investigated their overlapping relationships and intersections.

The current study aims to examine the connections between mental health, sexual health, emotion regulation, and well-being among sexual minority and heterosexual individuals in Israel. The main purpose was to provide a comprehensive understanding of the unique challenges sexual minority individuals face.

The study included 465 participants, 324 (70%) were identified as heterosexual individuals and 119 (26%) as sexual minority individuals. Various variables were assessed using an online anonymous questionnaire, including mental health (anxiety, depression, suicide ideation, substance use disorder), sexual health (sex-related distress, problematic pornography use, compulsive sexual behavior disorder), emotion-regulation, and well-being. Between-group differences were analyzed using Mann-Whitney U tests. Network analysis was conducted to examine the centrality and edges of relationships between variables within each group.

Significant differences were found between the heterosexual and sexual minority groups across the measured variables. Sexual minority individuals reported higher levels of psychopathology, lower sexual health, as well as lower levels of emotion regulation and well-being compared to heterosexual individuals. Network analysis revealed that the number of diagnosed psychopathologies and depression were central nodes in the sexual minority group, while sexual functioning played a central role in the heterosexual group. The sexual minority group’s network showed less stability, suggesting distinct subpopulations within this group.

This study contributes to understanding the unique mental and sexual challenges sexual minority individuals face and the intersections between mental health, sexual health, emotion regulation, and well-being. These findings highlight the importance for mental health professionals to acknowledge and address these connections, emphasizing the need for tailored psychosocial interventions that integrate sexual health.

None Declared

Doctors Without Borders works in humanitarian settings. In these settings, we have observed a notable movement away from first generation medications such as haloperidol towards second-generation antipsychotics, where these medications are available. We began to question whether the evidence clearly justified this and decided to contribute to the evidence.

To assess the clinical benefits and harms of haloperidol compared to olanzapine for people with schizophrenia and schizophreniaspectrum disorders.

Searched the Cochrane Schizophrenia study-based register of trials, screened the references of all included studies. We contacted relevant authors of trials for additional information where clarification was required or where data were incomplete. The register was last searched on 14 January 2023.

We didn’t find a statistically significant difference between haloperidol and olanzapine in global state (RR 0.84, 95% CI 0.69 to 1.02), nor in relapse (RR 1.42, 95% CI 1.00 to 2.02). Haloperidol resulted in an increase of extrapyramidal side effects compared to olanzapine (RR 3.38, 95% CI 2.28 to 5.02). For weight gain, there may be a large reduction in the risk with haloperidol compared to olanzapine (RR 0.47, 95% CI 0.35 to 0.61). Haloperidol may result in an increase of leaving the study early compared to olanzapine (RR 1.99, 95% CI 1.60 to 2.47).

Overall, the certainty of the evidence was low to very low for the main outcomes in this review, making it difficult to draw reliable conclusions. There is no clear difference between haloperidol and olanzapine in terms of global state and relapse. Different side effect profiles were noted. These findings should contribute to continue using haloperidol and olanzapine.

Many studies did not use equivalent doses of the two medications when they were compared. Most studies used comparatively higher doses of haloperidol compared to olanzapine.

None Declared

Psychosis encompasses a complex spectrum of psychiatric manifestations that can arise from diverse organic etiologies, such as severe head trauma (1), epilepsy, systemic diseases, and tumors. While brain tumors are typically considered neurological conditions primarily affecting cognitive and motor functions, they can also present with psychiatric symptoms that exhibit clinical and evolutionary atypicality. This interplay between organic pathologies and psychiatric symptomatology underscores the intricate nature of mental health disorders originating from physiological disruptions.

To describe a case of chronic psychotic disorder with intermittent exacerbations secondary to a neurological tumor and discuss the diagnostic and therapeutic challenges.

We report the case of a 46-year-old male patient who was admitted to Razi Hospital for aggressive behavior, delusional syndrome, and auditory hallucinations in 2023. The case report is followed by a discussion reviewing relevant literature on the subject.

A 46-year-old Caucasian man with no significant medical history was referred to our psychiatry service due to recent behavioral disturbances marked by hetero-aggressive outbursts. During evaluation, the patient was conscious, well-oriented in time and space, but anxious and attentive. He reported auditory hallucinations with religious content, persecutory delusions, and mystical-religious ideas. According to the patient’s history, auditory hallucinations began at age 16, with exacerbations at 25, 34, and 42 years.

Psychometric evaluation using the Positive and Negative Syndrome Scale (PANSS) yielded scores of 39 for positive symptoms and 16 for negative symptoms. Neurological examination revealed no abnormalities. Brain MRI showed a tumor in the splenium of the corpus callosum measuring 18 x 14 x 8 mm, with mild hypointensity on T1, hyperintensity on T2 and FLAIR, and minimal contrast enhancement suggesting a glial origin.

The patient was treated with risperidone (4 mg/day) and diazepam (5 mg/day). Over six weeks, PANSS scores decreased (positive: 23 points, negative: 7 points).

After consultation with the neurosurgery team, surgical intervention was not pursued due to the absence of tumor growth and neurological symptoms.

The observed partial remission of psychotic symptoms with pharmacological intervention highlights the potential efficacy of such treatments in ameliorating psychiatric manifestations of organic brain pathologies.

Reference

(1) Khouloud Razki, Uta Ouali, Sofiene Ben Aissa, Chaima Najar, Amina Aissa, Raba Jomli, Journal of the Neurological Sciences, Volume 455, Supplement, December 2023, 122512, ISSN 0022-510X DOI : https://doi.org/10.1016/j.jns.2023.122512

None Declared

Serotonergic antidepressants, particularly Selective Serotonin Reuptake Inhibitors (SSRIs), have been known to cause relevant sexual adverse effects, which were originally thought to disappear after treatment course. In later years, an emergent condition concerning the persistence of sexual impairment following SSRI discontinuation has gathered increasing social and scientific interest. Post-SSRI sexual dysfunction (PSSD) is still underrecognized and understudied.

Our aim was to gather available evidence regarding the pathophysiological mechanisms and contributing factors to PSSD, as well as current management options.

A literature review was conducted using PubMed, through research of the following MESH terms: “Selective Serotonin Reuptake Inhibitors”, “Antidepressive Agents”, “Sexual Dysfunction, Physiological” and “Sexual Dysfunctions, Psychological”. Only papers published in English were included.

PSSD has been described as an iatrogenic condition whose symptoms could persist indefinitely. Despite clinical heterogeneity and lack of robust literature surrounding PSSD, there is growing evidence of this concern. In order to diagnose PSSD, sexual dysfunction due to reemergence of depressive illness must be ruled out. Accurate incidence and prevalence rates of this condition are unknown, though it appears to be a rare phenomenon. Several potential etiological explanations for PSSD have been proposed. Some have highlighted a dysregulation in serotonergic activity induced by SSRIs, while others have tested the role of neuroregulatory agents and bioelectric circuits. Another theory involves a possible link between PSSD and other post-discontinuation syndromes. In contrast, some authors have theorized that sexual impairment induced by a long course of SSRIs could induce a negative conditioning effect towards sexual activity in some patients. Despite abovementioned hypotheses, sexual dysfunction is usually complex in nature and thus multifactorial. There is no established treatment to PSSD. Pharmacological and psychotherapeutic approaches have been tested and proposed to ameliorate symptoms of PSSD, but further investigation is warranted.

PSSD is a heterogenous and idiosyncratic syndrome that needs further characterization. It remains unclear why only certain individuals develop PSSD and treatment options are limited. Current evidence is still incipient and insufficient to justify adjusting current SSRI prescription patterns. However, clinicians must be aware of this condition and should monitor and address these issues with patients. Future research should provide further insights into underlying pathophysiological mechanisms, which in turn could help acknowledge possible preventive and therapeutic interventions.

None Declared

Substance use is a prevalent issue in individuals with psychotic disorders and has major implications for the course of the disease. Substance use is associated with treatment noncompliance, more positive symptoms and increased risk of relapse. However, reasons for substance use in people diagnosed with psychotic disorders are insufficiently understood.

This study seeks to explore the specific reasons for substance use among patients diagnosed with psychotic

disorder, while aiming to identify subgroups of patients that may benefit from targeted interventions to reduce drug use.

We investigated the reasons for maintaining substance use in patients with a dual diagnosis of psychotic disorder and substance use disorder that were admitted to Alexandru Obregia Clinical Psychiatric Hospital, Addictions Department, Bucharest, Romania, between October 2024 and March 2025. Patients were evaluated through a semi-structured interview developed for this study.

The results of the study will be available and presented during the EPA 2025 Congress.

Understanding the underlying motivations for substance use is crucial for developing targeted interventions that address the unique needs of patients with psychotic disorders, ultimately improving treatment outcomes and promoting long-term recovery.

None Declared

The COVID-19 pandemic has emphasized the crucial need to understand the lasting mental health effects on individuals.

This study aims to investigate the occurrence and connections of post-COVID-19 mental health disorders among adults treated at a community mental health center in Tirana. By closing existing knowledge gaps, it seeks to lay the groundwork for tailored interventions.

Employing a historical cohort study design, data will be collected from Tirana residents diagnosed with COVID-19. Comprehensive clinical and laboratory assessments will focus on mental health outcomes post-infection. Demographic, socio-economic, psychiatric, and biomarker data will be analyzed to provide a thorough understanding of post-COVID-19 mental health disorders in the study cohort.

Preliminary findings are expected to provide valuable insights into the occurrence and connections of post-COVID-19 mental health disorders among Tirana’s adult population. Statistical analyses will identify potential risk factors, informing the development of interventions. Robust data presentation will enhance the credibility and applicability of the study outcomes.

This study promises to elucidate the public health implications of post-COVID-19 mental health disorders in Tirana, guiding targeted interventions. Recommendations based on study findings aim to strengthen mental health services and implement tailored interventions, addressing the unique needs of the community.

Main Messages:

Assessing post-COVID-19 mental health disorders in Tirana informs targeted interventions.

Study findings guide public health actions to enhance mental health services in the community.

Key words: Post-COVID-19 mental health disorders; Tirana; community mental health center

None Declared

When an adolescent or young adult is diagnosed with cancer, they’re frequently accompanied by their caregiver. Literature shows that caregivers of adolescents and young adult cancer survivors (AYACS) frequently experience high anxiety and depressive symptoms. Being these caregivers an important source of support to AYACS during this challenging journey, one question emerges: does caregivers’ mental health impact AYACS’ quality of life (QoL)?

Considering this, this study examined the associations between caregivers’ mental health and AYACS’ QoL.

Forty-eight dyads were recruited in four hospitals and one association in Portugal. AYACS were mostly women (62.5%) and off-treatment (62.5%). They were, on average, diagnosed at 18.9 years (range: 15-25) and currently 21.98 (range: 15-38). Their caregivers were mostly women (77.1%) and, on average, 47.02 years (range: 19-76). Parent-child dyads were the most frequent. The Quality of Life Questionnaire Core-30 assessed the AYACS’ QoL. Caregivers’ mental health, the Hospital Anxiety and Depression Scale, and the FCR7 scale assessed caregivers’ anxiety and depressive symptoms and fear of cancer recurrence, respectively.

Preliminary results show that among AYACS’ QoL, only low social functioning was significantly related to high anxiety and depression in caregivers. Treatment status was also significantly positively related to AYAs’ social functioning and negatively to caregivers’ anxiety and depression. AYAs and caregivers’ ages at recruitment were also negatively correlated with caregivers’ anxiety. Age of AYACS at diagnosis, living with caregiver, and type of caregiver were not related to AYACS social functioning nor caregiver anxiety and depression. A model was tested, showing that caregivers’ anxiety and depression predict AYAs’ social functioning, having treatment status as covariable.

Caregivers’ mental health and treatment status were shown to be important for AYACS’ QoL, especially social functioning. This supports the need to assess how caregivers are adapting to this new stage of life and provide specialized support when needed. This could indirectly have a positive impact on the QoL of AYACS. It’s important that the support provided considers the diverse challenges these caregivers face, which can differ from other caregiver groups.

None Declared

Negative symptoms and cognitive deficits in schizophrenia (SZ) significantly affect patients’ quality of life and functionality, but show limited response to antipsychotic treatment.

The present study aims to investigate the acute (n=32) and one-month (n=25; active-tDCS:13 vs. sham-tDCS:12) effects of repeated transcranial Direct Current Stimulation (tDCS) on negative symptoms and executive attention in recent-onset SZ.

In this study, 32 clinically stable SZ patients (age:24.7±4.5, 65% male) with a disease duration under 5 years were included in a single-blind, randomized sham-controlled trial. Patients received 10 sessions of either active-tDCS (n=17) or sham-tDCS (n=15) (anode: left dorsolateral prefrontal cortex, DLPFC; cathode: right orbitofrontal region) at 2 mA for 20 minutes, twice daily, across 5 consecutive days and were followed up after the 10th tDCS on day 5 (acute effect), and at weeks 2 and 4. Pre- and post-tDCS assessments included the Brief Negative Symptom Scale (BNSS), Brief Psychiatric Rating Scale (BPRS), Calgary Depression Scale for SZ (CDSS), Global Assessment of Functioning (GAF), Clinical Global Impression Scale, Verbal Fluency Test (VFT), and the Penn Computerized Neurocognitive Battery’s Letter N-Back and Continuous Performance Test (CPT). One-way ANCOVA was used to assess between-group changes over time, controlling for pre-tDCS measurements, while mixed-design ANOVA explored time × tDCS-group interactions, followed by repeated measures ANOVA to assess within-group effects. Pairwise comparisons over time within each group were examined using a post-hoc Bonferroni test.

The active-tDCS group showed significant acute improvements in Avolition-Apathy (AA) (F(1,29)=13.55, p<0.001, pη²=0.319) and Expressive Deficit (EXP) (F(1,29)=4.66, p=0.039, pη²=0.138) domains, BNSS-total (F(1,29)=25.12, p<0.001, pη²=0.464), BPRS-General Psychopathology (F(1,29)=19.68, p<0.001, pη²=0.404), CDSS (F(1,29)=8.16, p=0.008, pη²=0.22) scores, VFT-phonemic fluency (F(1,29)=11.98, p=0.002, pη²=0.292) and CPT (F(1,29)=5.29, p=0.029, pη²=0.154) performances compared to sham-tDCS. Time-group interactions were significant in BNSS-AA domain (F(1,21)=16.44, p<0.001, pη²=0.701), BNSS-total (F(1,21)=15.77, p<0.001, pη²=0.693), and BPRS-General Psychopathology (F(1,21)=6.42, p=0.003, pη²=0.479). Following the mixed-design ANOVA, repeated measures analyses showed significant score decreases over time in the active-tDCS, while the sham group showed no significant changes or a slight increase (only for BNSS-total scores) (Fig. 1).

Image 1:

The present results suggest that anodal tDCS over the left DLPFC may be effective in alleviating negative symptoms, reducing general psychopathology severity, and acutely enhancing complex attention functions and working memory in recent-onset SZ.

None Declared

War and conflict have significant long-term effects on mental health, affecting both civilians and military personnel. Exposure to armed conflict greatly increases the risk of psychiatric disorders such as PTSD, depression, and anxiety. These effects are not limited to the immediate aftermath but can persist for years, even across generations. Vulnerable populations, including children, women, and refugees, are particularly at risk, facing compounded mental health challenges due to prolonged exposure to trauma and limited access to support.

This poster aims to:

1. 1. Explore the psychiatric consequences of war and conflict.

2. 2. Investigate the development of PTSD, depression, and anxiety in conflict-affected populations.

3. 3. Assess the role of transgenerational trauma transmission and its epigenetic effects.

4. 4. Highlight the role of resilience and psychosocial support in mitigating these effects.

Data were drawn from various studies examining populations affected by conflict across different regions. Key metrics included the prevalence of PTSD, depression, and anxiety, and the impact of traumatic experiences. The role of social support and resilience factors in mitigating psychiatric outcomes was also analyzed.

The findings consistently demonstrate high rates of PTSD and other psychiatric disorders in individuals exposed to conflict. Mental health impacts are often prolonged, with many individuals showing persistent symptoms years after the initial trauma. Additionally, research on epigenetic changes suggests that trauma can be passed down to future generations, potentially affecting their mental health. However, protective factors such as strong social support and community resilience were found to buffer the negative effects of trauma in some cases.

War and conflict have profound and lasting psychiatric consequences. The prevalence of mental health disorders is significant among affected populations, and these effects can be transmitted across generations. Interventions should focus on providing timely mental health care, building resilience, and addressing the broader societal impacts of trauma. Early identification and support are critical to reducing the long-term mental health burden in conflict-affected areas.

None Declared

Daridorexant, a dual orexin receptor antagonist [DORA] which works by selectively reducing the orexin-induced wake signalling, has been shown to induce a dose-dependent reduction in wake time after sleep onset [WASO] in patients with insomnia disorder (Dauvilliers et al. Ann Neurol 2020; 87 347–356).

This exploratory analysis examined the efficacy of daridorexant in reducing the duration of awakenings in each quarter of the night, when compared to placebo and to the GABA-receptor agonist zolpidem, which induces sleep through widespread CNS sedation.

This was a multi-centre, double-blind trial (NCT02839200), including adult (18–64y) patients with insomnia randomized (1:1:1:1:1:1) to placebo, daridorexant (5, 10, 25, or 50mg), or zolpidem (10mg) for 30 days. Polysomnography [PSG]-determined WASO was evaluated using descriptive statistics by quarter of the night (Q1–Q4) i.e. every 2 hours over 8 hours at Days 1 & 2, 15 & 16, and 28 & 29. Baseline was defined as the mean of the two PSG nights during the run-in period and Days 1&2 as the mean of the first two PSG treatment nights; Days 15&16 and 28&29 were defined similarly.

Dose-dependent decreases in mean change from baseline in Q1–Q4 WASO were observed with daridorexant (5–50mg) at Days 1 & 2 (Figure 1). Whereas the approved doses of daridorexant (25mg and 50mg) provided similar response to zolpidem 10mg in the first half of the night, mean reductions from baseline in WASO were numerically greater with daridorexant 50mg versus zolpidem 10mg during the second half of the night – with the difference most pronounced in the fourth quarter (mean WASO change from baseline Q3: –13.49 min versus –9.73 min; Q4: –17.51 min versus –7.81 min). Similar effects were seen at Days 15 & 16, and Days 28 & 29.

Image 1:

In patients with insomnia disorder, daridorexant reduces the duration of awakenings throughout the entire night, including the last two quarters.

B. Steiniger-Brach Employee of: Idorsia Pharmaceuticals, O. Briasoulis Employee of: Idorsia Pharmaceuticals, A. Olivieri Employee of: Idorsia Pharmaceuticals, S. Pain Employee of: Idorsia Pharmaceuticals, L. Palagini Consultant of: Bruno, Fidia, Idorsia Pharmaceuticals, Pfizer, Sanofi, Pharmanutra, Neopharmed Gentili, D. Kunz Consultant of: Austrian Association of Skiing (ÖSV), Idorsia Pharmaceuticals, Speakers bureau of: AbbVie, Idorsia Pharmaceuticals, German Ministry for Economy (BMWi), Austrian Association of Skiing (ÖSV), P.-A. Geoffroy Consultant of: Apneal, Arrow, Biocodex, Dayvia, Di&Care, Idorsia Pharmaceuticals, Janssen-Cilag, Jazz pharmaceuticals, Myndblue, Mysommeil, Posos, ResilEyes, Withings, Speakers bureau of: Biocodex, Bioprojet, Ibsa, Idorsia Pharmaceuticals, Janssen-Cilag, Isis Medical, Jazz pharmaceuticals, Lundbeck, MySommeil, Withings.

Adherence to treatment plays a key role in the effectiveness of therapy of the cardiovascular diseases. Patient’s personality becomes an inevitable determinant of health behaviour influencing the way the patient reacts to the illness itself. The painful sensations, the need to adapt to the disease may be the cause of frustration in patients (Heszen-Klemens. Soc Sci Med 1987, 24 (5) 409-416). Hence, it is necessary to assess how the frustration reactions are connected with the adherence to treatment.

The aim of the research was to study the relationship between the frustration reactions and the adherence to treatment in patients with cardiovascular diseases.

The Picture Frustration Test (Rosenzweig. Journal of Personality 1945, 14 3-23) was used to assess frustration reactions of the patients. The Questionnaire for Comprehensive Assessment of Treatment Adherence was used to provide a complex evaluation of the adherence to treatment (Nikolayev, Skirdenko. Clinical Pharmacology and Therapy 2018, 1 74-78). The study was conducted from January 2024 to April 2024. The sample consisted of 42 male patients hospitalised with multiple cardiac pathology, whose average age was 49.40±7.71.

The average adherence to treatment of the patients with cardiovascular diseases in our sample was 61.17±18.53%, with twelve (30%) participants being defined as low-adherent and nine (22.5%) as high-adherent. What concerns direction of frustration reactions, low-adherent patients were more likely to exhibit extrapunitive reactions (H=7,760, p=0,021), whereas high-adherent patients demonstrated intropunitive reactions more often (H=6,062, p=0,048). More interestingly, there were significant differences in types of frustration reactions, with need-persistent reactions being more characteristic for the high adherent-patients (H=6,551, p=0,038). Intropunitive and need-persistent frustration reactions were associated positively with the adherence to treatment (r=0.428, p=0.013; r=0.459, p=0.007). Extrapunitive reactions were found to be negatively associated with the adherence (r=-0.409, p=0.004).

Our study was the first to consider the connection between the frustration reactions of the patients with cardiovascular diseases and their adherence to treatment. The results indicate that the way in which patients typically react to the frustration is connected with the way in which they handle limitations and requirements of the treatment process. When the patient is more likely to react to frustration in problem-solving manner, the chances are that their health behaviour will also lead to a sufficient adherence to treatment.

None Declared

Delayed perinatal grief occurs when the grieving process for a lost baby is reactivated after the birth of a healthy child. This case presents a 39-year-old mother who, after losing her first baby at 36 weeks due to Patau syndrome, experienced delayed grief following the birth of a full-term baby two years later. Despite receiving one psychological consultation at the time of the loss, the lack of follow-up contributed to the reactivation of her grief postpartum, presenting with sadness and anxiety.

• - To describe the process of delayed perinatal grief in a mother who lost a baby due to Patau syndrome.

• - To evaluate the psychological impact of the lack of follow-up after the loss on the subsequent development of reactivated grief.

• - To propose therapeutic interventions for the management of mothers experiencing delayed perinatal grief.

We present the case of a 39-year-old mother who lost a baby at 36 weeks of gestation due to Patau syndrome. Following the loss, she received a single psychological consultation with no further follow-up. Two years later, she gave birth to a healthy baby at 40 weeks, and six weeks after delivery, she was referred to psychiatry due to symptoms of profound sadness and anxiety, consistent with delayed perinatal grief. The patient was evaluated by the psychiatry team and began treatment with psychological intervention and pharmacological management when necessary.

The psychiatric intervention led to a gradual improvement in symptoms of sadness and anxiety. The patient responded favorably to psychological treatment, incorporating cognitive-behavioral therapy techniques to manage grief. However, feelings of sadness persisted on dates related to the previous loss. Ongoing emotional support was crucial for the recovery process.

Delayed perinatal grief can reactivate after the birth of a new child, especially in cases where the original loss was not adequately followed up. Proper psychological support is essential to help mothers process their grief and prevent long-term emotional complications.

None Declared

Behavioral dysregulation and aggression pose substantial challenges in treating adolescents within youth justice systems, particularly in cases with complex psychiatric histories and diagnostic ambiguity. Autism spectrum disorder (ASD) is often underdiagnosed due to its different presentations, particularly in females. Many girls with ASD show strong desire for social interaction, but due to difficulties in navigating social relationships, they frequently experience frustration, resulting in explosive and auto and heteroaggressive behaviors. For those ASD patients with comorbid conduct disturbances, standard antipsychotic treatments can be insufficient, being necessary to try alternative pharmacological approaches.

To explore the therapeutic impact of low-dose clozapine on severe conduct dysregulation and auto/heteroaggression in this minor with ASD, and to assess clozapine’s effectiveness in reducing anxiety and improving adaptability within a structured therapeutic environment.

We present a 17-year-old female patient with a history of severe behavioral disruptions with aggressiveness, initially diagnosed with various psychiatric conditions and treated with high-dose antipsychotics without clinical improvement. The case follows her through two separate admissions to a youth justice center’s therapeutic unit, where a retrospective review of her history and a longitudinal study of her diagnosis were made. After conducting a review of clozapine’s effects on reducing aggression, low doses of clozapine are finally tried, with the goal of stabilizing behavioral disturbances and reducing the patient’s associated distress.

When low-dose clozapine (up to 150 mg/day) was introduced, improvements in conduct regulation and emotional distress were documented. A treatment interruption occurred between admissions due to a lapse in its administration, followed by relapse in behavioral symptoms. Upon re-initiation of clozapine in the second admission, the patient’s symptoms stabilized again, with substantial behavioral improvement and reduced anxiety, enhancing the patient’s ability to function within the structured environment of the therapeutic unit. The patient achieved sustained clinical stability for over two months, a period marked by the absence of pharmacological rescue interventions or containment measures.

Low-dose clozapine may be a viable option for managing severe behavioral disturbances in adolescents with ASD within youth justice settings, especially when other treatments prove ineffective. This case underlines the potential of clozapine not only to mitigate aggression but also to facilitate better adaptive functioning and reduce anxiety, contributing to a more stable therapeutic experience. Further investigation into clozapine’s role in treating conduct dysregulation in ASD is warranted.

None Declared

There is a scarcity of research on the application of EMDR in addressing PTSD within correctional facilities, presenting varied results due to the difficulties associated with prolonged imprisonment. Prisoners encounter persistent mental health conditions such as depression, trauma, PTSD, and substance use disorders, contributing to maladaptive behaviors within the aggressive and psychologically taxing prison environment. Racial tensions and the pressure to conceal emotions further complicate matters, affecting daily life within the prison setting.

To conduct a systematic review, following PRISMA guidelines, to assess the efficacy and evidence supporting the use of Eye Movement Desensitization and Reprocessing (EMDR) therapy for Posttraumatic Stress Disorder (PTSD) within forensic settings, in order to address the limited research available and provide insights into the outcomes and challenges related to treating PTSD in incarcerated individuals.

A review of 11 studies meeting the inclusion criteria was conducted. The study involved 156 incarcerated participants with a median age of 36.9 years, examining gender-based differences in reported trauma experiences and evaluating the effectiveness of EMDR therapy for PTSD in forensic environments. Primary assessment tools included PCL-C and CAPS scores for pre- and post-therapy evaluations. The timing of the initial EMDR session post-incarceration and symptomatic improvements over sessions were analyzed.

Analysis of the study revealed significant improvements in symptoms over an average of six EMDR sessions, with no reported adverse events during therapy. The study highlighted the challenges and outcomes of implementing EMDR therapy for PTSD in correctional settings, shedding light on the effectiveness of the treatment among incarcerated individuals.

Despite positive initial results, it is vital to approach the interpretation of the benefits of EMDR therapy with caution, given factors such as the absence of standardized clinical trials, variability in reported outcomes, and the potential for study bias. Recognizing the need for additional investigation, further exploration is warranted to understand the lasting effects of EMDR therapy on recidivism rates, taking into account variables like the nature of the offense, length of incarceration, and frequency of reoffending.

None Declared

Tunisian women, seen as symbols of freedom, have achieved social equality despite various challenges. This study examines the role of sociodemographic factors and coping strategies in shaping psychological resilience among Tunisian women.

To investigate how sociodemographic factors and coping styles influence resilience in Tunisian women.

This cross-sectional study targeted Tunisian women aged 18 and above through an online survey between June and August 2024. Sociodemographic data were collected, coping styles were measured using the Brief COPE inventory, and resilience was assessed via the 25-item Connor-Davidson Resilience Scale (CD-RISC 25).

Data from 695 women (mean age = 36.72 ± 12.23) showed that 90.9% had university education and 34.1% were unemployed. Personal income was the main income source for 61.7%. The mean resilience score was 68.26 ± 14.09, with 26.3% exhibiting low resilience. Higher resilience was significantly associated with university education (p < 0.001) and higher economic status; 34.3% of those in lower brackets showed low resilience (p = 0.007). Personal income also predicted resilience (p < 0.001). Regarding coping, resilience positively correlated with problem-focused (r = 0.496, p < 0.001) and emotion-focused coping (r = 0.271, p < 0.001), but was negatively associated with avoidance coping (r = -0.093, p < 0.05).

This study reveals that resilience among Tunisian women is linked to education, economic status, and income, with effective coping strategies (problem- and emotion-focused) enhancing resilience. Findings underscore the importance of economic empowerment and effective coping skills in strengthening resilience among women.

None Declared

In Eastern Cameroon, the psychological needs of both Central African refugees and host communities are significant. Following psychological group interventions over a two-month period, many participants expressed a desire to continue the support process. To meet this need, a self-support protocol was implemented to encourage participants to maintain and strengthen their emotional and social bonds.

The aim of this intervention was to enable participants to continue engaging in psychological support autonomously, enhancing their well-being, resilience, and coping mechanisms. The program sought to provide tools for ongoing emotional regulation and peer support, addressing the psychosocial challenges identified during the initial psychological care.

A flexible, peer-led protocol was developed and implemented after group psychological sessions. Participants were invited to form their own self-support groups, with a recommended size of up to 10 members, meeting weekly for approximately 90 minutes. The structure was intentionally loose to promote autonomy, creativity, and peer leadership. Two initial sessions were facilitated by psychosocial supervisors, while subsequent meetings were primarily observed to assess group evolution. Key dimensions such as emotional well-being, resilience, and social cohesion were measured pre- and post-intervention.

The qualitaive analysis revealed increased cohesion and social connection between group members, especially between refugees and host communities. Participants reported feeling empowered and valued the emotional stability gained through the exercises introduced during the program. However, the evaluation also highlighted challenges, such as maintaining motivation without ongoing supervision and the need for economic opportunities to sustain long-term engagement.

This self-support protocol demonstrated the feasibility and positive impact of peer-led psychological care in contexts with limited resources. The program reinforced emotional resilience, social cohesion, and mutual support, but future iterations should consider integrating economic empowerment initiatives and more structured follow-up to ensure sustained participation.

None Declared

Due to the potentially severe side effects of antipsychotics, overtreatment is an important concern. Previous research focussed on antipsychotic polypharmacy and excessively high doses.

In this study, the aim is to map trends in potential overtreatment, antipsychotic polypharmacy, total antipsychotic dose and the subjective side effect burden. Moreover, the association of the total antipsychotic dose and antipsychotic polypharmacy with the subjective side effect burden will be investigated.

Data from a large (n>5000) naturalistic longitudinal cohort was used (PHAMOUS, 2013-2021). Potential overtreatment was defined as a total antipsychotic dose equivalent to >5mg risperidone, in combination with a high subjective side effect burden. Mixed effect models were used to investigate trends in potential overtreatment, antipsychotic polypharmacy, total antipsychotic dose and the subjective side effect burden. A mixed effect model was used to assess the association of total antipsychotic dose and antipsychotic polypharmacy with total subjective side effect burden.

Overall, 15,717 observations nested in 5,107 patients were used. About one-third of patients were potentially overtreated, with no change over time. The prevalence of a dose above the equivalent of 5 mg risperidone decreased over time, while antipsychotic polypharmacy prevalence increased. The total subjective side effect burden slightly decreased. A higher dose and antipsychotic polypharmacy was associated with a higher subjective side effect burden.

The subjective side effect burden did decrease the last decade. This might be caused by lower doses and more adequate use of polypharmacy. Still, the overtreatment rate is about one-third and the subjective side effect burden is still high. To reduce the subjective side effect burden and overtreatment, addressing inappropriate antipsychotic polypharmacy remains prudent.

None Declared

Tardive dyskinesia is a movement disorder mostly associated with long-term antipsychotic use. Patients may present with a wide variety of clinical features such as stereotypic movements, dystonia, etc. There are many treatment approaches but the level of evidence is low. (Vasan et al. StatPearls Pub 2024)

To draw attention to the clinical presentation of tardive dyskinesia and its treatment.

A detailed case report is documented.

A 43-year-old woman, married, housewife, diagnosed with psychotic disorder. Last year, she admitted to our outpatient clinic for the first time. She was receiving Amisulpride 400 mg/g, Zuclopentixol deconoate 200 mg/month, Biperiden 4 mg/g, Propranolol 80 mg/g on admission. Her complaints were slowed movements and difficulty in doing housework. On examination, mouth puckering and periodic head movement were noticeable. She complained of contractions in her legs and numbness in her tongue. Her speech and walking were slow. In cerebellar tests she was clumsy. She stated that her complaints increased sometimes, the contraction in her neck and legs never stopped, but the mouth puckering movement ceased at night. Her AIMS scale point was 11.

It was learned that about 4 years ago she had started to complain of feeling that she was being spied on and hearing bad things. She had been hospitalized and diagnosed with psychotic disorder. Paliperidone and aripiprazole long-acting injections, olanzapine, quetiapine treatments had been tried during hospitalization and outpatient follow-up. She had been continuously switched to another treatment because of her suspicion. Lastly zuclopentixol deconoate had been started and combined with amisulpride. She stated all her complaints of movement appeared shortly after first hospitalization. Biperiden and propranolol were added to treatment, but her complaints didn’t improve.

During our follow-up she was consulted to neurology. Her current picture was evaluated as tardive dyskinesia. Her treatments were gradually stopped. Clonazepam was started and gradually increased to 2 mg/g and combined with vitamin E and its dosage was increased to 1200 mg/g. After discontinuation of antipsychotics during close follow-ups she had no psychotic complaints. Within 5 months, mouth puckering movement, stereotypic left-turning movement in the neck, numbness in the tongue and contraction in the leg completely resolved. Her speech and walking improved. Last AIMS scale point was 3.

Tardive dyskinesia is an iatrogenic movement disorder. Many methods have been proposed for treatment but no definite treatment is known. It’s thought that vitamin E may be beneficial with its antioxidant effect and clonazepam may be effective above 2 mg. The case is important in terms of demonstrating the efficacy of the combination of vitamin E and clonazepam. (Cornett et al. Ochsner journal (2017):162-174.)

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The recent development of the socalled “psychedelics” reminds us that unfortunately some medications which we used in psychiatry have a large burden of side effects, like the anticholinerg side effects of the older tricyclic antidepressants as well as the extrapyramidal motoric side effects of socalled typical neuroleptics. These side effects were sometimes also related to the efficacy of these medications. Interestingly, it seems that the neglection of side effects is still an unresolved issue in clinical psychopharmacology, since there are researchers and clinicians who argue that the psychedelic experience induced with psychedelics are associated with therapeutic efficacy. Furthermore, studies in this field not even mention these side effects as such and argue, when confronted with the issue, that these are necessary for the therapeutic outcome. Even more so, there are researchers and clinicians who think that these side effects allow the patients to understand their unconscious, like in the early days of psychoanalysis. However, recent preclinical animal models demonstrated antidepressant-like behavioral effects and synaptic actions that are not only linked to the serotonergic activation (mainly via the 5HT2A receptor), but also via opioid and glutamatergic pathways which share neurobiological mechanisms of network reconfiguration likely by intracellular plasticity cascades. It seems to be important from my point of view to develop antidepressant medications devoid of the side effect of psychedelic experience in order to produce a safer, non-hallucinogenic medication that has therapeutic potential for depressed patients.

S. Kasper Consultant of: In the past 3 years Dr Kasper served as a consultant or on advisory boards for Angelini, Biogen, Boehringer, Esai, Janssen, IQVIA, Mylan, Recordati, Rovi, and Schwabe; , Speakers bureau of: In the past 3 years Dr. Kasper served on speakers bureaus for Angelini, Aspen Farmaceutica S.A., Biogen, Janssen, Recordati, Schwabe, Servier, and Sothema.

Artificial intelligence (AI) is emerging as a disruptive tool in medicine and healthcare, especially in Mental Health. Its ability to process large volumes of data and detect complex patterns has opened up new possibilities for the diagnosis, treatment, and monitoring of mental disorders, providing opportunities to improve the clinical accuracy and personalisation of therapeutic intervention. However, the use of AI in Mental Health poses critical challenges involving ethical, privacy, and inherent issues regarding the quality and validity of the models employed.

The aim of this review is to critically analyse the strengths and limitations of the use of AI in Mental Health, offering a balanced perspective on the potential benefits and associated risks.

A narrative review of the current scientific literature was conducted on the main applications of AI in the diagnosis, treatment, and monitoring of mental disorders as well as the barriers to its effective implementation.

The main strengths identified were the ability of AI to provide more accurate and personalised diagnoses, continuous monitoring of patients’ well-being, increased efficiency in the delivery of Mental Health services, and the possibility of analysing large volumes of data in reduced times, thus improving the ability to detect and track symptoms. However, regarding limitations, the scientific literature highlights the lack of transparency in many of the studies conducted, problems of methodological quality, risks regarding the perpetuation of pre-existing biases, concerns about the privacy of sensitive data, and the potential risk of dehumanisation of care by prioritising automated systems over human contact. In addition, the need for rigorous validation and a clear regulatory framework are key issues in ensuring the ethical and safe use of these technologies.

In conclusion, AI represents a resource with immense potential for transforming clinical practice in Mental Health care, providing more accurate diagnoses, personalised interventions, and real-time monitoring. However, its implementation must be accompanied by rigorous scientific and regulatory scrutiny to mitigate ethical risks and ensure the protection of patients’ privacy and dignity. It is necessary to ensure that technological advances go hand in hand with a humanised approach, where technology complements, but does not replace, the essential therapeutic connection in Mental Health care.

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