Daridorexant is a dual orexin receptor antagonist approved for the treatment of chronic insomnia. Phase 3 studies have demonstrated that consistent nightly use of daridorexant 50 mg significantly improved both subjective total sleep time (sTST) and daytime functioning (Insomnia Symptoms and Impacts Questionnaire [IDSIQ] sleepiness domain) at Months 1 and 3 in patients with insomnia disorder versus placebo (Mignot et al. Lancet Neurol 2022; 21 125-39).

This exploratory analysis evaluated how the effect of daridorexant on both sleep and daytime functioning are perceived by patients with insomnia over time (i.e. week by week), as compared to placebo.

In this multi-centre, double-blind trial (NCT03545191), adult (18–64y) and elderly (≥65y) patients with insomnia disorder were randomized (1:1:1) to receive daridorexant 25mg, 50mg or placebo every evening for 3 months. Patients completed daily eDiary entries throughout the study, and weekly mean changes from baseline in sTST and IDSIQ-sleepiness domain were used to assess patients’ perceived duration of sleep and daytime functioning, respectively.

Weekly mean changes from baseline of both the sTST (Figure 1) and IDSIQ-sleepiness domain (Figure 2) from Week 1 to Week 12 of treatment improved over time in all treatment groups. At each week, the observed improvements from baseline were numerically larger for daridorexant 25 and 50 mg than placebo, with the 50 mg group demonstrating the greatest response. For sTST, treatment differences versus placebo were seen from Week 1 of treatment (mean increases from baseline for 25 mg, 50 mg vs placebo of +23.83, +32.63 vs 10.07, respectively), and were maintained throughout the study. For IDSIQ-sleepiness domain scores, treatment differences vs placebo were seen from Week 1 (mean reductions from baseline for 25 mg, 50 mg vs placebo of –1.56, –1.90 vs –0.92, respectively), with further separation from placebo until Week 4.

Image 1:

Image 2:

The benefits of daridorexant treatment on total time asleep and daytime functioning start to be perceived from Week 1. With consistent nightly use, efficacy on sleep and daytime functioning continued to build over the course of the 3-month treatment period, with the greatest effect being observed with daridorexant 50 mg.

T. Bakker 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

Depression is a pervasive mental health disorder that can significantly influence symptomatology, which remains a crucial area of research. This study aims to investigate whether gender correlates with PHQ-9 total scores, enhancing the general understanding of depression across different demographic groups.

This study examines the correlation between gender and PHQ-9 total scores, investigating the hypothesis that gender influences various depressive symptoms as measured by the PHQ-9. We aim to determine whether there is a significant difference in depression severity between male and female participants.

To fulfill this purpose, we collected data from a total of 146 participants, primarily Turkish immigrants of the first and second generation, who were recruited from the Neuro-Psychiatrisches Zentrum Riem. First, we gathered the participants’ sociodemographic data, including gender, marital status, and education level. Furthermore, they were asked to complete the PHQ-9 questionnaire, and we conducted a Pearson correlation analysis.

The PHQ-9 total scores and gender show a significant correlation, with a p-value of 0.040. Furthermore, these results indicate that female participants had higher average PHQ-9 scores compared to male participants, suggesting a greater intensity of depressive symptoms among women. Since the participants were predominantly Turkish immigrants, these findings may suggest that Turkish women are more prone to severe depressive symptoms, potentially as a consequence of their immigration history.

This study emphasizes the significance of gender in relation to depressive symptoms, as measured by the PHQ-9 questionnaire. However, future research should investigate other factors, besides gender, that may influence the severity of depressive symptoms in immigrant participants. It is recommended that these studies focus on the long-term effects of immigration, depression, and gender by including a diverse range of participants, such as immigrants from the first, second, third, and fourth generations. These generational differences could indicate significant variations in the experiences and consequences of severe depressive symptoms.

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There are limited data to guide treatment continuation decisions for clinicians caring for patients with treatment resistant depression (TRD). Identifying the magnitude of early improvement (at Weeks 4 and 8) as a predictor of long-term outcomes for TRD can guide treatment continuation decisions.

To evaluate the probability of achieving response or remission by Week 32 in patients with TRD after 4 or 8 weeks of esketamine nasal spray (ESK-NS) treatment, flexibly dosed in combination with an ongoing selective serotonin/serotonin-norepinephrine reuptake inhibitor (SSRI/SNRI).

ESCAPE‑TRD was a randomised phase IIIb trial comparing the efficacy of ESK-NS versus quetiapine extended release, both in combination with an ongoing SSRI/SNRI, in patients with TRD (Reif et al. NEJM 2023; 389 1298–309). Remission was defined as a Montgomery-Åsberg Depression Rating Scale (MADRS) total score ≤10, and partial response and response as ≥25% and ≥50% improvements, respectively, in total MADRS score (or remission). Long-term outcomes were based on the best outcome on-treatment across 32 weeks (≥1 instance of response or remission) from earliest outcome endpoint onwards. Non-responder imputation (NRI) was applied after treatment discontinuations.

336 patients were randomised to ESK-NS; 334 received ≥1 dose. Table 1 shows long-term outcomes following at least partial response, response or no partial response at Weeks 4 and 8. For example, among those who had at least a partial response at Week 4, 94.1% and 79.8% had response and remission by Week 32, respectively.

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This analysis demonstrated a relationship between short- and long-term outcomes. Presence of at least partial response at Week 4 led to more favourable outcomes by Week 32. Moreover, most patients with response by Week 4 achieved remission by Week 32. Continued symptom improvements were observed beyond the induction phase even in some patients with no partial response at Week 4.

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The presentation of psychotic symptoms in adults requires a global medical assessment, especially in cases of atypical presentations or if warning signs are present. The presence of cognitive symptoms and behavioral changes requires screening for various neurological diseases.

Underline the importance of neurological evaluation in atypical psychotic conditions with cognitive and behavioral symptoms. Describe Brain Sagging Dementia as a possible etiology of these conditions.

Presentation of clinical case and bibliographic review.

The clinical case of a 59-year-old female patient brought to the emergency department for psychiatric evaluation due to behavioral alterations is described. During the evaluation, paranoid symptoms were detected, with marked suspicion towards her family, which led to her admission for psychiatric hospitalization. During observation, the clinical history was completed, revealing marked changes in behavior, apathy, perseveration, and decreased functionality for more than five years. Neuropsychological tests were performed, where cognitive and visuospatial alterations were evident. A consultation with the neurology service was requested, who initially considered the diagnosis of behavioral-variant frontotemporal dementia.

Given the history of orthostatic headaches secondary to cerebrospinal fluid hypotension due to a dorsal fistula, a new brain MRI was performed, which found evidence of cerebrospinal fluid hypotension without frontotemporal atrophy. Given all the clinical and radiological findings, a possible diagnosis of Brain Sagging Dementia was considered.

Brain Sagging Dementia is a rare syndrome caused by spontaneous intracranial hypotension (SIH), which mimics the behavioral clinical findings of frontotemporal dementia (bvFTD), excluding it due to the absence of frontotemporal atrophy. It is insidious in nature, with gradual cognitive and behavioral alterations.

The first-line treatment is an epidural blood patch, with partial resolution of symptoms in up to 81% of cases and complete resolution in up to 67%.

In this case presented, the patient is awaiting evaluation by neurosurgery.

In case of suspected neurological origin of psychiatric symptoms, a complete evaluation is essential with special attention to potentially reversible causes.

It is important to keep in mind the neuropsychiatric manifestations that can occur in dementia and other neurology conditions, to avoid delaying a correct diagnosis. These include behavioral alterations, psychotic symptoms, eating disorders, as well as affective disorders ranging from apathy and depression to expansiveness with signs of disinhibition.

Brain sagging dementia is a reversible condition with symptoms of bvFTD, whose early diagnosis and treatment significantly improve the medical prognosis.

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Neurological soft signs (NSS) are subtle sensory and motor deficits linked to neurodevelopmental disorders, schizophrenia, and thyroid disorders (TH). TH are essential for neurodevelopment and the modulation of the proinflammatory response. Indeed, a growing body of evidence suggests that thyroid function is altered in individuals with schizophrenia spectrum disorders (SSD).

We aimed to evaluate the relationship between TH, NSS, and psychopathology in individuals with schizophrenia.

Opportunistic recruitment took place at the 3rd Department of Psychiatry at AHEPA University General Hospital of Thessaloniki, Greece. Inclusion criteria were an SDD diagnosis and age above 18 or below 65 years. Patients were excluded if they had a history of neurological or other somatic disorder, a history of substance abuse, an IQ estimate <70, and if they were pregnant, or on treatment with glucocorticoids and/or thyroxin. Clinical symptomatology was assessed using the Positive and Negative Syndrome Scale (PANSS), and NSS were assessed using the Neurological Evaluation Scale (NES; Greek version). Blood samples were drawn after an overnight fast to measure serum levels of TSH, fT4, and fT3. We used the t-test to compare differences between sex and the Pearson correlation to test for correlations between PANSS scores, NES scores, and TH (R statistical software version 4.3.2).

A total of 73 patients (31 female) with SSD were included [mean age 41.2 (SD 11.6) years]. TSH and fT4 levels were significantly higher in females, p<0.0005 and p=0.020, respectively. fT3, but not fT4 or TSH, was negatively correlated with age (r=-0.479, p<0.001). A negative correlation between NES total score and fT4 (r=-0.416, p=0.014) was only found in males. Serum fT3 levels exhibited no significant correlation with NES scores but the PANSS negative subscore was negatively associated with fT3 (r=-0.471, p<0.001).

Our study suggests that TSH and fT4 abnormalities are more prevalent in females with SSDs. Moreover, it appears that with increasing age, the likelihood of hypothyroidism increases. Interestingly, in individuals with SSDs, lower fT4 levels predicted NSS severity but only in males, and lower fT3 levels predicted an increase in negative symptoms. Hypothyroidism has been reported to cause damage to the central nervous system and has been associated with increased apoptosis and altered expression of cerebellar neurons leading to impairment in motor function. In this sense, restoring fT3 and fT4 levels might have a positive effect on negative symptoms and NSS severity (in males), respectively. However, antipsychotic medication may affect TH levels in SSDs. Thus, future studies should examine a larger sample of drug-naïve individuals with SSDs, followed-up longitudinally in time to infer causality.

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Medical and psychiatric conditions often coexist, with complex interrelationships that affect patient outcomes. Medical conditions can induce mental illness through psychological or physiological effects, while mental illness may hinder engagement in medical care due to barriers such as poor motivation and functional impairment. Anxiety and depression are among the most common psychiatric conditions encountered on medical floors, and improved management of these conditions can enhance patient outcomes and increase post-discharge follow-up.

The objective of this project was to improve the confidence of medical professionals in treating anxiety and depression on the medical floor by establishing an evidence-based approach for identifying and managing these conditions. The guidelines developed serve as a protocol for rapid, safe interventions, improving outcomes and reducing inefficient healthcare utilization.

A survey was conducted among 18 medical residents to assess their confidence in evaluating and managing anxiety and depression, and determining when a psychiatric consult is necessary. After completing the initial survey, residents were provided with a stepwise guideline for managing anxiety and depression on the medical floor. A post-guideline survey was then conducted to assess changes in their confidence levels and understanding.

Pre-intervention survey results showed 85.7% of residents were comfortable identifying anxiety, 64.3% with identifying major depressive disorder (MDD), and 71.4% with differentiating MDD from bipolar depression. However, only 64.3% felt comfortable treating anxiety, and 50% initiating treatment for MDD. Post-guideline survey results showed improvements in several areas, including 90% confidence in identifying anxiety and 70.2% in diagnosing MDD. Notably, all residents felt comfortable continuing treatment for depression, and knowledge of medication side effects increased to 100%.

The results suggest that medical residents on the floor showed improved confidence in evaluating and managing anxiety and depression after receiving the guideline. There was increased comfort with knowledge of medications and their side effects, although some discomfort remained in initiating treatment and titrating medications. Implementing universal screening protocols and further educational interventions, such as didactic sessions on specific medications and their side effects, can help address these gaps and enhance psychiatric care on the medical floor.

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Mood in puerperium is a subject of great interest since it can undergo variations in such a significant period of a woman’s life as motherhood. It is equally true that the presence of a partner with a secure attachment style can constitute a stable base for a woman to lean and to rely, while it is more likely to hypothesize cracks in mood in absence of effective support in the relational context.

The aim of this research is to analyse the trend of puerperal mood in women in the period immediately following the delibery and after a few months. The study also examines the attachment styles of the partners of these women and the relationship between mood in women and the attachment of their partners.

The study was conducted on a sample of women and their partners.

The women were administered 2 administrations of the Edinburgh Peripartum Depression Scale (EPDS): the first within 24 hours of delivery and the second four months after delivery.

The Relationship Questionnaire (RQ) was administered to the male partners immediately after the evnt of delivery.

The data were analyzed from a statistical point of view, with analysis of variance (ANOVA) and post hoc tests.

A 2-way ANOVA with repeated measures was performed using the different attachment styles as emerged from the RQ (secure attachment and insecure attachment) in the partner group as the independent variable and the EDPS scores in the 2 times (EPDS1, EPDS2) of the women themselves as the dependent variable. The ANOVA described the main effect of Time as significant (F (1, 14) = 5.79; p < .05). The post hoc (LSD - Least Significant Difference test) highlights how there is a significant decrease in the EPDS score of women in the before-after comparison (M = 8.71 vs M = 4.93; p = .005) considering, as an independent variable, the secure attachment group of partners. While this decrease is not significant in the group of partners with insecure attachment.

The initial data of this study suggest that security in the attachment style of the partner can favor an increase in the mood of the woman after a delivery. In particular, the research data tend to highlight a significant improvement in the mood of women 4 months after giving birth. The proximity of a partner with secure attachment therefore seems to favor a good mood in the woman in pueperium.

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Non-mental health professionals play an important role in the diagnosis and treatment of Eating Disorders (EDs).

This study aimed to explore attitudes toward EDs and knowledge of diagnosis, aethiology, and management of EDs among health professionals.

A new questionnaire was validated and administered to residents and consultants working in disciplines involved in the management of EDs. Health professionals were grouped in the following areas: internal medicine, general practitioners, psychiatric area, psychological area, and surgical area. One-way ANCOVA and chi-square tests were employed to compare knowledge and attitudes among the study groups.

For all health professionals, the most deficient area was the aetiopathogenesis, while the best one was the management of physical complications. A gap in the knowledge of diagnosis, aetiopathogenesis and treatment emerged in nonmental health professionals. Psychotherapy effectiveness and the role of family members in the therapeutic process were not sufficiently acknowledged, and general psychological factors contributing to the onset of EDs were not recognized. Stigma was found primarily among surgeons, although all nonmental health professionals often considered those patients responsible for their ED.

Inadequate knowledge and impaired attitudes toward EDs occurr among health professionals. This type of stigma may impair early diagnosis and treatment of EDs. Educational programs should provide continuous education to update and improve the knowledge of EDs among non-mental health professionals.

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Mindfulness involves being aware of both your thoughts and emotions as well as your surroundings. Regular practice of mindful self-care can enhance the overall well-being. For university staff, these practices can help counteract negative effects on mental health.

Our study aims to evaluate the practice of mindful self-care and its impact on the psychological health of university staff.

We conducted a descriptive, analytical and cross-sectional survey among university staff. The survey was carried out during a one-day training session on mental health promotion using a self-administrated questionnaire. We collected socio-professional data. We assessed psychological health using the depression anxiety and stress scale (DASS 21) and self-care behaviours using Mindful Self-Care Scale (MSCS).

Our study included 65 participants, 67.7% of whom were female. The average age was 53±6.8 years, and the average job tenure was 21.3±8 years. We found that 36.9% of participants experienced mild to moderate stress, 35.4% had mild to moderate depression, 7.7% had severe to extremely severe depression, and 23.1% had severe to extremely severe anxiety.

The average mindful self-care score was 102.8±26.3. The means for specific aspects of mindful self-care were: mindful relaxation 12.6±4.5, physical care 19.9±5.6, self-compassion and purpose 20.7±7.6, supportive relationships 15.4±5.6, supportive structure 13.4±4.6, and mindful awareness 14.5±4.8.

We found a negative correlation between anxiety and depression and mindful self-care (p = 0.02, r = -0.2). In female participants, stress was also negatively correlated with mindful self-care (p = 0.02, r = -0.3).

According to our findings, mindful self-care may be a potential strategy for anxiety, depression and stress management available to university staff. Given the considerably poor psychological health in the study population, we recommend to increase awareness of mindful self-care in university staff.

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Sexuality, although an essential component of human health, remains a controversial topic, shrouded in stigma, particularly in the context of dementia, where the expression of sexuality presents unique challenges.

The main objective of this work is to address the complexity of the biopsychosocial components of sexuality in patients with dementia, promoting a change in medical perspective and social attitudes.

Evidence-based review, through research conducted on PubMed and selection of the most relevant studies on this topic, published in the last decade, using the keywords: “Sexuality” and “Dementia”.

Cognitive impairment can affect the frequency and satisfaction with sexual activity. Most studies focuses exclusively on the biological (and dysfunctional) component of sexuality, devaluing the challenges and barriers to the expression of this sexuality. The deterioration of cognitive processes, with emphasis on the involvement of the prefrontal cortex, can influence the ability to make decisions, setting boundaries and providing consent. Inappropriate sexual behaviors, such as disinhibition and hypersexuality, have an incidence of 7-25% in patients with dementia, and may require intervention psychopharmacological. These vulnerabilities result in an enormous challenge in terms of establishing a balance between autonomy and safety of these patients, sometimes resulting in neglect of sexual health in treatment environments.

A comprehensive understanding of the sexuality of older adults with dementia is essential to improve the quality of life and clinical care of this population, highlighting the importance of accurate education and inclusive sexual orientation, creating safe spaces for dementia patients to explore and express their sexuality.

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Social isolation (SI) is defined as the lack of social contact or support. Older adults have a higher risk of social isolation because of the changes in health and social relationships that can occur during ageing. Several studies have shown that SI is independently associated with poorer physical and mental health and worsened quality of life. However, limited evidence is available on SI predictors in old public housing populations.

To assess the risk of SI and dependency in Basic and Instrumental Activities of Daily Living (BADL; IADL) in a sample of older people living alone in public housing. To identify predictors of SI, namely whether ADL dependency is one of them.

As part of the ongoing “Porto Importa-se” project, this study included a sub-sample of older persons aged 70 years and over living alone in public housing communities in Porto City, Portugal. All participants were assessed with a comprehensive multidimensional assessment protocol, which encompassed the Barthel and Lawton Indexes (BADLs and IADLs dependency) and the Lubben Social Network Scale-6 (SI risk). Loneliness was measured with a categorical question. A multiple logistic regression model was performed to identify predictive factors for SI. Odds Ratio (OR) and its 95% Confidence Interval (95%CI) were calculated. A p<0.05 was considered statistically significant.

The final sample (n=716) was namely female (84%), with an average age of 80.4 years (SD=6.2). Around 36% presented a risk of SI, and 24% reported feeling lonely almost always to always. About 53% had moderate dependency on IADLs, and 11% dependency on BADLs. The proportion of participants dependent on BADLs and at risk of SI is more than double the proportion of cases considered not to be at risk (17%v.s.8%; p<0.001). Similarly, the proportion of cases considered to be severely dependent on IADLs and at risk of SI is about four times higher than the proportion of cases considered not to be at risk (13%v.s.3%; p<0.001). Based on the logistic regression model, severe dependence on IADLs (OR=5.16, 95%CI[2.37;11.24], p<0.001) and loneliness (OR=2.87, 95%CI[2.02;4.09], p<0.001) were significant predictors of the risk of SI. The model has a modest explanatory power (Nagelkerke R2=0.126).

The rate of SI found in this study aligns with the results reported in other studies with similar objectives. The identification of loneliness and dependence in ADL as predictors of SI also complies with previous studies. These results reinforce the importance of monitoring elderly people who find themselves alone and dependent on the fulfilment of their ADLs more closely.

This work was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDP/4255/2020)

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Interpreting and perceiving adequately others’ emotions and the regulative processes within one’s mental health are barriers or predisposing factors in the development of smartphone addiction.

The research explores the role of mental health, fear of negative perception, and assessment of other people’s emotions, which influence excessive smartphone use.

The survey included 400 respondents, of whom 104 were men (26%), 293 women (73.2%), and three persons (0.8%) who indicated a different gender. The mean age of the participants was 25.9 years (SD 10.9). Registered answers refer to demographic data (gender, age, smartphone usage habits) as well as psychological measures: a Smartphone Application-Based Addiction Scale (SABAS), a Mental Health Continuum Scale (MHC), an Assessing Emotions Scale (AES), and Fear of Negative Perception Questionnaire (FNPQ).

Results show a significant negative correlation between the SABAS score and global mental well-being (r(398) = -.15, p = .005) and a significant positive correlation between the SABAS score and fear of negative perception (r(398) = .27, p = .001). Using SABAS’s cutoff point (23 points), non-problem (M = 59.6, SD = 11.4) and problem users (M = 55.8, SD = 11.3) differ significantly in global mental well-being (t(398) = -2.9, p = .004) and each of its sub-factors, emotional, social, and psychological well-being; as well as non-problem (M = 20, SD = 8.2) and problem users (M = 24.1, SD = 8.4) in fear of negative perception (t(398) = 4.3, p = .001). Relevant associations between emotional regulation and problematic smartphone use we did not find.

The resulting data will support to investigation of the role of mental health well-being factors in the development of problematic smartphone usage, besides prevention and psychotherapeutic intervention.

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Traumatic brain injuries are serious traumatic situations

Aim of this study was to evaluate the attentional skills in cases with traumatic brain injuries, in elite female athlete

3 female elite athletes (1 basket ball player, 1 runner and 1 ping pong player ) were participated in this study, 60 days more or little less after cervical spine injuries. Range of age 25-35 years and mean age 29.

We used specific performance tests, letter cancellation exam, naming trials and iq tests.

All of them(3,100%) reported deficits in all areas of attention function and also cognitive and emotional status.2 of them(66%) reported also difficulty in complex task activities, especially when time limits were imposed.

All these exams are good and efficient tools in order to evaluate this kind of patients.

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In the rapidly evolving landscape of contemporary education, high school teachers are increasingly confronting significant professional stress that critically undermines their mental health and overall well-being. This pervasive issue not only affects teachers but also has broader implications for the effectiveness and sustainability of educational systems.

This study aims to elucidate the complex dynamics of occupational stress, psychosocial workplace factors, and burnout among high school teachers in Tetouan, Morocco.

A cross-sectional survey was conducted among 258 high school teachers. The study utilized the Maslach Burnout Inventory (MBI) to assess burnout levels, the Job Content Questionnaire (JCQ) to evaluate psychosocial factors, and the Perceived Stress Scale (PSS-10) to measure perceived stress levels.

The MBI indicated that 43% of teachers experienced high emotional exhaustion, 46% reported low depersonalization, and 47% indicated low levels of personal accomplishment. On the JCQ, 55% of teachers faced high psychological demands, 57% had limited decision latitude, and 44% received insufficient social support at their workplace. There was a significant correlation between MBI emotional exhaustion and JCQ psychological demand scores (r = 0.381, p < 0.01), indicating a complex interplay between burnout dimensions and psychosocial factors in the workplace. Furthermore, the PSS-10 results exhibited a median stress score of 27, indicating a significant variability in stress perceptions among the participants.

This study underscores the critical need to address burnout, psychosocial workplace factors, and perceived stress among high school teachers. The prevalent emotional exhaustion, substantial psychological demands, and varied perceived stress levels revealed by this study necessitate integrated strategies that address these complex interactions to foster a more supportive and healthy professional environment. Further research should focus on operationalizing these insights into concrete, actionable policies that enhance educational professionals’ well-being and productivity.

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Adapting to a new socio-cultural environment presents a major challenge for African medical students, often leading to the development of anxiety-depressive disorders. To date, a number of therapeutic approaches including psychotherapy, educational programmes and pharmacological treatments are available, but their comparative effectiveness for this group remains poorly researched.

The present study aims to comparatively evaluate different methods of psycho-emotional state correction.

The study included 72 African undergraduate medical students (age range 18-23 years, 54.9% female, 45.1% male).

Participants were assigned to three therapeutic groups. Statistical processing with post-hoc test and Bonferroni correction confirmed the benefit of the psychotherapeutic approach in reducing levels of anxiety and depression (p≤0.01). An 8-week cognitive-behavioural therapy programme demonstrated the greatest effectiveness. A one-day educational workshop showed moderate efficacy. Medication therapy with antidepressants for 8 weeks resulted in minimal improvement.

Participants were assigned to three therapeutic groups. Statistical processing with post-hoc test and Bonferroni correction confirmed the benefit of the psychotherapeutic approach in reducing levels of anxiety and depression (p≤0.01). An 8-week cognitive-behavioural therapy programme demonstrated the greatest effectiveness. A one-day educational workshop showed moderate efficacy. Medication therapy with antidepressants for 8 weeks resulted in minimal improvement.

Cognitive-behavioural therapy demonstrated the greatest efficacy in the correction of anxiety-depressive disorders in international medical students, outperforming both educational and pharmacological interventions. Subjective satisfaction of participants was also higher in the psychotherapy group, indicating that it is appropriate to prioritise the use of non-pharmacological methods in this population.

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Burnout among mental health professionals poses a significant threat to personal wellbeing, patient care, and healthcare systems. Addressing this challenge aligns with the broader mission of the European Academy of Neurology (EAN) to promote brain health not only for patients but also for clinicians. This presentation highlights education, collaboration, and systemic interventions, integrating neurological and psychiatric perspectives.

This initiative stems from the EAN Task Force for Wellbeing (TFW), in collaboration with the European Psychiatric Association (EPA). A multipronged strategy was designed to enhance awareness, build resilience, and foster systemic reforms:

1. - Educational Media: A podcast series exploring burnout’s conceptualization, its neurobiological and psychological aspects, gender disparities, and practical solutions.

2. - Interactive Webinars: Interdisciplinary sessions combining insights from neurology and psychiatry, showcasing evidence-based strategies and technological innovations.

3. - Public Debates: Open forums to engage professionals across career stages, raising awareness and encouraging action to tackle burnout.

These initiatives were supplemented by systematic reviews, case studies, and suggestions of novel tools to monitor mental health and stress factors.

The combined educational and intervention efforts yielded significant outcomes:

1. - Advancing Brain Health for Clinicians: Awareness initiatives emphasized the vital link between clinician brain health and professional resilience

2. - Skill Development and Resilience: Practical strategies for time management, mentorship, and self-care were disseminated through case studies and interactive discussions.

3. - Collaborative Solutions: Webinars and public debates highlighted shared challenges and fostered interdisciplinary advocacy for systemic reform.

Burnout is not just an individual issue but a systemic challenge requiring collective action. By prioritizing clinician brain health as a mission, the EAN and EPA collaboration provides a unifying framework to tackle burnout. Educational initiatives bridged the gap between theory and practice, while public debates fostered community engagement and systemic advocacy. Interdisciplinary collaboration underscored the shared nature of burnout and the need for unified, brain-health-centric strategies.

Promoting wellbeing through education, collaboration, and innovative tools aligns with the broader goal of achieving brain health for clinicians. These initiatives provide a sustainable pathway to counteract burnout and foster a resilient and thriving workforce. Continued investment in education, public discourse, and systemic reform is essential to realizing this mission.

burnout, brain health, wellbeing, education, interdisciplinary collaboration, neurology, psychiatry, systemic reforms

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Attitudes toward people with mental illness change. We present evidence of attitude change from different contries, with regard to different mental health conditions. While attitudes towads mental health problems in general, and towards depression, seem to soften, there is little positive change with regard to people with substance use disorders, and attitudes have even worsened towards people with schizophrenia. We discuss possible explanations for these diverging trends, and hypothesize on potential remedies.

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Effective discharge management is essential for psychiatric inpatient care, significantly impacting patient outcomes during and after the transition from inpatient to outpatient settings. A well-coordinated discharge process ensures continuity of care, reduces readmission risks, and supports long-term recovery. However, there is a notable lack of comprehensive data on discharge practices across European countries, impeding the evaluation of their effectiveness and the development of informed improvements.

The present study has two primary objectives: first, to systematically review current practices, challenges, and outcomes related to psychiatric discharge management across European countries. Second, to evaluate and compare existing discharge guidelines, protocols, and toolkits. By synthesizing these findings, we aim to identify best practices, highlight gaps, and offer recommendations for optimizing discharge procedures. Additionally, we will briefly present a current mixed-method research project from Germany, titled “Evaluation of Discharge Management in Psychiatric Care,” which aims to assess discharge management practices for psychiatric inpatients. These insights will supplement the broader European review by offering a focused perspective on the practical considerations and challenges of discharge management practices within a specific national context.

We will conduct a systematic search and review by exploring multiple electronic databases (MEDLINE, Embase, Cochrane Library and PsycINFO) and grey literature sources (Google and Google Scholar) for both quantitative (observational studies, reports) and qualitative (clinical guidelines, protocols, interviews, focus groups) data related to psychiatric discharge management. Additionally, we will hand-search the references of key papers, including existing systematic reviews and included articles. The search will include documents published from 2000 to December 31, 2024.

The presentation will provide an overview of the current research and literature on psychiatric discharge management practices in Europe. The review is expected to provide critical insights into advancing psychiatric care standards. Additionally, the presentation aims to engage researchers and clinical practitioners attending EPA25 by providing a platform for knowledge exchange on psychiatric discharge management, facilitating networking opportunities and fostering potential collaborations for future research in this vital field.

Discharge management is a critical aspect of psychiatric care that requires meticulous planning and coordination. The insights gained from this review will contribute to the development of evidence-based discharge protocols that are adaptable to diverse patient populations and healthcare settings, ultimately leading to more effective and cohesive care strategies across Europe.

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The abrupt occurrence of neuropsychiatric symptoms in patients with alcohol-related cirrhosis requires detailed evaluation not only for hepatic encephalopathy but also for other etiologies like Wernicke-Korsakoff Syndrome. In this case, we present a patient with alcohol-related cirrhosis who was initially admitted to gastroenterology unit with a preliminary diagnosis of hepatic encephalopathy but was ultimately diagnosed with Korsakoff Syndrome.

This case highlights the critical need for comprehensive neuropsychiatric assessment in patients with alcohol-related cirrhosis and offers a review of the current literature on the definition and clinical presentation of confabulation.

Description of a clinical case and literature review

45-year-old male with a history of alcohol-related cirrhosis was admitted to gastroenterology unit with symptoms suggestive of hepatic encephalopathy. On hospital day two, he was consulted to consultation-liaison psychiatry unit with the complaints of sleep disturbances and meaningless talking. In his story; over the past 3 months, he was talking about unrealistic events, having anger outbursts and disrupted sleep cycle, although his total sleep duration remained normal. Aside from grandiosity, mild irritability and disruptions in thought content, there were no signs of manic episode, such as euphoria, distractibility or reduced sleep. In mental state examination, he was alert, oriented in time, place and person, displaying normal psychomotor activity, speech, and impulsivity with euthymic mood. Neurological examination revealed no signs of Wernicke encephalopathy, such as nystagmus, ataxia or confusion. Subsequent psychiatric evaluations revealed fluctuations in narrative, lack of insight, mild memory impairment, and grandiose thought content suggestive of momentary confabulation, all indicative of Korsakoff Syndrome. He was transferred to the psychiatry inpatient unit and treatment with amisulpride at 200 mg daily and thiamin at 300 mg per day were initiated. Following treatment, there was a gradual improvement in aggression; however, no significant enhancement in confabulations or memory function was observed.

To our knowledge, this is the first case report of Korsakoff Syndrome presenting with a preliminary diagnosis of hepatic encephalopathy. The neuropsychiatric components of hepatic encephalopathy can manifest with a variety of symptoms, posing a challenge in differentiation from psychiatric disorders, such as mania or Korsakoff Syndrome. This report highlights the importance of a collaborative evaluation for patients presenting with neuropsychiatric symptoms and a history of alcohol-related cirrhosis.

None Declared