Schizophrenia is a severe mental illness manifested by various symptoms. Negative symptoms (NS) are associated with disability and poor function of patients. The study of NS neurobiology is complicated by their heterogeneity. Factor analysis revealed two distinct NS subdomains with different pathophysiological mechanisms: volitional pathology, including avolition and apathy (AA), and diminished expression (DE). Inflammation is one mechanism that may underlie NS, including their heterogeneity.

To investigate the differentiated associations between polymorphisms of interleukin genes IL-1β (rs16944), IL-4 (rs2243250), and IL-10 (rs1800872, rs1800896) and adverse childhood experiences (ACE) with NS of schizophrenia, specifically the factors of AA and DE. We hypothesize that genetic variants, which may aggravate the inflammatory response, are associated with higher NS and NS factors scores.

Data from 564 patients diagnosed with schizophrenia or schizoaffective disorder were included in the study. NS factors were calculated based on the Positive and Negative Syndromes Scale. The two-way ANOVA (sex, genotype) with Bonferroni post hoc test was used to examine the effect of the genotypes on the PANSS-derived NS subdomains.

The high-expressive allele of IL-1β and low-expressive alleles of IL-4 and IL-10 are associated with more severe NS. However, a differentiated association with the AA and DE factors was found only for the IL-10 rs1800872 polymorphism. Among carriers of the low-expressive AA allele with ACE, there is a trend towards increased ED scores, but not AA scores.

The findings confirm that the imbalance between pro-inflammatory and anti-inflammatory cytokines may be a key mechanism influencing the severity and heterogeneity of NS.

None Declared

Last scene of all That ends this strange eventful history, Is second childishness and mere oblivion, Sans teeth, sans eyes, sans taste, sans everything. Shakespeare, As you like it, II, vii, 163-166

The paper will make reference to the debate generated by the implementation of the Law 8/ 2021 approved three years ago in Spain. The objective was to provide support measures to persons with dementia according to their wishes, beliefs, values and preferences without resorting to legal incapacity. Respect to the person´s wishes is pivotal to the Law and is creating many problems due to the fact that some patients with severe cognitive impairment cannot make a judgement and is not clear what the judge can decide.

From the start, forensic psychiatrists received an increasing number of requests to produce medico-legal reports due to the omission to refer to the protective, medical and personal aspects that such measures involve. Some decisions totally ignore these aspects referring only to the patrimonial ones with no mention of the person`s life trajectory nor to the personal and medical care provided and the medication prescribed.

In the second section, a case where the medical aspects where not contemplated in the sentence will illustrate the consequences for a patient who was misdiagnosed and mistreated.

An extensive observation following the Tavistock Method will describe the process, including the organizational dynamics.

As Kitwood suggested, working with people suffering from dementia includes confronting organic impairment and the great difficulties there may be in consciously articulating any psychological conflicts, there may also be a breaking down of the individual’s lifelong defences that leaves the person exposed and vulnerable to episodes of catastrophic anxiety and rage. Fear of abandonment and inability to bear separateness are characteristic of dementia sufferers, and these persecutory states of mind increase with organic impairment. Caregivers, whether family or staff in residential or nursing homes, have a crucial function in containing those deteriorated aspects of the person they are with.

“Dementia will always have a deeply tragic aspect, both for those who are affected and for those who are close to them. There is, however, a vast difference between a tragedy in which persons are actively involved and morally committed, and blind and hopeless submission to fate” (Kitwood, 1997).

None Declared

Ketamine has been established as a rapid and potent antidepressant. However, despite its groundbreaking efficacy, it has several limitations, including the transient nature of its antidepressant effects following a single infusion, as well as the phenomenology of acute intoxication. This state is characterized by altered consciousness, manifesting as dissociative or psychotomimetic phenomena, along with cardiovascular changes, such as fluctuations in systolic and diastolic blood pressure.

The presentation explores whether these phenomena should be regarded as mere side effects or if they might play a role in ketamine’s antidepressant mechanisms. Furthermore, it addresses the ongoing challenge of identifying clinical and phenomenological predictors of a better antidepressant response.

None Declared

Attention Deficit Hyperactivity Disorder (ADHD) is a complex neurodevelopmental disorder that presents challenges in achieving accurate and timely diagnosis.

This study investigates the effectiveness of using electroencephalogram (EEG) data combined with machine learning techniques to enhance the prediction accuracy for ADHD diagnosis.

A total of 168 subjects were evaluated using the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version Korean Version (K-SADS-PL-K), categorizing them into two groups: ADHD (n=107) and Neurotypical (NT, n=61). We analyzed quantitative EEG (qEEG) data across 19 channels, focusing on frequency ranges including delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), beta (12–25 Hz), high beta (25–30 Hz), and gamma (30–80 Hz). To classify ADHD versus NT groups, the Extreme Gradient Boosting (XGBoost) classifier was utilized, with Leave-One-Subject-Out (LOSO) cross-validation employed to assess model performance.

To address the issue of limited data, we segmented each subject’s EEG data into 30-second intervals, resulting in 2434 segments for the ADHD group and 1060 segments for the NT group (figure 1). These segments were used to train the machine learning model. The XGBoost algorithm, combined with the LOSO cross-validation strategy, achieved a test accuracy of 90.81% and an F1 score of 0.9347, demonstrating robust performance in distinguishing between ADHD and NT subjects (figure 2). Feature importance analysis using SHAP values highlighted that EEG features from specific frequency bands, particularly the middle beta/theta ratio and relative gamma of O1 electrode sites, played a crucial role in the classification (figure 3).

Image 1:

Image 2:

Image 3:

Our findings suggest that EEG-based machine learning models hold significant potential as non-invasive tools for assisting in the diagnosis of ADHD. Further research with larger datasets and additional validation is necessary to confirm these results and explore their clinical applicability.

None Declared

Using a ‘transdiagnostic’ paradigm for psychopathology, we review the evidence-base for the different treatment interventions for anger, aggression and violence (AAV). We aim to more accurately link the range of psychopathology associated with AAV to underlying brain structures and functional neurocircuitry. Building upon these findings, we propose a working model that may have greater clinical utility than reliance upon a purely ‘disorder-based’ paradigm for addressing AAV. This will permit greater understanding of when anger (which has also conferred evolutionary survival advantages) can become maladaptive and destructive. This comprehensive, ‘interventionist’ model will hopefully lead to better clinical conceptualization of AAV, especially since most AAV presents more commonly in the context of interpersonal/situational stressors and to non-forensically trained clinicians.

1. 1. To identify biological, cognitive, disorder-based, developmental and personality predispositions to AAV

2. 2. To link neuroanatomical and functional brain circuitry with onset and maintainence of AAV

3. 3. To identify how pharmacological and non pharmacological interventions work, and ‘where’ in the brain,

4. 4. To review the evidence-base supporting various treatment interventions

Database review of PUBMED, PsychINFO, Google Scholar and treatment guidelines dating back 15 years (review articles, treatment guidelines, meta-analyses and randomized controlled trials).

This will be visually depicted in an electronic slide (or >1 slide, if permitted) to identify:

1. 1) The inter-relationship between contextal factors, the psychopathology of AAV and undelying brain ‘circutry’

2. 2) The specific nature of the impulsive anger, ‘reactive’ aggression and violence response ‘cycle’ and where in this cycle various interventions can be effectively utlized

3. 3) Which patient populations respond best to which types of interventions

1. 1. AAV are hyperarousal states, with outcomes that can be successfully managed

2. 2. The evidence-base for the role of medications is more limited

3. 3. The evidence-base for the role of various psychotherapies is greater, with specific therapies being particularly useful across psychiatric disorders and populations

4. 4. Psychodynamic approches remain curently underutilized and underappreciated

5. 5. Both medications and therapy influence brain neuroplasticity separately and synergistically

None Declared

Anxiety and depression are prevalent mental health conditions in patients with diabetes, significantly impacting their quality of life and complicating glycaemic control. The interplay between psychopharmacological agents and diabetes medications presents unique challenges in managing both mental health and metabolic conditions. This presentation reviews of psychotropic drugs commonly used to treat anxiety and depression in diabetic patients, with a focus on their efficacy, safety, and potential adverse effects. Special attention will be given to drug interactions between antidepressants, anxiolytics, and antidiabetic medications, which can influence treatment outcomes. Key considerations include the effects of psychotropic agents on insulin sensitivity, glucose metabolism, and the risk of hypoglycaemia. The presentation will also discuss personalized treatment strategies, adjusting for individual patient profiles and comorbidities. By integrating both psychiatric and endocrinological perspectives, we aim to improve clinical outcomes through optimized pharmacological management and minimize the risk of adverse drug interactions in this vulnerable patient population.

None Declared

Multiple sclerosis (MS) is a chronic and progressive inflammatory autoimmune disease of the central nervous system. Beyond physical symptoms, it can cause various socio‐affective symptoms such as depression, anxiety, sleep disorders and loneliness, leading to a significant psychosocial burden.

This study aimed to identify factors contributing to loneliness in MS patients and to examine its associations with psychological distress, stigma, and resilience.

We conducted a nationwide cross-sectional study of patients with MS from October 2022 to January 2023. Data were collected using an online questionnaire, which included socio-demographic information, disease characteristics, experiences of social stigma, psychological distress, coping strategies, and perceived social support. Validated tools used were the Stigma Scale of Chronic Illness (SSCI-8), Kessler Psychological Distress Scale (K10), Brief Resilient Coping Scale (BRCS), and UCLA Loneliness Scale.

A total of 108 patients, 69.4% women, mean age 44.8 years, participated in the study. Higher loneliness scores were associated with greater psychological distress (p<0.001) and higher perceived stigma (p<0.001). Inversely, higher loneliness levels correlated with lower resilience (p<0.001). Patients living in small urban or rural areas reported higher levels of loneliness compared to those in large urban centers (p=0.002). Additionally, full-time employment (p=0.032) and better financial status (p = 0.025) were associated with reduced loneliness, while a family history of psychiatric illness was linked to higher loneliness (p=0.043).

This study reveals that loneliness is an important issue in MS patients and is associated with mental health problems, stigma and reduced coping resilience. Patients living in smaller urban areas, with poorer financial status, or a family history of psychiatric illness are particularly vulnerable. Addressing loneliness should be a priority in psychosocial interventions to improve quality of life. Future research with larger samples is recommended to confirm and extend these findings.

None Declared

Gelatinous bone marrow transformation (GBMT) is a degenerative change in hematopoietic bone marrow, initially linked to anorexia nervosa (AN) and recently to bariatric surgery (BS) (Böhm et al. Am J Surg Pathol 2000; 24(1) 56-65). BS is associated to malabsorption, nutrient deficits, diets, and medical complications resembling eating disorders (ED) (Conceição et al. Int J Eat Disord 2023; 56(4) 831-834), complicating diagnosis and management. Treating the underlying cause is key for GBMT recovery.

Review BS complications: malnutrition, GBMT and AN with normal Body Mass Index (BMI).

This case study highlight the emergence of GBMT and atypical AN following BS.

A 55-year-old woman first sought treatment from the Community Mental Health Team (CMHT) over 30 years ago for marital issues and was given medication. In 2006, she underwent bariatric surgery (BS) due to morbid obesity (BMI 52.6 kg/m²). Since 2007, she had 3 hospitalizations for cosmetic surgeries and 5 for medical complications, including oedema, hypoproteinaemia, pancytopenia, zinc deficiency, and sepsis requiring ICU admission. She also showed symptoms of depressive disorder (DD), AN, and purgative symptoms. In 2017, she was re-referred to CMHT and diagnosed with DD, anorexia was considered a symptom of DD.

In 04/2024 she was readmitted under Internal Medicine care with subacute multifactorial diarrhoea, severe malnutrition, pancytopenia, coagulopathy, vitamins A, E, D and Zn deficiency and lower limb oedema (likely contributing to a normal BMI).

Diarrhoea was managed by switching sertraline to citalopram and budesonide added to treat lymphocytic colitis. Moreover, ciprofloxacin and metronidazole were used for small intestinal bacterial overgrowth.

Psychiatric involvement confirmed DD, anxiety disorder (AD), and atypical AN. Topiramate, mirtazapine and olanzapine were stopped to possible myelotoxic effects. A bone marrow aspirate confirmed GBMT. Benzodiazepines and gabapentin were used to manage AD. Her malnutrition was managed with Total Parenteral Nutrition and she was transferred to a psychiatric ward where she received specific treatment for ED. Pancreatic enzymes were added to reduce malabsorptive impact of BS. The option of reversing the bypass was considered.

Once the vital risk decreased and she was consuming normalized intakes, she was discharged with a BMI=20.9.

One month later, she was euthymic, reduced anxiety and coagulopathy and nutritional parameters normalized with haematological improvement.

Given the high prevalence of malnutrition and ED post-BS, ED should be systematically assessed even in patients with normal BMI. Early diagnosis prevents worsening of symptoms, which only improve after nutritional recovery (Steinhausen et al. Am J Psychiatry 2002; 159(8) 1284-93). Multidisciplinary management is crucial to achieve optimal nutritional outcomes.

None Declared

Recently, there has been growing interest in leveraging large language models (LLMs) in psychiatry and counseling. Specifically, there is a need to develop LLM-based programs that generate psychodynamic assessments, helping individuals gain self-insight and evaluate the quality of such services. However, research in this area remains limited.

This pilot study aims to evaluate quality, risk of hallucination, and client satisfaction with psychodynamic psychological reports generated by GPT-4.

The reports consisted of five components: psychodynamic formulation, psychopathology, parental influence, defense mechanisms, and client strengths. Participants experiencing distress from recurring interpersonal issues were recruited for the study, which followed three stages: 1) GPT-4 generated tailored questions for participants to infer psychodynamic formulations, then used the responses to create psychological reports. 2) Seven psychiatry professors from various university hospitals assessed the reports for quality and hallucination risk, comparing GPT-4-generated reports with expert-inferred reports. 3) Participants evaluated their satisfaction with the psychological reports. All assessments were conducted using self-report questionnaires based on a Likert scale developed for this study.

Ten participants were recruited for the study, with an average age of 32 years. The median response indicated that the quality across all five components of the psychological report aligned closely with expert evaluations. The risk of hallucination was assessed to be minimal, ranging from unlikely to minor. In the satisfaction evaluation, over 90% of participants agreed or strongly agreed that the report was clear, insightful, credible, useful, satisfying, and recommendable.

These findings suggest that artificial intelligence may have the potential to provide expert-level psychodynamic interpretations with minimum face-to-face interaction.

None Declared

Postpartum mental health challenges are common, with some women experiencing anxiety, depressive symptoms, or difficulties related to childcare and familial support. To address these issues, the University Psychiatric Hospital Vrapče in Zagreb, Croatia, launched the “Postnatal” outpatient program in 2023, offering structured support for women in the postpartum period.

The objective of the program is to provide psychological support for women with children aged 0–2 years through a combination of online and in-person group therapy, to address postpartum mental health issues and provide a supportive environment.

The program is promoted through the clinic’s website, social media, maternity hospitals, pediatric centers, and visiting nurse services. Women join the program through self-referral or on the recommendation of healthcare professionals. A team of three psychiatrists conduct an initial assessment, and approximately 80% of those evaluated are admitted into the program. The program comprises two 90-minute weekly sessions: an online educational workshop and an in-person group therapy session. Each cycle lasts for 8 weeks, followed by monthly 90-minute in-person group meetings.

A total of 45 participants have completed the program so far. About 30% of participants met the clinical criteria for anxiety or depressive disorders, while there were two cases of postpartum psychosis. The majority reported non-specific concerns, such as tension, insomnia, fatigue, and emotional instability. Around 30% indicated a lack of support from their partners, and 10% had pre-existing psychological diagnoses (including OCD, borderline personality disorder, and anxiety-depressive disorder). Most participants were first-time mothers, with around 10% being second or third-time mothers. In the program, participants share experiences related to conception, pregnancy, maternity hospital stays, postpartum mental health changes, and the challenges of maternal care. Participation rates have been consistently high, with only one dropout. Post-program evaluations show a high level of satisfaction, with participants highlighting the group meetings and peer support as the most valuable aspects.

The “Postnatal” program has demonstrated positive outcomes in providing support to postpartum women. The combination of educational workshops and group therapy has been effective in addressing both clinical and non-specific postpartum challenges. Further cycles and long-term follow-ups are recommended to evaluate the program’s sustained impact.

None Declared

Targeting insomnia may have a therapeutic value for mental disturbances. Indeed, insomnia chronic nature may necessitate switching between various insomnia approaches and medications. Daridorexant is a new pharmacological option for insomnia treatment, which is a dual orexin receptor antagonist (DORA).

The aim of the present study was to treat consecutive patients with insomnia disorder with and without mental co-morbidities with this new therapeutic option and during the deprescripion of previous hypnotic medications which have failed in insomnia treatment.

Ninety consecutive patients with insomnia disorder according to the DSM-5-TR criteria (sleep condition indicator SCI<16) were treated with daridorexant 50 mg. Baseline, 1 month, and 3 month evaluations were performed. Demographic and clinical data were incorporated. Insomnia severity (Insomnia Severity Index-ISI), mood and anxiety symptoms (Beck Depression Inventory II-BDI-II, Young Mania Rating Scale-YMRS, Self Reported Anxiety Scale-SAS), and pre sleep arousal(Pre Sleep arousal Scale-PSAS) were evaluated. The evaluation of psychiatric diagnosis was conducted in accordance with the DSM-5-TR criteria (SCID-5) and the concurrent use of pharmacological therapy was taken into account. For previous insomnia treatment discontinuation, cross-tapered programs were developed following the 25% per week rule while inserting daridorexant.

The final sample included 80 patients (N° 40, 50.0% females, mean age 60 ± 13.2). Most of them (75.5%) suffered from insomnia comorbid with unipolar/bipolar depression, anxiety disorders and sedative-hypnotics use disorders. Repeated Anova analyses showed that ISI and PSAS total score decreased across time (respectively F=63.42, p<0.001, F=61.44, p<0.001). Similarly mood symptoms, anxiety symptoms significantly improved over time and after 3 months of treatment (respectively F=62.45, p<0.001, F=31.48, p<0.001, F=41.14, p<0.001, F=21.44, p<0.001). Analyses conducted on a subsample of patients with comorbid sedative-hypnotics use disorders (50%) revealed a beneficial effect on insomnia, arousal and anxiety symptoms. Multiple regression models demonstrated that the clinical improvement of anxiety symptoms was most best predicted by the improvement in emotion regulation -PSAS score at T1 and T2, and the improvement in insomnia symptoms at T1and T2.

The treatment of chronic insomnia with daridorexant improved insomnia symptoms in patients with and without mental comorbidities across time. It was particularly effective in patients with sedative-hypnotics use disorders, where we deprescribed previous sedative hypnotics including neuroleptics and sedative antodepressants. These data are in line with the data showing that sleep is involved in the regulation of the reward system.

L. Anastasio: None Declared, G. Alfi: None Declared, G. Aquino: None Declared, E. Annuzzi: None Declared, G. Cerofolini: None Declared, A. Coccoglioniti: None Declared, M. Gambini: None Declared, M. Pioltino: None Declared, G. Perugi: None Declared, A. Gemignani: None Declared, L. Palagini Consultant of: Consultancy for Laura Palagini, Bruno, Idorsia, Fidia, Pfizer, Sanofi

Depression and suicide risk are particularly concerning mental health issues in the workplace, especially among nurses. This group of workers often faces high levels of stress and pressure due to the demanding nature of their job.

Our study focuses specifically on describing depression and suicide risk among nurses.

This is a descriptive study, conducted during January and February 2023, involving 55 nurses working at Sahloul University Hospital in Sousse. Data were collected through a self-administered questionnaire and the Beck Depression Inventory which assesses subjective aspects of depression.

51% of the participants report that working as a nurse constitutes a significant mental burden. During their hospital careers, 47% have faced violence from patients’ family members or companions. (43%) experienced violence from colleagues, mainly in the form of verbal aggression. Nearly all the nurses surveyed (94%) reported demotivation toward their work, with (97.9%) attributing it to work overload and (39.4%) to workplace conflicts. According to the Beck scale, (38%) of the nurses did not present depression, moderate depression was found in (58%) of participants and only 4% had severe depression. Reduced job performance was noted in (16%) of cases. Concerning suicidal ideation, it was reported by only 2 nurses.

Early identification of mental distress and the implementation of appropriate psychological support strategies, are crucial to mitigating these risks. Recognizing psychological risks in hospitals not only improves the well-being of nurses but also enhances the quality of care they provide to patients.

None Declared

Depression and anxiety are among the most prevalent mental health conditions, particularly in Western countries. Access to effective treatments, such as cognitive behavioral therapy (CBT), in publicly funded primary care settings is often insufficient.

This study aims to evaluate, within a non-inferiority framework, the effectiveness and cost-effectiveness of three treatment modalities for depression and anxiety within the Finnish public healthcare system: 1) a stepped care model, which involves sequential guided self-help (GSH) followed by face-to-face CBT for non-responders; 2) internet-delivered CBT (iCBT); and 3) face-to-face CBT.

Our objective is to recruit 948 adults (16+ yrs) exhibiting symptoms of depression (scoring ≥10 on the Patient Health Questionnaire, PHQ-9) and 948 adults exhibiting symptoms of anxiety (scoring ≥10 on the Generalized Anxiety Disorder scale, GAD-7). These participants should be suitable for step 1 or step 2 treatments, such as GSH, iCBT or CBT, within the Finnish public healthcare system. Individuals currently receiving psychological treatment, those with severe suicidal ideation, cognitive impairment, or those with substance abuse issues will be excluded from the study. Participants will be randomly assigned to one of three groups: GSH, iCBT, or face-to-face CBT. Those who do not respond adequately to GSH will be stepped up for further treatment with face-to-face CBT. Participants will complete symptom measures, such as PHQ-9, GAD-7, measures of function, work ability and social support at various stages over the course of the study to track changes in their mental health. The trial and follow-up period will span 5 years. In addition to data collected from the study participants, the study incorporates direct and indirect healthcare, social care, employment, and societal cost data from Finnish national registries. These registries will also be utilized to create population-matched controls for the study participants. The study will be conducted within several wellbeing service counties in Southern Finland and Western Finland. It is part of the Finnish First-Line Therapies –initiative in Finland’s public healthcare system.

Recruitment of study participants began in autumn 2024 and is expected to take approximately one year. Initial results are anticipated by 2026. The study protocol has been registered in the ISRCTN registry prior to the commencement of participant recruitment. The study is primarily funded by grants from the Ministry of Social Affairs and Health in Finland (VN/29619/2023 and VN/29613/2023).

The study aims to improve access to effective, evidence-based treatments for depression and anxiety within the public healthcare system.

None Declared

Sexual harassment (SH) is a pervasive issue, particularly in workplace environments. The medical field, especially in hospitals, is not immune to this issue with medical residents and interns often being disproportionately affected. SH can have profound psychological, emotional, and physical consequences, which can impair professional performance and well-being.

To assess the psychological impact of SH among medical residents and interns working in hospitals in Sfax Tunisia.

We conducted a cross-sectional and descriptive study involving medical residents and interns working in hospitals in Sfax. Data were collected using an anonymous self-questionnaire. This questionnaire was published on social media during January and February 2024. It included sociodemographic characteristics, medical history, psychoactive substance use, professional data, and experiences related SH. The Depression Anxiety Stress Scale (DASS-21) was used to assess the psychological distress of the participants.

We collected 141 responses, of which 19.9% declined to participate in this study.

Finally, a total of 113 participants, with sex ratio (M/F) of 0.54, were recruited. The average age was 27.92 years. In our population, 20.4% were interns. Among the participants, 68.1% were single, 91.2% were from urban backgrounds.

Among the participants, 41.6% reported experiencing sexual harassment during their practice at the hospitals in Sfax. Verbal harassment was the most common form reported as sexual harassment (43,3%). The assessment of the DASS21 questionnaire showed, that 17 participants had a moderate overall score (15%) and seven participants had a severe overall score (6.2%). In our study, the overall DASS scores (p<0.001), as well as the Depression (p<0.001), Anxiety (p<0.001), and Stress (p=0.002) sub-scores, were significantly higher among participants who were victims of harassment.

The findings underscore the urgent need for implementing preventive measures in hospital settings, providing support for victims, and raising awareness about SH and its consequences.

None Declared

Understanding the complex relationships between brain structure, function, and behavior is a central challenge in neuroscience. This presentation aims to showcase the transformative potential of neuroimaging and bioinformatics in bridging the gap between neural mechanisms and behavior, ultimately advancing our understanding of the human brain and informing precision medicine. Recent advancements in neuroimaging and bioinformatics enable researchers to explore these relationships with unprecedented precision and scale. This presentation will provide an overview of how neuroimaging modalities can be integrated with advanced bioinformatics tools, including machine learning to uncover novel brain-behavior associations. We will discuss key applications of these methods for neuropsychiatric disorders and specific examples will be used to highlight how combining neuroimaging data with bioinformatics pipelines enhances our ability to measure brain organization at the level of a single individual. Additionally, challenges such as data complexity, standardization, and interpretability will be addressed, alongside strategies to overcome them.

None Declared

Every year, 726,000 people take their own lives and many more attempt it. Suicides can occur at any age and were the third most common cause of death in people aged 15 to 29 worldwide in 2021.

Presentation of a clinical case.

We analyze the case of a 17-year-old patient who came to the ED after ingesting sodium hypochlorite with self-lytic intent. She says that, being accompanied by a friend, she begins to hear “a voice, which is my own voice, telling me to kill myself.” With a pretext, he enters the kitchen and overeats. She says that, although she was induced by “the voice,” she thinks that “if I continue like this all my life, it would be better to die.” She discusses it with her brother and her friend, who inform her mother.

She is the youngest of three brothers. He resides with his mother and her partner, parents divorced at 11 years old. He is in 4th ESO, with poor performance. Pregnancy, childbirth and maturation milestones within normality. Four years ago he began to experience behavioral alterations in the family environment characterized by drug abuse reactive to family arguments. These ingestions are becoming more frequent and for anxiolytic purposes, requiring attention in the ED. Throughout evolution, the attitude has become increasingly regressive, with demands for attention to which the family responds by reinforcing them. He has had several hospital admissions. On current treatment with olanzapine 5 mg/24h, fluoxetine 20 mg/24h and tranxilium 5 mg/8h.

Analysis with blood count, basic biochemistry, arterial blood gases, SO and toxic substances in urine; without significant alterations.

Gastroscopy: Esophagus: Mucosa, distensibility and peristalsis without alterations. Esophago-gastric junction 36 cm from the dental arch with competent cardia at the level. Stomach: isolated antral areas of circumscribed erythema. Centered and permeable pylorus. Duodenum: Bulb and second portion without alterations.

Psychopathological examination: COC. Regressive, character traits in the foreground. No alterations in psychomotor skills. Attentive, without memory errors. Discourse with an infantilized tone, spontaneous, fluid and coherent, structured, focused on feelings of vital failure. Referred hypothymia, without apathy or hypohedonia. Referred anxiety, not evidenced. Active autolytic ideation, without criticism, manifesting intentionality of repetition. Low tolerance for frustration with impulsive responses. Preserved appetite. Hypersomnia. Preserved reality judgment. Partial awareness of illness.

Suicidal behavior should never be considered a call for attention but rather for help. In the intervention we must not blame and reconnect the minor with the family. We must talk openly about the circumstances in which it occurred, facilitating emotional expression. We must guarantee the safety of the minor, open dialogue between parent-child and provide support from parents.

None Declared

Open access to psychological treatment manuals is critical for advancing research and clinical practice, particularly in low- and middle-income countries, where access to mental health care is scarce. Despite growing recognition of the need for freely available manuals to ensure replicability, transparency, and wider dissemination of evidence-based interventions, open and free access to intervention manuals remains limited.

We aimed to quantify the availability of protocols and manuals for psychological interventions used in randomized clinical trials (RCTs) for severe mental disorders. This research is part of the broader European Research Council – funded project DECOMPOSE, in which we employ a systematic and reproducible approach for decoding, classifying, and evaluating the active ingredients of psychological interventions.

Using recent network meta-analyses of RCTs, we collected psychological interventions for psychotic, bipolar, substance use, eating, and borderline personality disorders. We attempted to retrieve intervention protocols and manuals directly from trial publications or their published protocols and referenced manuals. If the protocols or manuals were not accessible, we contacted the study authors to request the materials.

We identified a total of 259 RCTs, but only 18 had published protocols. Of the 71 RCTs pre-registered on platforms such as ClinicalTrials.gov, only 5 provided an adequate description of the psychological treatment components, all of which overlapped with already published protocols. To retrieve missing materials, we contacted 450 authors from 241 RCTs. We received positive responses from 75 RCTs, negative responses from 55 RCTs, and no replies from 100 RCTs. We were not able to retrieve contact information for the authors of 11 RCTs.

Of the 75 positive responses, we obtained the complete requested materials for only 47 trials. In the remaining cases, we were instructed to purchase the manuals (n=11), provided with only partial materials (n=4), or given additional references that were not the full intervention manual (n=13). Negative responses included the trial being too old or no authors’ access to the materials (n=22), commitment to send the materials without further follow-up (n=8), suggesting the paper as the sole available resource (n=11), and various other reasons (n=14)

Our findings reveal a significant lack of freely available intervention manuals, limiting the implementation and replicability of psychological treatments. Coordinated action is needed to ensure open access to these materials for more replicable research, wider dissemination of results, and improved access to evidence-based mental health care.

None Declared

The collaboration between nursing, psychology, and psychiatry is essential for delivering comprehensive and effective mental health care. A multidisciplinary approach ensures that patients receive holistic support where everyone is aligned on the patient’s needs, treatment progress, and level of risk, and drawing on the unique skills and expertise of each discipline. Without proper coordination, there is a higher risk of gaps in care, conflicting interventions, or misunderstandings that could negatively impact the patient’s safety and well-being.

To highlight the importance of collaborative work between nursing, psychology, and psychiatry within the context of an acute, short-term, intensive outpatient program for suicidal ideation, such as PRISURE, is essential. For patients at high risk of suicide, particularly those experiencing acute symptoms, a combined multidisciplinary approach is critical to providing effective and timely care.

The program distinguishes between two types of interventions: an intensive program and a regular program, both offering a couple months long intervention but differing in the frequency of visits. The entire team meets weekly to assess new cases and discuss patients within the intensive program. An additional meeting is held to coordinate care for patients in the regular program between nursing and psychiatry. Regular multidisciplinary meetings are key to ensuring a coherent and unified approach across both programs. Appointment schedules are carefully coordinated to minimize the time between consultations, ensuring continuous and consistent follow-up for patients. The program also coordinates with regular mental health out-patient clinics within the public health system, to garantee a good transition of care.

During these collaborative meetings, each specialist shared their assessments and observations on the patient’s progress, enabling the team to develop a unified therapeutic plan. Any changes in symptoms or new events are promptly communicated among all treating professionals, allowing for a rapid and coordinated multidisciplinary response. The diverse perspectives of each team member contribute to a more nuanced and comprehensive understanding of the patient’s needs and treatment.

In summary, the collaboration between nursing, psicology and psychiatry creates a synergistic approach that is essential for delivering high-quality, patient-centered mental health care, particularly for those experiencing suicidal ideation.

None Declared

Migration, whether legal or illegal, is a growing phenomenon in Tunisia and can bring significant mental health challenges. Migrants often experience a decompensation of pre-existing psychiatric disorders, the development of new mental health issues, or travel driven by a delusion, known as “pathological travel.” These concerns emphasize the need for specialized psychiatric and social care for this vulnerable group, who endure considerable stress throughout their migration. However the quality of care can also depend on the support from their home countries, where stigma and identification issues with consulates can limit their access to help.

To study the different psychiatric pathologies observed among this population and to determine the number of cases of pathological travel.

It’s a retrospective study. We reviewed the files of all patients who were hospitalized in the Avicenne Psychiatric Department of Razi Hospital between January 2022 and December 2023.

We identified 19 patients and found 17 files. There were 11 men and 6 women, with an average age of 33 years (ranging from 20 to 54 years). The majority have a university-level education (52%) and with a history of psychiatric illness (58%). In total, 41.2% were from the Maghreb, 41.2% from Africa, 11.7% from Europe, and 5.9% from the Americas. The causes of migration to Tunisia were, for economic reasons (29%), for studies (11%), for seeking treatment for a pre-existing psychiatric condition (11%), marriage to a Tunisian partner (11%) and as part of a pathological travel (34%). In 35% of cases, the migration was clandestine and illegal. The reason for hospitalization was behavioral disorder in 64.8%, incoherent speech in 29.4% and suicide attempt in 5.8%. Among our patients, 28% have bipolar disorder, 17% have schizophrenia, 11% have brief psychotic disorder, 5% have depression, 5% have schizoaffective disorder, 5% have delusional disorder, and 5% alcohol use disorder. The diagnoses for the rest of patients were unspecified. In terms of social support we were able to contact the families in 62% of the cases. We succeeded in getting a response from the consulate of the native country in 17% and we collaborated with an International Organization in 5%.

Our study shows the complex psychiatric needs of migrants in Tunisia, with a range of mental health disorders, including cases of pathological travel. Economic reasons and clandestine migration were common factors. Despite efforts, social support remains limited, with minimal consular and organizational collaboration, economic challenges, emphasizing the need for stronger international and social support systems.

None Declared