Among children with developmental disabilities, there is a group with consequences of neurotrauma that requires comprehensive support at different age stages, with the obligatory inclusion of the family in the rehabilitation process. These children are shown both medical and psychological and pedagogical rehabilitation, the effectiveness of which is determined by the active position of the patient’s relatives.

The study the factor of involvement of close patients with neurotrauma in the rehabilitation process: manifestations of psychophysical activity.

140 children with neurotrauma consequences with neuropsychiatric disorders (2021-2024) and 136 families. Medical and pedagogical method with observation, examination, diagnostic and typological assessment of children’s mental activity; cluster analysis of the results of studying families (parents) as participants in rehabilitation.

Clusters were identified based on the assessment of the activity of parents’ inclusion in the rehabilitation process:

Cluster 1. Active families (40%). The patient’s relatives follow all the instructions of the specialists, are an important and integral part of the rehabilitation team. Children from the families studied show both qualitative and quantitative gains in rehabilitation, predominantly in the socio-communicative and cognitive domains.

Cluster 2. Estranged families (60%). Adults formally relate to rehabilitation activities. In children from these families, the dynamics of recovery is limited to an insignificant increase in psychophysical activity indicators, without transition to a higher level.

The effectiveness of the rehabilitation process for severe neurotrauma in childhood is influenced by the involvement of adults close to the child. The personality traits of the parents, adaptability and resistance to stress, the severity of the child’s illness - these factors turn out to be decisive. Most loved ones need medical and psychological support. Regardless of the severity of neurotrauma in children, parents become more active if they note the dynamics in improving mental health. In case of long-term, severe illness of children accompanied by disability, family members only provide care and supervision.

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This study examined the interplay between marital relationships and individual adjustment to cancer, considering the influence of attachment styles and marital duration under high-stress conditions.

This research aims to elucidate how these factors modulate the marital quality and the psychological well-being of individuals and their partners.

A total of 312 participants, comprising 223 cancer patients and 89 partners, completed the Golombok-Rust Inventory of Marital State and the Adult Attachment Inventory. Linear mixed-effects models were used to analyze the relationships between marital adjustment, attachment styles, and marital duration.

The findings indicated that females diagnosed with cancer reported significantly poorer marital adjustment compared to their male counterparts (both p < .05). Notably, secure attachment was significantly positively associated with better marital adjustment (β = .18, p = .016), while ambivalent attachment was significantly negatively associated with worse marital adjustment (β = -.11, p = .029). These patterns persisted across both patients and their partners, with no significant differences based on sex. Additionally, the impact of attachment styles on marital adjustment did not vary significantly with marital duration (all p > .05).

These results underscore the complexity of the marital dynamics among couples confronting cancer. The data reveal that secure attachment enhances marital stability, whereas ambivalent attachment detracts from it, irrespective of the sex of the respondent or marital duration. This study adds to the body of literature by highlighting the nuanced ways in which attachment styles influence marital dynamics under the strain of cancer. The implications for clinical interventions emphasize the importance of fostering secure attachment behaviors in couples therapy, particularly in contexts involving significant health challenges.

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Patient-reported outcomes are becoming increasingly important in the evaluation of antidepressant drug therapy. They capture the patient’s perspective on their symptoms, treatment experiences, and overall well-being, unlike traditional clinical measures that focus only on objective assessments (clinical scales measuring symptom reduction and psychological changes). These outcomes provide a more comprehensive understanding of the impact of antidepressants on daily living.

The main objective of the study was to determine patient-reported outcomes of antidepressant drug therapy.

300 patients from three study centers were included - a geriatric hospital (Germany), a Specialized psychiatric clinic (Germany), Outpatient psychiatric clinic (Croatia). Patients were assessed with the same questionnaire that consisted of two parts - the first one included questions about the patient’s current state (possible symptoms) and the second one included questions about possible antidepressant side effects. The main inclusion criterium was continuous antidepressant therapy, and the main exclusion criterium was the inability to communicate via a questionnaire.

Comparative analysis of patient perceptions in an acute psychiatric, outpatient psychiatric and geriatric patient cohort showed all patient cohorts were adherent to taking their medication but differed significantly in the level of awareness of any information regarding their medication taking (why are they taking it, when, what is the prescribed dose, etc.) with geriatric patients being the least aware. The results also show other differences between the three cohorts, especially between the Croatian and German cohorts. An interesting difference is shown in the open question about medication side effects - 99 Croatian patients didn’t report having side effects, while only 31 patients from one German center and 71 from another German center answered that they had no side effects when asked openly. When asked specifically, patients from all three cohorts gave similar answers.

Understanding patient-reported outcomes can be extremely beneficial, as antidepressant efficacy as well as side effect severity varies widely among individuals and affects adherence to treatment. Patient-reported outcomes are a great starting point for moving in the direction of patient-centered medicine and can help healthcare providers make more informed decisions regarding antidepressant drug therapy.

This study is a part of ArtiPro ERA PerMed (Multidisciplinary research projects on personalized medicine- development of clinical support tools for personalized medicine implementation) project. The main goal is to establish an artificial intelligence-based platform that integrates data from clinical research involving biomarkers as predictors of illness and treatment outcomes with a goal to identify robust multimodal biomarkers and outcomes for depression.

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Schizophrenia is a severe psychiatric disorder affecting 50% of patients intermittently and 20% chronically, with high unemployment rates (80-90%) and reduced life expectancy. Although genetic and neurodevelopmental factors are established non-modifiable risk factors, knowledge gaps persist regarding prevention strategies, particularly the combined impact of modifiable risk factors.

The aim of this study is to identify the modifiable risk factors and to estimate their joint effect on Schizophrenia.

We conducted an exposure-wide association study (EWAS) using the UK Biobank cohort to systematically evaluate 206 potentially modifiable factors associated with schizophrenia risk. The study population comprised individuals without schizophrenia at baseline, with diagnoses determined using ICD-10 criteria. We employed Cox proportional hazard regression models with Bonferroni correction (significance threshold: P<1.91×10-4) to identify significant factors. The identified factors were categorized into six domains: lifestyle, local environment, medical history, physical measures, psychosocial factors, and socioeconomic status (SES). Domain-specific, weighed, and standardized scores were calculated based on coefficients from Cox models, adjusting for covariates. Scores were stratified into tertiles (favorable, intermediate, unfavorable) for risk assessment. Population attributable fractions (PAFs) were calculated to quantify prevention potential.

The study cohort included 498,351 participants (54.45% female; mean age: 56.55 years) followed for a mean duration of 14.37 years, during which 1,345 participants developed schizophrenia. We identified 86 significant modifiable factors, with disability (HR 6.23, 95% CI 5.48-7.07), depression (HR 5.06, 95% CI 4.93-5.20), and anxiety disorders (HR 3.69, 95% CI 3.12-4.36) showing the strongest associations. Our analyses suggested that transitioning unfavorable profiles to intermediate and favorable status (Estimation 1) could prevent 59.6% of schizophrenia cases, while shifting both intermediate and unfavorable profiles to favorable (Estimation 2) could prevent 90.4% of cases. In Estimation 2, the preventive potential was highest for SES (18.0%), followed by medical history (17.5%), lifestyle factors (17.0%), psychosocial factors (14.3%), physical measures (12.8%), and local environment (10.8%).

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This analysis identifies multiple modifiable risk factors for schizophrenia, demonstrating substantial prevention potential through multi-domain interventions. Socioeconomic, medical, and lifestyle factors emerge as key targets for prevention strategies. The consistency of associations across genetic risk strata suggests interventions could be beneficial regardless of genetic predisposition, informing targeted prevention strategies and public health policies.

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Immediate physical assessment and management of patients on psychiatric wards who have been ligaturing is not standardised across the UK. There is little published research or literature on what is needed in terms of medical input and these incidents are usually initially assessed/managed by non-medical staff who are on site at the time of any such incidents. Within CWP NHS Foundation Trust, we have local guidelines (SOP 13 ‘The Management of ligatures in Mental Health and Learning Disability Services’) advising that any inpatient on the adult/older adult psychiatry wards who has ligatured should be seen by a doctor for a medical review,

To review a sample of recorded inpatient ligature incidents to see if Trust guidelines were being adhered to. We hope to use the findings from this audit to review the current guidelines and assess whether or not the additional medical reviews add to or change clinical management already instigated by ward staff. This may be more of an issue when medical staff cover is limited e.g. out of hours.

We accessed recorded ligaturing incidents on adult and older adult inpatient psychiatry wards across our Trust (accessing the ‘Datix’ reporting system) from the period starting 1st January 2022 to 31st May 2024. In total, there were 1127 and we took a sample of 112 picked using a random number generator. We reviewed the documentation from the incident to confirm how many had had a medical review after the incident, how long after the incident they were seen and whether or not the medical review had changed management following the incident.

Approximately 50% of patients had had a medical review post ligature incident. Approximately 4% of patient ligaturing (5/112) or 9% of those who received a medical review (5/55) had new management instigated as a result of the medic review. On review of these cases, there was limited medical input needed including application of steristrips for wound care and asking for ambulance transfer to acute hospital for CT head following seizure after ligaturing. There were no serious harm outcomes from the patients we reviewed in our sample.

Whether or not the we can review guidlines can be reviewed in light of the data is to be discussed following presentation of our results to the Trust. It appears that the initial managment plan, instigated by ward staff, has usually been appropriate and when additional input has been given by the medic on site at review, this has not been felt to have been critical in optimising patient safety. It would still be possible for a medic to review patients when felt by ward staff to be necessary even if guidelines were changed to suggest it was not mandatory for patients to be seen by a medic.

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Perinatal grief is the process that occurs after the loss of a baby, either during pregnancy or during the period immediately before or after childbirth (up to a year). In recent years, the increase in specific training and development of programs focused on perinatal mental health has facilitated the creation of specific action protocols. The case of a 38-year-old woman who suffers a gestational loss during the third month of pregnancy is explored. The presence of personal and family antecedents that suppose risk factors for the adequate elaboration of the duel, raise doubts about the handling of the case.

This work has several objectives, including reviewing the published literature on perinatal bereavement in an emergency situation and, on the other hand, presenting a case.

A bibliographic search has been carried out in the main sources of medical information such as pubmed, uptodate as well as in national and international journals. Likewise, the knowledge and clinical experience of the team has been reviewed in order to expose its own experience in this field, defining specific interventions as well as results.

On evaluation, the patient was conscious and oriented to person, time, and space. Approachable and cooperative. Overall calm, although with intermittent crying. Low mood reactive to vital situation, without apathy, apathy, or anhedonia. No previous episodes of hypomania or mania. Not another major affective clinic. Fluid and coherent speech, formally well constructed without glimpse alterations in the course or content of thought. She denied sensory- perceptual alterations, without showing a listening attitude, or suspicion or any other psychotic or dissociative symptoms.

She denied ideas of self-harm, death or self-harm, presenting an adequate request for help and coherent and realistic future plans. Altered biological rhythms with insomnia of three days of mixed pattern evolution, preserved appetite. Judgment of reality preserved.

The grief reaction is an experience that must be normalized after the loss of a loved one. However, given the risk factors presented by the patient, preventive management is established in the face of possible complicated perinatal grief. A new appointment is established in less than 10 days to reassess the case with the perinatal mental health team.

Perinatal mental health is an area of knowledge that could provide assistance to mothers, fathers and family systems plunged into a crisis of perinatal grief.

Prevention in situations of possible complicated perinatal mourning is no less important than treatment when the disorder is already established.

None Declared

Early diagnosis and intervention are essential for managing and improving long-term outcomes of severe mental illness, highlighting the need for reliable early biomarkers. This longitudinal study explores whether there are sex differences in the development of the brain during childhood and adolescence differs between offspring of parents with and without a diagnosis in the mood-psychosis spectrum.

We obtained 286 T1-weighted and diffusion weighted MRI scans of 184 offspring (aged 8–18 years at baseline) of at least one parent diagnosed with bipolar disorder (n=78) or schizophrenia (n=52) and offspring of parents without severe mental illness (n=54); 102 offspring underwent a follow-up scan (on average 3.9 years between scans). Global brain measures, regional cortical thickness and surface area, gyrification and sulcul morphology were computed. Anatomical brain networks were reconstructed into structural connectivity matrices. Network analysis was performed to investigate anatomical brain connectivity. Group comparisons and the interaction with age were analysed with (non)linear mixed-effects models. Explorative analyses will be done on the interaction with sex. To correct for multiple comparisons, we applied a Benjamini-Hochberg false discovery rate (FDR) correction (q=0.05).

A significant effect of age was found on most of the included brain features, with suggestive evidence for subtle deviations in trajectories in the cortical thickness and network metrics, but not in the gyrification index and sulcul morpholoy in offspring of parents with schizophrenia. Sex effects will be discussed during the meeting.

Our findings suggest the brain development in familial high-risk youngsters is associated with being at familial risk for schizophrenia.

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Language Disorder, a prevalent developmental disorder, impedes children’s communication skills, with genetic and environmental factors playing pivotal roles in its pathomechanism.

This study aims to investigate the involvement of sequence variations in SETBP1 and CNTNAP2 genes, along with environmental variables, in Language Disorder’s etiology.

Between September 2022 and March 2023, thirty children aged 2-7 diagnosed with language disorders according to DSM-5 criteria, and evaluated using the Ankara Developmental Screening Inventory, were studied to identify genetic and environmental factors contributing to etiology.Thirty healthy children with similar age were included as a control group. DNA samples isolated from peripheral blood of both groups were analyzed for SETBP1 and CNTNAP2 genes using next-generation sequencing (custom design panel). The frequencies and clinical significance of the identified variants was evaluated, and variant verification and segregation analyses were performed by Sanger sequencing. The obtained data were compared using appropriate statistical methods.

Language Disorder showed a male-dominant distribution. The SETBP1 rs11082414-CC genotype frequency was significantly higher in patients (p=0.024), and two rare variants (CNTNAP2: c.973C>G:p.P325A; CNTNAP2: c.2236G>A:p.D746N) were exclusive to cases. In silico analyses yielded conflicting results for rare variants, inherited paternally from unaffected parents. Among non-genetic factors, patients had higher birth weights (p=0.043) and shorter lactation durations (p=0.044).

Homozygosity for SETBP1 rs11082414 polymorphic variant increases Language Disorder susceptibility. This study underscores the genetic dimension of Language Disorder, urging physicians’ awareness and early intervention strategies to mitigate its impact.

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Catatonia due to myocarditis is rare and poses a significant diagnostic challenge. We present a case of classical catatonia secondary to viral myocarditis.

We want to highlight the clinical issues in diagnosing catatonia due to specific medical conditions, especially in a resource-limited setting like Pakistan.

The case is discussed, followed by suggestions and a literature review.

A 22-year-old male with no known medical and psychiatric comorbidities presented to the emergency department in April 2023 with avolition, alogia and fever for 2 weeks. Patient was admitted to Neurology for workup; CSF analysis, CSF autoimmune screen, CSF culture, CSF HSV PCR, blood culture, urine culture, serum ceruloplasmin, MRI Brain were all unremarkable. He was treated with broad-spectrum antibiotics, following which his fever remitted.

On initial psychiatric exam, patient scored 13 on Bush Francis Catatonia Rating Scale for mutism, staring, posturing/catalepsy, stupor, grimacing, mitgehen, gegenhalten and rigidity. Initial work up included normal CBC, CMP, TSH, HIV/Syphilis, Urine toxicology, ESR and a CRP of 43 mg/L. He underwent echocardiography which revealed a severely reduced Ejection Fraction of 30% and dilated cardiomyopathy, consistent with viral myocarditis; which was considered in remission and thus managed conservatively by Cardiology. The patient then received IV infusion of Diazepam 10mg BID which adequately treated his catatonia over 3 days and he was discharged with instructions for close follow-up. On followup visits, the patient continued to display remission of catatonic symptoms, but exhibited new symptoms of acute psychosis including 2nd person auditory hallucinations and delusions of reference and persecution. These were treated with Olanzapine 5mg PO resulting in complete remission over 4 weeks. The patient continued to have residual symptoms of social withdrawal, decreased motivation and poor concentration on his most recent presentation. Patient was also noted to have an exaggerated startle reflex which was not associated with any other neurologically relevant symptoms. It prompted a workup to rule out seizure disorder, the results for which are pending at time of this submission.

This case underscores the clinical complexity and diagnostic challenge of catatonia linked to medical conditions. It also depicts the evolving presentation over time. It is important to note that the patient did not receive IV Lorazepam due to its unavailability in Pakistan. Electroconvulsive therapy should have been considered for his catatonic symptoms but was delayed due to his pending diagnosis. Limited findings from literature review related to catatonia associated with viral myocarditis demonstrate the need for further research to bridge the gaps in evaluation and management.

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Bipolar disorder is a serious mental disorder that requires follow-up and pharmacological treatment for the patient to function properly. It is known that stressful events can generate decompensation in these patients. Pregnancy and postpartum are moments of high vulnerability for women with bipolar disorder, being essential their immediate follow-up and treatment in case of decompensation. In these cases it is essential to ensure an adequate bond with the baby.

To present a case of a patient with a diagnosis of bipolar disorder, who in both pregnancies has a manic episode after delivery.

Case presentation and literature review.

The patient is a 37-year-old woman who comes to the emergency department for manic symptoms. Her psychiatric history includes a diagnosis of bipolar disorder in 2022 after an admission for a manic episode two months after the birth of her first child. She is currently under active follow-up by psychiatry and a perinatal group intervention program. She lives with her husband and two-year-old son.

During pregnancy she received lithium without decompensation. When she came to the emergency room, she was on lithium 400 mg every 8 hours and olanzapine 10 mg prescribed 4 weeks ago by her psychiatrist, who had noticed the decompensation, which she stopped a week ago on her own.

In the examination, he shows an accelerated speech with verbose and uninhibited contact. She says that 5 days ago she began to present the idea that she was a threat to her children, with increasing anguish. She began with a decrease in the hours of sleep and suddenly refers that the idea of having to travel to Bali appeared, since “it is her favorite place in the world”. Without considering the price and without informing her husband, she left her home and arrived in Bali, where she incurred high expenses. When she arrived there, she reported meeting a friend who helped her to return to her country and informed her family.

Pregnancy and postpartum are moments of high vulnerability and emotional intensity for any woman. It is known that for patients with mental disorders, this vital moment may involve a risk of decompensation of their mental disorder, compromising their health, and may have negative repercussions on the bonding with their baby and the style of attachment they build with it. It is essential to train professionals in pharmacological treatments allowed during pregnancy, postpartum and lactation, as well as to facilitate close follow-up programs for these patients in order to reduce the risk of decompensation as much as possible.

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Sexual function is essential to women’s health, impacting psychological well-being and relationships. In Tunisia, cultural norms may influence how sexual dysfunction is reported and perceived. This study examines the prevalence of sexual dysfunction and its psychological consequences.

To evaluate sexual function in Tunisian women and assess its correlation with psychological distress.

This cross-sectional descriptive study was conducted in March 2023 with 80 Tunisian women, aged 24-50, using a self-administered online questionnaire. Data collection involved the Female Sexual Function Index (FSFI) to assess sexual dysfunction and the Depression Anxiety and Stress Scale (DASS-21) for psychological well-being. Key sociodemographic variables, including marital status, number of children, and socio environmental context were also collected.

We gathered data from 80 women out of 500 distributed questionnaires (16%).

Participants had a mean age of 33.35 years. A majority (63.7%) had children, and 93.8% resided in urban areas. Notably, the majority of women who responded to the questionnaire (74%) were married.

Among the study population, the median FSFI score was 23.65, with 61.3% scoring below the threshold of 26.55, indicating sexual dysfunction. For married women (n=59), the mean FSFI score was 23.7 ± 7.9. The detailed FSFI scores for the entire population and married women are presented in Table I, indicating that the most affected domains of sexual function were excitation and desire. Severe depression, anxiety, and stress were reported by 6.3%, 12.5%, and 6.3% of participants, respectively.

Sexual dysfunction was significantly associated with depression (p=0.02). However, no statistically significant associations were found between anxiety, stress, and sexual dysfunction.

Table I: FSFI Scores among the Study Population

The study shows a high prevalence of sexual dysfunction among Tunisian women, tied to psychological distress, mainly depression. Enhancing sexual health and mental well-being is key to improving overall quality of life and addressing marital issues. Future research should explore culturally sensitive interventions to enhance sexual health and support women’s mental well-being.

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One of the directions of scientific research in modern psychiatry is the search for predictors of the developing of a manifest psychotic attack in patients with non-psychotic disorders, that is, predictors of an ultra-high risk of psychosis. Such predictors may include various biomarkers, for example, the quantitative EEG parameters, which subtly reflect the features of the brain functional state.

The aim of the study was to search for EEG correlates of the brain functional state in depressive patients of the group of an ultra-high risk of developing psychosis in comparison with EEG parameters of patients without symptoms of a risk of psychosis.

The study included 74 female depressive patients (F31.3-4, F32.1-2, by ICD-10) aged 16-26 years (mean age 20,8±3,5 years) at the stage of remission establishing after treatment course, clinically divided into two groups. First group consisted of 32 patients with depressive conditions and attenuated prodromal psychotic symptoms assessed by SANS and SAPS scales and by COGDIS and COPER criteria, but without a history of manifest psychotic attack. The second group included 42 depressive patients without symptoms of ultra-high risk of developing psychosis. In all patients, multichannel background EEG was recorded with spectral power analysis in narrow frequency sub-bands. Intergroup EEG differences were statistically analized using Mann-Whitney test.

According to EEG data, the functional state of the cerebral cortex in patients of group 2 at the stage of remission establishing was approaching normal. The EEG of the 1st group of patients differed from the EEG of the 2nd group by significantly lower values of EEG spectral power in the alpha3 sub-band (11-13 Hz) in the occipital leads and by significantly increased spectral power of theta1 (4-6 Hz) activity in the central-parietal areas. Such EEG frequency structure of patients in group 1 reflects a reduced functional state of associative areas, and may also indicate dysfunction of the frontal parts of the cerebral cortex. These EEG features of patients in group 1 are consistent with a significantly greater severity of their positive and negative symptoms scores by the SAPS and SANS scales compared to group 2.

In depressive patients at the stage of remission establishing who have symptoms of an ultra-high risk of developing psychosis a reduced functional state of the associative and frontal areas of the cerebral cortex is noted, which may underlie the characteristics of their clinical conditions.

None Declared

Infertility is a biopsychosocial crisis. While there are studies demonstrating heightened negative affect (e.g., depression and anxiety) in women undergoing in vitro Fertilization (IVF), the findings are still inconsistent. The network paradigm allows for a more in-depth examination of symptom dynamics behind specific psychopathological states. A recent development allows one to compare networks from different groups using three characteristics: global strength (overall level of network node connectivity), edge strength (level of association between symptoms), and network structure (comparing all edges in the network across two groups).

This study aims to compare the networks of anxiety, depression, and negative affect across women who have fertility issues or undergoing IVF and women without these issues.

Sample 1 consisted of 197 women with fertility issues (age: M = 37.73, SD =5.13) and 370 women without such issues (age: M = 36.25, SD = 6). Sample 2 consisted of 205 women undergoing IVF (M = 40; SD = 5.29) and 222 mothers without fertility issues (M=28; SD = 4. 93). Sample 3 consisted of 162 women undergoing IVF (M= 35.58; SD=5.04) and 129 mothers without fertility issues (M= 34.37; SD= 4.94). PHQ-9 (Patient Health Questionnaire; depression measure) was administered to the sample 1, GAD (generalized anxiety disorder measure) was administered to sample 2, and PANAS - NA (negative affect measure) was administered to sample 3. NetworkComparisonTest R package was used to compare the networks. EBICglasso was used to estimate the networks.

Regarding the depression symptoms (sample 1; image 1) - the networks across the two groups are highly similar with respect to overall connectivity (S =.051; p = .73) and overall network structure (M = .16, p =.87). Regarding generalized anxiety symptoms (sample 2; image 2), the findings are replicated with overall connectivity being the same across the two groups (S =.10, p = .34) and network structure being the same across the two groups (M = .28, p= .09). Finally, the negative affect (sample 3; image 3) network connectivity (S = .02, p = .93) and network structure (M = .23, p = .53) are identical across the two groups.

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The networks of negative affect, depression, and anxiety are highly similar across women with fertility issues and women without such issues. Therefore, fertility issues do not seem to affect the structure of symptoms of depression, anxiety, and negative affect. Finally, it is argued here that the knowledge of these disorders (and negative affect) can be generalized to the population of women who have fertility issues.

N. Ćirović Grant / Research support from: Nikola Ćirović was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe., J. Opsenica Kostić Grant / Research support from: Jelena Opsenica Kostić was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe., M. Mitrović Grant / Research support from: Milica Mitrović was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe., M. Guberinić Grant / Research support from: Mila Guberinić was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe., M. Spasić Šnele Grant / Research support from: Miljana Spasić Šnele was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe., I. Janković Grant / Research support from: Ivana Janković was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe., M. Trenkić Grant / Research support from: Milan Trenkić was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe.

I will present data from a range of Danish studies on both cannabis-induced psychosis and Danish epidemiological studies on the association between cannabis and psychotic disorders such as schizophrenia. A deeper understanding of these associations is important. If the consistent association that we have observed for many decades is indeed causal, then cannabis is perhaps the single most important preventable risk factor for schizophrenia that we have identified to date. The development over time of the population attributable risk fraction, gender differences, and other novel areas will be covered in the presentation.

None Declared

Despite the crucial need for objective diagnostic procedures in psychiatry, the research of the quantitative neural bases of mental disorders is in its infancy, and currently there are no well-validated markers that could be translated into clinical practice. Candidate brain markers for neurodevelopmental, psychotic, and mood disorders have been proposed, but confounding factors and low statistical power leave most of these markers at the very early stage of development. Increasing evidence suggests a crucial role of biological, especially including sex, and environmental factors in shaping behavioral development and psychopathological risk. Moreover, such risk seems associated with greater susceptibility to cardiovascular problems, possibly mediated by alterations in the brain-heart axis. In this context, the study of brain maturation trajectories and brain-heart interactions in relation to sex and environment can provide key insights on the etiology of complex mental illnesses.

This lecture will provide an overview of our recent research on the interactions among biological factors, in particular sex, environmental risk, brain morphology and function, and cardiac autonomic regulation in affective and psychotic disorders using multivariate analysis approaches. Evidence obtained from juvenile cohorts, including samples of twins, will be presented to provide useful information on the genetic and environmental determinants of behavioral developmental trajectories, and on sex differences in these trajectories. The complex relationships among sex, environmental risk, autonomic regulation, brain morphology and connectivity, and mental and physical health will be explored in transdiagnostic samples of young adults and elders. Special focus will be given to sex-shared and sex-specific brain and autonomic mechanisms affected by social stressors, including discrimination, bullyism, and chronic stress, and their possible role in determining the heterogeneous clinical dimensions of psychotic and affective disorders.

None Declared

Transgender and Gender Non-Conforming (TGNC) individuals are at increased risk of diagnosis with mental disorders, including suicidality and suicidal gestures (Anderson & Ford. Nursing Inquiry 2022; 29). Patients’ psychological distress may be secondary to gender dysphoria; however, the evidence may be unclear.

The goal of this review was to compile current evidence to assess a relationship between gender dysphoria and suicidal ideation, suicidal attempt, and self-harming behavior.

A literature review on PubMed databases was conducted using the search terms “transgender,” “gender non-conforming “suicidality,” “self-harm,” “suicidal gestures,” “child,” “adolescent,” and “youth” in various permutations to assess recent evidence on suicidality and suicidal gestures among TGNC children and adolescents. We also reviewed relationships between gender-dysphoria, social support as a protective factor, and suicidality and/or suicidal gestures among TGNC youths.

A study conducted across 19 states in the United States and large urban school districts found that within the last year, 43.9% of transgender students reported they have seriously considered attempting suicide compared to 20.3% in cis-females and 11.0% cis-males, 39.3% of transgender students reported having a suicide plan compared to <16.0% of cisgender students, and 16.5% of transgender students reported having a suicide attempt requiring medical treatment compared to <2.5% of cisgender students (Garthe et al. Transgend Health 2022; 7 416-422). Another study conducted across three different US cities found higher levels of suicidal ideation and behavior among TGNC youths, compared to their cisgender counterparts (Johns et al. MMWR 2019; 68, 67–71). Also, chosen name use was associated with less suicidal ideation, behavior, and depressive symptoms (Russel et al, J Adolesc Health 2018; 63 503–505). Additionally, a surveillance analysis concluded that TGNC youths reported experiencing higher levels of emotional distress, bullying victimization, risk behaviors (substance use and sexual behavior), and lower levels of protective factors such as internal assets, family connectedness, and feeling safe in their community (Eisenberg et al. J Adolesc Health 2017;61 521–526)

Further research needs to be conducted regarding the relationship between gender dysphoria and suicidality, and the presence of suicidal gestures. However, the current data suggests decreased depressive symptoms, as well as suicidal ideation and behavior associated with increased chosen name usage.

None Declared

Electroconvulsive therapy (ECT) has long been regarded as highly effective in the treatment of Treatment-Resistant Depression (TRD), with remission rates ranging from 50% to 70%. In recent years, esketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has emerged as a novel treatment option for TRD due to its rapid and potent antidepressant effects (1).

This case aims to reflect on the comparative use of esketamine versus ECT in the management of TRD, considering clinical outcomes, side effects, and patient response.

A literature review was conducted using PubMed to gather evidence on the efficacy of esketamine and ECT for TRD. We also present a case study of a 53-year-old female patient with TRD to illustrate the clinical application and response to esketamine.

The patient, a 53-year-old divorced woman with a 31-year-old son, has a history of three psychiatric admissions in 2021 due to major depressive episodes. She was previously treated at a day hospital and continues follow-up care in outpatient settings. Her current psychopharmacological regimen includes Venlafaxine 300 mg and Mirtazapine 30 mg, with Aripiprazole recently discontinued.

The patient presented to the emergency department with a marked deterioration in mood, neglect of daily activities, and increased social isolation. Psychiatric evaluation revealed a depressed appearance, slowed speech, bradypsychia, and passive thoughts of death, though without suicidal ideation. Her biological rhythms were disrupted, and she experienced unquantified weight loss, despite good family support.

The patient received her first intranasal dose of esketamine (56 mg) without complications, followed by six additional doses twice weekly. Mild side effects included nausea and occasional depersonalization and derealization. Over time, the patient showed progressive improvement in both affective symptoms and daily functioning.

This case highlights the rapid antidepressant effects of esketamine in TRD patients, aligning with current literature. Esketamine is noted for its quick action and efficacy compared to second-generation antipsychotics (2, 3). Despite these benefits, ECT remains a more cost-effective option with higher remission rates for TRD, even though it is slightly less expensive than esketamine (1). The patient experienced significant clinical improvement with esketamine, which was well-tolerated with minimal side effects. However, the long-term efficacy and cost-effectiveness of esketamine relative to ECT remain under discussion. Further research is needed to clarify esketamine’s role in TRD treatment and to establish the best approach for long-term management.

None Declared

Sexual dysfunction, which is frequently observed in cancer patients, especially those undergoing prostate cancer treatments, has significant implications for both psychological well-being and intimate relationships. This review consolidates the current understanding of treatment impacts on this patient group.

This study examines the prevalence and psychological impact of sexual dysfunction among prostate cancer survivors following treatment.

A narrative review was conducted, analyzing data from six observational studies involving 7,146 participants and one meta-analysis published between 2015 and 2024. These studies focused on elucidating the relationship between sexual dysfunction and psychological well-being post-treatment using databases such as Scopus, PubMed, and Web of Science.

All main prostate cancer treatments (surgery, radiotherapy, and hormonal therapy) are associated with substantial risks of sexual and erectile dysfunction, as well as depressive symptoms. Notably, radical prostatectomy significantly reduces sexual function, with about one-third of patients experiencing depressive symptoms post-surgery. Additionally, within a year of undergoing radical prostatectomy, approximately 90% of patients experience moderate to severe erectile dysfunction. The associated depressive symptoms largely stem from diminished sexual activity and dissatisfaction stemming from disrupted sexual normalcy. Anti-androgen therapies also progressively worsen sexual function, impacting perceived masculinity and contributing to psychological distress. Notably, older men generally adapt to these changes more adeptly than younger men.

Persistent erectile dysfunction is a major, detrimental side effect for prostate cancer survivors, profoundly impacting their quality of life. Enhanced education for patients and their partners about potential sexual side effects, along with improved awareness and preparedness strategies, are essential to alleviate the psychological burdens stemming from post-treatment sexual dysfunctions.

None Declared

New treatments for negative symptoms (NS) in schizophrenia spectrum disorders (SSD) are urgently needed. NS are believed to stem from disruptions between the mesocorticolimbic dopamine system and networks for socioemotional processes. Oxytocin (OXT) enhances connectivity between the neural networks, improving social cognition and NS. Lower plasma OXT levels are linked to greater NS severity and social cognition deficits in SSD. While OXT increases social cognition in healthy individuals, its effects in SSD are inconsistent. The social salience hypothesis suggests OXT’s effect varies with social context. Our pilot study showed reduced NS with OXT administration in a positive social setting using mindfulness-based group therapy (MBGT).

This trial aims to assess the effects of combining OXT with MBGT on each of the five NS in individuals with SSD. We hypothesize that OXT nasal spray administered before MBGT will significantly reduce NS compared to placebo. The primary outcome is the change in NS, measured by the Positive and Negative Syndrome Scale (T1 - T0 score difference) after 4 weeks and as secondary outcome on the Brief Negative Symptom Scale (BNSS) as well as changes of stress and affect.

The research design is a triple-blinded, randomized, placebo-controlled study comparing OXT to placebo. Manual-based MBGT sessions, led by experienced psychotherapists, occur weekly for four weeks with groups of up to six patients. Participants receive intranasal OXT (24 I.U.) or placebo 30 minutes before sessions, aligning with the peak effect window (30-80 min) for optimal social behavior reinforcement. Plasma oxytocin levels are measured by radioimmunoassay. Recruitment will be at the Department of Psychiatry, Charité, Berlin, including both genders in mixed-sex groups, controlling for contraceptive use and menstrual cycle phase. Nasal sprays are indistinguishable. The primary outcome will be analyzed using ANCOVA, with treatment condition and training group as covariates. Based on pilot and previous study effects, a conservative effect size of f = 0.25 is assumed. With 1:1 randomization, 80% power, a 5% two-sided significance level, and a 10% drop-out rate, 140 subjects will be recruited.

This project explores how OXT augmentation enhances the positive effects of MBGT. It is expected that combining OXT with MBGT will significantly improve NS, stress, and affect in SSD patients. Preliminary results already show a significant reduction in social withdrawal and blunted affect in the OXT group compared to placebo.

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Current treatments for NS in SSD are insufficient, highlighting the urgent need for new or combined strategies. Evidence supports the benefits of augmented psychotherapy. This project could pave the way for innovative, personalized psychiatric treatment for SSD.

None Declared

The structure of clinical manifestations in patients with a history of mental disturbances who suffered from COVID-19 and were exposed to the stressors of the SARS-CoV-2 pandemic is characterized by the predominance of affective disorders of the anxiety-depressive spectrum.

To investigate the structure of affective disorders of the depressive spectrum after COVID-19 in patients with a history of mental disturbances by nosological groups.

95 patients with a history of mental disorders who have experienced COVID-19 were examined and made up the main group (F 32.0-32.2, 33.1, 33.2 – 31 patients, F 06.3, 06.4 – 33 patients, F 41.1, 41.2, 42.2, 45.3, 48.0 – 31 patients). During the study, a thorough analysis of the anamnesis of the disease was carried out, including information about the experienced coronavirus disease COVID-19. Clinical-psychopathological, clinical-amnestic, psychometric (the Montgomery-Asberg Depression Rating Scale (MADRS)) and methods of statistical analysis were applied.

According to the results of the psychodiagnostic study, the features of affective disorders of the depressive spectrum of various degrees of severity were established, which had certain differences according to nosological groups. Patients with depressive disorders have depressive disturbances in the form of sleep impairment (4.48 points, p = 0.0001), manifestations of sadness (4.27 points, p ≤ 0.021), internal tension (3.95 points, p = 0.01), difficulties in experiencing feelings (3.87 points, p ≤ 0.019), concentration difficulties (3.85 points, p = 0.031), appetite disturbances (3.11 points, p ≤ 0.012), manifestations of fatigue (3.06 points, p = 0.027), pessimistic (2.78 points, p ≤ 0.026) and suicidal thoughts (1.67 points, p = 0.038). Patients with mental disorders of organic genesis are characterized by depressive disturbances in the form of a feeling of fatigue (4.18 points, p ≤ 0.021), significant concentration difficulties (4.16 points, p = 0.024), sleep deterioration (3.87 points, p = 0.018), feeling and expressing sadness (3.16 points and 3.49 points, respectively), difficulties in experiencing feelings (2.43 points, p = 0.035). Patients with neurotic, stress-related and somatoform disorders are characterized by depressive manifestations in the form of expression of sadness (4.78 points, p = 0.034), feeling of internal tension (3.67 points, p = 0.027), concentration difficulties ((2 .68 ± 0.29) points).

The results of the study of the structure of affective disorders of the depressive spectrum after COVID-19 in patients with a history of mental disturbances should be used as targets for effective therapeutic influence.

None Declared