The transition from childhood to adulthood is a complex process and an important developmental task with many opportunities and risks. Despite the fact that almost three-quarters of psychiatric disorders begin before the age of twenty-four, adolescents and young adults are poorly represented in psychiatric research, and the data used to guide diagnosis and treatment in this group rely mainly on studies in adult populations. The mental health system in Germany is also not organized to meet the needs of this age group, and as a result, the treatment outcomes for young adults in inpatient or day-care units of adult psychiatric centers are mostly unsatisfactory. For this reason, it is crucial to implement mental health care concepts that are tailored to the needs of young adults.

Here we present a milieu-therapeutic inpatient care concept, ‘House of the Future,’ which integrates different therapeutic approaches to provide holistic and targeted support for young adults in need of psychiatric care.

An innovative inpatient psychiatric care concept for young adults from a psychiatric training hospital in Lower Saxony, Germany, will be presented in detail.

The concept of the ward incorporates a variety of therapeutic approaches, including milieu therapy, systemic family therapy, and psychodynamic therapy. Additionally, it incorporates safe-wards elements and numerous non-verbal, innovative techniques such as art therapy, occupational therapy, music therapy, and sports therapy adapted for this age group. We provide a structured and needs-based environment for young adults, enabling them to engage with their experiences without being defined by their disorder or solely integrated into psychiatric systems. Our holistic approach aims not only to treat symptoms but also to promote sustainable personal development and a healthy lifestyle that empowers young adults. Young adults represent the future, and the development of their future is contingent upon the efficacy of the social support system, which is itself a significant challenge. Consequently, social work and pedagogical support are among the most essential elements of the concept. In addition to the comprehensive presentation of the concept, opportunities for networking with integration support institutions, day clinics, and specific outpatient units will be provided.

Adolescence and young adulthood are distinct developmental stages with unique needs. To reach optimal outcomes and to build our future on a safe base, it is fundamental to implement tailored care models in psychiatric settings that are in harmony with the specific requirements of this age group. Project ‘House of the Future’ aims to be a best practice example to address these needs.

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Background: Bipolar disorder (BD) is marked by dramatic mood and energy shifts, often mirrored in speech. Traditional diagnosis and monitoring largely rely on subjective clinical assessments. However, advancements in natural language processing (NLP) present an opportunity for more objective speech pattern analysis.

Aims: This study aims to (i) identify correlations between speech features and BD symptom severity, (ii) create predictive models for diagnostic and treatment outcomes, and (iii) pinpoint significant speech features and optimal tasks for analysis.

The CALIBER study is a longitudinal, observational project collecting audio from BD patients during euthymia, acute manic or depressive episodes, and recovery phases. Patients engaged in clinical interviews, cognitive assessments, standard readings, and storytelling (Figure 1). Automatic diarization and transcription enabled the extraction of speech features, including acoustic properties, linguistic content, formality, and emotionality. Analyses include (i) correlation of speech features with clinical scales, (ii) predictive modeling using lasso logistic regression, and (iii) feature importance identification.

Preliminary data from 76 patients (24 manic, 21 depressed, 31 euthymic) were analyzed. The cohort had a mean age of 46.0 ± 14.4 years, 63.2% female. Mean YMRS scores dropped from 22.9 ± 7.1 to 5.3 ± 5.3 post-mania, and HDRS-17 scores in depressed patients fell from 17.1 ± 4.4 to 3.3 ± 2.8 post-recovery. Euthymic patients showed lower baseline scores.

Automated speech analysis in BD can provide objective biomarkers for diagnosis and monitoring, highlighting subtle pre-relapse changes and informing treatment strategies. Establishing standardized protocols is vital for developing a global speech database to support collaborative research and enhance BD management.

G. Anmella Grant / Research support from: GA has received CME-related honoraria, or consulting fees from Adamed, Angelini, Casen Recordati, Janssen-Cilag, Lundbeck, Lundbeck/Otsuka, Rovi, and Viatris, with no financial or other relationship relevant to the subject of this article., Consultant of: GA has received CME-related honoraria, or consulting fees from Adamed, Angelini, Casen Recordati, Janssen-Cilag, Lundbeck, Lundbeck/Otsuka, Rovi, and Viatris, with no financial or other relationship relevant to the subject of this article., M. De Prisco: None Declared, J. Joyce: None Declared, C. Valenzuela-Pascual: None Declared, G. Chatzisofroniou: None Declared, D. Hidalgo-Mazzei: None Declared, E. Vieta: None Declared

Adverse Childhood Experiences, referring to potentially traumatic events such as sexual abuse, rejection, and family dysfunction, are strongly associated with the development of psychiatric disorders, including anxiety, depression, and substance misuse. Peer victimization related to sexual orientation and gender identity or expression has been linked to higher rates of depressive symptoms, disrupted educational paths, trauma, and increased use of substances such as alcohol and drugs. Gender-diverse youth are particularly vulnerable to substance misuse, especially in environments with limited support and prevalent discrimination.

To emphasize the complex interactions between substance use, early trauma, and gender identity struggles, while highlighting the importance of a multidisciplinary therapeutic approach.

This case report was developed through detailed psychiatric interviews and assessments conducted during the patient’s follow-up in an outpatient addiction treatment unit. The case description is supported by a focused literature review on PubMed using the keywords “Adverse Childhood Experiences”, “Substance Use Disorder” and “Gender Identity”.

The patient is a young adult with a history of polysubstance use, starting in adolescence. His substance use was closely associated to early trauma, including childhood sexual abuse and rejection by family and peers after disclosing his sexual orientation. These events led to dropping out of school, running away from home, and experiencing homelessness. As a result, he developed long-standing anxiety, depressive symptoms, and emotional instability. Internal struggles with gender identity, alongside ongoing familial conflict and unstable romantic relationships, further worsened his psychopathology. After a multidisciplinary intervention involving psychiatry, psychology, and social services, he showed significant improvements in emotional regulation, anxiety management and has remained abstinent since starting treatment.

Personal experiences, especially during childhood and adolescence, profoundly influence mental health and behaviors in adulthood. This case underscores the interaction between adverse childhood experiences, substance misuse, and discrimination related to sexual orientation, illustrating how these factors collectively impact psychiatric health. The patient’s journey through addiction, identity struggles, and mental health challenges reflects the deep influence of both personal trauma and systemic issues. This case highlights the need for multifaceted therapeutic approaches that address the psychological, social, and familial factors underlying the patient’s condition.

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We can learn a great deal about the power of writing to vanquish the worst forms of psychological trauma by looking closely at Mary Wollstonecraft in the second half of the eighteenth century. Mary Wollstonecraft wrote a Vindication of the Rights of Woman (1792), which is considered by many to be the most important work in feminist thought. Her literary impact went far beyond this foundational work. With the publication of Wollstonecraft’s first semi-fictional autobiography, Mary: A Fiction (1787), we can see how her personal life did not follow conventional rules either. Her dedication to individual freedom and social progress was not limited to women. Her own personal life history significantly shaped her influential stance on women’s equality. She was a pioneering advocate for women’s equal treatment to men.

This presentation aims to explore how ‘the author,’ Mary, coped with her own life traumas by going beyond the era of her time. By examining her real-life reflections of her fictional characteristics through the lens of psychoanalytic formulations, we seek to gain deeper insights into her inner self and coping mechanisms.

We critically analyzed Mary: A Fiction from a psychoanalytical and literary perspective. By connecting each real-life trauma with its fictional retelling, we uncover Mary’s liberation.

Self-analysis refers to Freud’s exploration and examination of his own psyche, emotions, thoughts, and behaviors in order to gain insight into the unconscious processes that influenced his behavior. In Mary: A Fiction, Mary Wollstonecraft wrote her autobiography as a way of her ‘self-analysis’ in order to erase her family’s repression of her ego. In this work, she explores a solitary and challenging self-analytical journey to address the erasure of her identity enforced by her family’s adherence to her mother’s martyrdom to the role of women. Through this process, she constructs a narrative of anger and righteousness to replace the previously “unspeakable” narrative of submission. In his Memoirs of Mary Wollstonecraft, Mary’s husband, William Godwin, locates the sadomasochism of her parents’, Elizabeth and Edward John’s patriarchal marriage, as foundational. In response to this trauma, Mary kills off her brother, mother, and father in the first seven chapters of Mary: A Fiction. Once her family is erased, so is their erasure of her. Mary can cast off her guilt and give herself the tools to “work through” the traumas of : her tyrannical, abusive, favored brother; the blows of her alcoholic father, and her family’s adherence to her mother’s martyrdom. These were the traumatic cornerstones for Mary’s pain and repressed rage.

Writing a fictional biography based on one’s own life story is a remarkable example of how unresolved conflicts in real life can be reprocessed and lead to eventual healing, similar to the work done in psychoanalysis.

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Mental health issues in children and adolescents are often influenced by ineffective parenting strategies such as poor communication, harsh punishments, lack of positive reinforcement, and imbalance between relationship and regulation. Although effective parenting interventions exist, access is typically limited to institutional services. Net PAMA, an internet-based parent management training program, was created to improve access. However, only city-dwelling, educated parents were able to effectively learn from the platform. A combination of local facilitators and the internet-based program, called ‘Net PAMA Classroom’, was then proposed as means to reach out to underserved communities.

This study examines the success factors and challenges of ‘Net PAMA Classroom,’ a community-based Parent Management Training intervention conducted by non-professional facilitators, with the use of the internet-based standardized program.

We interviewed fifteen Net PAMA Classroom facilitators. We then performed data triangulation and thematic analysis using Braun and Clarke’s six-step approach.

Three key themes were identified: curriculum, facilitators, and classroom management. Participants valued the practical skills provided through structured lessons. Successful facilitators had backgrounds in child and family work, prior facilitation experience, and supported parents in applying new skills. Support from community leaders significantly impacted the program’s initiation, delivery, and sustainability. Recommendations include making the curriculum culturally relevant, flexible, and less internet-dependent. Addressing propriety issues is also crucial for the program’s long-term success.

The Net PAMA Classroom’s effectiveness relies on a robust curriculum, experienced facilitators, and effective classroom management. Enhancing cultural relevance and flexibility, reducing internet reliance, community support, and resolving propriety concerns are essential for sustainability and scalability.

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Unlike data on public stigmatization with regard to the diagnosis of borderline personality disorder (BPD), literature concerning internalized stigma (IS) and stigma resistance (SR) is scarce.

The objective of the present study was collecting data about SR in patients diagnosed with BPD. Furthermore, quality of life and depressive symptoms were assessed and checked for possible associations with SR.

Patients meeting the inclusion criteria with 18-65 years of age and diagnosed with BPD were included into the study after giving written informed consent. The stigma resistance scale (SRS) had been translated to German. The SRS comprises 5 subscales and measures SR on a 5-point-Likert scale (1-5). Higher values indicate higher levels of SR. Furthermore, the German versions of the depression scale CES-D (ADS) and the quality of life – BREF (QOL-BREF) were used in this study. ADS measures depressive symptoms on a scale ranging from 0-60, with higher scores indicating more severe symptoms. QOL-BREF measures values between 0-100 on 4 domains, with 100 indicating a maximum of health in each domain. The recruitment took place in specialized inpatient and outpatient units between 2019 and 2022, with some interruptions caused by COVID protective measures.

101 participants (f = 90.1%) with a mean age of 29.2 years (18-59) were included into the study. The overall mean score of the SRS was 3.6. The mean scores of the subscales showed values between 2.8 (personal cognition) and 3.9 (public SR). The 4 domains of the QOL-BREF showed the following mean values: Physical health 47.4, psychological health 30.7, social relationships 51.2, environment 62.1. The study sample had a mean ADS score of 34.8. Interestingly stigma resistance, quality of life and depressive symptoms showed no correlation. Compared to the mixed sample in the original study, the sample of the current study showed comparable values in stigma resistance.

The use of the German SRS is feasible in a sample of patients with a diagnosis of BPD and yielded comparable results with the original mixed diagnoses study sample. As the measure exists already in several languages, comparisons between cultural, diagnostic and otherwise defined subgroups will be possible in the future. Further conceptual as well as qualitative and quantitative research work will be informed by these findings.

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Dissociative episodes are characterized by disruptions in consciousness, identity, or perception of reality and can be confused with other psychiatric disorders, such as manic episodes. This case describes a patient with both manic-like and dissociative symptoms, highlighting the need for a precise differential diagnosis. The case emphasizes how prolonged stress and psychosocial factors triggered a dissociative crisis, which improved significantly with anxiolytic and antidepressant treatment, a key factor in clarifying the diagnosis.

To describe a case of dissociative episode with manic-like symptoms, emphasizing the importance of differential diagnosis and appropriate treatment.

We present the case of a 43-year-old woman who was admitted to the emergency department following an acute dissociative episode. The patient arrived with a behavioral disturbance that had begun abruptly a few days earlier. She reported experiencing feelings of clairvoyance, mystical thoughts, and the sensation of receiving “alphanumeric codes,” interpreting gestures and everyday objects as messages with special meaning. During this episode, she exhibited behavioral disorganization, prolonged insomnia, euphoria, and a sense of hyperactivity, with impulses to compulsively reorganize her surroundings. These symptoms escalated until the patient, recognizing she could not control the situation, alerted her husband, who decided to take her to the emergency department due to the severity of her condition.

Disorganized behavior, with accelerated and delusional speech and megalomaniacal thoughts were present. Complementary tests were performed, ruling out organic causes. After administering midazolam for imaging procedures and initiating a fixed regimen of Lorazepam, the symptoms improved markedly, allowing for a more accurate assessment. The episode was interpreted as dissociative, with identified triggers including work-related stress, her relationship with her daughter, and the recent death of a friend. Pharmacological treatment with anxiolytics and antidepressants proved effective, leading to significant improvement in the following weeks, with resolution of delusions and insomnia.

This case highlights the importance of differential diagnosis between a dissociative episode and a manic episode, given the shared symptoms such as megalomaniacal delusions, insomnia, and euphoria. The rapid response to anxiolytic and antidepressant treatment suggests that the episode was more related to a stress-induced dissociative disorder rather than a bipolar affective disorder that would have required mood stabilizer treatment. This therapeutic approach resulted in a complete remission of symptoms, demonstrating the importance of a treatment plan tailored to the patient’s specific needs.

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Schizophrenia is a serious mental illness with positive, negative and cognitive dysfunctions and a significant deterioration in psychosocial functioning. Interactions between genetic predisposition and environmental stressors at the early stages of life, and subsequently a molecular level neurodegeneration process are important in the development of schizophrenia. Current approaches suggest that cytokines-induced neuroinflammation might have a role in the development of several psychiatric disorders, including schizophrenia.

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Patients with Parkinson disease (PD) may present psychiatric manifestations like delusions and hallucinations which can significantly impact their quality of life. These psychotic symptoms may also occur during neuro-cognitive decline which poses a diagnostic challenge.

This case study aims to investigate the clinical overlap between psychosis and cognitive decline in Parkinson’s disease, focusing on the diagnostic difficulties in differentiating these psychiatric symptoms.

We report a single case of a patient admitted to the psychiatric department “B” of Razi Hospital, who exhibited symptoms of both psychosis and cognitive decline. We also conducted a literature review on Pubmed using the following keywords: Parkinson disease, Dementia, Delirium, psychosis.

Mr. T.J, a 64-year-old man with a 10-year history of PD, was treated with levodopa, amantadine, and pramipexole. He developed depression a year ago, managed with fluoxetine. Recently, he was admitted to the psychiatric ward due to severe behavioral disturbances, including hetero-aggressiveness towards his wife.

Psychiatric assessment revealed a delusional syndrome with themes of jealousy and persecution towards his wife, accompanied by a hallucinatory syndrome primarily characterized by auditory hallucinations that appeared 2 years ago.

A neurological examination identified an amnesic syndrome that preceded the onset of delusions, raising concerns about the differential diagnosis between psychosis and dementia in the context of PD with the added consideration of the iatrogenic effects of his Parkinson’s treatment.

In collaboration with neurologists, we adjusted the treatment regimen by tapering off amantadine and pramipexole while maintaining levodopa. We introduced 5 mg of olanzapine, which led to a favorable clinical response. After two weeks, Mr. T.J was considered stable enough for discharge. Improvements included a reduction in delusional ideation and a decrease in the frequency and severity of auditory hallucinations.

This case highlights the complexity of managing psychiatric symptoms in Parkinson’s disease, particularly the challenge of differentiating between psychosis and dementia. The positive outcome following medication adjustments underscores the importance of a multidisciplinary approach in addressing both motor and psychiatric symptoms in PD patients.

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Opioid use disorder (OUD) is a national public health concern. Craving is a diagnostic criterion and is also implicated in the risk of relapse to opioids. Although sleep impairment is believed to relate with OUD, little research to date has examined the relationship between sleep components and craving in individuals with OUD as well as the moderators in the relationship.

This cross-sectional study was designed to address the relationship between sleep disturbance and OUD.

Individuals with current OUD (n=51) were enrolled. Each participant completed validated scales, including the Pittsburgh Sleep Quality Index for sleep, and Barratt Impulsiveness Scale for impulsivity, and the Opioid Craving Scale for cravings. Correlation and moderation analyses were performed using SPSS, v29.

Total scores of the PSQI were significantly associated with cravings (r=0.44, p=0.006). Among sleep components, sleep quality, sleep efficiency, and sleep disturbance were significantly associated with cravings, while four other sleep components were not. Impulsivity moderated the relationship between sleep impairment measured using total score of the PSQI and cravings for participants (b=0.15, p<.05).

Although preliminary, the findings add to literature on craving, impulsivity, and sleep among individuals with OUD. Sleep impairment and impulsivity may be important targets of a comprehensive, long-term treatment plan for some patients with OUD.

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Introduction

Cannabis-induced psychosis (CIP) is often assumed to resolve with sustained abstinence, although recent studies report adverse long-term outcomes, such as a high risk of diagnostic transition to schizophrenia. Cannabis is also known to increase relapse rate in individuals with psychotic disorders in general, and there is a lack of knowledge on optimal treatment of this patient group.

In this presentation, data on incidence and mortality associated with CIP, and real-world effectiveness of antipsychotics in relapse prevention in persons with CIP will be presented.

Nationwide Scandinavian registers were utilized to identify persons with first-time CIP (ICD-10 F12.5) during the years 2000-2021. Incidence and mortality of CIP were investigated with Danish, Norwegian and Swedish register-based data, and antipsychotic use with Swedish data. Annual incidence rates of CIP per 100 000 persons were calculated. For mortality study, incident cases of CIP were matched by age- and gender with comparison persons without substance-induced psychosis and hazard ratios (HRs) were calculated for all-cause and cause-specific mortality. Association between use of specific antipsychotics (oral vs. long-acting injectable, LAI, forms) and risk of hospitalization due to any psychosis relapse was investigated in within-individual design where each person acted as his/her own control to minimize selection bias, analyzed with stratified Cox models.

The incidence rate of CIP increased in time in all Scandinavian countries and was the highest in Denmark throughout the study years (rate in 2016 5.6, vs. 3.0 in Norway and 2.7 in Sweden). CIP was associated with an increased risk of mortality, risk estimates (HRs) ranging from 6.6 in Denmark, to 7.6 in Sweden, and 9.0 in Norway, compared with general population controls. In within-individual models, antipsychotic use was associated with a decreased risk of hospitalization due to psychosis relapse, with an adjusted HR of 0.75 (95% Confidence Interval 0.67-0.84), compared with time periods when the same individuals did not use antipsychotics.

Incidence of cannabis-induced psychosis is increasing in Scandinavian countries, and it is associated with significant mortality risk. Antipsychotics are effective treatments in preventing psychosis relapses also in individuals with CIP.

H. Taipale Grant / Research support from: Janssen, Speakers bureau of: Gedeon Richter, Janssen, Lundbeck, Otsuka

Several mental disorders are more common within the LGBTQ+ population, including depression, anxiety, eating disorders, and substance use disorders. Despite this, LGBTQ+ individuals face more barriers when accessing mental health services than the general population.

The primary aim of this study was to assess the perceptions of Cardiff University medical students on the barriers faced by LGBTQ+ individuals when accessing mental health help. The study also aimed to assess recommendations Cardiff University medical students have for improvement of services and to make them more accessible to LGBTQ+ individuals.

A qualitative approach was used. An online questionnaire was created and distributed among Cardiff University medical students. It included 10 open-ended questions about their knowledge of LGBTQ+ mental health, the barriers to accessing it, and recommendations to decrease these barriers. Thematic analysis was performed on the answers.

The questionnaire had 12 participants. The thematic analysis produced 22 subthemes, which were grouped into the following five themes: i) perceptions of LGBTQ+ mental health, ii) factors affecting LGBTQ+ mental health, iii) general barriers to accessing mental health help, iv) LGBTQ+-specific barriers to accessing mental health help, and v) recommendations to improve access to mental health services. A scoping review was conducted on this subject to further analyse the current research. The scoping review produced nine studies, and the main themes that emerged were mental health stigma, LGBTQ+ discrimination, lack of LGBTQ+-affirmative services, the pathologisation of LGBTQ+ status, and financial barriers.

It was evident that more formal training on LGBTQ+ mental health at an undergraduate level for health professionals is needed, and that a lack of this is causing barriers to adequate provision of mental health services to this population. Furthermore, existing mental health services need to be more LGBTQ+-affirmative. Further research with a higher response rate could provide more generalisable results.

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Digital mental health interventions have gained prominence as accessible and cost-effective solutions in workplace settings. However, our previous meta-analysis revealed a concerning trend: despite advancements in technology, the effectiveness of these interventions has not improved over time. This stagnation may be attributed to the significant and ongoing heterogeneity among interventions which indicates both variation in both sample and the intervention. We do not kow which theraputic approaches, design aspects or intervetnkion features enahnce efficacy.

We use a Bayesian meta-regression of an unpdated systematic review to develop a comprehensive framework to guide the design, development, and evaluation of workplace digital mental health interventions. By addressing the variability in intervention approaches and design and leveraging evidence-based practices, this framework seeks to enhance the quality and effectiveness of digital solutions for employee mental health.

A systematic literature review was conducted to identify randomized controlled trials of employee based digital mental health interventions. Eligible studies were assessed based on specific criteria, including participant characteristics, intervention characteristics, and outcome measures. Data extraction and coding were performed, followed by a Bayesian meta-analysis approach. This method allowed for a more nuanced evaluation of the effectiveness of various intervention features and designs, accounting for uncertainty and prior knowledge in the field.

The review identified 95 interventions involving approximately ˜25,000 participants. The Bayesian meta-analysis confirmed small positive effects in reducing mental ill-health symptoms. Both sample and intervention characteristics contributed to heterogeneity across studies. Stress management and mindfulness interventions, particularly those designed with input from mental health experts, demonstrated more effiacy than CBT based approaches. Several intervention features, such as videos, feedback scores, and reminder texts, were associated with positive mental health outcomes.

This review provides valuable insights into the optimal design and development of workplace digital mental health interventions. The identified framework and evidence-based practices offer guidance for developers to create effective interventions that address the heterogeneity within studies. Importantly, this framework has the potential to serve as a robust evidence base for app designers, enabling them to create more effective, personalised and engaging mental health applications.

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Climate change beliefs influence people’s behaviours such as the adoption of pro-environmental actions, therefore it is crucial to effectively measure them. We developed a short measure (Climate Change Beliefs and Attitudes Measure/CC-BAM), comprising 4 items whose content was adapted from previous studies, namely Loram et al. (2019)’s 8 item climate change denial measure. To the best of our knowledge, there is no instrument that validly assesses these beliefs in the general Portuguese population.

To analyse the psychometric properties of the preliminary Portuguese version of the CC-BAM.

Item content validity was guaranteed by 7 experts. 599 Portuguese adults (mean age=34.40±16.18) answered to the Portuguese preliminary version of CC-BAM (4 items) and to the validated instruments: Climate Change Distress and Impairment Scale/CC-DIS and Pro-environmental behaviour scale/PEBS. Item 1 (“Do you believe in climate change?”) had three possible options of answer: a) “No”, b) “Yes, I believe they are a natural phenomenon” or c) “Yes, I believe they are caused by human activity”. Items 2 (“How convinced are you of your previous answer?”) and 3 (“Do you think climate change is a serious problem?”) were answered on a Likert scale from 0 (“Not much”) to 4 (“Very much”). Item 4 (“How often do you think about climate change?”) was answered on a Likert scale from 0 (“Never”) to 4 (“All the time”). SPSS 29 was used to perform Exploratory Factor Analysis/EFA, descriptive statistics and inferential analysis.

EFA revealed a 1-factor solution with an explained variance of 55.90% confirmed by parallel analysis. Cronbach’s alpha was of .704 (lower if any item excluded) and all items had a corrected item-total correlation >.20. All items correlated with each other (from r=.27 to r=.59) and with the total score (from r=.63 to r=.85, all p<.01). CC-BAM correlated with CC-DIS (r=.51) and PEBS (r=.49, both p<.01). Women had significantly higher mean scores in all items and total CC-BAM. Age correlated with CC-BAM total score (r=.12) and with item 4 (r=.35, all p<.01). 86.5% of participants (n=518) answered to item 1 with option c) (group 1); 12.5% (n=75) answered b) (group 2) and 1% (n=6) responded a) (group 3). Kruskal-Wallis test revealed that those 3 groups significantly differed in mean/median scores of items 2, 3 and 4 and of CC-DIS and PEBS.

The preliminary version of CC-BAM shows adequate psychometric properties, however more studies are needed. Although caution must be taken in the interpretation of this preliminary results, this study provides a novel, internally consistent and short (easily implementable) measure of climate change beliefs.

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A 13 years old girl, who has always been an A* student, was brought to our Emergency Room, referred by her Psiquiatrist, to be hospitalized in our Unit.

During the first interview in the ER, the patient reported that she refused to eat food that had empty calories, which were essentially everything except water, and even water at times was an issue. She had a IMC of 16,57 kg/m2.

The objetive of this case is to try and explain how serious of a disorder anorexia nervosa can be, at times severe enough to distort completely the patients reality.

The following patient will be presented, doing a thorough systematic bibliography review.

The patient remains admitted to our unit. After more than one month and a half, since first being admitted, the patient has both verbalized wanting to end her life before gaining weight, as well as improved her disorder awareness.

At first, she was bluntly negative to eat any food, to a point to such extent, that feeding via nasogastric tube was necessary.

After daily interviews, along with many consultations, both with clinical psychology and psychiatry, using both cognitive behavioral psychotherapy and psychotrpic drugs; we achieved a slight improvement by eating half plates of both first and second plate, as well as dessert of a 1300-1500kcal diet.

Nonetheless, the patient still manifest up to this day, her willingness of not to eat and to end her life if its necessary to avoid eating.

Given the severity of the eating disorder suffered by the patient, social work was notified of the refferral to a long-term center specialized in eating disorders. The patient verbalized not wanting to got there, but recognized her disorder was getting more severe and the need for a long-term Unit.

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Sleep problems are very prevalent among university students, affecting their mood, energy levels, daily functioning, and quality of life. Irregular sleep-wake patterns contribute to the disruption of their circadian rhythms. Cognitive behavioural therapy for insomnia (CBT-I) has been proven effective in adults, but research in university students is still limited.

The aim of this study is to investigate the effectiveness of a guided digital self-help intervention targeting sleep and the biological clock in university students to improve sleep and mental health outcomes.

We conducted a two-arm randomized controlled trial in nine Dutch Universities. We included 196 university students (Bachelor, Master, and PhD) with self-reported insomnia symptoms (Insomnia Severity Index ≥ 10) and randomly assigned them (1:1) to receive the 5-week ‘i-Sleep & BioClock’ intervention or online psychoeducation. The intervention is based on CBT-I with specific emphasis on the biological clock. It consists of 5 weekly online modules and is guided by online coaches. The primary outcome is insomnia severity. Secondary outcomes are depression, anxiety, daily functioning, academic performance, quality of life, and sleep & light exposure diary outcomes. Outcomes were measured at baseline, mid-treatment (3 weeks), post-treatment (6 weeks after baseline), and at 18 weeks follow-up. Data will be analyzed with intention-to-treat analysis using linear mixed models. The study is registered at ClinicalTrials.gov (NCT06023693).

Recruitment started on Nov 1st, 2023 and ended on Sept 5th, 2024. Data collection is currently ongoing and will be finalized in January 2025. We hypothesize that the guided digital self-help intervention will reduce insomnia severity and improve mental health outcomes in students (results will be presented).

Findings from this randomized controlled trial will contribute to the growing body of knowledge on digital sleep interventions and their potential impact on mental health. If the intervention proves effective, we aim to disseminate the intervention widely in higher education to benefit a broader student population.

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Cocaine use is a significant health problem, since its abuse constitutes a substance use disorder and can produce cardiovascular symptoms, including acute coronary syndrome (ACS). Tako-tsubo syndrome (TTS) is a transient dysfunction of the apical left ventricle that can manifest with intense chest pain and alterations in the electrocardiogram. TTS can be triggered by physical stressors (hyperthyroidism, cocaine or amphetamine abuse) or psychological stressors (grief or reaction to acute stress).

The objective is to present the case of a patient who developed tako-tsubo syndrome after harmful cocaine use.

A 50-year-old woman, under psychiatric follow-up, diagnosed with mixed personality disorder, with a medical history of hypothyroidism. The patient has been presenting for 2 months after mourning the death of her husband with anxiety-depressive symptoms with a great behavioral impact with episodes of heteroaggression and begins with abusive consumption of cannabis and cocaine toxins. The patient presents an episode of psychomotor agitation after acute consumption of cocaine, presenting psychotic symptoms. During the study in the emergency area, she verbalizes chest pain and complementary studies are performed with elevated cardiac enzymes and alterations in the electrocardiogram. Cardiology is contacted and after hospital admission and complementary studies, the diagnosis of acute coronary syndrome is reached, filiating it with Takotsubo syndrome triggered by cocaine consumption. The diagnoses presented by the patient with dual pathology would be a psychotic disorder due to toxins, a borderline personality disorder and harmful consumption of cocaine.

Dual pathology in patients with personality disorder with toxin abuse such as in this case cocaine is very frequent.The situation of grief is an acute stressful situation that leads to greater emotional instability and, together with the toxic effects of cocaine, can trigger Takotsubo syndrome in patients. Therefore, when approaching patients with substance use, it is very important to always take into account the possible somatic complications that can be triggered.The treatment chosen to treat the psychotic symptoms that the patient presented was lurasidone, since it has a tolerability and cardiological safety profile.

In patients with dual pathology, it is very important to address all possible complications, both somatic and psychiatric, for proper therapeutic management.

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Considering the need to conduct studies on the treatment of BPD and considering the high prevalence of this disorder and its negative effect on the quality of life, especially in young age range and possibility of this disorder being in the Bipolar spectrum, it is necessary to investigate the effect of lithium on mood improvement in patients with BPD. So, this study aimed to investigate the effect of lithium on mood improvement in these patients.

Due to the lack of an FDA approved treatment, as well as discussed in the introduction, we dicided to compare the effect of lithiumin mood improvement in this disorder with the effect of other mood stabilizers and antipsychotics.

For this reason, we reviewed the published articles on the effects of other mood stabilizers and antipsychotics on improving the mood of this patints and compare them with those related to lithium in order to make better treatment decision.

This study presents a comprehensive review of the studies conducted related to the effect of lithium in improving mood in BPD patients. We conducted a systematic review based on PRISMA guidelines of published and indexed articles from the following databases;

EMBASE, MEDLINE, Google scholar, SCOPUS.Cochrane Library, PsycINFO.

KEY WORD: Lithium, Mood stabilizer, borderline personality disorder. Of the 131 retrieved articles, 9 included our inclusion criteria.

The review of 9 selected studies showed that lithium is useful in reducing emotional and impulsive behaviors, mood stabilization and suicidal tendencies and was more effective than placebo in preventing recurrence of mood disorders. In the study significant heterogeneity was found between all group of patients which could be due to the difference in the selection of participants and different exposure in the pre-study phase. Quantitative data on participants general health and social functioning were not reported and the direction of effect was the same in all studies.

No studies reported a negative effect for lithium and compared to other mood stabilization, it is more effective in controlling emotional and mood changes and aggression, also its side effects are less if controlled regularly and consistently. However, due to the small number of studies in this field and small sample size in studies, we suggest that more studies be conducted in all age groups.

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