Rates of anxiety in the general population increased significantly during the COVID-19 pandemic. Several studies have shown that people exposed to SARS-CoV2 are at increased risk for both exacerbation and de novo development of anxiety disorders. Therefore, screening for anxiety disorders in this at-risk population is essential. In pre-pandemic studies, the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) was one of the most commonly used self-report instruments. Its validity has been demonstrated in several studies. However, there is no agreement among researchers about its underlying internal structure. Both one-factor and two-factor solutions have been reported. This discrepancy may be due to linguistic, cultural, and clinical differences between the populations studied. To our knowledge, no studies have been conducted to investigate the factor structure of the GAD-7 in the Russian-speaking community sample and the psychometric properties of this questionnaire in SARS-CoV2 exposed individuals.

The aim of the study was to determine the factorial structure and internal consistency of the Russian version of the GAD-7 in a large sample of Moscow residents exposed to SARS-CoV2.

Fourteen thousand 725 (male - 11479 (78.0%), age - 18-79 years (M - 47.09, SD - 12.70) Moscow residents exposed to SARS-CoV2 completed an online survey including the GAD-7 and an ad hoc questionnaire focusing on socio-demographic characteristics. McDonald’s Omega was used to assess internal consistency. Exploratory structural equation modelling (ESEM) with weighted least squares means and variance adjusted estimator and geomin rotation was used to assess the factor structure of the Russian version of the GAD-7.

The McDonald’s Omega of the Russian version of the GAD-7 was 0.85, indicating a good internal consistency of the questionnaire. ESEM provided evidence for a one-factor solution that fits the data well (CFI - 0.996; TLI - 0.995; RMSEA (95% CI) - 0.041 (0.037 - 0.045)).

In Russian people exposed to SARS-CoV2, the GAD-7 showed good internal consistency. Our results are consistent with those of previous studies that reported a single-factor solution for the questionnaire.

None Declared

Mental disorders often manifest broad cognitive deficits that detrimentally affect daily functioning. Stress indicated by heart rate variability (HRV) has been linked to these cognitive functions.

We aimed to develop a new method to assess cognitive performance and simultaneous measurement of psychophysiological signals related to stress and relaxation levels.

20 adult patients with mental disorders in a rehabilitation program were recruited along with 21 healthy volunteers. A test protocol was carried out with a purpose-developed computerized psychophysiological device. The protocol consisted of a relaxation period; digitized questionnaires on pathological distress (GHQ) and sense of coherence (SOC); gamified cognitive tasks to assess working memory, attention, and decision-making; and a final relaxation period. Acute stress was assessed by heart rate variability measured by a wireless ECG sensor. The inter-beat interval’s root mean square of successive differences (RMSSD) was calculated as an inverse stress measure. Relaxation levels were assessed by the relative power of the alpha frequency band measured by a commercial 4-channel EEG headband. Stress and relaxation levels were compared to the first relaxation period as a baseline.

Patients scored worse than the reference group both regarding distress (d=7, p=0.004) and sense of coherence (d=-8, p=0.047). The cognitive performance of patients was significantly lower (p<0.001) than the reference group for all tasks.

RMSSD at baseline tended to be lower for patients (d=-12.69, p=0.098), reflecting a higher level of physiological stress; 61% of patients started at an elevated stress level compared to 25% of the reference group. In addition, relative alpha levels at baseline were also lower (d=-5.8%, p=0.007) for patients.

Compared to baseline, RMSSD decreased on average to 94% during cognitive assessments in patients and decreased to 91% by the end of the final relaxation. RMSSD decreased to 76% in the reference group and reached a final value of 78% of the baseline. Alpha levels slightly increased among patients during the tasks (103.4%) and then returned close to baseline (99.1%). For the reference group, alpha decreased during the tasks (95.5%) and then slightly increased (97.3%).

Patients displayed heightened distress, reduced sense of coherence, and inferior cognitive scores compared to controls. While starting with higher stress, patients exhibited less elevation in stress during tasks, coupled with alterations in alpha levels, suggesting diminished engagement or focus. Our innovative method could aid in the diagnostics of cognitive performance in mental patients after further measurements for validation.

None Declared

Acquired epileptic aphasia or Landau-Kleffner syndrome (LKS) is a disorder with onset in the childhood between the ages of 2 and 8 years. The main defining psychopathological symptom of Landau-Kleffner syndrome is the acquired aphasia with epileptiform electroencephalographic abnormalities. The aphasia has both receptive and expressive features. The onset is usually subacute and the course is usually progressive with spontaneous improvements and exacerbations. The electroencephalographic abnormalities include pathological findings in the temporal and parieto-occipital brain regions.

An 11 year old girl with generalized tonic-clonic and partial seizures is referred to our child and adolescence outpatient service due to language impairment. Her first generalized seizure has been at the age of 11 months old, caused by high temperature. The presence of articulation difficulties has raised suspicion for intellectual disabilities. She has been diagnosed with Epilepsy, grand mal seizures and has had continuous treatment with sodium valproate since the age of 3 years.

We used medical history, EEG-recordings, clinical observation and psychological assessment.

Patient`s language development has been normal till the age of 3 years old. She has started using single words properly at the age of 1 year and 6 months old. Her first simple sentences have appeared at the age of 2 years old. At the age of 3 years old after severe generalized tonic-clonic seizures she has stopped talking for a month. After this month she had started vocalizing and using simple words, but she had lost her ability to form sentences. She has had some mild difficulties in understanding verbal information and following instructions. Her speech has had bad articulation and deficits in the verbal fluency. Her gross and fine motor development, her social skills and problem-solving abilities have all been intact and age-appropriate. She has worked with speech therapist for 5 years and achieved partial recovery from the acquired aphasia. She continues to have problems with the articulation – the speech is still with mild dysarthria. We used WISC-IV to assess her IQ (IQ=108).

The patient has already developed age-appropriate speech prior to the onset of the language impairment. Considered as secondary or acquired, the observed aphasia together with the medical data for her epileptic seizures allows us to diagnose the patient with Acquired epileptic aphasia or Landau-Kleffner syndrome. Later development will be presented and discussed.

None Declared

Schizophrenia, a multisystem chronic psychiatric disorder of unknown etiology, is associated with several immune dysfunctions, including abnormal levels of circulating cytokines. Exsisting evidence shows a potential causative role for cytokines in schizophrenia symptom development. Furthermore, disease duration, symptom severity, aggressive behavior, and cognitive deficits are correlated with levels of certain cytokines. Despite the development of new antipsychotics, the negative and cognitive symptoms of schizophrenia often do not respond adequately to pharmacotherapy.

Research questions and hypotheses: 1. Can there be a cytokine or cytokines among the different cytokine levels detected in schizophrenia that can be used as biomarkers of treatment response? 2. Can changes in cytokine levels indicate the occurrence of psychotic relapse? 3. Can changes in the cytokine level play a role in predicting the prognosis of the disease? The secondary objectives of the planned research, in addition to the above, are to clarify the knowledge gathered so far about the relationship between cytokine level changes and the clinical symptoms associated with them.

We investigate cytokine levels, blood samples are taken on hospital admission. Based on the publications, we mainly focus on the Il-2, Il-4, Il-6 and Il-10 levels, which can serve as possible predictive biomarkers relating to treatment response. We will also assess the possible role of abnormal cytokine levels and their association with symptoms severity and their potential clinical implications. The severity of the symptoms is monitored with the PANSS.

15 schizophrenic patients who were hospitalized due to a psychotic relapse have been included. Blood samples were taken to measure cytokine levels, the PANSS scale was recorded during a psychotic relapse. We have included 9 healthy, age- and gender-matched healthy controls in the study, from whom blood samples were taken to measure cytokine levels. Preparation for measurement of cytokine levels is underway. Patient involvement is ongoing.

A better understanding of cytokine imbalance in schizophrenia patients can potentially help in early diagnosis, novel therapeutic target indentification and development, patient stratification for choosing the best therapeutic protocol, and predicting prognosis, relapse and treatment response.

None Declared

There are differences in clinical presentation with and without insomnia in MDD, and it is expected that there are brain biological differences that contribute to this, but functional MRI studies of MDD with insomnia vs MDD without insomnia are scarce. In particular, few studies have examined resting state functional connectivity (RSFC) seeding the habenula and septal nuclei, which play key roles in both mood and sleep.

The purpose of this study is to determine whether there are differences in habenula and septal nuclei and RSFC in the presence or absence of clinically significant insomnia in patients with MDD.

To identify the effects of insomnia in MDD group, one-way ANCOVA covariate control was used to compare differences of RSFC between MDD_w/INS and MDD_wo/INS group. The potential confounders (i.e., age, sex, education years, and total score of HDRS-17) were adjusted in this analysis. To examine the relationship between RSFC and clinical sleep questionnaires (i.e., ISI and PSQI) in the participants with MDD, Pearson’s partial correlation analysis controlling same potential confounders was performed by using Fisher-transformed correlation coefficients and scores of ISI and PSQI. For comparing the difference of RSFC between MDD and HC, the analysis was also performed with ANCOVA controlling for age, sex, education years.

The analysis in this study included 36 in the MDD_w/INS group, 21 participants in the MDD_wo/INS group, and 38 in the healthy controls (HC) group. The main finding of this study was that MDD with insomnia showed increased RSFC in Habe_L - Rolandic_Oper_R, Habe_L - Cuneus_R, Habe_R - Thal_Pul_R, and decreased RSFC in Septal - Cerebellum_Crus1_R compared to MDD without insomnia. All regions with significant results were significantly correlated with insomnia severity.

Since the RSFC of all pairs of regions that showed significant differences between the two groups in this study were significantly correlated with insomnia severity (i.e., ISI score), the association of these regions with insomnia in MDD is supported. The significance of this study is that there have been studies that have examined the RSFC in fMRI for insomnia, but there are few studies on MDD with insomnia, and since the habenula and septal nuclei play an important role in insomnia, sleep, and mood, it is meaningful to seed fMRI studies on these areas.

None Declared

VNS is a long-term adjunctive treatment option in patients with DTD. It has been shown that patients with VNS as add-on to treatment-as-usual (TAU) have higher response and remission rates than TAU alone. Data on the impact of VNS on the other complex concomitant treatments are limited.

In this study we evaluated changes in drug load from baseline to 12 months as well as the impact of previous ECT response status at baseline on changes in mean depression severity after 12 months of VNS.

We included n=20 DTD patients (mean age 52.6 years) in the prospective, observational, naturalistic Restore-Life study, who have been treated with adjunctive VNS as add-on to treatment as usual. The RESTORE-Life study is a multi-center study. In this analysis, we report on exploratory results from a single tertiary center. An index has been calculated for each drug by comparing the actual dose with the standard dose of the drug. The drug load for each patient has been constructed by summing up the indices of all agents prescribed for the patient.

We observed a slight decrease in mean drug load from 4.5 at baseline to 4.4 at 12 months (p=0.594). The drug load was lower in previous ECT-responders than in ECT-non-responders at both timepoints. There was a significant decrease in mean MADRS score from 27.3 at baseline to 15.3 at 12 months (p=0.001). Patients with a history of ECT response at baseline have experienced significantly greater improvement in mean MADRS score at 12 months (p=0.013). Number of maintenance electroconvulsive therapy (ECT) and esketamine sessions decreased from 37 ECT and 58 esketamine sessions in the first six months to 17 ECT (-54%) and 29 esketamine (-50%) sessions between months 6 and 12. VNS-related adverse events were present in 50 % of patients at 12 months (voice alteration/hoarseness 45%, dyspnea and pain during stimulation each 5%). There was no discontinuation of VNS due to adverse events.

Overall, VNS was associated with significant decrease in mean MADRS score at 12 months, whereas we did not detect any significant change in medication load. A more extended observation period might be necessary to observe changes in medication load. There was a reduction in the need of maintenance treatment sessions of ECT and esketamine. History of ECT response may be predictive for greater improvement of depression severity in VNS patients.

E. Kavakbasi Grant / Research support from: The Sponsor of the Restore-Life study is LivaNova. Our institution received fees from LivaNova for study visits of the Restore-Life study. LivaNova had no influence on the content of this work., H. Bauermeister: None Declared, L. Lemcke: None Declared, B. Baune: None Declared

Artificial intelligence (AI) and virtual reality (VR) are useful tools that can improve precision medicine and can prove useful in the clinical care of patients with psychosis.

Our aim was to determine whether AI and VR have been applied to the prediction of clinical response in women with schizophrenia.

A systematic review was carried out in PubMed and Scopus from inception to September 2023 by using the PRISMA guidelines. Search terms: (“artificial intelligence” OR “intelligent support” OR “machine intelligence” OR “machine learning” OR “virtual reality” OR “intelligent agent” OR “neural networks” OR “virtual reality” OR “digital twins”) AND (“schizophrenia” OR “psychosis”) AND (“women” OR gender”). Inclusion criteria: 1)English, French, German or Spanish language, 2) reporting treatment response in schizophrenia (as long as information in women was included), and 3) including AI and VR techniques.

From a total of 320 abstracts initially screened (PubMed:182, Scopus:138), we selected 6 studies that met criteria.

• - Prediction of treatment response. (1) Clinical information, genetic risk score and proxy methylation score have been shown to improve prediction models. (2) Graph-theory-based measures have been combined with machine learning.

• - Therapeutic drug monitoring. (1) A machine learning model has been useful in predicting quetiapine blood concentrations.

• - Pharmacovigilance. (1) Machine learning has connected prolactin levels and response in olanzapine-treated patients. (Zhu et al., 2022).

• - Treatment-resistant schizophrenia (TRS). (1) Women with TRS have been found to receive clozapine less frequently than men (adjusted for sociodemographic, biological and clinical factors). (2) Statistical learning approach: Women have been found to respond better to clozapine than men.

AI, including machine learning, show promising results in the prediction of treatment response in women with schizophrenia. As of yet, digital twins have not been investigated to test specific interventions or to personalize treatment in women with schizophrenia.

None Declared

The prevalence of schizophrenia in the world is between 0.4 and 1.4%, and the number of patients with negative symptoms (NS) in this group reaches 90%. NS are considered key components of schizophrenia that negatively affect social functioning (SF) and quality of life in patients with schizophrenia. The purpose of the study was to determine the features of SF among patients with NS in schizophrenia.

Features of SF in 252 patients with NS in schizophrenia (main group) and in 79 patients with positive symptoms (PS) in schizophrenia (comparison group) were examined.

A set of methods was used: Scale of personal and social functioning (PSP), which is a semi-structured interview and allows to assess the social status of patients, their functioning and satisfaction with the relevant field and statistical methods.

The analysis of the social and personal functioning of patients was carried out in four domains: socially useful activities, personal and social relationships, attention to oneself and one’s condition, restless and aggressive behavior patterns. In the sphere of socially useful activities, including work and study, in a significant part of patients with NS in schizophrenia, SF violations were expressed at moderate (41.27 ± 1.26) % and significant (33.33 ± 1.08) % levels. In the sphere of personal and social interaction, 41.27 % of patients had significant violations, 28.97% of patients had moderate violations, and 21.83% had severe violations in the social sphere. In the field of self-care, 21.83% of patients had no violations, in 36.90% - violations in self-care were weakly expressed, and in 26.19% of people - moderately expressed.

When comparing the obtained results with patients with PS in schizophrenia, it was established that among patients with NS in schizophrenia there were more patients with significant impairments in the sphere of social activity (33.33%, p = 0.033, DC = 1.42, MI = 0, 07).. Patients with NS in schizophrenia were distinguished by a greater number of patients with significant impairments in the sphere of social interaction (41.27%, p = 0.001, DC = 2.58, MI = 0.24).. In the field of self-care, there were more persons with no violations among patients with NS in schizophrenia (21.83%, p = 0.008, DC = 3.33, MI = 0.20). There were more patients with the absence and weak expression of aggressive behavior patterns among patients with NS in schizophrenia (30.95%, p = 0.0001, DC = 10.87, MI = 1.55 and 45.63%, p = 0, 0001, DC = 6.54, MI = 1.16, respectively) in comparison with patients with PS in schizophrenia.

The obtained data should be taken into account when creating psychocorrective programs for patients with NS in schizophrenia.

None Declared

Psychotic disorders present a significant lifetime risk for suicide. Past estimates suggest that up to 25-50% of individuals with schizophrenia (SCZ) may attempt suicide during their lifetime. A growing body of literature indicates that the level of cognitive performances may be associated with a differing level of lifetime suicide attempts, albeit inconsistently depending on the diagnostic category and study setting. However, the vast majority of the literature in the field is composed of cross-sectional studies, limiting the overall interpretation of the available evidence.

In the present study, we probed the possible association of BDNF plasma levels, cognitive functions assessed through the Brief Assessment of Cognition in Schizophrenia (BACS) and lifetime suicide ideation and/or attempts (LSI+LSA). More specifically, we tested whether such association would persist during the 2 years follow-up divided in 5 different timepoints at 6-month intervals, if present.

The present study represents a secondary analysis of a previously described cohort (Manchia et al. Brain Sci. 2022 Dec 4;12(12):1666). The sample comprised 105 subjects with SZC or schizoaffective disorder. We employed the 1) Wilcoxon test for non-parametric data 2) linear modelling to test the possible association of BACS-defined cognitive task performances with LSI+LSA. We also investigated if either BDNF plasma levels or four tested BDNF SNP genes would mediate this association.

From a total of 105 subjects, data relevant to the analysis were available for 89 subjects. We observed a significant association between BACS-Letter fluency task (BACS-LF) with LSI+LSA, persisting even when adjusting for gender, duration of untreated psychosis, total Positive and Negative Syndrome Scale score, age, chlorpromazine equivalents of antipsychotic therapy and for the effect of time. The association remained significant even when adjusting with the Bonferroni-Holms method for multiple comparisons (p=0.002). No association was found either for BDNF plasma levels or the tested BDNF genes for the tested outcomes.

In our sample, higher BACS-LF performances appeared to be associated with a higher lifetime risk of LSI+LSA. This report adds to the previous literature suggesting that different cognitive performance levels may represent one of the many chronic risk factors associated with LSI+LSA, and that may ultimately complexly interact with more proximal ones.

None Declared

Bipolar disorder (BD) in the elderly patient may present as the evolution of illness initiated earlier in life or as a new-onset entity. Therefore, two groups of patients are distinguished: “late onset” (LOBD) when the first mania occurs in old age and “early onset” in elderly patients with long-standing history. BD in elderly patients (≥60 years) constitutes 25% of all BD cases. Specific aspects of older age bipolar disorder (OABD) are somatic and psychiatric comorbidity, impaired cognition and age-related psychosocial functioning. The management of BD in the elderly is complex given the high sensitivity of these patients to pharmacological side effects, particularly of psychotropic drugs.

The case of a patient with LOBD is presented, followed by a theoretical review of the subject.

A case is presented with a bibliographic review.

A 76-year-old woman who had no prior history of mental health issues until March 2023 when she was initially admitted to a geriatric hospitalization unit for manifesting manic symptoms. She was readmitted in July 2023 due to worsening depressive symptoms that included a declining mood, passive thoughts of death, deterioration in self-care, weight loss, insomnia, constipation, and dry mouth despite recent changes in her medications. She was on treatment with escitalopram (which was gradually discontinued and replaced with mirtazapine), quetiapine, lormetazepam, and lorazepam. Imaging tests showed chronic ischemic lesions in her brain and a small meningioma, the rest of the test were normal.

The initial diagnostic hypothesis was a bipolar depressive episode, and her treatment was adjusted accordingly. She was started on lithium, and her quetiapine dosage was increased, along with the anxiolytic lorazepam. Due to the persistence of depressive symptoms, including low mood, anhedonia, apathy, and negative thoughts, she was also prescribed antidepressant medication (venlafaxine and mirtazapine). Her condition gradually improved, with better eating and sleep patterns, increased participation in activities, and reduced somatic complaints and anxiety.

As she continued to experience somnolence and decreased morning energy, her antipsychotic medication was switched from quetiapine to lurasidone. The dose of lithium was decreased due to tremors in her extremities, although they remained within the therapeutic range. Despite these adjustments, her mood significantly improved, and she showed no signs of worsening or psychotic symptoms, leading to her discharge.

Summarizing different studies, LOBD who develop mania for the first time at an advanced age (≥ 50 years) constitute 5-10% of all BD. It is important to perform a thorough differential diagnosis, as an organic substrate and diverse etiologies may be present. Current guidelines recommend that first-line treatment of OABD should be similar to that of BD in young patients, with careful use of psychotropic drugs.

None Declared

Internet Addiction Disorder, a concept introduced for the first time by Ivan Goldberg in 1995, is one of the most recently identified forms of addiction, but already considered a real psychosocial phenomenon, capable of having a profound impact on different aspects of social and psychological life of individuals. One of its most recently identified manifestations is Nomophobia, a neologism formed from the combination of terms such as “no mobile”, “phone” and “phobia”, which can be understood as the fear of feeling disconnected. It is today considered a situational phobia, characteristic of contemporary times. The most common symptoms include excessive cell phone use and constant anxiety at the thought of losing the internet connection. Others are, for example, “Ringxiety”, ringing anxiety, or the “phantom vibration syndrome”.

This study aims to examine the spread of Nomophobia in the Italian population, evaluating psychopathological correlations that can explain its diffusion.

Between January and May 2023, an anonymous online questionnaire was randomly sent to the general population. Alongside with tests to evaluate psycho-social features, the instrument used to study Nomophobia was the Nomophobia Questionnaire (NMP-Q) (Yildrim et al. Comput Hum Behav. 2015; 49:130–7), in its Italian version (Adawi et al. JMIR MHealth UHealth. 2018;6:e24).

The sample consists of 308 people (189 F, 119 M), with an average age of 32 years (sd 14). In our sample, 100% of the subjects tested positive for Nomophobia. Values indicating a state of severe Nomophobia are found in 12.3% of the sample (F 15.9%, M 6.7%). The young population, between 18 and 25 years old, represents 54% of the affected population, but more than 60% of severe cases (95% confidence interval 50-65%). The severe cases correlate positively (p<0,05) with findings of high impulsiveness. There are no other studies that investigate the psychopathological correlates of Nomophobia among Italians.

Despite possible biases, the data obtained are an alarming sign of the spread of internet addiction that characterizes our times, of which the excessive use of cell phones in the form of Nomophobia is an expression. Despite their now undisputed usefulness, mobile devices are capable of causing the onset of serious health problems, starting from exposure to radiation capable of causing dermatitis, tumors, and infertility. Furthermore, they dramatically interfere with driving safety, becoming a major cause of road accidents. Considering these consequences, it appears to be extremely important to characterize the phenomenon, as well as its psychosocial determinants, in order to proceed with its better definition and prevention.

None Declared

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition marked by difficulties in attention, hyperactivity, and impulsivity. Its subtypes—predominantly inattentive, predominantly hyperactive-impulsive, and combined—vary in symptom presentation and impact on daily functioning. Understanding these subtypes is crucial for tailored interventions and support.

Our aim is to clinically characterize the psychopathological aspects of the subtypes of ADHD.

Our study is conducted on patients (>18 years) referred to the adult ADHD outpatient service of the Psychiatric Clinic of Ancona (Università Politecnica delle Marche, Italy). The Diagnostic Interview for ADHD in adults (DIVA 5.0) was used for diagnosing ADHD. The following rating scale were administered: Temperament Evaluation in Memphis, Pisa and San Diego (TEMPS-M), and Temperament and Character Inventory-Revised (TCI-R).

76% (n=170) of all screened patients were diagnosed with ADHD in adulthood. 57.6% (n=98) were diagnosed with ADHD combined subtype, 35.3% (n=60) with ADHD inattentive subtype, and 7.1% (n=12) with ADHD hyperactive subtype. Only 12.9% (n=22) were diagnosed with ADHD in childhood. Based on the results obtained at TEMPS-M, 43.8% (n=32) of patients were found to have cyclothymic temperament. Subjects with ADHD combined subtype scored significantly higher mean on the irritable temperament subscale of the TEMPS-M than those with ADHD inattentive subtype (p=0.016), while patients with ADHD inattentive subtype had a significantly higher mean score on the disorderliness subscale of the TCI-R than those with ADHD hyperactive and combined subtype (p=0.010). Given the logistic regression analyses using the TCI-R, developing an inattentive type of ADHD is negatively predicted by the disorderliness subscale of the TCI-R (exp(B)=0.788, IC95%=0.669-0.929, p=0.005) and positively predicted by the extravagance subscale of the TCI-R (exp(B)=1.104, IC95%=1.009-1.208, p=0.031), the hyperactive subtype of ADHD is negatively predicted by the fatigability subscale of the TCI-R (exp(B)=0.775, IC95%=0.597-1.005, p=0.055) and the combined subtype that is positively predicted by the disorderliness subscale of the TCI-R (exp(B)=1.140, IC95%=1.011-1.287, p=0.033). Regarding temperament, through a logistic regression analysis, the inattentive subtype of ADHD is negatively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=0.904, IC95%=8.39-0.974, p=0.008), while for the combined subtype of ADHD it is positively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=1.088, IC95%=1.014-1.167, p=0.019).

The results show that irritable temperament is a predictor for the inattentive and combined subtype, but with different polarities. In addition, how different patterns of personality are specific to the various subtypes of ADHD are highlighted.

None Declared

Huntington’s Disease is a neurodegenerative disease inherited in an autosomal dominant fashion.The underlying genetic defect is unstable CAG trinucleotide repeat expansion with a repeat length longer than 36 resulting in pathological aggregation of abnormal protein causing cell death.

The clinical symptoms encompass 3 main domains-motor,cognitive and psychiatric.The psychiatric symptoms often in atypical form appear decades before other symptoms causing significant impact on patient’s functioning and quality of life.

Here, we discuss an unusual presentation of Huntington’s Disease causing diagnostic dilemma.

Case report discussing the unusual presentation of Huntington’s Disease.

Case: Mr X is a 61 year old Caucasian male.He had an uneventful birth and early childhood attaining milestones appropriately. He experienced childhood adversity in the form of sexual abuse between ages 2-14 years. His mental health difficulties started following sexual abuse when he attempted to end his life by hanging and overdosing at age 15. He got married twice, both of which broke down. There is a history of significant alcohol abuse between ages 40-50. Following this, he had a myocardial infarction and a stroke requiring stenting.

He presented to Psychiatric Outpatient Services in 2011 with auditory hallucinations, social anxiety with panic attacks, OCD type rituals, claustrophobia and feeling hot all the time. He was started on an antipsychotic medication for psychosis ,but clinically deteriorated. He started having anger outbursts, marching on the spot ,and head banging. He was diagnosed with Huntington’s Chorea in 2021 after he had developed chorea. He currently has low mood and is head banging for hours.

Psychiatric symptoms in HD can span a variety of domains but most common are symptoms of frontal lobe dysfunction-disinhibition, poor attention, irritability, impulsivity and personality change. Apathy, emotional blandness and social withdrawal are also prominent features.

Mr X had strong family history of Paranoid Schizophrenia (aunt and cousin).There was no family history of HD. His mental health problems started early in life with DSH, Depression and Harmful use of Alcohol. He presented predominantly with psychotic symptoms like auditory hallucinations, social anxiety, paranoia. Motor symptoms started late which he incorporated into voluntary movements like head banging which made it difficult to differentiate from deliberate self harm.

Psychiatric symptoms constitute the core of HD. Studies have shown that though depression and personality change are typical of HD, there are number of other psychiatric symptoms that can impair quality of life. Early diagnosis and treatment of these symptoms will help patients and families to cope better with severe symptoms of this progressive disease.

None Declared

In ordinary circumstances, the employed individuals demonstrate significant levels of psychological distress and presenteeism, a situation that has been further intensified by the COVID-19 epidemic. Furthermore, a limited number of studies have examined the phenomenon of presenteeism in the context of the COVID-19 pandemic, therefore necessitating the undertaking of the present study.

The goal of this study was to investigate the levels of presenteeism and its related characteristics, as well as job satisfaction and psychological distress, among a sample of employees employed at a Private Social Solidarity Institution (IPSS) in Portugal.

A cross-sectional survey was undertaken in 2022 to observe personnel from an IPSS located in the central area of Portugal. The research had a sample size of 71 workers who were provided with a signed authorization. The survey was designed to gather both general and professional information from participants. Additionally, it included the Stanford Presenteeism Scale (SPS-6), the Job Satisfaction Questionnaire (S20/23), and the Kessler Psychological Distress Scale (K10) as measurement tools.

The occurrence of presenteeism was seen in 32 employees, accounting for 45.1% of the sample, whereas illness absence was reported by 38 workers, representing 54.3% of the sample. The majority of the individual assessments for S20/23 demonstrated a higher degree of satisfaction (mean ≥ 4.5 points.), with the exception of the salary-related issue, which elicited a higher level of discontent (mean = 3.36 ± 1.9 pts.). Approximately 50.7% of the individuals had a high or very high susceptibility to experiencing or developing a mental condition. The correlation matrix revealed a statistically significant moderate positive association between presenteeism and work satisfaction, as well as a statistically significant moderate negative link between presenteeism and psychological distress (p<0.01). The associated factors of presenteeism were found to be marital status, quality of sleep, illness absenteeism, health perception, and psychological distress. The combined effect of these predictors was shown to account for 35.8% of the variance in presenteeism.

It is expected that the outcomes of our research will stimulate more investigations into the tangible implications of presenteeism in promoting improved health and well-being within the workplace.

None Declared

Among young medical practitioners, the exigencies of daily practice entail many challenges concerning both physical and mental dimensions. The study of the interplay between these two dimensions is crucial to provide the necessary care for this population.

This study aims to evaluate the prevalence of back pain and its association with mental health issues in young medical practitioners.

A cross-sectional study (January to April 2023) was conducted in the university interns and residents from Sfax. The Nordic questionnaire was used to evaluate back pain. The Generalized-Anxiety-Disorder (GAD -7) and the Patient-Health-Questionnaire (PHQ-9) were used to assess signs of anxiety and depression respectively.

Our population consisted of 404 young doctors. One-hundred and twenty were males with a sex-ratio of 0.42. Among them, 76 (18.8%) had surgical specialties. Mean age was 28.03±2.89, BMI’s mean was 23.65±3.98. Medical history was reported by 29.2% and psychiatric history by 4.9%. The median of the PHQ-9 and GAD-7 score were 3.5 (IQ: [1;6]) and 2 (IQ: [0; 5]). Signs of depression were found in 11.1% of the population whereas anxiety was found in 8.4% of them. Sixty-seven residents (16.6%) reported having back pain in the previous year. Neck pain, upper-back pain and lower back pain were experienced by 8.7%, 6.4% and 10.1% respectively.

Bivariate analysis showed that back pain was associated with PHQ-9 score (p=0.006), GAD-7 score (p=0.018) and it was not associated with BMI (p=0.769) neither with surgical specialties (p=0.824). Lower Back pain was associated with GAD-7 score (p=0.004).

Our study highlights the link between back pain and mental health problems in young doctors. Interventions englobing a better understanding of these two facets are needed to ensure an optimal care for this young population.

None Declared

Alcohol addiction can lead to withdrawal seizures, but most patients do not develop epilesy. In some cases a permanent complication occurs - symptomatic epilepsy. In other cases epilepsy precedes alcohol addiction. Comorbidity may pose serious chalenges to treating clinicians. There are conflicting data regarding relationship between alcohol use, seizures and epilepsy (Scorza CA et al.,CLINICS 2020;75:e1770). Other factors like brain trauma may have impact in genesis of epileptic states as well.

Evaluation of interplay between seizures, epilepsy and brain trauma in patients with alcohol use disorder.

Analysis of a case series in a hospital setting and review of relevant literature.

In our series of cases the number of patients who have suffered epilepsy before the onset of alcohol use is small. In most of the hospitalized patients epilepsy occurred after the development of alcohol use disorder. In this group we observed that head and brain trauma play role in genesis of seizures and epilepsy and in some instances the reverse happens.

Our data indicate the potential role of brain trauma as predisposing and complicating factor in patients who developed seisures and epilepsy. Seizures sometimes increase the risk of brain trauma. Seizures and trauma are important factors in typology of Lesch (Lesch et al. 2011) and a serious evaluation in this direction is improtant, because its diagnostic, therapeutic and prognostic implications. Further clarification in this field is necessary.

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Given the widespread prevalence of ADHD and Axniety Disorders, and their obvious impact on mood, cognitions, individual productivity, interpersonal relationships and self-esteem, accurate diagnosis and treatment of these disorders should rightly be considered paramount. ADHD shares several co-morbidities (including and especially the anxiety disorders). With the decades-long rise in the number of stimulant prescriptions, the increasing number of self-report measures, and ‘confusing’ DSM-5 criteria, concerns remain as to how accurately ADHD and/or anxiety disorders are actually being diagnosed and treated, especially when comorbid with one another.

This presentation seeks to highlight the downstream consequences of overdiagnosis, underdiagnosis and missed diagnoses when it comes to both Anxiety disorders and ADHD. Its overarching aim is to offer clinicians a ‘roadmap’ through the ADHD and Anxiety Disorders diagnostic and treatment ‘maze’. A pragmatic, guided evaluation of symptoms and functionality is outlined, striving for improved clinical understanding of how ADHD and Anxiety Disorders (when co-morbid) actually affect each other and whether they are, in fact, related disorders.

Particpants will be expected to have a more solid understanding of:

The extent and ramifications of underdiagnosis, missed diagnoses and overdiagnosis with respect to Anxiety Disorders and ADHD, as result of current DSM-5 diagnostic criteria, common clinical pitfalls and assumptions, as well as clinician biases.

How ADHD and Anxiety disorders can affect the presentation and prognosis of the corresponding comorbid disorder.

How clinicians should approach these two disorders (whether comorbid or not) in order to facilitate effective individualized treatment.

The hypotheses and evidence that ADHD and anxiety are different or that they are related subtypes of the same endophenotype.

The circuitry of. and inputs to, the Prefrontal Cortex and how this can be usefully applied in clinical practice.

1. 1. Literature Review of electronic research databases to include: PubMed, Google Scholar, and PSYCHINFO

2. 2. Review of statistics of prevalence, incidence of the above two disorders, and number.type of prescriptions for ADHD and anxiety worldwide derived from the above as well as the CDC and NIMH

3. 3. Review of existing North American, European and Australasian treatment guidelines as well as expert consensus recommendations for ADHD, Anxiety Disorders, as well as both disorders when comorbid with one another.

To be provided by the presenters via Powerpoint slides at the open panel discussion

To be provided and discussed at the open panel discussion

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Working in the intensive care unit (ICU) often involves intensely stressful and emotional situations, which can be strong predictors of poor mental health. Healthcare workers are required to perceive, understand, manage, and use their emotions to provide quality care.

To evaluate the impact of emotional intelligence (EI) on anxiodepressive disorders in nursing staff in the ICU.

This was a descriptive, cross-sectional, analytical study conducted among nursing staff in the ICUs of two hospitals in Tunisia. Data were collected over a 3-month period. EI was assessed using the SSEIT self-report test, and the hospital anxiety and depression scale (HADS) was used to measure anxiodepressive disorders. Sociodemographic aspects were also taken into account.

We included 92 healthcare workers. The majority were women (67.4%) with an average age of 25 to 54 years. Nurses represented 58.7% of the study population. About half had less than 5 years of occupational seniority. In terms of lifestyle habits, 76% were smokers, 90.2% did not consume alcohol, and 53% had no leisure activities. The majority had no personal, family, or medical psychiatric history.

The mean EI score was 109.9, ranging from 62 to 150. Anxiety was present in 43.49% of participants and depression in 51.08%.

A significant association was observed between anxiety and the perception of emotions (p=0.0196) and the management of others’ emotions (p=0.0261).

As for depression, a significant association was observed between perception of emotions and depression (p=0.0259), as well as between management of others’ emotions and depression (p=0.0126). EI was positively associated with HADS (p=0.0281), with a correlation value of 0.114.

Caregivers with anxiodepressive disorders had significantly lower levels of EI than those without anxiodepressive disorders, suggesting that EI maybe a protective factor against these disorders

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Atypical antipsychotic (AAP) drugs are the gold-standard treatment for psychotic patients but are nowadays also widely prescribed among people with other mental disorders. Notwithstanding the benefits of AAP in terms of symptom improvement, there are severe adverse effects including the metabolic syndrome. A novel hypothesis is that part of these undesirable effects of antipsychotics could be mediated by their deleterious effects on the microbiome. This may result in dysbiosis, the disruption of bacterial species of the gut microbiota. Recently, dysbiosis has been linked to poor quality of life, depression and anxiety through the gut-brain axis. Mounting evidence proposes that prebiotic consumption may be helpful in the recovery of dysbiosis, although this effect is unclear among long-term antipsychotic users.

The main objective of this study is to assess the potential beneficial effects of the prebiotic Galacto-oligosaccharides (GOS) in combination with 2′-fucosyllactose (2’-FL) on the gut microbiota, by showing a relative increase in Bifidobacteria in fecal samples following intervention. The secondary objective is to assess the effects of GOS on mental wellbeing, sleep, and metabolic parameters. We hypothesize that GOS+2’FL supplementation will improve gut health, mental wellbeing, sleep, and metabolic parameters. Data will be collected 4 weeks prior to the start of the intervention during an observation only phase [t0], at baseline [t1], and after 2 [t2] and 6 [t3] weeks of GOS+2’FL intake. A follow-up will take place at week 10, 4 weeks after the intervention [t4]. Other outcomes that are assessed include the FiberScreen tool, the form of human faeces (Bristol Stool Chart), side effects and the defined daily dosis (DDD) of antipsychotic medication.

The study is a single-arm pilot study (non-randomized and non-blinded). We aim to include 30 psychiatric patients on long-term atypical antipsychotic use, irrespective of their specific psychiatric disorder, with a BMI > 25 kg/m2. Following a run-in period of 4 weeks (no intervention but all other aspects of the study), the participants will consume GOSplus (7.0 g BiotisTMGOS + 0.7 g 2’-FL) daily during the first consumption moment of the day (preferably in the morning) for 42 days. The GOSplus powder has a slightly sweet flavour. The primary endpoint is the change in Bifidobacteria in fecal samples from week 0 to week 6.

The study started recruiting participants in October 2023.

Conclusions are expected by the end of 2024.

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Cardiac surgery patients, former cardiac patients, face additional sources of stress connected with surgical intervention.

To devise the main principles of a personalized approach in psychosocial interventions for cardiac surgery patients.

We have devised these principles based on the analysis of contemporary scientific literature and the operational experience of the Cardiology Clinic of the Chuvash Republic located in the city of Cheboksary.

A personalized approach in psychosocial interventions for cardiac surgery patients is used at all levels of medical support. It implies taking into consideration in every specific patient a unique correlation of their clinic-anamnestic peculiarities, clinic-psychological risk factors of the condition’s gravity and their psychological resources. At the same time, all the psychological interventions must focus on the personality and comply with the clinic specificity of the actual somatic and mental condition of the cardiac surgery patients. The underlying principles of the personalized approach in psychosocial interventions for cardiac surgery patientsinclude the principles of accessibility, openness, continuity, collaboration, integration, differentiation, variation, participation, awareness and prevention.

Relying on the personalized approach in psychosocial interventions for cardiac surgery patientsallows working out a personalized treatment and rehabilitation course for an individual patient.

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