Motivational interviewing (MI) is an evidence-based communication style that is effective in facilitating behaviour change and patient engagement. Originally developed in the field of addiction, MI can be applied to address a range of health behaviours including smoking cessation, medication adherence and diabetes and weight management. Given its demonstrated efficacy, training clinicians in medical and psychiatry specialties in MI has potential to enhance patient outcomes.

1. Enhance awareness and understanding of the basic concepts and methods of MI among NCHDs (Non-Consultant Hospital Doctors) and hospital staff.

1. Assess the perceived effectiveness of the training and help foster a culture of teaching and learning within the hospital.

MI training was organised by the psychiatry department and delivered by a certified external trainer. The training was structured into 2 sessions, each lasting three hours, with a six-week gap between sessions. The training was integrated into the regular academic teaching for psychiatry trainees and a circular email invite was sent to the medical NCHD cohort and psychology department. Pre and post-training questionnaires were collected from participants with five-point Likert scales used to gather responses

There were 40 attendees across the two sessions. In total, 25 questionnaire responses were collected for the pre training (62.5%) and 30 responses were collected post-training (75%).

Prior to training 48% (12/25) indicated they were familiar with MI, 48% felt confident in using MI and 88% (22/25) felt it was applicable to their practice. Post-training, 73% (22/30) felt confident in using MI, 90% (27/40) felt MI was applicable to their practice and 100% indicated they would use MI in their practice. The perception of applicability (p=0.011) and likely utilisation of MI skills (p<0.001) significantly increased over the course of the training as measured by paired t-test (n=23). Ninety-seven percent of responders stated they would recommend the training and 57% (17/30) indicated that they would use MI on a weekly basis in the future.

NCHDs and other staff welcomed this training and indicated the training was relevant to their practice. MI demonstrated a positive effect on staff perceptions of applicability and future utilisation of MI skills. Increasing clinician self-perceived efficacy through training events may help contribute to a culture of learning and teaching in hospital settings.

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Treatment-resistant depression (TRD) lacks a universally consistent definition due to varied interpretations despite attempts to define it based on inadequate response or remission despite sufficient antidepressant treatment. There’s a crucial demand for a uniform definition and staging to streamline its effective management amid diverse treatment options and the complex nature of resistance. Five methods have emerged to define and classify treatment resistance reliably.

The aim of this study is to compare the five staging methods (Thase&Rush SM (T&R), European Staging Method (ESM), Maudsley Staging Method (MSM), Massachusetts General Hospital Staging Method (MHG-s), Conway Staging Method(Conway)) in assessing treatment resistance within a single sample.

Retrospective analysis involved medical records of inpatient psychiatry clinic admissions at Hacettepe University between October 2012 and October 2014. Patients with a primary diagnosis of bipolar affective disorder, schizophrenia, other chronic psychotic disorders, dementia or cognitive disorders, alcohol and substance use disorders, and those with missing data were excluded.

Initial screening yielded a total of 115 patients. 64 patients were included in the study, 13 patients were excluded due to missing data, and 38 patients were excluded due to comorbidity.

There is no universally agreed-upon definition for treatment resistance. In this sample, different definition and staging methods were employed to examine the similarities and differences in the clinical and treatment related characteristics of groups with TRD identified with each. The reasons and possible implication of concurrence and discordance between the methods will be discussed.

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The evaluation of manic behavior with later onset is crucial, as various organic factors such as medications, infections, metabolic disturbances, tumors, and epilepsy can serve as potential etiological causes. While not universally observed, most studies indicate a connection between late-onset mania and neurological disorders like neurosyphilis.

Our study aims to investigate the relationship between late-onset mania and neurosyphilis.

In this paper, we present a case of neurosyphilis presenting exclusively with symptoms of mania.

A 72-year-old Tunisian woman with no prior medical or psychiatric history was referred to the psychiatric emergency room due to alterations in her mental state and behavior over the past ten days. During the psychiatric assessment, she displayed increased motor activity, fluctuating emotions, and rapid flow of ideas. The general physical examination yielded no notable findings. The serum Venereal Disease Research Laboratory (VDRL) test returned a strongly positive result (+++), and the TPHA examination confirmed a positive result at a titer of 1/60. In the serologic analysis of cerebrospinal fluid, VDRL was also positive, thereby confirming the diagnosis of neurosyphilis (NS). The diagnosis of mania secondary to a medical condition was established. The patient was treated with ceftriaxone and antimanic medications, resulting in a significant improvement in her psychiatric symptoms within a few days.

This case underscores the importance of conducting serologic testing for syphilis in patients who present with manic symptoms, experience a late-onset mental disorder, and have no prior history or family history of affective disorders.

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Current healthcare policies encourage the investment in transition units between hospitalization and outpatient care. Psychiatry day hospitals (DH) serve as partial hospitalization structures that facilitate this transition. The DH at the Faro Unit of the Centro Hospitalar Universitário do Algarve (CHUA), began its activity in 2008, is situated in southern Portugal and provides support to the entire eastern Algarve region (approximately 300,000 people). Its focus is on rehabilitating individuals with severe mental illnesses necessitating multidisciplinary care, with personalized therapeutic plans.

We aimed to categorize patients based on diagnoses (primary psychotic disorder, depressive disorder, and others) according to the International Classification of Diseases (ICD-11) and to characterize and compare sociodemographic and clinical data among these three groups.

A retrospective study spanning from May 2008 to June 2023 was conducted. We assessed sociodemographic, clinical, and epidemiological data of patients undergoing treatment at CHUA Faro Unit’s DH.

Over this period, 541 treatment cycles were carried out to 433 distinct patients, between 18 and 78 years old. Of the total treatments, 38% were for Primary Psychotic Disorder (PPD), 24% for Depressive Disorder (DD) and among the others (39%) the diagnosis of Bipolar Affective Disorder and Personality Disorder predominated . Statistically significant differences were identified among these three groups. The PPD group exhibited a male predominance, whereas DD and others were largely female. Patients in the PPD group were significantly younger (average age of 36 in PPD, 40 in others, and 48 in DD), more likely to be single, and a majority were unemployed (with several patients retired due to disability). No significant differences were noted regarding dropouts, expulsions, or the duration of DH treatment. These results are preliminary, and additional relevant data are being collected and processed.

The diagnostic group’s consideration revealed differences in the social, demographic, and clinical characteristics of patients. These findings offer insights into patient details, enabling the future adaptation of intervention strategies in a more personalized manner.

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Understanding adolescents perceptions of their weight status and the factors influencing these perceptions is pivotal for developing targeted interventions and policies to counteract the rising obesity trends.

This cross-sectional study aimed to determine the accuracy of weight status perceptions among Tunisian adolescents compared to objective metrics and to identify sociodemographic characteristics and life habits associated with the underestimation of weight status.

A cross-sectional, school-based study was conducted among a randomized sample of adolescents attending secondary schools in Sousse, Tunisia. A total of 1399 students participated, with anthropometric measurements taken, and a pre-tested Arabic questionnaire administered to gather sociodemographic data and perceived weight status, assessed using the Figure Rating Scale (FRS). The accuracy of perceived weight status was determined by comparing the measured weight status with participants; self-reported perceptions. We evaluated the association between body weight distortion and life habits which included regular physical activity, screen time (time spent on internet per day), number of fruits and vegetables consumed per day, and fast-food consumption.

The study achieved an 86.68% response rate, with over half of the participants being female (60.5%), and the average age being 17 years. The majority of adolescents (41%) perceived themselves as having normal body weight, while 34.5% perceived themselves as underweight, 16.6% as overweight, and 7.9% as obese. However, based on BMI categories, 72.6% had a normal measured weight, 20.4% were overweight, and 6.9% were obese. A substantial proportion of participants (45.6%) underestimated their weight status, with a significant proportion being objectively overweight or obese (26%). Furthermore, we found a significant association between the perception of weight accuracy with four correlates: gender, mother educational level, regular physical activity, and the number of fruits and vegetables consumed per day.

The findings revealed a disparity between perceived and actual weight status among Tunisian adolescents, with a significant underestimation of weight status, particularly among those who are overweight or obese. The results highlighted the crucial need for interventions that address weight perception inaccuracies and promote healthy weight awareness and management among adolescents in Tunisia. The study underscored the importance of further research to understand the development and progression of body weight underestimation throughout adolescence and the roles of lifestyle behaviors in shaping weight perceptions.

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This presentation provides an overview of the impact of information technologies on contemporary psychiatric practice, focusing on resources and strategies beneficial for early career psychiatrists. Considering the increasing role of digital technologies in diagnosing and treating mental disorders, the presentation emphasizes the practical applications of artificial intelligence (AI) and machine learning. These technologies offer novel approaches for analyzing large volumes of clinical data, enhancing diagnostic accuracy, and personalizing treatment.

The presentation further examines ethical and legal issues associated with using digital technologies in psychiatry, including ensuring data confidentiality and complying with patient rights. The importance of developing competencies in information security and ethical principles when using digital tools is highlighted.

The talk concludes with an overview of the current and future trends in the use of digital technologies in psychiatry, including the development of virtual therapeutic environments and mobile applications for monitoring and supporting mental health. Examples of successful integration of these technologies into clinical practice are presented, emphasizing their potential to improve the quality of patient care.

Overall, the presentation underscores the importance for early career psychiatrists of mastering information technologies, highlighting their role in enhancing diagnosis, treatment, and patient care, as well as discussing the challenges and opportunities they present.

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Previous research has implicated herpes simplex virus 1 (HSV1) and cytomegalovirus (CMV) in severe mental illness (SMI) with conflicting results. Both pathogens have high universal seroprevalence, are neurotropic and after the primary infection typically establish a persistent latent infection with periodic reactivations. Increased immunoglobin G (IgG) concentrations are considered to be attributable to an increased infection severity with more frequent reactivations or host immune system alterations.

We assessed the HSV1 and CMV IgG concentrations in previously infected (seropositive) patients with SMI and healthy controls (HC). We hypothesized that seropositive patients would show higher IgG concentrations than seropositive HC.

We included 765 patients, 515 with schizophrenia (SZ) and 250 with bipolar disorder (BP), and 541 HC. HSV1 and CMV IgG seropositivity and concentrations were measured with immunoassays. 355 patients, mean age 33 years, 45% females, and 238 HC, mean age 35 years, 44% females, were HSV1 seropositive (HSV1+) while 447 patients, mean age 33 years, 50% females, and 296 HC, mean age 34 years, 47% females, were CMV seropositive (CMV+). In our main analysis among seropositive participants, we investigated the main effect of patient/control status on HSV1 and CMV IgG concentrations.

There were no significant differences in CMV or HSV1 seropositivity frequencies between patients with SZ, patients with BP and HC. Among seropositive participants, patients had higher HSV1 (p<0.001) and CMV (p=0.018) IgG concentrations than HC; stratifying by diagnosis, both patients with SZ (p=0.001) and patients with BP (p=0.001) had higher HSV1 IgG concentrations than HC, while patients with SZ, but not BP, had higher CMV (p=0.045) IgG concentrations than HC (Image). For HSV1, higher IgG concentrations were associated with higher general (p=0.017), negative (p=0.041) and positive (p=0.028) psychotic symptom scores.

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Seropositive patients with SMI showed higher HSV1 and CMV IgG concentrations than seropositive HC suggesting that patients suffer a more severe infection or exhibit an altered immune response when contracting the pathogens. For HSV1, higher IgG concentrations were linked to more psychotic symptoms.

D. Andreou: None Declared, N. E. Steen: None Declared, K. N. Jørgensen: None Declared, T. Ueland: None Declared, L. Wortinger: None Declared, L. Mørch-Johnsen: None Declared, R. Yolken: None Declared, O. Andreassen Consultant of: Consultant to HealthLytix, Speakers bureau of: Received speaker’s honorarium from Lundbeck and Sunovion, I. Agartz Speakers bureau of: Received speaker’s honorarium from Lundbeck

The global COVID-19 pandemic and subsequent lockdowns have significantly impacted global wellbeing and highlighted the close link between mental and physical health. Social isolation and quarantine have proven to be major stressors, leading to emotional distress and unpredictable psychological consequences.

We explored the pandemic’s impact on individuals’ physical and mental health and social relationships.

We conducted a cross-sectional study using a questionnaire which included among other socio-democratic questions, the Fear of COVID-19 Scale, the World Health Organization Quality-of-Life Scale (WHOQOL-BREF) and the Toronto Empathy Questionnaire (TEQ).

A total of 511 adults (55.1% males) participated in this study. Participants reported increased social media use (more than 4-5 times/week) during the lockdown, which was associated with increased fear of COVID-19 and negative effects on mental and physical health, and social relationships (p<0.01). Conversely, non-work-related outings (once a week) were associated with lower fear (p<0.01) and better well-being (p<0.05). Higher fear, particularly for loved ones, was associated with negative effects. The level of physical health was moderate to high, with varying levels of satisfaction in different areas. Empathy correlated with increased fear (p<0.01) and reduced mobility (p<0.05).

The COVID-19 pandemic and lockdowns significantly affected physical and mental health, highlighting the importance of tailoring interventions for vulnerable populations and promoting adaptive coping strategies in times of crisis.

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Since its first publication in 1977, the World Health Organization’s (WHO) Model List of Essential Medicines (EML) has guided the national procurement of medicines deemed essential to inform public health policy worldwide. Aiming to include the most effective, safe, and cost-effective medicines for priority conditions, WHO updates the EML every two years. However, over the past 45 years, updates to the mental health section of the EML have been infrequent, mostly involving the addition of individual medicines. A comprehensive revision of the entire section was never attempted.

The aim of this project was to update the mental health section of the EML to identify the most effective and safest medicines for mental disorders in the light of the most up-to-date evidence base.

A series of nine evidence-based applications were submitted to the WHO Expert Committee on the Selection and Use of Essential Medicines in December 2022, recommending a substantial revision of the entire mental health section.

All of our applications were accepted by the WHO Expert Committee. For psychotic disorders, aripiprazole, olanzapine, paliperidone, and quetiapine were added as therapeutic alternatives to risperidone; short-acting intramuscular chlorpromazine was replaced by short-acting intramuscular olanzapine; first-generation antipsychotics were limited to oral haloperidol and chlorpromazine. For bipolar disorder, the list now includes second-generation antipsychotics such as quetiapine, aripiprazole, olanzapine, and paliperidone. Tricyclic antidepressants for depressive disorders were limited to amitriptyline alone. Treatment options for anxiety and obsessive-compulsive disorder are now expanded to include SSRIs. For anxiety disorders, diazepam and lorazepam became the only benzodiazepines recommended, with the specific caveat that they should only be used for short-term emergency treatment of acute and severe anxiety symptoms. Finally, chlorpromazine and haloperidol are no longer considered essential medications for psychotic disorders in children under 13 years of age.

The WHO released the 23rd EML in July 2023. After decades of minimal and inconsistent updates, groundbreaking changes have been made to its mental health section. The updated mental health section provides a compelling opportunity to improve the quality of medicine selection at the country level, with the goal of increasing the availability of the safest and most effective psychotropic medicines worldwide.

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A 56-year-old patient diagnosed with bipolar affective disorder type II, who remains stable, with no manifest episodes, thanks to aripiprazole 60mg daily.

The aim is to carry out a brief review of the use of the drug as the only stabiliser in bipolar affective disorder.

A 56-year-old patient, who has been suffering from episodes of hypomania since the age of 40, with episodes of depression. After poor tolerance to the use of the usual stabilisers, and the impossibility of using antidepressants due to hypomanic swings, it was decided to start treatment with aripiprazole orally, up to a maximum of 60mg daily. Despite the fact that the patient, with this treatment, had no side effects and remained more stable psychopathologically, the patient did not comply adequately with the correct dosage, due to his rotating work shifts. This fact explained that although he acknowledged an improvement, he continued with episodes of depressive symptoms lasting several days followed by episodes of hypomanic characteristics.

For this reason, it was decided to change treatment to aripiprazole long-acting injectable, in order to ensure linear blood levels of the drug. Initially, it was decided to prescribe 400mg every 28 days. However, after the first administration, 20 days later, the patient began to show dysphoric mood, with marked emotional lability, living in an egodystonic manner. For this reason, the dose was increased to 600mg on a monthly basis. Since then, after a year and a half with the same treatment, the patient has been stable and in line. There has been no further decompensation of the underlying psychopathology and no side effects.

Aripiprazole in TAB is superior to placebo in type I patients, mainly affecting manic and mixed episodes, but not so much in depressive episodes. It has also been observed that it not only acts in the acute phases, but also has a stabilising function, preventing manic episodes.

One study showed that up to 65% of patients on oral aripiprazole in whom it was replaced by AOM remained clinically stable. In the same study, approximately 50% of those who completed 52 weeks of follow-up were able to maintain clinical stability.

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Orthorexia and exercise addiction can lead to serious health problems, such as malnutrition and exercise-related injuries.

The aims of our study were to assess the prevalence of exercise addiction and orthorexia nervosa in Tunisian students at the Institute of Physical Education in order to investigate the relationship between these different health dimensions.

An anonymous self-administered questionnaire was distributed to students in the Sfax and Gafsa sports sections during March 2023. The orthorexic tendency was assessed using the ORTO-15 questionnaire. An ORTO-15 score below 40 points indicates orthorexic tendencies. The Exercise Addiction Inventory (EAI) was used to study exercise addiction

In our study, 240 students were included. Mean scores on the ORTO-15 and EAI scales were 38.6 ± 8 and 16.6 ± 4.1 respectively. Participants at risk of exercise addiction had a statistically significant tendency towards orthorexia (p<0.001). Among the students, 82.5% had engaged in regular physical activity at a gym in the last two years. The reasons given by students for going to the gym were muscle strengthening (57.9%) and preparation for a sporting competition (37%).

Among students taking part in sports activities at the gym, the mean ORTHO-15 score was significantly lower among those doing so to prepare for a sports competition (p=0.005). Participants who believed that they were addicted to sport had a statistically greater tendency towards orthorexia (p=0.012).

Our study revealed an association between addictive exercise and orthorexic eating in Tunisian athlete students.

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Contrary to classical belief, people affected by this disease are at greater risk of developing organic pathologies.This risk has a very complex origin: a greater exposure to risk factors and specific socioeconomic conditions, a high prevalence of risk behaviors, the use of antipsychotics, and a potential common genetic background. (Reynolds et al.Int. J.Neuropsychopharmacol.2021; 24 854–855, Suvisaari J et al. Curr Diab Rep. 2016 16). Multiple studies demonstrate that Schizophrenia confers a high endogenous risk of Diabetes. Before patients diagnosed with Schizophrenia start taking antipsychotics (Andreassen OA et al. Am J Psychiatry. 2017;174 616-617), they have an approximately 3 times higher risk of developing Diabetes compared to the general population. The risk increases 3.6 times after the initiation of antipsychotic treatment compared to drug naive patients(Annamalai A et al World J Diabetes. 2017 390-396)

To study the association between Schizophrenia or other Psychotic Disorders and Diabetes Mellitus in a sample of patients diagnosed with Schizophrenia or other Psychotic Disorders.

This is a Descriptive and Cross-sectional Observational Study. Clinical Histories were reviewed and a personal or telephone interview was established to expand data related to the objectives of the study. The patients were recruited among the patients seen in the specific Severe Mental Disorder consultation who had a diagnosis of schizophrenia or other Psychotic Disorders, according to DSM 5-TR criteria.

From a sample of 93 patients, 24 had Diabetes. The Prevalence of Diabetes in patients with Schizophrenia or other Psychotic Disorders was 25.8%. Of the patients without a diagnosis of Diabetes, 15 of them had values of Glycosylated Hemoglobin (HbA1c) for Prediabetes. Using the Chi-Square Test, statistically significant differences were found between the variable Main Psychiatric Medication and Diabetes. Patients treated with Clozapine, Aripiprazole and Olanzapine had a Prevalence of Diabetes of 40.9%, 33.3% and 28.5%, respectively.

Prevalence of Diabetes in our sample was 3.4 times higher than the 7.51% of the general population in Spain. This presumes a significant importance and impact on the health of these patients. The diabetic patients in our sample were diagnosed with Diabetes years after the diagnosis of the mental illness, which seems to indicate that the causes have to do with lifestyle, dietary habits, weight, and exposure to chronic antipsychotics. Premature death in schizophrenia has several explanations, being of special importance the development of cardiovascular disorders and Diabetes This can be due to many reasons, but it is worth highlighting the metabolic side effects of some antipsychotics and lifestyle. In this sense, it is essential to carefully monitor this group of patients.

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In general, resilience is a process in which the interplay of risk and protective factors of the system itself and its environment is balanced in such a way that positive development opportunities open up. The resilience of a person, a system and a profession is therefore reflected in the ability to shape conditions in such a way that positive coping with challenges and crises is possible as a basis for positive further development. The time of the pandemic and the war in Ukraine has led to a large number of adjustments to psychology as a science, as a profession and as a perspective on life. This is associated with opportunities for positive further development of the discipline. European psychology has so far mastered the challenge of the pandemic and the war in Ukraine very well. The task now is to harness its successes as a multifunctional hub for other sciences, professions and society as a whole. The aim is to develop an identity that strengthens the unity of psychology in its diversity. With wisdom and resilience, psychology is also increasingly facing up to the challenges expressed in the United Nations Sustainable Development Goals (UN SDGs). In the discussion of social and professional change, the possibilities for a joint positive development of all professions in these stressful times become clear.

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Major depressive disorder stands as one of the most significant mental health issues in the general population. It impacts the patients’ quality of life and increases both morbidity and mortality. Response and tolerability to available pharmacological treatments are often inefficient, sometimes requiring extended periods to achieve acceptable remission through combinations or augmentations. Non-pharmacological approaches constitute an element in the therapeutic options for this mental disorder. In recent years, there has been a growing interest in non-pharmacological biological treatment interventions. Among the principal ones are Electroconvulsive Therapy (ECT), Transcranial Magnetic Stimulation (TMS), Deep Brain Stimulation (DBS), and Vagus Nerve Stimulation (VNS).

The aim of this paper is to review the current available literature to expand our knowledge about biological non-pharmacological treatment in depression, particularly ECT, TMS, DBS, and VNS.

A qualitative review was conducted over the last 5 years, using the Medline database through PubMed. We selected studies in English or Spanish that met the objectives of the review, excluding references in other languages. The scientific evidence obtained was analyzed and synthesized.

There is growing evidence in this area. TMS, whose place in clinical guidelines remains unclear, is a less available treatment but might be considered in patients with moderate to severe depression who cannot receive pharmacological treatment. DBS, which shows good results in treatment-resistant major depressive disorder, achieves response rates greater than 50%. VNS has accumulated studies since its approval for treatment-resistant depression, showing some latency of response but demonstrating improvement persistence for at least two years, although some studies have not clearly shown a benefit. We also found studies demonstrating the effectiveness and favorable cost-benefit balance of ECT.

This review highlights the importance of increasing knowledge in these types of treatments. They have shown significant progress in recent years. We have a better understanding and use of the technique of ECT, while newer options have gained evidence in effectiveness over these years, with improvements facilitating their use in patients with treatment-resistant depression.

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To discuss novel approaches in the development early detection, response and interventions of drug overdoses.

There is an urgent need to research and develop novel strategies to rapidly and accurately detect, respond, and treat them with the ultimate goal of reducing drug deaths secondary to fatal drug overdose incidents. This should be additional to supporting communities and networks able to intervene utilizing novel public health approaches.

We will describe technologies and associated systems that are able to accelerate detection and result in a timely response to potential overdose with effective and timely intervention to these occurrences using digital technologies and therapeutics. This will be contextualised around novel public health approaches.

We will describe 11 protypes as part of a £5 million UK inititiative. The themes will include:

1. – Use of discrete digital technology for easy use by people who use drugs in clinical and non-clinical settings

2. – Simple alert / responder pathways that created effective responses to potentially fatal overdose events

3. – Enhance innovative therapeutics as antidotes to overdose episodes

4. – Novel public health approaches

The use of remote monitoring devices like wearables and smartphone applications, paired with artificial intelligence and innovative therapeutics is an emerging field of research. This needs to be balanced around novel public health approaches.

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Autism spectrum disorders (ASD) and schizophrenia (SCZ) have a strong historic connection. At the beginning of the 20th century when referring to schizophrenic patients Eugen Bleuler used the term autism to describe the apparent withdrawal from the outside world. Other authors also emphasized the association between this two entities. In fact, only in DSM-III were these disorders placed in different diagnostic categories. Today, even though this nosological vision still prevails, a growing number of studies have shown significant overlaps between the two disorders. Patients with the diagnosis of ASD often experience psychotic symptoms and similarly schizophrenic patients have a high prevalence of autistic traits.

To clarify the distinction between ASD and psychotic disorders, namely to help the clinical and phenomenological distinction between patients with a primary psychotic disorder versus patients with the diagnosis of an autism spectrum disorder that might also experience psychotic symptoms.

Research on UpToDate using the terms “Autism Spectrum Disorders”; “Schizophrenia” and “psychosis”.

Delusional beliefs and paranoid ideation are common findings in autistic individuals in the same way that they constitute one of the main features of schizophrenia spectrum disorders. However, in ASD individuals one must be vigilant of its distinction with “childish fantasies”. Both disorders (ASD and SCZ spectrum disorders) share Theory of Mind (ToM) impairments that contribute to the development of paranoia.

Sensory anomalies are common in ASD and might be confused with hallucinations. However, anomalous perceptual experiences can and do often happen in ASD and are clinically overlapping with hallucinatory phenomena. In the case of a neurodevelopment disorder, however, they could probably be better understood as a part of it more than the signal of a co-ocurring psychotic disorder. Attenuated psychotic symptoms pose an even more complex subject because of the overlap between autistic symptoms and subclinical psychotic symptoms. Another area that poses diagnostic difficulties has to do with the distinction between negative symptoms seen in schizophrenia and autistic symptoms. Lack of emotional reciprocity in ASD can be confused with “blunted” affect in schizophrenia.

Other overlapping features between these two entities can be identified.

The diagnostic boundaries between ASD and SCZ are not always clear. Their overlapping characteristics and potential co-occurrence might pose important diagnostic challenges in clinical practice. The clinical course of both diseases frequently represents a key element for the differential diagnosis between autism and psychosis. The profound knowledge of these two entities is of extreme importance contributing to the implementation of more targeted and effective management strategies.

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Endometriosis is a gynaecological pathology characterized by endometrial tissue similar to stroma and endometrium in extra endometrial and myometrial sites. This condition affects women’s mental health and quality of life and can elicit shame feelings.

To explore the role of quality of life in endometriosis, chronic illness-related shame, self-compassion, and psychological flexibility in depressive symptoms.

260 people diagnosed with endometriosis, aged 18 years or older, were recruited through patients’ associations. Participants completed an online sociodemographic and clinical questionnaire and the following self-report instruments: Anxiety, Depression, and Stress Scales (DASS-21), Endometrioses Health Profile (EHP-5), Chronic Illness-Related Shame Scale (CISS), Compassionate Engagement and Action Scales (EEAC-SC), and the Psy-Flex Scale.

Regression analyses showed that years of education, endometriosis-related quality of life (pain, control, emotional well-being, social support, and self-image), chronic illness-related shame, and psychological flexibility were the significant predictors of depressive symptoms. On the other hand, endometriosis-related quality of life (work life, relationship with children, sexual life, relationship with healthcare professionals, treatment, and infertility) and self-compassion were not significantly associated with depressive symptoms.

The identification of chronic illness-related shame and quality of life related to endometriosis as relevant variables regarding the presence of symptoms of depression points to the relevance of early detection of these phenomena to prevent the development of depressive symptoms. Moreover, interventions targeting the development of psychological flexibility may contribute to the amelioration and prevention of depressive symptoms.

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Mortality from cardiovascular disease is increased in people with mental health disorders in general and schizophrenia in particular. The causes are multifactorial, but it is known that antipsychotic medication can cause cardiac side-effects beyond the traditional coronary risk factors. Schizophrenia itself is a contributor to an increased risk of cardiovascular mortality via cardiac autonomic dysfunction and a higher prevalence of metabolic syndrome, both contributing to a reduced life expectancy.

Overall, management of cardiovascular risk within this population group must be multifaceted and nuanced to allow the most effective treatment of serious mental illness to be conducted within acceptable parameters of cardiovascular risk; some practical measures are presented for the clinical cardiologist.

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Insecure attachment is considered a general risk factor for eating disorders (ED). Emotion dysregulation has been proposed as one of the possible mechanisms by which attachment insecurity may affect ED psychopathology.

Aim of the present study was to investigate whether difficulties in acceptance of emotions or emotional clarity may mediate the connection between insecure attachment and ED psychopathology.

One hundred and twenty patients participated and completed the Italian version of Eating Disorder Inventory‐2 (EDI-2), Experience in Close Relationship questionnaire (ECR) and Difficulties in Emotion Regulation Scale (DERS). A mediator path model was performed, in which insecure attachment dimensions were set as independent variables, ED specific psychopathology measures as dependent variables, and non‐acceptance of emotion and lack of emotional clarity as mediators.

The association between both attachment avoidance and anxiety and ED specific symptoms was mediated by emotional non‐acceptance, but not by emotional clarity.

This study showed the importance to address emotion regulation in individuals with ED, focussing on improving emotional acceptance. Exploring early developmental processes which lead to non‐acceptance of emotions could improve this psychological trait in people with ED.

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In patients affected by Schizophrenia and Bipolar Disorder disorders the use of antipsychotic drugs is essential in preventing the exacerbation of symptoms. The use of long-acting injectable (LAI) antipsychotics is considered an important treatment option. The aim of this study was to evaluate the incidence and predictors of relapse during antipsychotic treatment with LAIs in a sample of psychiatric outpatients up to a year after the start of long-acting therapy.

The study included 103 adult patients admitted to the psychiatric unit of Sant’Andrea University Hospital in Rome.

We evaluated duration of untreated illness, previous treatments, substance abuse, suicidal status, LAI dose, and use of other medicines for association with new episodes of illness or of symptomatic worsening as well as hospitalization, using bivariate and multivariate analyses.

Seventy-three patients were diagnosed with schizophrenia spectrum and 30 with bipolar disorders. Age at study entry averaged 36.7 years (SD= 11.55). 40.8% of patients were women. The mean age at onset were 23.11 (SD= 7.0). All the other information were reported in Table 1. On 103 patients undergoing with LAI treatment for a year only 9 (8.7%) patients had a relapse during the study period. The two groups differed according to the presence of hospitalization during the 12 months before the LAI treatment (p = .022), in particular patients with relapse were more hospitalized than patients with no relapse (62.5% vs. 21.7%). Moreover, group with relapse were more at risk of suicide during the 12 months before the LAI treatment than the other group, for both suicidal ideation (11.1% vs. 4.3%; p= .015) and attempt (25.0% vs. 3.2%; p= .049). Finally, the two groups differed according to the side effects reported during the year of LAI treatment (χ² =38.48; p< .001). Specifically, patients’ group with relapse reported more side effects caused by parkinsonism (25.0% vs. 1.1%) and tremor (25.0% vs. 0%). No differences were found for the other variables (See table 1).

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In conclusion, our observations confirm the importance of LAI therapy in real word. However, our results indicate that these drugs might not prevent subsequent exacerbations for a proportion of individuals whose illness is stabilised on continuous antipsychotic treatment. Extra pyramidal symptoms in particular might have pathophysiological implications for relapse.

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