Epilepsy is one of the most common serious brain illness, with symptoms influenced by multiple risk factors and a strong genetic predisposition, rather than having a single expression and cause¹. Neuropsychiatric symptoms in epilepsy can encompass manifestations such as mood alterations, anxiety, sleep disturbances, psychosis, and behavioral disorders. While the motor and sensory manifestations of epileptic seizures are widely recognized, neuropsychiatric symptoms accompanying epilepsy are often underestimated. Therefore, it is essential to understand the most prevalent epidemiological profile of these patients to improve the diagnosis and management of these symptoms.

Our goal was to evaluate the neuropsychiatric behavior of epilepsy patients in Brazilian over the past 3 years through hospitalization data in order to outline an epidemiological and behavioral profile.

A cross-sectional, descriptive, retrospective, and quantitative study was conducted on hospitalizations of individuals simultaneously diagnosed with epilepsy, schizotypal and delusional disorders, and mood disorders in all five regions of Brazil (South, Southeast, Midwest, North, and Northeast) between February 2020 and December 2022. Data from January 2020 were not available. The data used were collected through the Department of Health Informatics of the Brazilian Unified Health System (DATASUS) in the “Hospital Information System of SUS” section, gathering information regarding the nature of care, age range, gender, and ethnicity of the patients.

The analysis covers the years 2020 to 2022, totaling 503,045 hospitalizations. In 2022, the highest number of cases occurred (≈ 37.55%), followed by 2021 (≈ 33.62%) and 2020 (≈ 28.81%). Urgent hospitalizations represented ≈ 90.85% of the total. The most affected age group was 30 to 39 years old (≈ 18.30%). Men were more affected than women (≈ 52.03% and ≈ 47.96%, respectively), and Caucasians accounted for ≈ 36.07% of the hospitalizations. The average length of stay was 19.1 days, and the mortality rate was 1.4%.

Thus, there is a gradual and annual increase in the number of hospitalizations during the observed period. While there is a minimal disparity between the affected genders, it is evident that the profile of male, caucasian, and adult patients is the most prevalent. Moreover, the predominantly urgent nature of hospitalizations points to an alarming scenario regarding this issue. From the analysis of the data obtained in the study, there is a clear need for interventions capable of reducing the prevalence of hospitalizations for neuropsychiatric symptoms in epilepsy patients in Brazil.

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Osteoarthritis is one of the most common diseases and a leading cause of functional limitation and dependence, significantly impacting the quality of life (QOL).

The aim of this study was to evaluate the impact of knee osteoarthritis on QOL and identify associated factors.

This prospective cross-sectional descriptive study was conducted in the Physical Medicine and Functional Rehabilitation Department over a 4-month period, involving patients with symptomatic bilateral knee osteoarthritis (according to the American College of Rheumatology (ACR) criteria). Sociodemographic data, comorbidities, and characteristics of knee osteoarthritis were collected. The assessment of QOL and the functional impact of knee osteoarthritis were based on the KOOS (Knee Injury and Osteoarthritis Outcome Score) self-questionnaire, Lequesne Index, and modified WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) Score. The KOOS questionnaire included 5 subscales: pain (KOOS-Pain), symptoms other than pain (KOOS-Symptoms), activities of daily living (KOOS-ADL), sports and recreational function (KOOS-Sport), and QOL (KOOS-QOL).

We included 30 patients with an average age of 59.27±6.3; the male-to-female ratio was 0.15. Sixty percent of patients lived in urban areas, with varying levels of education: primary (n=10), secondary (n=4), and university (n=4), while the majority were illiterate (40%). Most of our patients were employed, with 64.28% engaging in significant physical activity, resulting in an average of 6±2 days of work absenteeism every 3 months due to knee pain. The mean duration of knee osteoarthritis was 7.97 years±3.14. The average pain visual analog scale (VAS) score was 5.2±0.4. Knee osteoarthritis was classified as stage 2 in 40% and stage 3 in 60% of cases. Regarding functional impact, the mean WOMAC global index was 16.6±4.68, and the mean Lequesne Index was 11.05±3.45; moderate disability was observed in 16.7%, significant disability in 50%, and severe disability in 16.7% of patients. Furthermore, the KOOS questionnaire revealed decreased KOOS-Sport and KOOS-QOL scores, with mean values of 35±10.2 and 37±8.9, respectively. Our study identified factors associated with a poor quality of life: age > 65 years (p<0.05), disease duration (p=0.02), and VAS pain > 5 (p=0.02).

Improving the quality of life is an essential therapeutic goal in managing knee osteoarthritis. Our study demonstrates that advanced age, longer disease duration, and high pain intensity can negatively impact quality of life.

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According to UNICEF, 2 million children have left the country since the beginning of the war. 2.5 million Ukrainian children are internally displaced persons. Minors often become victims or witnesses of violence.

The events of 2022-2023 are the largest military conflict in the world since World War II. The impact on the mental health of the population is characterized by the variety and mass of traumatizing factors.

Mental trauma causes PTSD, depressive disorders (DD), anxiety disorders (AD), behavioral disorders (CD), attention deficit hyperactivity disorder (ADHD).

The aim of the study was to determine the prevalence of PTSD and its comorbidities at different stages of experiencing a traumatic experience.

785 teen`s displaced from the zone of military operations, occupied territories were surveyed. Examinations included: K-SADS-PL, PSC-17, SCARED, CATS. 260 teen`s were examined during - 6, 400 – 6–12 months after traumatization.

After 6 months of trauma, PTSD was diagnosed in 9.8%, ADHD – 10.2%, DD-22.3%, AD-30.8%, CD – 15.4%, 28.8%; examined 6 to 12 months after the injury, respectively: 21.9%, 12.6, 33.3%, 11.5%, 18.0%.

In war-affected children, PTSD is a risk factor for the subsequent development of comorbid depression, anxiety, conduct disorders, and ADHD. Female sex, secondary traumatization after displacement increase the risk of developing depression, signs of pervasive development and ADHD - the risk of destructive and self-injurious behavior. The prevalence of PTSD, DD, ADHD increases within 6-12 months after the trauma, the sensitivity of children with PTSD to secondary traumatic events increases.

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We present the case of an elderly patient with a severe depressive episode who, in order to maintain psychopathological stabilisation, receives ECT on an outpatient basis.

The objective is to briefly review the use of ECT as a maintenance treatment for severe depression in the elderly.

Patient aged 76 years, multipathological, with a history of hypertension, DM and LBP. Femoral head fracture, myelodysplastic syndrome, severe osteoporosis with vertebral crushing, requiring rescue treatment with tramadol, and renal failure.

She came for consultation, reporting depressive symptoms of months’ duration, together with delusions of ruin and nihilism. Despite antidepressant and stabilising treatment with duloxetine at daily doses of 120mg, extended-release quetiapine 600mg, lorazepam 2.5mg and mirtazapine 45mg, the patient began to show negative behaviour towards accepting food, clinophilic behaviour and abandonment, which led to her being admitted to the short-term hospitalisation unit.

Due to the severity of the depressive symptomatology, it was decided to start ECT, administering a total of 12 sessions, which were effective, and outpatient follow-up was resumed. However, after a week, the patient again began to show marked apathy and abulia, as well as complete anorexia lasting more than 24 hours, which led to a new admission. It was then that it was decided to maintain the ECT treatment, on an outpatient basis, as maintenance treatment, together with pharmacological treatment.

ECT is indicated in severe depression, with or without psychotic symptoms, with malnutrition and organic pathology. According to studies, it has a beneficial response of more than 60%. However, the rate of receiving depressive symptomatology in a severe episode is high, despite ECT, so studies and clinical practice recommend maintenance ECT. It is usual to start with weekly sessions, and progressively space them out to maintain the minimum that guarantees stability.

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Individuals experiencing psychotic symptoms often lack insight into their conditions, especially in first psychotic episodes. According to the Portuguese Mental Health Law, involuntary hospitalization may be necessary in cases of severe mental disorder, involving a threat to the patient or his/her legal assets, when there is a refusal of the necessary treatment.

The aim of our study was to characterize patients admitted involuntarily for first psychotic episode and to compare them with the patients undergoing inpatient voluntary treatment.

Out of a total of 87 patients diagnosed with first psychotic episode, hospitalized between 2020 and 2022 in our service, at Hospital Magalhães Lemos, 65 were included in the study. Exclusion criteria included patients from other residential areas. 40 patients were admitted under involuntary treatment, whereas 25 were hospitalized voluntarily. For both groups, we calculated the duration of untreated psychosis, the prevalence of psychoactive substance abuse, the type of treatment provided and the number of re-hospitalizations.

Patients in involuntary treatment had longer duration of untreated psychosis (71 vs 38 weeks). Among these patients, 53% had comorbid psychoactive substance abuse, in contrast with only 36% of voluntarily treated patients. Upon discharge, 58% of patients in involuntary treatment were prescribed depot antipsychotic medication, whereas only 12% of the ones in voluntary treatment. Out of 40 patients admitted involuntarily, 11 were re-hospitalized, but only 4 of the 25 patients in voluntary treatment (28 vs 16%).

Patients in involuntary treatment probably suffered from more severe disease, as seen for the higher duration of untreated psychosis and frequent comorbid substance abuse. Injectable medication was the preferred choice at the time of discharge for this group. Additionally, they experienced higher rates of re-hospitalizations. Recent changes in Portuguese Mental Health Law, that aims to safeguard the rights and responsibilities of individuals with mental health care needs, motivated this study.

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In recent times, there has been a growing emphasis on the significance of fostering intergenerational learning and interaction. This involves individuals from diverse age groups engaging in purposeful and mutually beneficial activities aimed at enhancing their knowledge, skills, and values.

This systematic review was undertaken to explore the psychosocial consequences of intergenerational learning experiences among primary school-age children and older adults.

In accordance with the PRISMA guidelines, a comprehensive review of both quantitative and qualitative data was conducted. Electronic databases such as PubMed, Scopus, and ERIC were meticulously searched up to July 26, 2022, using the following Population (P) - Exposure (E) - Outcome (O) criteria: primary school-age children and older adults (P), participation in intergenerational learning (E), and psychosocial effects (O). Additionally, we extensively scrutinized the reference lists of included datasets and pertinent review articles (Figure 1). To evaluate the quality of the eligible studies, we employed the Mixed Methods Appraisal Tool (MMAT). Data analysis was structured around a narrative synthesis approach.

A total of seventeen studies were deemed eligible for inclusion in this review. The findings regarding the psychosocial consequences of engaging in intergenerational activities for both children and older adults predominantly underscored positive improvements in their attitudes, well-being, happiness, and various other aspects of their social and psychological well-being, although certain methodological limitations were identified (Figure 2).

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Promoting intergenerational interactions and learning experiences holds promise as a means to enhance the overall quality of life and well-being for both younger and older members of our communities.

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Opioid use disorder is still the main presenting illicit substance use disorder that patients present within Addiction and Mental Health Services even though the majority of the patients are polysubstance users. Innovation in the field will allow providers to understand better how systems work to support a population with physical and psychological morbidities

We will present novel narratives in describing:

1. 1. Standards and principles

2. 2. Pharmacology

3. 3. Delivery systems

4. 4. Neuroscience based interventions

5. 5. Systems and implementation

The above desscriptors will allow a landscape that is less stigmatising and better in responding to the needs of the people who are highly stigmatised and multidisdvantaged.

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The Contrast Avoidance Model (CAM) was developed to explain pathological worry in generalized anxiety disorder (GAD). The CAM posits that those with GAD are sensitive to sharp increases in emotions, and use worry to maintain heightened states of negative arousal to avoid these emotional shifts. Research has widely supported the CAM in the conceptualization of GAD, and has extended these findings to other disorders, including major depressive disorder (MDD) and social anxiety disorder (SAD). Despite the utility of the CAM model in informing the etiology of these conditions, research has yet to expand these findings beyond GAD, MDD, and SAD. Specifically, obsessive-compulsive disorder (OCD), which co-occurs with GAD, MDD, and SAD in adults at a rate of 15.0%, 40.7%, and 14.7%, respectively, and shares many of their etiological features, has yet to examined in the context of the CAM. Thus, examining CA as a relevant mechanism and therapeutic target for OCD is an unstudied conceptual framework that may offer meaningful clinical utility.

The present study used receiver operator curve (ROC) analyses to examine the predictive utility of the CAQ-W and CAQ-GE in detecting probable OCD in a large undergraduate sample. We hypothesized that the CAQ-W and CAQ-GE would be higher in participants with probable OCD and would offer sufficient sensitivity and specificity in predicting probable OCD.

1259 undergraduates were recruited for a mass University screening. Participants were included in the OCD group (N = 291) if they met diagnostic criteria for OCD (DOCS total score > 20). Participants were included in the nondisordered group (n = 249) if they did not meet diagnostic criteria for any of the screened disorders (SAD, MDD, GAD, OCD, panic disorder, post-traumatic stress disorder, OCD, borderline personality disorder), denied suicidality, and denied receiving mental health treatment in the last 12 months. ROC analyses were used to examine the accuracy of the CAQ-W and the CAQ-GE in detecting probable OCD.

Results of ROC analyses are reported in Table 1. AUC values for the CAQ-W and CAQ-GE were significantly different from the null hypothesis (AUC = .50, p < .001), and demonstrated excellent (.89) to outstanding (.91) accuracy in predicting probable OCD (Figure 1), respectively. Optimal sensitivity and specificity to detect probable OCD (Table 2) was achieved at a cut off score of 67.5 for the CAQ-W (Sensitivity = 81.4%; Specificity = 82.3%) and a cutoff score of 43.5 for the CAQ-GE (Sensitivity = 84.9%; Specificity = 85.5%).

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Results suggest that OCD can be accurately characterized by CA. Findings also highlight the utility of examining CA as a relevant maintenance factor for OCD symptoms. Future research should examine the impact of CA on OCD symptoms in-laboratory and ecological settings.

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Research indicates that psychopathy can hinder treatment success and can lead to dropout. Impulsivity is a complex construct that overlaps with psychopathic personality traits and is often targeted in forensic psychotherapy due to its relation to the risk of reoffending.

Our aim was to investigate the overlap between psychopathy and impulsivity and the influence of psychopathic traits on change in impulsivity.

We conducted a pre-post-study for measures of psychopathy and impulsivity in men imprisoned for sexual and non-sexual violent offenses. All participants took part in standardized pre- and post-treatment ratings shortly after admission as well as after an average of 19 months (n=370 for pre-rating, n=168 for post-rating). Psychopathy was measured via the PCL-R, impulsivity with the BIS-15.

We calculated two-tailed Pearson correlations for BIS-15 Pre-, Post-, and Change Scores and the PCL-R. In a second step, the BIS-15 pre-post-differences were compared using independent t-Tests, effect sizes were calculated using Cohen’s d (small, medium, and large effect sizes are d = .20, .50, and .80). Further, unpaired t-tests were carried out to compare between participants with lower and higher PCL-R sum scores (median split, mdn= 15.8, M=15.5, SD=7.9).

In the total population a significant reduction of self assessed impuslivity can be demonstrated for total impulsivity (p<.001, cohens d= .34) nonplanned (p<.001, cohens d= .39) and motor impulsivity (p=.004, cohens d= .23). In both groups, with higher and lower psychopathic traits, a significant reduction in total  and nonplannend impulsivity can be seen.

While the reduction in total impulsivity was 0.9 points higher in the group with higher psychopathy, the difference was not significant, t(147.8)= -1.1, p = .285. Also, the nonplanned impulsivity was showed a stronger reduction in the high PCL group, though the effect was not significant, t, t(166)= -1.2, p = .243.Table 1.

Correlationen between BIS-15 post-ratings and PCL-R

We demonstrate a significant correlation between psychopathy and impulsivity, especially regarding facets 3 and 4, but also for the sum score. Neither the PCL-R sum core, nor the facets correlate with the change in impulsivity during treatment progress in the STU. In both groups, with higher and lower psychopathy, impulsivity was reduced during therapy but there was no significant difference in the change scores. Our results underline that treatment progress can be achieved also in patients with higher psychopathic traits.

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Today, the most vulnerable group of Ukrainians are children. Their physical and mental health has been tested since 2020, from COVID-19 to 2022, the start of a full-scale-russia’s war against Ukraine. The children of Ukraine were the first to feel the changes, since a complete change in life and the principles of acquiring primary adaptive skills of social interaction were distorted by COVID-19. Subsequently, new challenges in the form of war deformed the idea of life, happiness and the future.

Studying the level of adaptation potential in children and adolescents living in the front-line zone in Ukraine.

The examination included the use of clinical-psychological, psychodiagnostic and psychometric research methods.

The study in 2021 involved 217 children and adolescents with signs of maladjustment. In 2022, 378 children and adolescents with signs of maladjustment, of which 285 children are still in the frontline zone of Ukraine, 93 children, at the time of 2022, were taken abroad and returned to Kharkov in 2023.

During the initial analysis of the results, it was revealed that children with low adaptive resources are more susceptible to showing signs of maladjustment. One of the main factors of an adaptation resource is interaction with others (direct communication). It was this criterion that became the primary frustrating factor for children in the first months of the war. External isolation has led to a lack of communication between children and everyone in Ukraine, who during COVID-19 have adapted to a way of communicating while staying at home in physical isolation. War is a powerful independent psychogenic factor for the formation of maladaptation, but in today’s realities it has also become an additional trigger for a previous psychogenic event in the life of Ukrainians.

Parents, for their part, note a sharp deterioration in the well-being of their children, frequent complaints of headaches (89.4%), overwork, aggressiveness (81,5%), closed-mindedness (78,6%), health complaints (74,5%), which is why they have to often consult a doctor and endlessly carry out diagnostics in search of reasons for deterioration (72,3%), weight loss (64,5%). The data indicate the frustration of being in the front-line zone, which aggravates mental health and triggers the process of disruption of adaptation and mental health of children and adolescents.

The study is aimed at developing a psychorehabilitation program for children and adolescents with a low level of adaptive resource.

None Declared

It is known that many psychopharmacological drugs have anti-inflammatory, as well as antibacterial and antiviral effects.

To investigate the association between the severity and duration criteria of COVID-19 with psychopharmacotherapy in double-diagnosed patients.

A total of 169 case histories from a specialized infectious psychiatric department (May 2020 to January 2021) were evaluated. Progression indicators of severe and mild COVID-19, along with the duration of persistent SARS-CoV-2 viral shedding, were assessed in correlation with the administration of antidepressants, antipsychotics, and acid sphingomyelinase inhibitors (FIASMA-active drugs).

The use of any psychotropic agents was associated with a 0.9% increase in the risk of severe course of COVID-19 for each unit increase in the systemic inflammation index PLR, specifically in patients with intellectual disability (ICD-10 codes F70-79), when compared to patients with schizophrenia (ICD-10 codes F20-29): R²McF=0.138; AIC=181; χ²=25.8; df=9; p=0.002. High PLR values and the use of FIASMA-active drugs were associated with prolonged COVID-19 duration, while antidepressant therapy and elevated C-reactive protein levels were associated with a reduced predicted duration of viral shedding in 13.8% of variance: R²=0.0864; AIC=1299; F=5.2(3), p=0.002. Including the nosology of psychiatric disorders in the regression model increased the proportion of explained variance to 22.8%.

Thymoanaleptic therapy for individuals with psychiatric disorders may act as a protective factor against COVID-19. There is no evidence suggesting adverse effects of antipsychotics on the severity and duration of COVID-19. Further research is necessary to investigate the effects of FIASMA-active psychopharmacological agents within nosologically homogeneous groups.

None Declared

Suicidal behaviors are frequently observed among patients with substance use disorder, including suicidal ideation (SI) (1). Alcohol use disorder (AUD) is one of the most prevalent addictions and may be related to suicidal behaviors (2,3). However, the association between AUD and SI requires a deeper analysis which includes several clinical features observed among AUD patients.

To analyze the clinical characteristics and features associated with lifetime SI among patients who had AUD.

This is a cross-sectional study performed in an outpatient center for addiction treatment in patients seeking treatment who met the criteria for AUD between 01/01/2010 and 12/31/2021. Patients were evaluated with an ad-hoc questionnaire and the European addiction severity index (EuropASI). SI was evaluated by using the item for SI in EuropASI.

From a potential sample of n=3729 patients, only n=1082 (73.8% males; mean age 42.82±12.51) met inclusion criteria and had data for the current analysis. Lifetime SI was present in 50.9% of the AUD patients. Several clinical features were related to SI, including: sex differences, any type of lifetime abuse, polyconsumption, benzodiazepine use disorder, any psychiatric diagnosis aside of SUD, and higher addiction severity according to the EuropASI (See table)

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SI among AUD patients is related to several clinical features which indicate a higher addiction severity, more polyconsumption, and a higher prevalence of psychiatric comorbidities. These findings may contribute to the understanding of suicidal behaviors in AUD patients but it is required further investigations, including longitudinal studies.

REFERENCES

1. Rodríguez-Cintas L, et al. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res. 2018;262:440-445. doi:10.1016/j.psychres.2017.09.02

2. MacKillop J, et al. Hazardous drinking and alcohol use disorders. Nat Rev Dis Primers. 2022;8(1):80. doi:10.1038/s41572-022-00406-1 3. Darvishi N, et al. Alcohol-related risk of suicidal ideation, suicide attempt, and completed suicide: a meta-analysis [published correction appears in PLoS One. 2020;15(10):e0241874]. PLoS One. 2015;10(5):e0126870. doi:10.1371/journal.pone.0126870

R. Palma-Alvarez Speakers bureau of: RFPA has received speaker honorariums from Angelini, Cassen Recordati, Exeltis, Lundbeck, MSD, Rubió, Servier, and Takeda., A. Rios-Landeo: None Declared, G. Ortega-Hernandez Speakers bureau of: GOH has received speaker honorariums from Rubió., E. Ros-Cucurull Speakers bureau of: ERC has received speaker honorariums from Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Lilly, Servier, Rovi, Juste., C. Daigre: None Declared, M. Perea-Ortueta: None Declared, L. Grau-Lopez Speakers bureau of: LGL has received fees to give talks for Janssen-Cilag, Lundbeck, Servier, Otsuka, and Pfizer., J. Ramos-Quiroga Speakers bureau of: JARQ has been on the speakers’ bureau and/or acted as consultant for Janssen-Cilag, Novartis, Shire, Takeda, Bial, Shionogi, Sincrolab, Novartis, BMS, Medice, Rubió, Uriach and Raffo.

The COVID-19 pandemic involved stringent social restrictions, a surge in mortality, and significant economic consequences, affecting age groups differently and leading to increases in loneliness and mental health problems, particularly depression, which was already very common before the pandemic.

Analyse changes and related factors of the relationship between loneliness and depression by age group from (1) before to the COVID-19 outbreak, (2) during the pandemic, and (3) after the last state of emergency. Moreover, we aim to (4) evaluate the effect of social support to alleviate feelings of loneliness and improve the course of depression.

We used data from three different cohorts, all representative of the Spanish adult population. (1) We longitudinally analysed the association between loneliness and depression with a sample interviewed before (N = 1,880) and during (N = 1,103) the pandemic. We used mixed-models to study changes in major depressive disorder (MDD) by age group and regression models to quantify the association between age and potential mediating effects. (2) We analysed data of 2,000 adults during the pandemic. Several regression models were constructed to assess the impact of pre-pandemic mental disorders on the main association by age group. (3) Out of those 2,000 participants, 1,300 were interviewed 9 months later, to determine group-based loneliness trajectories and its associated risk factors. (4) We analysed the relationship between loneliness, social support, and MDD over a 7-year period (N=404 individuals aged 50+ having MDD). We tested cross‐lagged panel models using structural equation modelling.

During the pandemic the probability of having MDD increased significantly among younger individuals, and was partly explained by loneliness, low resilience, and worsened economic situation. Loneliness was associated with more depressive symptoms, and this association was stronger in younger adults without pre-pandemic mental disorders and in older adults with them. At the end of pandemic, three courses of loneliness were detected: invariant low loneliness (42.6%), decreasing medium loneliness (51.5%), and fairly invariant high loneliness (5.9%). Risk factors for worse trajectories were being younger, female, not married, and, notably, having pre-pandemic mental disorders. Among individuals with depression prior to the pandemic, lower social support predicted higher subsequent levels of loneliness, resulting in an increase in MDD recurrence.

Strategies to decrease the impact of loneliness on depressive symptoms should consider individuals mental health background, address social determinants, and adopt an age-driven perspective.

None Declared

In recent years, overweight and obesity have reached an alarmingly high incidence and prevalence worldwide; they have also been steadily increasing in military populations. Military personnel as an occupational group are often exposed to stressful and harmful environments that represent a risk factor for disordered eating with major repercussions on both physical and mental health.

This study aims to explore the effectiveness of weight loss interventions and to assess the significance of current obesity treatments for military populations.

Three online databases (PubMed, PsycInfo, and Web of Science) were screened to identify randomized controlled trials (RCTs) aiming to treat obesity in active-duty military personnel and veterans. Random-effects meta-analyses were conducted for body weight (BW) and body mass index (BMI) values, both longitudinally comparing treatment group from pre-to-post intervention, and cross-sectionally comparing the treatment group to controls at the end of the intervention.

A total of 21 studies were included: 16 cross-sectional (BW: n=15; BMI: n=12) and 16 longitudinal (BW: n=15; BMI: n=12) were meta-analyzed, and 5 studies were narratively synthesized. A significant small overall BW and BMI reduction from baseline to post-intervention was observed (BW: g = -0.10; p = 0.015; BMI: g = -0.32; p < 0.001), together with a decreased BMI (g = -0.16; p = 0.001) and nominally lower BW (g = -0.08; p = 0.178) in the intervention group compared to controls at post-intervention time-point. When conducting additional meta-analyses dividing by sample type, a significant decrease in both BMI (g= -0.35; p< 0.001) and BW (g= -0.12; p= 0.041) from pre-to-post intervention was observed in active-duty military personnel but not for veterans.Recommendations for clinical practice have been outlined from the findings of this study and summarized in Figure 1.

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Despite limitations, such as the heterogeneity across the included interventions and the follow-up duration, our findings highlight how current weight loss interventions are effective in term of BW and BMI reductions in military populations, and how a comprehensive approach with multiple therapeutic goals should be taken during the intervention.

None Declared

Psychiatric pathologies are more common in people with epilepsy than in the general population and have a negative impact on the quality of life of these patients.

The objective of this work is to illustrate, through a series of cases, the complex relationship between epilepsy and psychiatric pathologies.

We report the cases of four patients with different psychiatric pathologies associated with epilepsy admitted to the psychiatry department of Hedi Chaker Sfax. We collected the clinical characteristics of these patients based on their medical files.

The patients were aged 64, 45, 38 and 26 respectively. The first patient had a late-onset vascular epilepsy following the psychiatric pathology onset by 20 years. In the remaining cases epilepsy onset preceded the psychiatric pathology by 6, 3 and 1 year respectively. The aetiology of epilepsy was juvenile myoclonic epilepsy, and idiopathic in 2 cases. The psychiatric pathologies were schizophrenia, obsessive compulsive disorder with schizoid personality, schizoaffective disorder in the bipolar type and mild intellectual disability with histrionic personality, respectively. Familial history of psychiatric disorders was found 2 patients and of epilepsy in one.

Epilepsy and psychosis have a complex and bidirectional relation. Not only are patients with epilepsy at a greater risk of developing a psychotic disorder, but patients with a primary psychotic disorder are also at greater risk of developing epilepsy. The fact that the association between these pathologies is more frequent than expected should prompt more in-depth studies concerning the underlying etiopathogenic mechanisms to improve their management.

None Declared

During the past 2 decades there has been intense interest in the clinical significance of the concurrence of manic symptoms in depressed patients. DSM-5 introduced a mixed features specifier for both bipolar depression and major depressive disorder. Studies of the DSM-5 mixed features specifier have generally found a low prevalence of mixed depression. One approach towards increasing the sensitivity of the DSM-5 mixed features criteria is to lower the classification threshold.

In the present study we examine the impact of lowering the DSM-5 diagnostic threshold from 3 to 2 criteria on the prevalence and validity of the DSM-5 mixed features specifier for depression.

Four hundred fifty-nine psychiatric patients in a depressive episode were interviewed by a trained diagnostic rater who administered semi-structured interviews including the DSM-5 Mixed Features Specifier Interview. The patients were rated on clinician rating scales of depression, anxiety and irritability, and measures of psychosocial functioning, suicidality, and family history of bipolar disorder.

If the DSM-5 diagnostic threshold is lowered from 3 to 2 symptoms, then the prevalence of mixed features based on the DSM-5 majority of episode time frame tripled from 3.9% to 13.1% (n=60). Based on a past week time frame prevalence more than doubled from 9.4% to 22.9% (n=105) going from the 2 and 3 symptom threshold, respectively. There was no difference between the patients with 2 mixed features and patients with 0 or 1 mixed features on family history of bipolar disorder, psychosocial impairment, presence of comorbid disorders, age of onset, history of suicide attempts or psychiatric hospitalization.

The results of the present study do not support lowering the DSM-5-TR diagnostic threshold for the mixed features specifier in depressed patients from 3 to 2.

None Declared

The European Journal of Psychiatric Trainees was founded in 2022 as the official journal of the European Federation of Psychiatric Trainees (EFPT) to offer a peer-reviewed open-access scientific journal with minimal article processing charges. The journal is edited by trainees and early career psychiatrists and published its first issue in July 2023. The journal aims to facilitate publishing experience and opportunities for trainees. To reflect the global identity and inclusivity of psychiatric research, the journal changed its name in 2023 to become the International Journal of Psychiatric Trainees.

To present the International Journal of Psychiatric Trainees, the successor of the European Journal of Psychiatric Trainees, and other practical aspects related to the article submission.

We will reflect on the International Journal of Psychiatric Trainees, focusing on what this name change will imply for the journal’s scope, mission and readership.

Due to training programmes’ requirements or out of interest, psychiatric trainees are encouraged to conduct scientific research. However, several known barriers to scientific publishing exist, ranging from a lack of mentorship and supervision to limited scientific support. Like the European Journal of Psychiatric Trainees, the International Journal of Psychiatric Trainees continues to be an open-access, double-blind peer-reviewed journal with minimal/no publication fees that publishes original and innovative research as well as clinical, theory, perspective, and policy articles and reviews in the field of psychiatric training, psychiatry, and mental health.

Since the difficulties and needs in creating research output are not exclusive to European trainees, the journal will become more attractive to readers and authors from other countries while increasing the diversity of articles.

The first International Journal of Psychiatric Trainees issue will be dedicated to the 31st EFPT Forum with the theme “Trainee Mental Health”, containing articles reporting on the projects from National Psychiatric Trainee Associations looking into trainee mental health. Submissions for the regular edition remain open, and articles should be submitted through the manuscript submission platform (https://ijpt.scholasticahq.com)

The International Journal of Psychiatric Trainees aims to be an educative scientific journal for psychiatric trainees and other psychiatry and mental health researchers. The name change and its increased openness will help the authors reach a wider readership while the journal can feature a more comprehensive record of psychiatric research through its global scope.

None Declared

The digital age has transformed mental health support in Tunisia. This study explores how individuals seek assistance for mental health concerns online, considering their comfort levels, preferences, and decision-making factors.

This study aims to: Investigate the comfort levels of Tunisians when discussing mental health concerns online Identify preferred online sources for mental health support Explore factors influencing the choice between online sources and mental health professionals

To unearth these insights, an exhaustive online survey was meticulously conducted. This survey was posted online on different social media platforms and cast a wide net, drawing responses from an eclectic cross-section of Tunisian society. The survey methodically gathered data on participants’ demographics, their inclinations towards online avenues for seeking assistance, and the multifaceted factors that sway their choices in this digital age.

Intriguingly, the results of this study illuminate several key findings:

Comfort Levels: A striking 47% of respondents expressed their unease about discussing their mental health concerns online. This statistic vividly underscores the intricate interplay between digital platforms and the persistent social stigma surrounding mental health issues.

Preferences for Online Sources: The study notably revealed that mental health apps and online counseling websites are emerging as the favored choices among those seeking support. This underscores the surging significance of digital mental health solutions tailored to individual needs.

Factors Influencing Preferences: An array of factors sways the preference for online sources. Among them, the allure of anonymity, the appeal of convenience, and the perception of limited access to in-person mental health professionals were prevalent. Additionally, financial constraints emerged as a notable consideration in the decision-making process.

Trust in Online Information: In contrast, individuals who leaned toward seeking assistance from mental health professionals stressed the pivotal importance of professional expertise, personalized guidance, and a comprehensive understanding of their concerns. Importantly, 38% expressed reservations about the reliability of online mental health information, underscoring the critical role of trust in the process.

This study sheds light on the nuanced process of seeking mental health assistance in the digital age. It emphasizes the need to address mental health stigma and improve online resource credibility. The findings highlight the importance of comprehensive mental health strategies that integrate digital solutions and traditional professional care, catering to diverse preferences and needs in Tunisia.

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In March 2020, the WHO declared the outbreak of SARS-CoV-2 a pandemic and Ireland went into its first lockdown. The Mental Health Liaison team at Sligo University Hospital operate 8 am to 8 pm, 7 days a week, with out of hours covered by the on-call Psychiatry junior doctors. The service has seen an increase in referrals, many of whom are known to community mental health teams.

We reviewed the numbers and trends of mental health presentations to the Emergency Department at Sligo University Hospital throughout the pandemic, including the patterns of presentations around the implementation of lockdowns.

The Liaison Mental Health Service at Sligo University Hospital gathers data relating to numbers and types of presentation to the service. Data was taken from a pre-existing database of psychiatric presentations to the emergency department at Sligo University Hospital including patient demographics, nature of presenting complaint, time period in which they presented and whether they were previously linked in with a community mental health team in the preceding six months. We also looked at the pattern of ED mental health presentations from March 2019 to August 2021. In order to compare psychiatric presentations pre and during covid, data was broken down into two groups: the twelve months preceding March 2020 and the twelve months from March 2020. Categorical data were analysed using the Chi squared test for homogeneity in SPSS.

Overall, there was a 14% increase in mental health presentations during the pandemic. There was a significantly greater proportion of presentations of psychosis during the pandemic period (p<.014) and for medication review (p=.03) and significantly less presenting with addiction (p <0.001). Of those patients seen in the Emergency Department in 2021, 54.3% were known to the CMHT in the previous 6 months. in 2019, mental health presentations made up 1.36% of total ED attendances. This increased to 1.47% in 2020. From January to August 2021, 2.62% of ED attendances were mental health presentations.

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The Covid-19 pandemic led to increased mental health presentations to Sligo University Hospital emergency department, with a significantly greater proportion presenting with psychosis and for medication review. These findings have implications around patient care and service provision. These results show that the prevalence of mental health has increased during the pandemic, particularly severe and enduring mental illnesses. New strategies must be implemented to accommodate to this increase in presentations.

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