The single-injection start regimen for aripiprazole once-monthly 400 mg (AOM 400) in patients with schizofrenia requires a single intramuscular injection in the gluteal or deltoid site and 14 days of concurrent oral therapy. Based on a population-pharmacokinetic model, the European Medicines Agency and Canada has recently approved a simplified starting strayegy of aripiprazole once a month with single-day regimen of two injections at separate gluteal and deltoid injection sites, together with a single 20 mg dose of oral aripiprazole on the 1st day.

The aim of the study is to evaluate the two injection start (TIS) regimen in inpatients in the Psichiatric Unit (SPDC) of the Hospital of Rimini.

We retrospectively reviewed medical records of patients, from February 2021 to April 2023, that have more than 18 years, who received the newly approved 2-injection start regimen as part of their standard care, evaluating if exist changes in clinical indicators, safety and tolerability of this regimen.

We valuated retrospectively the days of hospitalization after the aripiprazole 400 mg TIS and the number of emergency room access, analyzing the “repository of AUSL della Romagna” and discharge letters and the “CURE” program of the Psychiatric Service of Rimini.

We evaluated 24 patients from February 2021 to April 2023, 11 male (45,8%), 13 female (54,2%); average age 37,95, average lenght of stay in hospital was 11,75 days. 10 patients with diagnosis of psychosis/schizophrenia (41,7%), 6 patients with bipolar disorder (25%), 4 patients with personality disorder (16,6%), 2 patients with substance induced psychosi (8,3%), 1 patients with delusional disorder (4,2%), 1 patient with schizoaffective disorder (4,2%). 6 patients had the two-injection start regimen in 2021 (25%), 13 patients in 2022 (54,2), 5 patients in 2023 (20,8%); 20 patients did not have admission in hospital after the TIS (83,3%), 4 patients had 1 or more admission after the injection (16,7%). 3 patients (12,5%) had accesses in emergency-room after Abilify Maintena. 15 patients (62,5%) continue therapy; 9 patients (37,5%) had suspended the injection for drop-out or because of change of therapy not correlated at adverse effects (1 female patient had suspended treatment after the two-injections due to pregnancy). Just 1 patient that continue Abilify Maintena 400 mg had 2 accesses in the emergency-room.

The coadministration of 2 injections of 400 mg aripiprazole was not associated with safety concerns beyond those expected with a single-injection start regimen. From the study it appears that the long-acting therapy with Alibify Maintena 400 mg once-monthly helps to stabilize the patient to prevent hospitalization and accesses in emergency-room.

None Declared

Digital technologies and interventions (defined as patient-facing or self-administered interventions delivered through a digital platform) have an increasing role in mental health care. It is key to ensure that appropriate patient and public involvement (PPI) is not overlooked when developing new digital mental health interventions (DMHIs). The unique perspective offered by those with lived experience can improve study conduct and design as well as ensure that interventions meet the needs of users, which may improve their quality and acceptability.

To develop guidance for the involvement of people with lived experience of severe mental illness in designing and conducting research on DMHIs.

Four co-production workshops were arranged online with people who have lived experience of severe mental illness. Initial ideas were formulated in the first workshop and were then prioritised in the second workshop using the nominal group technique. The prioritised ideas were then refined in workshops three and four. Minutes were generated from each workshop and were validated by the those who took part. These minutes were analysed using thematic analysis.

Nineteen people with lived experience participated in the co-production workshops overall. Six people took part in one workshop only and 13 took part in multiple workshops. Two main themes were identified in this study: why do people become and remain involved in PPI?; and what areas should be discussed within PPI consultations? Three subthemes associated with the second theme were also identified. These are: areas related to specific types of DMHI; areas related to any type of DMHI; and what can make a difference within DMHIs? To ensure that people become and remain interested in PPI around DMHIs, it is important to provide a non-judgemental space for people with lived experience to discuss any concerns and ensure they feel valued during consultations. Aspects to consider discussing in PPI consultations around the development of DMHIs include the provision of safety and security within DMHIs, issues around digital exclusion and the potential impact of people’s symptoms on DMHI use. Finally, points that were identified as important to consider when developing DMHIs include offering encouragement throughout the DMHI, accommodating for individual and collective needs within DMHIs and developing a structure within the DMHI which includes adding in attainable goals.

If used, the information provided from this study can generate positive and productive PPI consultations where those with lived experience can make significant contributions to the development of DMHIs. Such contributions will increase the acceptability and efficacy of the DMHIs developed.

None Declared

Telepsychiatry has emerged as a transformative force in the field of mental health care, addressing disparities in service delivery and increasing access to care. This exploration focuses on the role of telepsychiatry in achieving equitable mental health care for individuals with intellectual disabilities (ID). Intellectual disabilities affect millions globally, posing significant public health challenges. This vulnerable population encounters numerous barriers in accessing quality mental health care, including geographical isolation, limited transportation options, and a shortage of specialized providers. Telepsychiatry offers a promising solution, leveraging technology to overcome these challenges. The presentation reviews the current landscape of mental health care for individuals with intellectual disabilities and the specific barriers they encounter. It highlights the potential benefits of telepsychiatry, including increased availability of specialized care, reduced geographical barriers, and enhanced caregiver support. Ethical considerations and best practices associated with implementing telepsychiatry in the context of intellectual disabilities are discussed. Case studies and success stories illustrate how telepsychiatry positively impacts individuals with intellectual disabilities and their families. In conclusion, telepsychiatry plays a promising role in promoting equitable mental health care for individuals with intellectual disabilities. Embracing technology and adopting best practices pave the way for a more inclusive and accessible mental health care system, leaving no one behind.

None Declared

Natural disasters are and will continue to represent a great challenge in addressing mental health issues globally. The most devastating recent (earthquakes on 6th February 2023 in Turkey and Syria) caused death of more than 55,000 people, injury of about 100,000 people and loss of property, overall affecting millions of people. Moreover, in the last several years in Europe, they came in a form of double disasters (for example coupled with the COVID-19 pandemic) and pointed out the unpreparedness of the health (including mental health) sectors for the emergency situations.

However, in going through these experiences, we also learnt some of the practices that proved effective – including the fast creation of collaborative networks on a larger scale that also allowed fast spread of good practices and practical organisation of help. As a practical example of it - verbalized by the mental health professionals from Turkey through the Council of National Psychiatric Associations of the European Psychiatric Association, we organized a webinar delivered by experienced clincians, trauma experts and experts with lived experince in the earthquake zones. However, structural -implementation of mental health policies that focus on prevention and improving crisis response in care delivery are important to support populations affected by natural disasters to prevent the trauma sequel.

None Declared

Promoting high quality mental health (MS) services is an obligation of many social agents due to the impact of these diseases on the population. Making care increasingly evidence-based does not depend exclusively on technical training, but also on gradual and functional changes in the structure of an institution. Improving the quality of services in MH is a predominantly social intervention, in which it is necessary to group and interpret complex data. They represent real-time interventions in a real world by teams delivering health services.

Describe the context where the MH service (iNC) is inserted, its main characteristics and purposes.

Mixed study identifying the location, socio-demographic data, characteristics and fundamentals of an organization providing services in MH that proposes to act based on evidence.

iNC is a private secondary care institution located in the city of Blumenau, Vale do Itajaí, state of Santa Catarina, Brazil (FIG 1). Vale do Itajaí is a mesoregion with approximately 1.5 million inhabitants composed of small regions: Blumenau, Itajaí Ituporanga and Rio do Sul. Most of the population is of German and Italian descent. Blumenau has 361,261 inhabitants, an average monthly income of 2.9 minimum wages, 97% of schooling between 6-14 years old and the number of deaths of 6.48 (1000 live births). iNC is located in the center of the city (3-story building) with a clinical staff idealized for 3 psychiatrists, 16 psychologists, 4 nutritionists, 1 nurse, 1 nursing technician and 1 physical educator in face-to-face and online, individual and in-person sessions group. Performs care for adult patients between 18-70 years. Its missions are: to promote MS care from an interdisciplinary perspective, to provide health interventions supported by the best individualized scientific evidence and to encourage teaching and research in the field of MH. Its guiding principles are: psychopathology and nosology (DSM-5 and CID-11), neuroscience and psychopharmacology, mood, anxiety, sleep, eating and obesity disorders (FIG 2), psychological treatments and psychoeducation, assessment instruments in MH and neuropsychology, evidence-based medicine, health promotion and disease prevention.

Identifying, measuring and quantifying a local assistance service in MH can help in its development and allow comparisons over time. The improvement of services depends on multiple factors and is necessary for their development, both for researchers, implementers, health professionals and patients.

None Declared

The mental health consultation and liaison programme plays a crucial role in comprehensive medical care by addressing psychiatric co-morbidities in hospitalised patients.

The aim of this study is to analyse demand and assess referral patterns to the mental health consultation and liaison programme in order to identify areas for improvement and optimise the provision of care.

A descriptive cross-sectional study was conducted by analysing records of referrals to the mental health consultation and liaison programme over a one-year period. Demographic data, origin of demand, type of request, episodic diagnosis, psychiatric diagnoses, follow-up and discharge referral were collected.

A total of 1180 referrals to the mental health consultation and liaison programme were reviewed. Most of the episodic diagnoses were related to anxious-depressive symptomatology, acute stress reaction and acute confusional syndrome. The majority of patients followed up did not require further referral to mental health facilities.

Analysis of the demand for the mental health consultation and liaison programme helps us to optimise care on psychiatric co-morbidities. These results support the importance of integrated care that addresses both medical and psychiatric aspects of inpatient health. Strategies to improve collaboration between different services should be implemented to ensure optimal care and provide a holistic approach.

None Declared

Breast cancer is the most common type of cancer and the leading cause of death from malignant neoplasms in women in Russia and in most countries in the world (Lima et al. EClinicalMedicine 2021; 38 100985). According to an analysis of the incidence and mortality from 36 cancers in 185 countries (Sung et al. CA Cancer J Clin 2021. 3 209-249) in 2020, 2261419 new cases of breast cancer were identified in the world in both sexes, which is accounted for 11.7% of the total cancer incidence. Mortality from breast cancer in 2020 amounted to 684996 cases. Patients with comorbid depression and anxiety disorders experience more severe symptoms, have longer recovery time, use more healthcare resources and have poorer outcome compare to those with cancer alone (Katon et al. Gen Hosp Psychiatry 2007; 2 147-155).

Analytical review of data on the impact of depressive spectrum disorders as comorbid conditions on the survival of breast cancer patients and their quality of life.

The following databases were searched for publications: PubMed, Embase, CINAHL, PsycINFO, Scopus, Science Citation Index/Social Sciences Citation Index, Cochrane Evidence Based Medicine database. The searches were limited to English language and studies with more than 100 subjects with diagnosed breast cancer where this information was mentioned. The analyzed period is between 1977 and 2018.

The reported prevalence of depression in breast cancer patients, according to researches, varies 4,5 to 38%. In patients with I-III stage breast cancer depression increased hazards of all-cause mortality by 50% compared to non-depressed patients. Stage-specific analyses demonstrated a 2–2.5 fold increase in breast cancer-specific and all-cause mortality in patients with stage I and II disease (Vodermaier et al. Breast Cancer Res Treat 2014; 2 373-384.). Women with non-metastatic breast cancer who report mild to moderate depressive symptoms in the weeks after surgery have approximately 2.5 times greater risk of death 8–15 years later than women who report little or no depressive symptoms post-surgery (Antoni et al. Gen Hosp Psychiatry 2017; 44 16-21). Depression in advanced cancer not only reduces quality of life but is also an independent predictor of poorer survival (Lloyd-Williams et al. J Affect Disord 2009; 113 127-132.).

Depression and anxiety both have adverse effects on recurrence and all-cause mortality in patients with breast cancer. Untreated depression leads to significant increase in incidence and mortality. Depression can debut at any stage of cancer, including the stage of diagnosis. It proves the necessity for affective disorders screening in patients with cancer on the stage of diagnosis. Patients with diagnosed affective disorders should be observed not only by oncologist, but also by a psychotherapist in order to receive the necessary treatment to improve the quality of life and reduce the risk of mortality.

None Declared

Despite improvements and innovation in recent years, people living with schizophrenia face variations in access to optimal treatment and care. There is a lot about schizophrenia that is not fully understood, and the high-quality care and support needed by people living with this condition is often unavailable.

Develop an evidence-based, compelling policy narrative on schizophrenia Engage a pan-European, multidisciplinary group of experts Offer concrete tools to patient and professional advocacy groups Disseminate findings Draw from our findings practical solutions on how to implement recommendations

Based on carefully selected existing literature and available resources, literature review includes but is not limited to: Value of Treatment Recommendations, Global Burden of Disease Study, Comprehensive Mental Health Action Plan, Mental Health Atlas. The aim is to establish state of play, identify problems and solutions and take stock of current recommendations.

We established a multi-disciplinary working group to lead the project, and ensured that representation on this group is cross-disciplinary and cross-sector. The expert group includes country-level patient advocates and clinical leads including key opinion leaders (KOLs) to keep the project focused on what is happening at a national level, and to help create ownership at the national level to take recommendations forward within each country.

We conducted qualitative semi-structured interviews with people living with schizophrenia where they provided their insights into how to rethink the way we deal with schizophrenia.

Provide clear, concrete and adaptable solutions Joint ownership by key stakeholder groups of a common policy narrative on schizophrenia Sustained policy engagement on schizophrenia at the EU and national level

There is a clear need to rethink the management of schizophrenia and redesign the care pathways to ensure optimal treatment and care for all people living with schizophrenia in Europe. Based around patient testimonies, the aim of the session is to highlight the need to optimise the way we manage schizophrenia by building a strong, coherent, evidence-based policy narrative which speaks to the current priorities in schizophrenia and draws from the current policy landscape in Europe.

Experts involved in the Rethinking Schizophrenia project, coordinated by the European Brain Council, have explored the ways in which we can and need to change the way we deal with schizophrenia. The Rethinking Schizophrenia project falls under the Rethinking the management of brain disorders series, research-driven projects offering policy recommendations to make tangible changes with the aim to improve the lives of people living with brain disorders, neurological and mental alike, across Europe.

None Declared

The nine-item Patient Health Questionnaire-9 (PHQ-9) is the first choice for screening for depression in primary care and other medical settings. The PHQ-9 has been shown to be a reliable and valid measure of depression symptoms, but there is disagreement among researchers about the factor structure of this questionnaire. Recent systematic reviews have found four different factor models of the PHQ-9, with one- and two-factor models being the most common. This discrepancy may be due to linguistic, cultural and clinical differences between the populations studied. The factor structure of the Russian version of the PHQ-9 during the COVID-19 pandemic has not been examined in any study to date.

The aim of our study was to determine the factorial structure and internal consistency of the Russian version of the PHQ-9 in COVID-19 survivors.

Fourteen thousand 725 (female - 11479 (78.0%), age - 18-79 years (M - 47.09, SD - 12.70) participants completed an online survey including the PHQ-9 and an ad hoc questionnaire focusing on sociodemographic and COVID-related characteristics. McDonald’s omega coefficient was estimated to determine the internal consistency of the questionnaire. Exploratory structural equation modelling (ESEM) with weighted least squares mean and variance adjusted estimator and geomin rotation was performed in Mplus 7.

ESEM provided evidence for a three-factor structure of the PHQ-9, representing affective (items 2, 6, 9), anergic (items 1, 3) and somatic (items 3, 5, 7, 8) dimensions of depression. These factors fit the data well (CFI - 0.998; TLI - 0.994; RMSEA (95% CI) - 0.028 (0.024 - 0.032)), better than a single factor (CFI - 0. 955; TLI - 0. 940; RMSEA (95% CI) - 0.089 (0.087 - 0.092)) and two-factor (CFI - 0.985; TLI - 0.971; RMSEA (95% CI) - 0.062 (0.059 - 0.065)). The McDonald’s omega was 0.82.

Our study revealed a three-factor structure of the Russian version of the PHQ-9 in COVID-19 survivors. COVID-19. A high internal consistency of the Russian version of the instrument was confirmed.

None Declared

SARS-CoV virus showed transneuronal penetration through the olfactory bulb resulting in the rapid intracranial spread. So, olfactory dysfunction is an early marker of COVID-19 infection. However, individuals may develop chronic olfactory impairment for more than six months in 1–10% of cases.

The study’s objective was to evaluate the efficacy and safety of intranasal immunotherapy using bioactive substances produced by M2 macrophages for the treatment of people with long-term post-COVID-19 hyposmia.

Seven individuals with long-term persistent hyposmia (7 to 24 months), associated with PCR-confirmed coronavirus infection were evaluated for olfactory function at baseline, one, and six to twelve months after therapy.

The intranasal inhalation of M2 macrophage conditioned medium (one time per day for 28-30 days) was well tolerated. Furthermore, olfactometry demonstrated that the patients restored their capacity to perceive (Kruskal-Wallis H test 14.123, p = 0.0009) and recognize odors (H = 11.674, p = 0.0029). In addition, the subjective evaluation of smell significantly improved (H = 11.935, p = 0.0026). At the 6- to 12-month follow-up, the majority of patients (5/7) reported extremely high levels of satisfaction with the outcomes, and the remaining two patients also felt generally positive about the therapy’s success.

Overall, our study showed that the use of intranasal inhalations as a method of delivering bioactive factors and the conditioned medium of M2 macrophages as a therapeutic agent are both safe, well tolerated and, according to preliminary data, clinically effective in the treatment of patients with long-term post-COVID-19 hyposmia.

None Declared

Major Depressive Disorder (MDD) is associated with a high burden of disease and notable economic costs. Standard treatments (e.g. medication or cognitive therapy) have been shown to be effective, but some patients remain unresponsive. With the knowledge that MDD patients have been shown to display an attentional cognitive bias towards negative stimuli, Cognitive Bias Modification (CBM)-training to focus attention on positive information is thought to improve emotional processing and depressive symptoms. Some studies imply reduced duration and occurrence of microstate D in MDD compared to healthy controls. However, the effect of CBM on microstates is still unclear.

(1) To replicate previous findings that duration and occurrence of microstate D is reduced in patients with MDD compared to healthy controls in an independent sample and (2) to investigate the effect of an active CBM-training versus a control-training on microstates and its association with symptom improvements.

Thirty patients receiving outpatient treatment with MDD according to DSM V (aged 18-60) will be recruited in Essen and Aachen. The control group will consist of 30 healthy age-and-sex-matched participants. Psychological testing will be administered and all participants will be randomized to either an active or a control training. During the next visit, resting state EEG and a GoNoGo Task with positive, neutral and negative pictures will be measured. The participants will take a tablet home to undergo 10 sessions of CBM within 14 days. The training will be consisted of a dot-probe-task. In the active condition the probe will be more likely to appear behind a positive versus a neutral picture, while appearing randomly in the control condition. After 14 days, a second EEG will be recorded.

Differences in duration and occurrence of microstate D between patients and healthy controls will be analyzed by conducting ANCOVAs with age and sex as covariates. ANCOVAs for repeated measurements will be calculated to study effects of time (pre- vs. post-training) and group (patients vs. healthy controls in active training; patients in active vs. patients in control-training), on duration and occurrence of microstate D.

CBM-training is proposed to be an effective treatment option for MDD patients, reflected in a reduced topographical bias of microstate D in EEG.

None Declared

Pregnancy and postpartum is an important life event associated with profound physiognomic and psychosocial changes affecting the female body in all its physiological, psychic and affective reality. It might influence the sexual function in expectant mothers.

To investigate the relationship between the body satisfaction and perception and the sexual function among pregnant and postpartum women.

It was a cross-sectional study established over a period of 3 months from the June 1st, 2023 to August 31, 2023. This study focused on a population of pregnant and postpartum women recruited from outpatient consultations and inpatient of the obstetric gynecology department at the university hospital of Gabes. We used a pre-established sheet exploring socio-demographic data, medical and gyneco-obstetric history, the body mass index (BMI) and informations concerning the marital relationship and the woman’s sexual activity. We administered the validated Arabic version of the Arizona Sexual Experiences Scale (ASEX) to assess sexual functioning and we used the body satisfaction and global self-perception questionnaire (QSCPGS) to explore the body satisfaction and perception.

Fifty-eight women were included. The average age was 35.6±5.5 years; they were from an urban origin in 75%. They were pregnant in the first, second and third trimester in (15.6%, 15.6% and 25% respectively). They were in postpartum in 43.8% of cases with a cesarean delivery in 73.3% and breastfeeding in 56%. All women reported being on good terms with their spouses and satisfied with their sexuality. The usual frequency of sexual relations was (1/day: 22.6%, 1/week: 74.2%, 1/month: 3.2%) and 25% reported wanting to reduce the frequency. The mean ASEX score was 13 ± 4.3 and 47% of the sample had sexual dysfunction. For the total score of the QSCPGS, we observe a mean value of 33 ±28.3, which means that our sample has a good level of positive body satisfaction and self-perception. The mean value of the “body satisfaction” factor is higher (23.7 ± 10.4) than the mean value of the “self-perception” factor (11.4 ± 14.3). The mean value of BMI was 28.74 ± 4.4 wich means an overweigh. We found a significant association between the “body satisfaction” factor and the sexual dysfunction (p=0.03), insufficient lubrication (p=0.01) and difficulty reaching orgasm (p=0.001).

We found that body and physical changes among pregnant and postpartum women can negatively affects their body perception and it might deteriorate its global sexual function. Further researches are recommended to study other potential factors affecting sexual function during this period.

None Declared

The COVID-19 pandemic has had an impact on the mental health of the population that, to some extent, may be due to the neurotropism of SARS-CoV-2. However, evidence is extremely sparse on the prospective association between serological evidence of COVID-19 infection and psychological distress.

We aimed to explore the prospective association between seropositivity and psychological distress – assessed by symptoms of depression, anxiety and stress – in the general adult population in southern Switzerland. Further, we investigated whether this association varied over time and between pandemic waves.

We used data from 305 adults who participated in the Corona Immunitas Ticino (CIT) prospective sero-survey cohort study. We tested the association between serologically confirmed SARS-COV-2 infection at baseline (June–December 2020) and depression, anxiety and stress scores as measured by the DASS-21 scale at three time points between December 2020 and March 2021, also taking into account for sociodemographic characteristics (age, gender, education level, presence of chronic diseases, smoking, obesity).

In our sample, 84.3% (mean age of 51.30, SD= ± .93) were never infected. Seropositive participants were significantly younger on average (M=46.90, SD= ±2.00, P= .04). At the first follow-up (see Table 1), seropositive participants had higher rates of mild conditions for depression (OR= .64; P= .014) and anxiety (OR= .50; P= .030), than seronegatives. Overall, after the 6-month follow-up, seropositive participants had significantly lower rates of mild conditions for DASS-21 subscales. In addition, prevalence of mild conditions for depression, anxiety and stress decreased more rapidly over time among infected vs. never infected (see Figure 1). Older age and the presence of chronic diseases were associated with mild anxiety (OR= .97; P= .013; OR=3.47; P= .001) and stress (OR= .96; P= .003; OR= 2.56; P= .010).Table 1.

Associations (Odds Ratios) between seropositive immunological status and mental health between December 2020 and March 2021 in Ticino, southern Switzerland (N=305)

Our results provide new evidence on the association between COVID-19 seropositivity and poor mental health and underline the public health implications of the pandemic because the number of infected individuals largely exceed the 770 million of recorded COVID-19 (symptomatic) cases.

None Declared

Depression is a major cause of disability world-wide. Up to a third of patients have a treatment-resistant form (TRD), presenting a major challenge. Ketamine has been introduced as a novel rapid-acting antidepressant effective in this population. However, at present, ketamine treatment is not routinely informed by any objective neural markers. Basic research has shown promising electroencephalogram (EEG) changes including a decrease in alpha power. However, clinical translation is lacking.

Assess the feasibility of identifying EEG correlates of ketamine infusions in a routine outpatient setting with a low-cost, easily usable system.

The study was carried out at the Oxford Health Foundation Trust Ketamine Clinic (ethics reference 22/EM/0226). N=18 EEG recordings from N=12 patients were collected (5 women, mean age 44, range 33-62, IV dose 0.5-1mg/kg over 40min). 4-channel EEG was collected with a Muse-S headband at 256Hz, from 5min before to 55min after infusion start. 5s epochs were rejected if gyroscope data indicated head movement above 10 deg/s or if amplitude was above 200μV. A spectrogram (4s window, 3s overlap) as well as band-limited power (theta: 4-8Hz, alpha: 8-13Hz, beta: 13-25Hz) were computed. Significance of changes was found with a repeated measures analysis of variance (RM-ANOVA) on power in 5min segments together with post-hoc Tukey’s P-values.

Across the ketamine infusion recordings, there was a significant effect of time (F=3.65, P=0.0105) and Channel*Time interaction (F=3.80, P<0.001) on the EEG spectrum. Effects were largest on temporal electrodes, particularly TP9 in the alpha and theta bands (Figure 1, Table 1).Table 1:

Effect sizes (Cohen’s d) and FDR-corrected ANOVA P-values for ketamine effects on each EEG channel and frequency band. P<0.05 was considered significant (bold). n.s. = not significant (P>0.2).

Image:

In a routine outpatient setting, sub-anaesthetic ketamine infusions in TRD patients were associated with decreased fronto-temporal EEG alpha and theta power. Future work should assess the potential of low-cost routine EEG, and alpha desaturation specifically, to inform individualised ketamine treatment.

None Declared

Fat plays an important role in brain function; 60% of the brain’s dry weight is fat. Among fats, omega-3 fatty acids, which are long-chain fatty acids, have been reported to reduce depressive symptoms. On the other hand, there are few studies on short-chain fatty acids (SCFAs), and those that do exist are mostly animal studies, with only a few human studies (about 100 cases). This is the first study to examine the association between fecal short-chain fatty acids and depressive symptoms on a large scale in the general population.

We examined the association of fecal SCFAs with depressive symptoms. In addition, we analyzed the associations stratified by age and examined differences in the associations.

This study was conducted using data from the Dynamics of Lifestyle and Neighborhood Community on Health Study (DOSANCO Health Study). The target population was all residents of the city of Suttu, Hokkaido, Japan, excluding residents of special nursing homes (n=2638). 579 individuals (22% of the target population) aged 18 years and older who were able to measure fecal SCFA participated in this study with written informed consent. Approval was obtained from the Ethics Committee of Hokkaido University School of Medicine (15-002 and 15-045). Fecal SCFA was measured by high-performance liquid chromatography. We examined the association of fecal concentrations of SCFA subtypes (i.e., acetate, butyrate, and propionate) and total SCFA concentrations (mg/g wet weight as a continuous variable) with total Patient Health Questionnaire-9 (PHQ-9) scores using multiple regression analysis. We adjusted for age, sex, habitual exercise, total energy intake, and total dietary fiber intake. We performed additional multiple regression analyses with stratification by age group (18-59 years and 60 years or older). Two-tailed tests were used for all analyses with a significance level of P < 0.05.

The mean age (standard deviation) of the study participants (n=534) was 58.3 (16.0) years. Among them, 48% were 18-59 years old and 54% were female. Fecal propionate concentration was significantly associated with total PHQ-9 score (beta=0.62, p<0.01). Other SCFAs and total SCFA were not significantly associated with total PHQ-9 score. In addition, using stratification analyses by age group, the associations between fecal propionate concentration and total PHQ-9 score showed a different trend by age group (beta=0.18, p=0.62 for 18-59 years; beta=0.80, p<0.01 for 60 years or older).

The study showed an association between higher concentrations of fecal propionic acid and higher levels of depressive symptoms. The association was particularly pronounced in older people, those aged 60 years and older. The results suggest that improving dietary habits to reduce fecal propionic acid may be effective in preventing depression in the elderly.

R. Okubo Shareolder of: None, Grant / Research support from: A Grant-in-Aid for Scientific Research from Japan Society for the Promotion of Science (No. 22K17844), Consultant of: None, Employee of: None, Paid Instructor of: None, Speakers bureau of: Speakers bureau from Takeda Pharmaceutical Company Limited, R. Yamamura: None Declared, S. Ishikawa: None Declared, T. Kimura: None Declared, S. Ukawa: None Declared, K. Nakamura: None Declared, A. Tamakoshi: None Declared

Parkinson’s Disease (PD) is a neuropsychiatric disorder whose diagnosis is mainly based on motor impairment. However, increasing evidence suggests that neurodegeneration precedes the appearance of motor disturbances to manifest itself with hyposmia, sleep, and affective disorders. The disease’s insidious onset and comorbidity with psychiatric symptoms require specialized knowledge and delicate pharmacological maneuvers to provide the patient with the best possible treatment at the most precise moment. Studies have also highlighted the potential increase in impulsivity patients may experience upon initiation with levodopa.

Τo raise awareness of the complexity of treating patients with PD that also face psychiatric comorbidities that appeared before the motor symptoms, including preoccupation with death, and highlight the need for intensive interdisciplinary medical follow-up of such patients.

We report a clinical case of a 54-year-old man who was admitted to the psychiatric emergency department after a suicide attempt by self-inflicting severe bilateral neck, wrists, and femoral triangles injuries, as well as self-cutting his Achilles tendon. The patient had a history of a one-year mixed anxiety and depressive disorder and was treated on an outpatient basis with amitriptyline/perphenazine (10+2)mg, sulpiride 50mg, and clonazepam 2mg. One month before his attempt, the patient started experiencing unilateral upper and lower limb rigidity with bradykinesia and “pill-rolling” resting tremor of the same hand and was prescribed levodopa/benserazide (200+50)mg three times per day. After two days of starting the new medication, the patient attempted suicide by the method mentioned above.

After surgical assessment and care, the patient recovered at the psychiatric department for 21 days and was treated with sertraline 50mg, which was later increased to 100mg. As an adjunctive treatment, the patient also received mirtazapine 15mg/day, quetiapine 200mg/day, and lorazepam 3mg/day. On the 15th day of his hospitalization and after a neurological assessment, the patient was started on levodopa/benserazide (200+50)mg one-quarter three times per day. At discharge, he presented significant clinical improvement regarding both his mental health and neurologic somatic symptoms.

Patients with PD require a multidisciplinary approach by a trained medical team. Clinicians should titrate dopamine replacement agents with caution, especially for those experiencing mood disorders, because they might increase the patient’s impulsivity, “assisting” a depressive patient with suicidal ideation to finally commit suicide.

None Declared

In this review, medication incidents accross different mental health care facilities was reviewed and nuances, challenges, and advancements in the administration and management of psychiatric medications was noted. Through gaining a better understanding of the complexities surrounding these incidents, valuable information can be gathered that will enhance patient safety, improving healthcare practices, and fostering a deeper understanding of the critical intersection between mental health care and medication management.

To identify the most frequent types of medication errors or patterns of medication errors in a mental health service accross different settings including inpatient, outpatient, liaison and long term residential unit

This is a multicentre project as it covers medication incidents in mental health care in a regianal area in Ireland. It includes an acute psychiatric Unit, the General Hospital and patients admitted in medical and surgical wards and as well long term residential care. Using the National Incident Management System we collected National Incident Report Forms (NIRF) relating mental health care provided and medication prescribed within a region in Ireland. From these we selected the ones were medication hazard was noted. Data collection happened between July 2020 and July 2021. A statuystical analysis was then performed to identify any patterns to medication errors.

A total of 22 incidents were included. On review of these, it was noted, among other findings, that here was a significant increase in the frequency of medication errors during the month of December. It was also noted errors ranged from medication being given to the wrong patient, medication being given twice and medication being missed.

Minimising medication errors requires a comprehensive, multidisciplinary approach that involves healthcare providers, patients, and healthcare systems. Healthcare organizations should foster a culture of safety where medication errors are seen as preventable and where providers are encouraged to report errors without fear of retaliation.

None Declared

Several studies have called atention to the mental health disorders associated with chemsex -the intentional use of drugs before or during sexual intercourse GBMSM (gay, bisexual and men who have sex with men) population-. Sexualized intravenous drug use is also known as slam or slamsex. There are few studies that analyze the mental health differences between intravenous drug users compared to non-intravenous drug users in chemsex context.

We aim to describe the mental health outcomes including current and past depressive disorders diagnosis in a sample of users with sexualized drug use (chemsex) attended by the non-governmental organization Apoyo Positivo in the program “Sex, Drugs and You” and to compare the differences of current and previous diagnosis of depressive disorders between intravenous drug users compared to non-intravenous drug users.

A cross-sectional descriptive analysis of a sample of users attended by the non-govenrmental organization Apoyo Positivo in the program “Sex, Drugs and You” between 2016-2019 was performed.

We included 217 participants. Current or past diagnosis of depression was found in 137 participants. Depressive disorders were significantly higher in the intravenous drug use group compared to the non-intravenous drug use group (p<0.05).

Our study reports high levels of depression in chemsex users. The participants in our sample who engaged in intravenous drug use presented a higher frequency of depressive disorders than non intravenous drug use participants. Further studies analyzing the relationship between chemsex, slamsex and depresssion are needed. A multidisciplinary team is necessary to address chemsex and provide care and mental health treatment to chemsex users.

None Declared

This section will be destinated to the presentation of specific cases of patients with bipolar disorder admitted to our acute psychiatric ward. For each case, sociodemographic, clinical and environmental characteristics will be described and pharmacological treatment discussed. In addition, predictive and protective factors for mood relapses will be identified, and then, prospective information regarding their clinical prognosis will be provided in order to discuss with the attendees the impact of the mentioned factors on clinical outcomes.

None Declared

Police-officers are in a strategic position of providing the first immediate response to a crisis as mental health frontliners.

In this nation-wide cross-sectional study, we explored knowledge and attitudes towards suicide in the local police force, a crucial first step in the design and implementation of effective suicide prevention programmes.

An online, anonymous questionnaire was distributed to all local police-officers (n=2600). It contained questions about their demographics and their experience with suicide while on duty, along with 34 statements from the validated tool Attitudes Towards Suicide (ATTS) (Renberg & Jacobsson. Suicide Life Threat Behav. 2003; 33 52-64), scored on a 5-point Likert Scale (1 = Strongly Disagree, 5 = Strongly Agree).

The sub-scale “Suicide as a right” was positively correlated with “Tabooing” (r (201) = .25, p=<.001), “Normal-common” (r (201) = .29, p=<.001), and “Resignation” (r (201) = .47, p=<.001), but negatively correlated with “Incomprehensibility” (r (201) = -.26, p=<.001), and “Preparedness to Prevent” (r (201) = -.19, p=<.001), meaning such individuals had a more permissive attitude towards suicide. On the other hand, the subscale Preventability was found to be positively correlated with Incomprehensibility (r (201) = .21, p=<.001) and Preparedness to Prevent (r (201) = .30, p=<.001).

Females scored higher in the sub-scale Non-communication (M=3.40, 95% CI [3.29, 3.51]) while males scored higher in Preventability (M=3.35, 95% CI [3.27, 3.44]). The higher the educational status of police-officers, the more they adopt a pro-prevention attitude to suicide (M=3.67, 95% CI [3.44, 3.89]) and the more likely they are to appreciate that suicidal thoughts and behaviour can be common (M=3.40, 95% CI [3.20, 3.60]). Participants with a mixed/different composition at home (M=4.05, 95% CI [3.86, 4.24]) and/or have experienced only between 0 to 2 situations related to suicide in the past one year alone (M=4.05, 95% CI [3.94, 4.16]), were the most likely to feel prepared to prevent suicide.

This study brings out different attitudes police-officers hold towards different aspects of suicide, influenced by their gender, educational background, personal life at home and total exposure to suicide during their career. Training programmes can help improve their knowledge and attitudes towards suicide, leading to a more positive behavioural response to individuals in crisis and create a safer environment. Malta, through an EU-funded programme, is currently investing its resources on drafting a national suicide prevention strategy, and such educational opportunities for our frontliners will ensure we have the right tools in screening, identifying, treating, and saving more lives.

Abbreviations: M: Mean score; CI: Confidence Interval

None Declared