In the modern scientific discourse, there is a lack of data on risk factors for the occurrence of emotional burnout in employees of neurosurgical medical institutions. This is what determines the relevance of the study.

To determine the prevalence and risk factors of emotional burnout among medical workers of a neurosurgery center.

In 2022-2024, a prospective study of the medical workers involved in emergency care for patients with acute ischemic stroke, in particular mechanical thrombectomy, was conducted at the Center for X-ray Endovascular Neurosurgery of the Kyiv City Clinical Hospital № 1. The average age of the sample was 32.2 ± 5.8 years. The gender structure was: 40 (80.0%) men and 10 (20.0%) women. The clinical-psychopathological, psychodiagnostic and statistical methods were used. The psychodiagnostic method was implemented by using the Maslach Burnout Inventory (MBI, C. Maslach et al., 1997).

It was determined that such a criterion as the gender of medical workers of the neurosurgery center does not affect the severity of any component of emotional burnout (p> 0.05). Statistically significant differences in the prevalence of high rates of emotional burnout components were determined between groups of medical workers with different specializations. In particular, it was determined that working in the center as a neurosurgeon is reliably associated with high rates for such components as “Emotional exhaustion” (p=0.04) and “Depersonalization” (p=0.006). A direct correlation was also established between the length of total work experience, length of service in the neurosurgery center and the number of working hours per month with the intensity of manifestations of emotional burnout in the selected contingent of individuals.

The prevalence of emotional burnout among medical workers of the neurosurgery center has been established for various components of this phenomenon: “Emotional exhaustion” – 52.0%, “Depersonalization” – 40.0%, “Reduction of personal achievements”– 50.0%, which indicates a high level of stress, which negatively affects the mental health of the selected contingent. The risk of developing emotional burnout among the medical workers increases with increasing workload, length of service and length of service in the center. An absolute risk factor for emotional burnout is working as a neurosurgeon. The development of psychotherapeutic measures aimed at overcoming the manifestations of emotional burnout in medical workers and increasing their resilience to stressful working conditions of the neurosurgery center is promising.

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Attention-Deficit/Hyperactivity Disorder (ADHD) has been reported as a risk factor for COVID-19 infection and severity of illness. This presentation outlines the research trajectory that began during COVID-19 studies and has since demonstrated that ADHD is not only associated with an increased risk of infection but also with long-term COVID-19 syndrome (LCS). The chain of studies supporting these findings includes the association of ADHD with infections and inflammatory/autoimmune disorders, such as Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency and Familial Mediterranean Fever (FMF). These links, alongside globally reported associations between ADHD and other autoimmune disorders, such as Systemic Lupus Erythematosus (SLE), underscore the potential involvement of inflammatory and immune dysregulation in the pathophysiology of ADHD. The emerging data linking ADHD with inflammatory conditions—at both clinical and genetic levels—represents a significant new direction in ADHD research. Further investigation into these connections may provide deeper insights into the underlying mechanisms of ADHD and contribute to developing novel therapeutic strategies.

I. Manor Consultant of: Last three years: Teva Israel Ltd., Madison Israel Ltd., Takeda Israel Ltd., Peri Ltd., Mindtension Ltd.,

Prolonged Grief Disorder (PGD) has been recently included in the “Trauma and Stressor-Related Disorders” chapter of the latest edition of the DSM (DSM-5-TR), being fully acknowledged among mental disorders. PGD extend the period of acute grief and increase the risk for a wide range of health impairments. The availability of biomarkers for mental disorders is thought to be crucial in the development of precision psychiatry. The hypothalamus-pituitary-adrenal (HPA) axis activity and cortisol reactivity have frequently been investigated in mental disorders. Data on neurobiology of PGD is lacking. Some studies found that PGD might be associated with increased HPA axis activity and impaired autonomic nervous system regulation.

Aim of the present study was to examine the levels of cortisol excreted in urine during the night and first morning and to assess any differences and specificity of HPA axis functioning in a group of individuals with PGD and in one of healthy controls.

Thirthy-three subjects, comprising 16 subjects diagnosed with PGD (PGD group) and 17 controls (CTL group), were recruited at the Psychiatric Clinic of the University of Pisa (Pisa, Italy). Psychometric assessments included: the Structured Clinical Interview for Mental Disorders-Clinician Version (SCID-5-CV), the Inventory of Complicated Grief (ICG) and the Impact of Events Scale-Revised (IES-R). Enrolled subjects, previously informed on collection procedures, delivered urine samples to the health care providers the same day of the clinical evaluation. Urine cortisol levels were measured by indirect enzyme-linked immunosorbent assays (ELISAs). Analyses were carried out at the Department of Pharmacy of the University of Pisa. Between-groups differences were performed by the non-parametric Mann-Whitney (MW). A p-value <.05 was considered statistically significant.

Descriptive results showed a higher variability (SDs and interquartile ranges) of urinary cortisol levels (total

μg) in the PGD group in respect to the CTL one; by inferential statistics, MW comparisons showed significantly higher urinary cortisol levels in PGD group vs CTL one (p< .05).

Results report that PGD patients had impaired cortisol outputs with respect to control subjects, suggesting a different pattern of production of the hormone during the night and the sleep-wake shift. If this prelimary data will be confirmed in wider samples, there will be a need to understand whether the increased cortisol profile reported in PGD may be due to increased production of the hormone at night (sleep alterations), to an increased peak on awakening (hyperarousal) or both conditions. Such findings might help to define more accurate patient-tailored therapeutic interventions.

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Chemsex is typically described as the use of specific substances to enable or enhance sex during extended sessions with multiple partners among men who have sex with men (MSM). Numerous studies have linked chemsex with different physical and mental health risks and other potential harms.

According to the latest European online survey por MSM (EMIS-2017), the section on substance use revealed the prevalente of substance use for sexual purposes in the last twelve months was 14.1% with Spain being one of the countries with the highest prevalence of chemsex at the European level.

As the prevalence of chemsex is increasing, consequences from this phenomena arises and a progressive increase in the number of psychiatric consultations and admissions related to chemsex practice have also been described, with substance abuse disorders, depression, and anxiety as the most prevalent diagnoses.

From our Liaison and Emergency Psychiatry Service consultations related with mental health issues and chemsex are increasing with growing number of suicide attempts, psychotic, maniac and depressive episodes.

Our objective in this poster is to describe the mental health risks of chemsex, its peculiarities and the main manage issuses in the Liaison and Emergency Pscychiatry Service.

Systematic review of the scientific literature related with chemsex and mental health risks will be carried out and we will also analyse some of our cases to describe presentation and management of the symptoms.

Chemsex is related with an increased rate of mental health issues and consultations related with substance use disorders, depression and anxiety. Clinical features due to this disorders are unique and integral treatment in coordination with Infectious Medicine Specialist is needed.

Chemsex is an increasing phenomena and it is intimately related with psychiatric disorders.

Psychiatrists must be concerned about it and trained to approach and treat these complex disorders in an integrative way.

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Suicidal behaviors, non-suicidal self-injury, and risky behaviors are significant concerns in young adulthood.

This study investigates the causal relationships between dark and vulnerable personality traits, guilt and shame proneness, and these behaviors among young adults (ages 18-40) in Tehran. Adopting a dimensional and dynamic perspective on personality, the study aims to develop a comprehensive model that incorporates proposed pathological personality traits from DSM-5 (PID-5).

Using a cross-sectional design and structural equation modeling, the study analyzed data from a large sample of 1,876 participants, including both a general population sample (n=1,696) and a clinical population (n=180) with suicidal/self-harm behaviors or personality disorders. Data were collected using the Short Dark Tetrad (SD4), Triple Scales of Vulnerable Dark Personality Traits, Guilt and Shame Proneness Scale (GASP), Domain-Specific Risk-Taking (DOSPERT), Self-Harm Inventory (SHI), and Suicidal Behaviors Questionnaire-Revised (SBQ-R).

The study evaluated three main models and nine sub-models. Findings from the comprehensive research model indicated that the proposed causal model, incorporating dark and vulnerable personality traits and guilt and shame proneness, effectively explains self-harm, suicidal, and risky behaviors in both young adults and those with diagnosed personality disorders. Key findings include:

A spectrum of dark and vulnerable personality traits significantly influences self-harm, suicidal, and risky behaviors. Pathological shame proneness, particularly when accompanied by detachment, increases suicidal tendencies. The absence of healthy guilt and shame proneness is associated with higher levels of risky behaviors and non-suicidal self-injury. All dimensions of the dark and vulnerable personality spectrum predict lower healthy guilt and shame proneness and higher pathological shame proneness.

Finally, Healthy guilt and shame proneness plays a mediating and protective role, reducing the likelihood of self-harm and risky behaviors.

This study contributes to the conceptualization of self-harm, suicidal, and risky behaviors within a dimensional and spectrum-oriented framework, considering personality traits, moral emotions, and behavioral consequences. Practical and research implications are discussed.

Dark Personality Traits, Risky Behaviors, Self-Harm Behaviors, Suicide, Guilt and Shame Proneness, Vulnerable Personality Traits, Young Adults.

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Mental health is one of the fundamental personal values of every human being. Thus its protection should be one of the primary obligations of every state. To ensure common standards in aforementioned matter, it is necessary to exist an universal (supranational) grounds and rules for the protection of mental health, as well as the protection of people with mental disorders rights. Especially that, mental disorders are found all over the world, and in an age of globalisation and migration, borders are only a legal construct. In the Western European axionormative order, one of the factors shaping common normative standards is European Union law.

The aim of this study is to identify the norms of European Union primary law from which the right to mental health protection can be derived (directly or indirectly), with a subsequent assessment of their adequacy.

The study is based on a dogmatic analysis of the primary legislation of the European Union (i.a. the founding Treaties or the Charter of Fundamental Rights of the EU - CFR) with analysis of the relevant literature of the subject and jurisprudence of the Court of Justice of the European Union.

No provision of EU primary law explicitly statutes a ‘right to mental health protection’. Currently, this right can be derived indirectly from norms relating to its particular aspects - e.g. the protection of mental integrity (Article 3 of CFR or Article 165(2) of the Treaty on the Functioning of the European Union - TFEU), the removal of threats to mental health (Article 168(1) TFEU) or the prohibition of discrimination on grounds of disability (Article 10 TFEU).

The current regulations are incomplete and therefore inadequate. The protection of mental integrity or the fight against discrimination are necessary for mental health (well-being) of entities, but do not fully cover the latter concept. The strengthening of the legal position of people with mental disorders requires the introduction into EU legislation of a comprehensive regulation that statutes the right to mental health protection, together with mechanisms for its enforcement against state authorities.

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Transitional care refers to the coordination and continuity of care between different healthcare locations or levels of care within the same facility, regardless of the patient’s age. Transition planning and management is therefore a key element in the organization and delivery of health services. Unfortunately, for many young people with mental health problems, transition is poorly planned, lacks coordination, and results in discontinuity of care. This is particularly true for intellectual disability, Autism Spectrum Disorder, and ADHD: as neurodevelopmental conditions, care typically begins at a young age with attendance at Child and Adolescent Mental Health Services (CAMHS), and the transition to Community Mental Health Services (CMHS) encounters numerous challenges.

A narrative review of the literature was conducted on the topic of transition from inception to January 26th, 2025. The following search string was used through PubMed, Web of Science, Scopus, and PsychInfo: (“Transitional Care” OR “Transition to Adult Care”) AND (“Neurodevelopmental Disorders” OR “Intellectual Disability” OR “Autistic Disorder” OR “Autism Spectrum Disorder”) AND (“Child and Adolescent Mental Health Services” OR “CAMHS” OR “Community Mental Health Centers”).

A total of 202 references were identified and screened considering titles and abstracts. After excluding papers not relevant to the topic and those that were unretrievable, 31 papers were included in the review. A significant majority of the included papers were qualitative studies based on focus groups and interviews conducted with family members and caregivers.

Findings reveal a lack of clarity and consistency regarding service availability for the conditions studied, possibly due to different eligibility criteria between child and adult mental health services, with variable service provision for young people with neurodevelopmental conditions (specifically, ASD, ADHD and ID). While high workloads and staff shortages were perceived to influence service thresholds and eligibility criteria, the lack of perceived severity by the CMHS often led to loss of follow-up.

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Perinatal loss is a prevalent health concern worldwide, with one in four pregnancies ending in loss. Spontaneous perinatal loss (i.e., miscarriage, stillbirth, and neonatal death) is an excruciating experience that becomes part of parental identity and represents a unique form of grief. Online interventions offer a cost-effective and feasible option for reducing symptoms of depression, anxiety, and grief in cases of perinatal loss. Involving stakeholders during the early stages of content design and development results in interventions that are more relevant and effective.

This study aims to co-design evidence-based online content for offering psychological support in the early stages after perinatal loss and to integrate this content into the e-Perinatal app (mHealth application for the prevention of Perinatal Mental Health Disorders). It involves collaboration with local stakeholders, including bereaved women, non-birthing partners, and health professionals, to ensure that the intervention meets the population’s needs and aligns with the local sociocultural context. This is a secondary study of the ERC Starting Grant ePerinatal project (101042139), funded by Banco Sabadell Foundation.

This study employed a qualitative design to conduct a multi-stage co-design and development process (pre-design, generative and evaluative phases). Two online focus groups were conducted: 1) bereaved women and non-birthing partners (n = 9), and 2) healthcare professionals with experience in perinatal loss care (n = 12). Following the presentation of the app prototype, participants were asked to provide feedback on both the evidence-based content (micro-intervention contents and information provided) and the app design features. The qualitative data were analysed using thematic analysis with NVivo software, while sociodemographic data were analysed through descriptive analysis. All data were coded by two researchers.

The analysis process is ongoing, and the emerging themes and subthemes are being categorized into: 1) user-related (e.g., health status, previous experience with the public health system, social support), 2) program-related (e.g., intervention content, formal and informal social connectedness), 3) user experience (e.g., information architecture [length], content strategy [wording]), and 4) professional-related (e.g., factors influencing healthcare professionals’ recommendations of the app).

The content developed for perinatal loss will be designed to align with local stakeholders’ expectations and be integrated into the e-Perinatal app. By offering accessible support for women and their partners, the app will aim to help manage the psychological reactions often experienced during this vulnerable period, including grief, stigma, and an increased risk to mental health, as it is implemented in routine maternal care.

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New psychoactive substances (NPS) are a heterogeneous group of new drugs that are not controlled by the United Nations drugs conventions but may represent public health threats of largely the same impact as substances listed in the respective conventions, according to the European Union Drugs Agency (EUDA). The history of NPS encompasses approximately two decades, but this category of substances is continually expanding.

To review the literature for data regarding the practical challenges the use of NPS raises for mental health specialists, in order to help clinicians in the construction of an adequate case management plan for these patients.

A literature review was conducted in three electronic databases (PubMed, Cochrane, and Web of Science/Clarivate) to find primary and secondary sources published between January 2000 and September 2024. The keywords used were „novel psychoactive drugs”, „synthetic cathinone”, „cannabimimetics”, „synthetic cannabinoids”, „synthetic stimulants”, „phenethylamines”, „legal highs”, „designer drugs”, „emergency”, „intoxication”, „case management”, and „challenge”. There was no restriction regarding the age of participants, but only sources published in English were selected.

Based on the 27 sources retained for detailed analysis, six main clinically focused challenges related to NPS use were identified. The lack of characteristic clinical manifestations of NPS intoxication is provocative, especially for the presentations in the emergency rooms (ER), where a rapid differential diagnosis is needed. The second challenge detected was polydrug use, with studies reporting more than 50% of the users combining different NPS or NPS with conventional drugs of abuse. The third difficulty is related to the difficulty of detecting the NPS in the consumers due to the continuously changing structures by designers, who are trying to avoid the current legislation. The fourth aspect is related to the high costs of screening for NPS and the need, despite these costs, to apply such screening in the psychiatric population, which is considered vulnerable to the use of these drugs, according to epidemiological studies. The fifth challenge is related to the lack of specific treatments in the case of NPS intoxication, with management strategies being limited to supportive and symptomatic care. The sixth aspect refers to the need to hospitalize patients with NPS intoxication in ICU departments due to their unpredictable evolution, need for monitoring, cardiovascular and neuropsychiatric toxicity, polydrug use, etc.

There is an acute need for routine screening for NPS in the ER whenever a drug intoxication is suspected and especially in psychiatric populations where the anamnesis could be difficult. Case management requires ICU hospitalization, intensive monitoring, supportive care, and a post-ICU psychiatric evaluation and treatment for relapse prevention.

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Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by attention problems, hyperactivity, and impulsivity that can persist into adulthood. Autism Spectrum Disorder (ASD) is also a neurodevelopmental disorder with deficits in communication and social interaction, as well as restricted interests and stereotyped behaviors. High comorbidity between ASD and ADHD suggests an overlap of the two disorders, which can exacerbate the severity of both conditions.

Adapt and analyze the inter-rater reliability of a protocol for observing symptoms of ADHD and evaluate the presence of these symptoms in a sample of adults diagnosed with ASD.

The study was conducted at a residential center dedicated to the care of adults with ASD in Granada - Spain. The experimental procedure was approved by the Ethics Committee of the University of Granada. The adapted version of the protocol for observing symptoms of ADHD in adults with ASD, consisting of 19 items that evaluate three areas: inattention; hyperactivity, and impulsivity. The response options were: Never=1, Rarely=2, Sometimes=3, Often=4, Very Often=5. The questionnaire was translated into Spanish by experts. Items were adapted to better reflect the daily activities in the residential setting. Behavior of the participants was recorded by 2 observers, the Caregiver and Technical Staff (Psychologists or Occupational Therapists), who had known the participant for at least 6 months. Each professional received training on how to fill it out. Analyses consisted of a reliability test to evaluate the agreement and consistency of the observers’ responses using the Intraclass Correlation Coefficient (ICC) through a two-factor Mixed Fixed-Effects Model. The presence of ADHD symptoms in the sample of 20 participants (14 men) diagnosed with ASD was tested descriptively.

The results for agreement on ICC were: 9 items were below .5 (poor); 3 items between .5 and .75 (moderate); 7 items between .75 and .9 (good). For consistency, the results were: 7 items below .5; 5 items between .5 and .75; 7 items between .75. The ICC result for absolute agreement (ICC = 0.943; 95% CI = [0.900, 0.973]; p < 0.001) was .94, indicating reliability above 0.9 (excellent). The ICC result for consistency (ICC = 0.949; 95% CI = [0.911, 0.976]; p < 0.001) was .94, with reliability above 0.9. The mean scores for the presence of ADHD symptoms indicate that both Caregivers and Technicians most frequently rated the items as 2 (Rarely) and 3 (Sometimes).

In the overall instrument analysis, the results of interobserver agreement and response consistency reinforce that the adapted instrument is useful to identify ADHD behaviors in individuals with ASD. The need to continue developing and adapting instruments to identify comorbidities between profiles remains important.

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The surgical treatment process involves not only physical recovery but also the management of psychiatric and psychosocial issues. Psychiatric disorders can negatively affect postoperative recovery, complicate adherence to treatment and decrease the quality of life (Begum et al. World J Surg 2022; 46(6) 1408-1419).

This case series highlights less commonly encountered psychiatric conditions that arise after surgery and emphasizes the importance of considering how these conditions interact with pre-existing diseases during postoperative follow-up.

This case series examines three distinct cases of psychiatric disorders following surgical interventions:

Delusional disorder after hypophysectomy

Somatization disorder after cystoscopy

Psychotic depression following colostomy creation

Informed consent was obtained from all patients.

Case 1

A 62-year-old male patient diagnosed with hypophyseal macroadenoma underwent transsphenoidal hypophysectomy. Two months after surgery, he developed paranoid delusions, believing his wife was having an affair. Initially treated with aripiprazole 15 mg/day, the patient did not improve. His treatment was switched to risperidone 2 mg/day, resulting in resolution of his symptoms.

Case 2

A 58-year-old male with benign prostatic hyperplasia (BPH) developed persistent groin pain after cystoscopy. Despite urological treatment, the pain did not subside, and he was referred to algology for gabapentin, which was ineffective. Referred to psychiatry, he reported pain radiating to his back and arms, worsened by stress, and trouble sleeping due to his pain. Diagnosed with somatization disorder, he was treated with olanzapine 2.5 mg/day and cognitive interventions, which led to decreased pain.

Case 3

A 72-year-old male patient with rectal cancer, following abdominoperineal resection and colostomy creation, began consuming other people’s medications. He exhibited disorganized behavior and suicidal ideation, and was diagnosed with psychotic depression. Treated with olanzapine 5 mg/day and venlafaxine 75 mg/day, his disorganized behavior resolved during follow-up, and olanzapine was discontinued. He remains in remission on venlafaxine 75 mg/day.

This case series illustrates the diversity of psychiatric conditions that can arise after surgical interventions and emphasizes the importance of postoperative psychiatric monitoring. Although there is a lack of sufficient studies on this topic, a postoperative follow-up study conducted with a group of 200 patients found that the risk of developing anxiety after surgery was 31%, and the risk of developing depression was 56% (Basak et al. Int J Surg 2015; 23 18-22). Psychiatric symptoms can complicate physical recovery, affect adherence to treatment, and reduce quality of life. A multidisciplinary approach is essential to support both physical and psychological recovery, ultimately improving the overall health status of patients.

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Aging leads to a progressive deterioration at the communicative level. The identification of language impairment in older adults could help to prevent or slow down the development of a possible neurocognitive disorder.

To evaluate psychopathological manifestations in language and communication by means of a psychopathological evaluation protocol in a control group of subjects matched by age and sex to a group of people with mild cognitive impairment.

The sample consists of twenty healthy older adults (75% female, 25% male) with mean age of 84.15 years (SD = 6.81). A descriptive and observational study was carried out. Subjects of both sexes between 70 and 95 years of age, with absence of possible cognitive impairment, were included. The Mini-Cognitive Examination was used to assess cognitive performance, the PRESEEA interview was used to obtain the speech sample and a psychopathological assessment protocol.

Increasing age is associated with greater intensity of language impairment (R2 = .02, p = .047). In the MEC-35 total score, the control group shows a significantly higher performance than the patient group (F = 49.11, p < .001). A negative correlation appears between the total score of psychopathological manifestations and the variables ‘educational level’ (R2 = .23, p = .029) and ‘socioeconomic level’ (R2 = .33, p = .007).

Anomia, perseverations, disintegrated language, concretism and paragrammatism are possible early indicators of cognitive impairment. The elaboration and application of both assessment protocols and speech therapy intervention programs in older adults may improve communication skills.

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Psychotic experiences (PEs) are subclinical symptoms of psychosis affecting about 10% of children and adolescents. They may cause significant distress and impair daily functioning. Moreover, when persisting over time they are more likely to result in psychotic disorders.

This longitudinal study aimed at assessing the effects of polygenic and environmental risk factors for schizophrenia on distressing and persisting PEs in a cohort of adolescents.

Data were obtained from participants of European ancestry derived from the Adolescent Brain and Cognitive Development Study, Release 5.1. Past-month PEs were assessed using the Prodromal Questionnaire-Brief Child Version. The primary outcome was distressing PEs at 3-year follow-up. Secondary outcomes included varying levels of persistence of distressing PEs, occurring in 1, 2, 3, or all 4 waves. Polygenic risk score for schizophrenia (PRS-SCZ) was calculated using the continuous shrinkage approach (PRS-cs). The exposome score for schizophrenia (ES-SCZ) was generated by summing up the weighted risk of nine environmental exposures across lifetime: emotional neglect, physical neglect, emotional abuse, physical abuse, sexual abuse, cannabis use, winter birth, hearing impairment, and bullying. Multilevel logistic regression was carried out to test the individual associations of PRS-SCZ and ES-SCZ with the outcomes; the relative excess risk due to interaction was calculated to determine the additive interaction between PRS-SCZ and ES-SCZ on distressing PEs. Main analysis was adjusted for age and sex as covariates; sensitivity analysis also included family income and parental education.

ES-SCZ was significantly associated with 3-year follow-up distressing PEs (OR 1.27 [95% CI 1.14, 1.43], p<.001) and lifetime distressing PEs at all degrees of persistence, with an increasing magnitude of association for a higher degree of symptom persistence (≥1 wave: OR 2.77 [95% CI 2.31, 3.31], p<.001; ≥2 waves: OR 3.16 [95% CI 2.54, 3.93], p<.001; ≥3 waves: OR 3.93 [95% CI 2.86, 5.40], p<.001; all 4 waves: OR 3.65 [95% CI 2.34, 5.70], p<.001). PRS-SCZ was significantly associated with distressing PEs persisting for more than one (OR 1.29 [95% CI 1.08, 1.53], p=.040) or two waves (OR 1.34 [95% CI 1.08, 1.65], p=.070) and also additively interacted with ES-SCZ for these outcomes (≥1 wave: RERI 1.26 [95% CI 0.14, 2.38], p=.027; ≥2 waves: RERI 1.79 [95% CI 0.35, 3,23] p=.015). Sensitivity analysis confirmed all main results.

PRS-SCZ and ES-SCZ showed independent and joint effects on distressing PEs. The more pronounced contribution of ES-SCZ on distressing PEs and its gradient effects on the degree of persistence calls for particular attention to environmental risk factors for schizophrenia on the development and persistence of PEs.

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Intercultural psychotherapy aims at an understanding of and translating between cultural differences which may be experienced between the psychotherapist and the client. This is especially important when considering that due to crisis, conflict and war, but also due to globalisation and increased mobility, an increased number of clients with a migration background seek to undergo psychotherapy. In this presentation, current literature on needs and challenges of intercultural psychotherapy is discussed with regard to an intersectionality framework and more specifically in the context of power and privileges. These frameworks provide a useful understanding of cultural competency and sensitivity in intercultural psychotherapy.

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Auditory verbal hallucinations (AVH) are prevalent in schizophrenia but also occur in bipolar disorder, yet differences in their phenomenology remain poorly understood. This ongoing study aims to fill this gap by comparing the phenomenological characteristics of AVH in schizophrenia and bipolar disorder.

The research questions we are interested in are:

• - The nature of hallucinations. We hypothesize that hallucinatory experiences in bipolar disorders is connected to the mood, for example mania.

• - We hypothesize that auditive verbal hallucinations in bipolar disorders will not have the immanent character as in schizophrenia and won’t be experienced in a pathologically altered private space.

• - We hypothesize that bipolar patients after a remission from the episode will consider their voices as a sign of disease whereas the patients with schizophrenia will continue to ascribe extraordinary meanings to their hallucinations.

Building on our prior research in schizophrenia, we are conducting semi-structured, phenomenologically oriented qualitative interviews with patients diagnosed with bipolar disorder who experience AVH. Participants are recruited from outpatient clinics and hospital wards in Denmark. Data will be analyzed using thematic analysis with a bottom-up approach.

Preliminary findings from our ongoing study will be presented.

A deeper understanding of AVH phenomenology in schizophrenia and bipolar disorder can lead to more accurate differential diagnoses, reducing the risk of misdiagnosis and ensuring that patients receive appropriate and timely treatment.

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Burnout is a set of experiences and symptoms which occurred in the context of stress and high ideals in the helping professions who feel drained, exhausted, tired, listless and unable to cope. Burnout leads to disengagement, blunted emotions, helplessness and hopelessness with feeling trapped causing detachment and depression. Prevention of burnout is important and includes interventions at policy, institutional and personal levels. These resources must include financial and human resources where appropriate; prompt and culturally acceptable help is available and easily accessible. Institutions must allocate sufficient funds for well-being of its staff. Various steps can be taken but perhaps most important is accessibility of services in a non-stigmatising manner. These services must be confidential, fit for purpose and widely advertised and accessible. Physical space to rest and access to affordable nutritious food are important. Access to occupational heath services or primary care are important.

Dinesh Bhugra

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Chronic medical conditions like hypertension may increase the risk of mental disorders such as anxiety and depression.

This study aimed to investigate if hypertension is associated with a higher incidence of major mental disorders, including anxiety disorders, depressive disorders, bipolar disorders, psychotic disorders, sleep disorders, vascular dementia, and Alzheimer’s dementia, compared to controls.

I analyzed standardized data from patients with hypertension (n = 48,466) and those without hypertension (n = 442,660) at a university hospital. Clinical data was standardized into a common data model. Using propensity score matching (PSM) at a 1:5 ratio, I compared the incidence of mental disorders between the hypertension and control groups over a 5-year period. A multivariate Cox proportional hazards model was used to estimate the risk of mental disorders, with hazard ratios (HR) and 95% confidence intervals (CI).

After PSM, the hypertension group had a higher prevalence of being elderly (over 60 years old) and having conditions like diabetes, hyperlipidemia, atrial fibrillation, cerebrovascular disease, and heart disease compared to controls. The hypertension group also had significantly increased use of antithrombotic agents, beta-blockers, calcium channel blockers, diuretics, acid-related disorder drugs, diabetes medications, lipid-modifying agents, and opioids. The incidence rates per 1,000 patient-years for mental disorders were as follows: anxiety disorders (7.22 vs. 4.49), depressive disorders (8.51 vs. 5.47), bipolar disorders (1.13 vs. 0.91), psychotic disorders (0.18 vs. 0.22), sleep disorders (16.32 vs. 8.60), vascular dementia (0.77 vs. 0.14), and Alzheimer’s dementia (9.29 vs. 2.53). Compared to controls, the hypertension group had a higher risk of developing vascular dementia (HR, 6.03; 95% CI, 4.34–8.44; p<0.01), Alzheimer’s dementia (HR, 3.89; 95% CI, 3.56–4.24; p<0.01), sleep disorders (HR, 1.96; 95% CI, 1.85–2.07; p<0.01), anxiety disorders (HR, 1.69; 95% CI, 1.56–1.83; p<0.01), and depressive disorders (HR, 1.64; 95% CI, 1.52–1.76; p<0.01). There were no significant differences for bipolar disorders (HR, 1.17; 95% CI, 0.95–1.43; p=0.12) or psychotic disorders (HR, 0.85; 95% CI, 0.51–1.34; p=0.50).

Hypertensive patients have an increased risk of major mental disorders, particularly vascular dementia, Alzheimer’s dementia, sleep disorders, anxiety disorders, and depressive disorders. Older age, age-related diseases, and various medication uses contribute to this increased risk.

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Our patients often come to us through wait-lists, but when does the wait really start? Early intervention psychosis programs have introduced policies and benchmarks aimed at minimizing the time between referral and first contact. While programs that meet these targets are often celebrated for their success in reducing untreated psychosis, these targets leave out a critical piece of the puzzle: the time elapsed from symptom onset. Understanding how patients and caregivers experience the wait for care in its entirety is critical to further reducing treatment delays in psychosis.

This presentation aims to first examine a disconnect between early intervention wait-list policies and patients’ experiences. Next, it will explore how patient and family member narratives reflect the complex and nuanced nature of waiting for care. Finally, it will propose clinically relevant solutions for reducing the delay between symptom onset and appropriate treatment.

We conducted individual semi-structured interviews with patients and caregivers accessing early intervention psychosis services across Canada. For this presentation, three interviews from different geographic and socio-cultural regions were selected for their distinct perspectives. We performed a two-reviewer narrative inquiry to derive emergent narratives about waiting for services.

Patient and caregiver experiences revealed two distinct waiting periods. Aside from the “wait-list” period between referral and first contact that is addressed by early intervention policies, participants noted experiencing a much longer initial waiting period, with narratives beginning at symptom onset. Participants described this period as an active, dynamic, frustrating, and often traumatic process that involves multiple ER visits and attempts at receiving care.

We propose formally distinguishing between two forms of waiting for services: passive waiting, which is the state of being on a wait-list, and active waiting, which begins at symptom onset and includes the complex struggle to receive stable care. Early intervention programs’ efforts to reduce passive waiting are important, but the high burden of active waiting suggests a need for larger efforts such as clinician education and systemic changes in how patients access healthcare. Reducing active wait times could truly transform how first episode psychosis is managed and improve outcomes for those in urgent need.

None Declared

Stigmatization and self-stigmatization remains an actual problem for patients with endogenous mental illnesses, as it is an obstacle to seeking psychiatric help. Taking this into account, it is necessary to develop effective psychosocial interventions aimed at reducing self-stigmatization and improving patients’ integration into society.

To identify the features of self-stigmatization in patients with schizophrenic spectrum disorders and, taking into account these features, to develop a program to reduce it.

30 patients with schizophrenic spectrum disorders (F20, F23, F25 according to ICD-10) were included in the study. The average duration of the disease was 13.5±3.2 years. Among them, 14 were males, 16 were females, and the median age of the patients was 42.21±10.36 years. To assess the severity of self-stigmatization and to determine its components, the “Questionnaire for assessing the phenomenon of self-stigmatization in psychiatric patients” (Yastrebov V.S., Mikhailova I.I., Yenikolopov S.N. et al., 2005) was used.

A rather high general level of self-stigmatization (1.20±0.57 points) was revealed in the studied patients, exceeding the average indices according to the mentioned questionnaire. The most pronounced were the indicators on the following scales: “Overestimation of inner activity” (1,61±0,67 points); “Overestimation of self-actualization” (1,48±0,78 points); “Willingness to distance from mentally ill patients in the social sphere” (1,44±0,72 points); “Violation of self-identity” (1,17±0,59 points). Taking into account the identified disorders, a program including psychoeducation, as well as art-therapeutic training based on the approach of Z. Russinova et al. “Anti-stigma photovoice Intervention” (2014) was developed and adapted for the Russian population. The psychoeducation included three sessions where the manifestations of mental disorders, their treatment, forms of psychiatric care, issues of stigmatization and its overcoming were discussed. The training included six sessions discussing the following topics: “My daily life”, “Health and illness”, “Me and others”, “Accepting help and giving help”, “My achievements and my possibilities”, and “The next chapter of my life”. Participants provided pictures according to the session topic and discussed personal experiences, their emotions and feelings. The sessions were held in a closed group, the number of participants from 8 to 12 people, and the duration of the session was 90 minutes.

The developed program contributed to the identification of resources that help in overcoming the disease and reducing self-stigma. The program can be used for patients in the initial stages of the disease and with a long-term course of the disease.

None Declared

Emetophobia, an intense and disproportionate fear of vomiting, is a chronic and debilitating condition characterized by the avoidance of situations or activities that may increase the perceived risk of vomiting. It is often accompanied by an overwhelming fear of losing control, becoming severely ill, or being perceived as repulsive by others. Treating emetophobia is particularly challenging, primarily due to the difficulties in implementing exposure-based interventions effectively. Data on the pharmacological management of emetophobia is limited, with only a few case reports in the literature suggesting potential benefits from selective serotonin reuptake inhibitors (SSRIs).

With this case report we aim to describe a case of emetophobia treated with an SSRI.

Description of a clinical case of a patient with emetophobia observed in a psychiatric outpatient consultation.

We present the case of a 21-year-old male with a one-year history of emetophobia. At the time of consultation, he was unemployed, having recently completed a computer engineering degree. He had no relevant past medical history and was not on any regular medication. The patient was referred for psychiatric evaluation after three years of psychotherapeutic treatment for generalized anxiety disorder. His anxiety symptoms worsened one year prior after an episode of vomiting, which triggered a fear of recurrence. This fear led to restrictive eating, resulting in a 10 kg weight loss over the preceding year (current weight: 63 kg), and significant social avoidance due to the fear of vomiting in public. Physical and neurological examinations revealed no abnormalities. Routine blood tests, urinalysis, and urine drug screening showed normal results. Given the limited efficacy of prior psychotherapeutic interventions, pharmacotherapy with escitalopram 10 mg daily was initiated. After one year of follow-up, the patient reported substantial improvement in anxiety symptoms and avoidance behaviors related to his fear of vomiting. He was able to resume normal eating patterns and gained 5 kg during this period.

This case highlights the potential efficacy of SSRIs, specifically escitalopram, in the treatment of emetophobia. After one year, the patient showed significant improvement, with the return of normal eating patterns and weight gain. While exposure-based interventions remain a cornerstone of treatment for specific phobias, pharmacological options like SSRIs can serve as a valuable adjunct, especially in cases with comorbid anxiety disorders. Further research is needed to better understand SSRIs’ role in managing emetophobia and refine treatment strategies for this complex condition.

None Declared