Dual diagnosis, the co-occurrence of substance use disorders (SUD) and mental health conditions, presents unique challenges influenced by gender-related factors. This narrative review explores the role of gender in the epidemiology, treatment access, environmental factors such as intimate partner violence, clinical features, and outcomes of dual diagnosis, highlighting structural and social determinants that exacerbate disparities. Women and gender minorities with dual diagnosis face heightened stigma, higher rates of trauma, and significant barriers to healthcare, often resulting in delayed treatment and poorer prognoses. Additionally, traditional gender roles and caregiving responsibilities influence coping mechanisms and treatment adherence. Despite increasing awareness, research on gender-responsive interventions remains limited. This review underscores the need for gender-sensitive approaches in dual diagnosis treatment, advocating for integrated, trauma-informed care that addresses the specific needs of diverse gender identities.

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Suicidality is one of the leading causes of death in young adults. Most of the suicidal patients suffer from background depression. Developments in the last few years in brain simulation technology as dTMS enables a more intensive care in accelerated protocols that have already been approved in the treatment of the depression field. However, most major studies in the field excluded the participation of patient with active suicidality.

This study focuses on efficacy of dTMS in patients with active suicidality.

This double-blind randomized study offers an accelerated protocol dTMS treatment in the span of 10 treatment days, while the patient is maintained in full hospitalization and secure conditions. The study examined the efficacy of the dTMS accelerated protocol (which includes 3 treatments a day for the course of 10 treatment days) on suicidality indicators. This treatment was given in addition (add-on) to standard ward treatments in three arms (1:1:1) sham, active H1 coil and active H7 coil.

38 patients were enrolled in the study. 30 patients successfully completed 10 treatment days. 8 patients did not complete treatment due to withdraw of informed consent before starting treatment (N = 4), panic attack (N = 2), discharge from the ward (N = 1) and suicide attempt (N = 1). Patients received active treatment (both H1 and H7) showed superior response (defined as >50% improvement in depression scale) compared to placebo arm (PA) (p = 0.03). Additionally, clinically close to significance improvement in suicidality intensity scales was found after 5 and 10 days of treatment in active treatment compared to placebo (p = 0.09). However, no significant difference was found regarding suicidality type scores. No major differences in depression and suicidality were found comparing H1 and H7 coils. The main side effects were headaches and dizziness, motoric tremor during the treatments, vomiting and general exhaustion. One patient (placebo group) completed suicide a month following the end of the study.

Active suicidality is a major challenge in treating severe mental disorders, and death by suicide is still a leading cause of death among patients. However, most clinical studies in mental health still exclude patients with active suicidality, hence treatment options are limited. In this study, we found deep TMS accelerated protocol (both H1 and H7 coils) to be both safe and effective in decreasing suicidality intensity and depression symptoms among inpatients with severe mental disorders accompanied by suicidality. Further studies are needed to differentiate H1 and H7 coils effectiveness in different depression sub-types and common psychiatric comorbidities.

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Depressive disorders and anxiety disorders are typical comorbidities in autism spectrum disorder (ASD), with a reported prevalence of 20% and 9%, respectively (Lai, 2019). Autistic subjects are more at risk for suicidal thoughts and behaviors compared to typically developing peers; moreover, depressive symptoms are often resistant to both pharmacological and psychotherapeutic treatments. In 2019 intranasal esketamine was approved in Italy for treatment-resistent depression (TRD). We observed two young outpatients affected by autism (diagnosis made by “Lab-Aut”, a specialized mental health service in Pavia) treated with esketamine in our ambulatory for TRD. Clinical information and personal details were summarized in Image 1.

To evaluate the clinical response to intranasal esketamine in subjects with major depression in ASD and to compare the outcome with neurotypical patients.

Autism diagnosis wase made according to ADOS-2 and ADI-R scores, confirmed by a clinical judgment of senior psychiatrist. Our follow-up protocol during esketamine treatment consists in the following scales: MADRS, C-SSRS, DES-II, Psychace Scale, Reading the Mind in the Eyes Test, HAM-A, HAM-D, BDI, PANSS. Psychometric evaluation was performed at T0 (before esketamine), T1 (one week of pharmacotherapy), T2 (one month), T3 (2 months) T4 (3 months) and T5 (6 months). We collected results from neurotypical patients (n=12) and autistic patients (n=2) between 2022 and 2024.

Both in autistic patients and in neurotypical ones we noticed a premature decrease in depressive symptoms and a reduction of suicidal thoughts. This improvement was testified by a reduction from T0 to T1 in MADRS total score and in C-SSRS sub-score focused on intensity of suicidal ideation. The reduction was maintained during the observation period (Image 2). Due to the small sample size of autistic patients, we couldn’t reach the statistical significance threshold for this population. Considering the entire sample (n=14) we obtained significant results (T0-T1: MADRS decrease p=0,00006, C-SSRS decrease p=0,00009. T0-T5 MADRS and C-SSRS variations p<0,00001). Comparing our sub-samples, it’s possible to notice a similar trend in follow-up between autistic and neurotypical patients. (Image 3).

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Our preliminary data coming from clinical experience suggest the efficacy of intranasal esketamine in depressive episodes occurring in autistic patients. A larger sample size of autistic patients will be necessary to set a comparative study and to give significance to these results. Esketamine could represent an important therapeutic option in depressed patients with ASD comorbidity.

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Perampanel is a selective antagonist of the AMPA receptor for glutamate, primarily approved for the treatment of certain types of epilepsy. With the evolving understanding of psychiatric disorders’ neurobiology, it’s hypothesized that targeting the glutamatergic system could offer substantial therapeutic benefits (Perversi F, Costa C, Labate A, Lattanzi S, Liguori C, Maschio M, et al. The broad-spectrum activity of perampanel: state of the art and future perspective of AMPA antagonism beyond epilepsy. Front Neurol [Internet]. 2023 [cited 2024 Sep 2] ;14:1182304).

The purpose of this study is to evaluate the effectiveness of perampanel in managing psychiatric symptoms such as sleep disturbances, depression, anxiety, and irritability.

A comprehensive review of scientific studies was carried out, centering on clinical trials and observational research that explored the application of perampanel in individuals exhibiting psychiatric symptoms. The review included articles published between 2013 and 2024, utilizing databases like PubMed, Scopus, and PsycINFO for sourcing. The inclusion criteria covered studies that assessed the impact of perampanel on psychiatric conditions, detailing both the clinical results and any side effects.

Findings indicate that perampanel may have beneficial effects in reducing symptoms of insomnia (Abenza-Abildúa MJ, Suárez-Gisbert E, Thuissard-Vasallo IJ, Andreu-Vazquez C. Perampanel in chronic insomnia. Clin Neurol Neurosurg. 2020 May 1;192), depression and anxiety (Scorrano G, Lattanzi S, Salpietro V, Giannini C, Chiarelli F, Matricardi S. The Cognitive and Behavioural Effects of Perampanel in Children with Neurodevelopmental Disorders: A Systematic Review. J Clin Med [Internet]. 2024 Jan 10 [cited 2024 Sep 3];13(2)) in certain patient groups. However, significant adverse effects were also reported, including behavioural changes and increased aggression in some cases, necessitating careful monitoring during treatment.

Numerous antiepileptic medications have been effectively utilized in treating psychiatric conditions. Perampanel, in particular, has demonstrated effectiveness in managing nocturnal seizures, preserving sleep architecture, and treating restless legs syndrome. A study conducted in Spain revealed that combining perampanel with either an antidepressant or an anxiolytic significantly enhances sleep quality after three months in patients without epilepsy (Abenza-Abildúa MJ, Suárez-Gisbert E, Thuissard-Vasallo IJ, Andreu-Vazquez C. Perampanel in chronic insomnia. Clin Neurol Neurosurg. 2020 May 1;192).

While there are no large-scale clinical trials specifically targeting mood disorders, some ongoing research is exploring the broader psychiatric effects of Perampanel, including its impact on anxiety disorders.

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Children and adolescents frequently encounter a range of adverse childhood experiences (ACEs), which encompass various forms of adversity such as abuse, neglect, and household dysfunction. These experiences can have profound and lasting effects on an individual’s health and well-being. Alarmingly, nearly three out of four children—approximately 300 million aged 2 to 4 years—are subjected to physical punishment and/or psychological violence by parents and caregivers. Moreover, statistics indicate that one in five women and one in thirteen men were sexually abused during their childhood (ages 0-17). Despite the widespread prevalence of these experiences, trauma in children often goes unrecognized. The nature of trauma can make it challenging for both the child and caregivers to identify and articulate trauma-related symptoms. Children may struggle to understand or express their experiences, and caregivers might misinterpret or overlook these signs, leading to underreporting and a lack of timely intervention.

Experiencing adverse events during childhood or adolescence is particularly concerning because it can significantly disrupt normal developmental trajectories, affecting physical, emotional, and cognitive growth. During these formative years, the brain is highly plastic and sensitive to environmental influences, making it especially vulnerable to the effects of trauma and stress. Such exposure can result in long-term consequences, including a heightened risk of developing mental health disorders, behavioral issues, and challenges in academic and social settings.

In this context, early identification of children and adolescents who have faced adverse experiences is crucial. By providing appropriate support and resources early on, it is possible to foster resilience and promote more positive growth despite the challenges posed by early adversity.

Using tools like the Child PTSD Symptom Scale (CPSS), a widely recognized self-report instrument designed to assess the severity of post-traumatic stress disorder (PTSD) symptoms in children and adolescents aged 8 to 18, can be especially effective for identifying and evaluating the impact of trauma exposure in young individuals and facilitating early intervention.

Research published by the National Institute of Mental Health (NIMH) indicates that early identification through screening can lead to timely interventions, significantly reducing the psychological harm associated with trauma exposure.

Research strongly supports the effectiveness of screening for trauma symptoms in children and adolescents, emphasizing its critical role in early detection, timely intervention, and the prevention of long-term negative outcomes. This proactive approach not only addresses the immediate psychological impact of trauma but also contributes to improved long-term well-being and quality of life for those affected.

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Cacosmia, the perception of neutral odors as foul, is an unusual and distressing postoperative complication. This case focuses on a 66-year-old female who experienced cacosmia after a colectomy, raising questions about the role of anxiety in postoperative sensory distortions. While colectomy is commonly associated with physiological complications, emerging research indicates that psychological factors, particularly anxiety, may influence sensory processing. Addressing these interactions is crucial for improving outcomes in patients with psychiatric comorbidities undergoing surgery.

1. 1. To examine the influence of pre-existing anxiety on the development of sensory distortions, specifically cacosmia, following colectomy.

2. 2. To investigate the relationship between the gut-brain axis and psychological factors, including anxiety, in the context of postoperative recovery.

3. 3. To highlight the gaps in the literature regarding sensory distortions in surgical patients and to propose potential areas for future research.

Patient: A 66-year-old female with a history of anxiety disorder developed cacosmia two weeks after undergoing colectomy.

She reported that food smelled like feces despite normal postoperative recovery and the absence of physical abnormalities.

a search was conducted using databases such as PubMed and Scopus with terms like cacosmia, postoperative sensory distortion, anxiety and surgery, and gut-brain axis. Articles exploring the relationship between anxiety and sensory distortions in surgical patients were included.

Gut-Brain Axis: The gut-brain axis is essential in regulating emotions and sensory processing. Disruptions from surgery can affect neurotransmitters, contributing to both anxiety and sensory misinterpretations like cacosmia. Anxiety’s Role: Anxiety is known to heighten sensory perception. The patient’s pre-existing anxiety likely amplified her awareness of sensory stimuli, leading to distorted odor perceptions.

While the role of anxiety in surgical recovery is recognized, there is a lack of research specifically addressing sensory distortions like cacosmia in the postoperative period.

This case underscores the importance of considering psychological factors, especially anxiety, in postoperative sensory distortions like cacosmia. The interaction between the gut-brain axis and sensory perception in anxious patients highlights the need for a more comprehensive, multidisciplinary approach to postoperative care. Current gaps in the literature suggest a need for future research on how anxiety and sensory processing intersect after surgery. Investigating preoperative interventions such as cognitive-behavioral therapy (CBT) or pharmacotherapy may help mitigate sensory distortions and improve postoperative recovery outcomes in patients with anxiety.

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This study is probably the first study on stalking conducted in the Republic of Serbia.

The aim of this study was to examine the stalking experiences of a sample of persons who, according to the Court’s judgment, were in need of treatment.

This retrospective study was conducted from January 2020 until January 2024 and included 46 persons on the measure of treatment treated at the Clinic for Mental Disorders “Dr Laza Lazarević” in Belgrade. All obtained data were from their medical records and based on the judgment of the Court. The data were processed using SPSS version 21 to produce mainly descriptive and inferential statistics. Difference were considered statistically significant if p< 0.05.

The participantes were mean age 49.5 ±12.9 years, and most of them 41 (89.1%) were men. The stalker was in most cases a male, he was unemployed (65.2%), unmarried (91,3%), lived with his parents (67.4%) in the city (91.3%). Stalkers were most often diagnosed with F22 (23.9%) and F23 (23.9%). The stalker with the diagnosis F22 most often pursued the desired partner (33.3%) and the stalker with the diagnosis F23 a person from the social environment (33.3%). After the treatment measure is completed, the stalker often repeats the same act (12.83%).

Stalking remains a major problem and insufficiently tested that must be taken seriously. It is best to look at stalkers as a heterogeneous group whose behavior can be motivated by various psychiatric illnesses, predominantly psychoses.

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In 2022, studies were conducted, the results of which revealed that nursing staff are at greater risk of developing anxiety disorders, and the development of these symptoms is influenced by work schedule and workload level. Also, do not forget about the relationship between anxiety and affective disorders and emotional burnout syndrome (EBS), which is important in diagnosis

The purpose of the study is to evaluate the role of the phenomenon of burnout as a predictor of the development of anxiety and depression based on a comprehensive assessment of EBS and anxiety-affective symptoms among medical residents; identify risk factors for the development of EBS.

A questionnaire including socio-demographic characteristics (gender, age, place of residence), the Maslach Burnout Inventory (MBI) questionnaire; questionnaire scale: PHQ-9 (via Google platform); clinical interviewing was carried out among 98 residents

two profiles of respondents – surgical (57.1%) and therapeutic (42.9%), 73.5% - female, 26.5% - male. The majority were in the age range from 25-29 years (77.6%). The most closely related to burnout is the time spent working at the clinical base and the workload outside of residency. 21% have mild depression, 24% have moderate depression, and 10% have severe depression, which further requires the identification of a correlation between two indicators of EBS and affective symptoms; 31.6% have severe emotional burnout, which affects education and the quality of medical care provided.

The question of the relationship between EBS and depressive symptoms remains open. In our simultaneous study, the relationship between the burnout index and the results of PHQ-9 is traced, which may suggest that EBS is considered as a risk factor for the development of affective symptoms of depression and requires further investigation of the problem It should be noted the importance of introducing digital technologies for the examination of employees and the timely detection of signs of EBS

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IMPORTANCE Changes in suicide rates after a nationwide trauma may be different from changes in psychiatric symptoms or general distress after such events. However, very few studies have examined short-term suicide-related reactions after such an event.

To evaluate the short-term outcome of the events in Israel on October 7, 2023, a large-scale terror attack and unfolding war, on changes in suicidality as reflected in percentages of suicide-related calls in relation to all calls to a national mental health first aid helpline, the Israeli Association for Emotional First Aid (ERAN).

DESIGN, SETTING, AND PARTICIPANTS The data included all interactions via the various ERAN helpline services between January 1, 2022, and December 31, 2023.

EXPOSURES The October 7, 2023, terror attack on Israel.

MEAN OUTCOMES AND MEASURES Changes in the numbers of overall calls and suicide-related calls to the ERAN helpline using an interrupted time-series analysis.

RESULTS. Analysis indicated that overall calls increased significantly on October 7. However, the number of suicide-related calls in the 3 months before October 7 was 1,887, whereas 1,663 suicide-related calls were registered in the 3 months after. The percentage of suicide-related calls decreased significantly on October 7 and gradually increased in the following period.

CONCLUSIONS AND RELEVANCE The findings suggest that although short-term emotional distress increased after national trauma, the percentage of suicide-related calls decreased. These results support previous studies suggesting that suicidality is not one of the immediate reactions to such traumas

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Public sector mental health services in Australia typically do not provide Adult ADHD assessment or treatment, creating a significant reliance on private sector care. Consequently, the demand for private ADHD services has surged, resulting in extended wait times for assessment and treatment.

This study aimed primarily to evaluate the wait times for Adult ADHD assessments for patients referred by GPs to a private clinic. A secondary aim was to analyze the relationship between sociodemographic and clinical variables, including illness characteristics and timing of diagnosis.

Data were collected through retrospective file reviews of consecutive patients referred to the authors’ private clinics for Adult ADHD assessment between January 2023 and October 2024. Patients included in the study met the criteria of an eventual clinical diagnosis of Adult ADHD. Data collected included sociodemographic details, ADHD subtype, psychiatric comorbidities, and wait times for initial psychiatric consultations. Total sample was 68.

Wait times ranged from 10 days to 305 days, with a mean wait time of approximately 4 months (112 days). Almost 30 % of the patients referred had wait time of more than 4 months. The sample comprised nearly equal numbers of male and female patients (33 vs. 35), with ages ranging from 17 to 56 years (mean age: 28.35 years). The majority (68%) were diagnosed with Adult ADHD - Combined Presentation, while 32% had the Predominantly Inattentive Presentation. Nearly all patients received their ADHD diagnosis in adulthood, with less than 5% having a childhood ADHD diagnosis.

There are significant delays in acessing appropriate care for people with Adult ADHD in Australia. Improvement in mental health policy and service delivery with regard to ADHD services is essential if this barrier to access appropriate care has to be overcome.

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Diagnostic overshadowing, or the tendency to attribute physical symptoms to mental illness, poses a significant risk to psychiatric patients, significantly delaying diagnostic and treatment possibilities. This case study highlights the potentially life-threatening consequences of dismissing physical complaints in patients with a history of mental health disorders.

To examine the impact of diagnostic overshadowing on patient care and outcomes, emphasizing the need for comprehensive, unbiased medical assessment, regardless of psychiatric history.

We present the case of a 72-year-old female patient with an extensive history of multiple psychiatric admissions, primarily for somatization and depressive episodes. The patient’s journey began with an initial admission in our psychiatric service. However, her condition rapidly degenerated, as she developed chest pain, leg numbness, and digestive issues. These symptoms were initially attributed to her psychiatric conditions by the internal medicine team, leading to a critical delay in appropriate medical intervention.

As a consequence, the patient’s condition deteriorated rapidly, culminating in a severe septic state. Further investigation revealed that the sepsis had a pulmonary origin, with Serratia marcescens identified as the causative pathogen. This underscores the potential for seemingly benign symptoms to mask serious underlying infections in vulnerable populations. The patient’s case was further complicated by the emergence of several severe medical conditions, including toxic hepatitis, cardiomyopathy, and valvular insufficiencies, highlighting the potential for cascading health issues when initial symptoms are not thoroughly investigated. In the course of treatment, the patient experienced additional complications arising from medical interventions, most notably drug-induced hepatotoxicity, serving as a reminder of the delicate balance required in managing complex cases and the potential for treatment-related adverse events to further complicate patient care.

This case study underscores the critical importance of conducting thorough and unbiased medical evaluations in psychiatric settings, or in cases where psychiatric history is present. It vividly demonstrates how preconceived notions and unconscious biases regarding psychiatric patients can lead to delayed diagnosis and treatment of serious medical conditions, potentially resulting in life-threatening consequences. The case serves as a wake-up call for healthcare providers to approach each patient with an open mind, regardless of their psychiatric comorbidities.

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Subacute combined degeneration (SCD) of the spinal cord is a well-known neurological disorder commonly associated with vitamin B12 deficiency. However, the condition can also present in individuals with normal B12 levels, making diagnosis more difficult.

This paper aims to examine the diagnostic challenges posed by subacute combined degeneration of the spinal cord in patients with normal B12 levels. Specifically, it aims to highlight the importance of early screening for nitrous oxide use and the complexities introduced by co-occurring functional gait disorders.

Literature research was conducted using PubMed databases. The following keywords were used “whippets” or “nitrous oxide” or “inhalant use disorder”, and “subacute degeneration of spinal cord” and/ or “normal B12 levels”. Furthermore, a comprehensive clinical evaluation was conducted, including a detailed inquiry into the patient’s substance use history.

The 56-year-old patient developed symptoms of subacute combined degeneration (SCD) despite normal B12 levels. He experienced worsening tingling sensations, starting in the extremities and moving upward, along with new gait instability requiring a cane. Initially denying substance use, he later admitted to daily nitrous oxide inhalation, which disrupts B12 metabolism and causes spinal demyelination, leading to neurological deficits even with normal B12 levels. The presence of a functional gait disorder complicated the diagnosis, but persistent questioning about substance use and recognizing the effects of nitrous oxide were key to accurate diagnosis.

This case highlights the importance of early and comprehensive substance use screening, particularly in patients presenting with unexplained neurological symptoms. The disruption of B12 metabolism by nitrous oxide can cause significant spinal cord degeneration, even when serum B12 levels are normal. This underscores the need for detailed, persistent questioning about substance use in clinical settings, particularly for patients with risk factors for inhalant abuse. Additionally, an awareness of the multifaceted nature of functional gait disorders is essential for accurate diagnosis and optimal patient outcomes. Routine screening for nitrous oxide use and a thorough examination of gait abnormalities can aid in the timely detection and treatment of subacute spinal degeneration, preventing further neurological damage. By incorporating recommended screening questions and being vigilant about the neurological effects of nitrous oxide, clinicians can better address the diagnostic challenges of SCD and functional gait disorders.

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Workaholism is an addiction, however the obsessive-compulsive components alone may prove insufficient in determining its nature.

The aim of the following study was to determine the mediating role of depressiveness in the relationships between workaholism and personality traits according to the five-factor model among Polish women.

The research study was carried out among 556 women residing in the West Pomeranian Voivodeship in Poland. The research was based on a survey performed using a questionnaire technique. The following research instruments adapted to Polish conditions were employed to assess the incidence of work addiction among female adults: The NEO Five-Factor Inventory (NEO-FFI), The Work Addiction Risk Test (WART) Questionnaire, and The Beck Depression Inventory–BDI I-II.

A positive correlation between the intensity of neuroticism and the work addiction risk was revealed (β = 0.204, p < 0.001). A partial mediation (35%) with the severity of depression symptoms as a mediating factor was observed (β = 0.110, p < 0.001). Respondents characterized by high neuroticism showed a greater severity of the symptoms of depression (β = 0.482, p < 0.001), which is a factor increasing the work addiction risk (β = 0.228, p < 0.001). Respondents characterized by a high level of extraversion displayed lower severity of the symptoms of depression (β = –0.274, p < 0.001). A negative correlation between the intensity of agreeableness and the work addiction risk was revealed (β = –0.147, p < 0.001). A partial mediation (27.8%) was observed. A positive correlation between the intensity of conscientiousness and the work addiction risk was revealed (β = 0.082, p = 0.047). Respondents characterised by a high level of conscientiousness showed a lower severity of depression symptoms (β = –0.211, p < 0.001).

Table 1. Indirect and total effects: Mediation model 1 - Neuroticism

NEU—neuroticims, WART—Work Addiction Risk Test, N – Neuroticism, BDI—Beck Depression Inventory–BDI I-II, b—unstandardized regression coefficient, β—standardized regression coefficient, p—significance level; * Confidence interval (CI) computed with method: bootstrap percentiles; ** Beta (β) is completely standardized effect size.

Depressiveness plays the role of a mediator between neuroticism, extraversion, agreeableness as well as conscientiousness, and work addiction. Depressiveness is a factor which increases the risk of work addiction.

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This research investigates gender differences in psychosomatic responses among individuals of various ages, who had been diagnosed with depressive or anxiety disorders, or were in remission. It evaluates symptoms using the Beck Depression Inventory–Second Edition (BDI) and DASS-42 scales in a cohort of 30 adults in an outpatient clinic environment.

The aim of the study was to demonstrate the relationship between the degree of development of nicotine and the severity of symptoms related to emotions and mood with patients suffering from schizophrenia.

A total of 30 adult participants (ages 21-69) were assessed using the BDI and DASS-42 scales. The study is focused on somatic symptoms (as measured by specific DASS-42 items) and their relationship to gender, age, and the severity of depression. The severity of depression was classified into mild, moderate, and severe categories based on BDI scores.

The study revealed that depression significantly affects both daily functioning and emotional responses to stress, with individuals suffering from severe depression showing psychosomatic symptoms most often, regardless of gender. The findings revealed that women diagnosed with depression reported higher rates of psychosomatic symptoms, such as dry mouth, breathing difficulties, and increased heart palpitations, compared to men. Men, on the other hand, exhibited difficulties in emotional regulation in response to stress, which can potentially indicate a general sense of insecurity and anxiety. Younger female individuals, under the age of 40, diagnosed with depression according to the BDI, exhibited more intense psychosomatic symptoms compared to older female patients. Furthermore, within the same cohort of women under 40, the intensity of psychosomatic symptoms was significantly higher in comparison to men in the same age group.

The study uncovered the strong and interconnected relationship between stress and depression. Moreover, it indicated that the severity of psychosomatic symptoms associated with depression and stress is influenced by gender and age. As a result, it is crucial to adopt a comprehensive and personalized approach when treating patients, considering the severity of their conditions. The BDI and DASS-42 scales are effective in capturing these differences, highlighting their usefulness in both clinical and research contexts.

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Adolescents with developmental disabilities and their families face significant challenges in the transition to adulthood. Comprehensive interventions that include psychological support, daily living skills training, and vocational guidance are crucial. This pilot study tests a program aimed at developing independence and adaptive skills in adolescents with developmental disorders.

The study aimed to evaluate the dynamics of adaptive and independence skills in adolescents with various developmental disorders who participated in a comprehensive intervention program.

10 adolescents (5 boys and 5 girls, mean age 15,11, SD 2,4) were included in the study. Participants were mainly diagnosed with the following primary DS: F70.xx, F84.xx. Also, participants had additional DS such as F48.xx, F80.xx, G40.xx, Q37.xx, Q74.xx. IQ of the participants was measured by the Leiter-3 Performance Scales (mean 62.8, SD 26.9). Comprehensive intervention program lasted the 2022/2023 academic year 3 d/week, 2-3 h/day. The intervention included individual and group sessions, several home visits and the parent groups led by a team of psychoeducational professionals (neuropsychologists, special educators, speech pathologists). The training outcomes were measured by the Vineland Adaptive Behavior Scales (VABS-2). Statistical analysis was performed using the paired samples t-tests and d-Cohen effect size (d).

Significant improvements were observed in all four VABS subscales. Communication improved from 56.1 to 59.6 (t=-3.42, p=0.008, d=-1.08), Daily Living Skills from 59.9 to 66.4 (t=-5.57, p<0.001, d=-1.76), Socialisation from 58.6 to 65.1 (t=-3.84, p=0.004, d=-1.21), and General Adaptive Behaviour Index from 56.9 to 62.0 (t=-5.31, p<0.001, d=-1.68). The largest improvements were seen in Daily Living Skills and General Adaptive Behaviour Index which highlight the program’s effectiveness in fostering independence and adaptive capacities in adolescents.

The pilot study demonstrated the promising effectiveness of the program in developing independence and adaptive skills, suggesting it as a valuable intervention for preparing young people for independent living in adulthood. Following research plans include follow-up analysis of current participants’ outcomes, an increase in sample size, and the implementation of between-group designs.

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Refeeding syndrome is a severe metabolic condition seen in psychiatric patients, particularly those with anorexia nervosa or other eating disorders, after rapid nutrient reintroduction. It involves disturbances such as hypophosphatemia, hypokalemia, and hypomagnesemia, creating challenges in psychiatric and medical settings. Early identification and management are critical to prevent complications like cardiac and respiratory failure (1,2,3).

This study analyzes the pathophysiological mechanisms of refeeding syndrome, focusing on key metabolic, psychiatric and electrolyte disturbances during the refeeding process in malnourished patients. It also discusses prevention strategies and clinical management, emphasizing the role of multidisciplinary teams in early diagnosis and treatment (1,2,3).

A literature review was conducted using Scielo, PubMed, Cochrane, and BMJ, focusing on studies about the pathophysiology, risks, and interventions related to refeeding syndrome. From 40 articles analyzed, 12 published between 2000 and 2023 were selected, focusing on clinical management and treatment guidelines for malnourished patients.

The review highlights that refeeding syndrome (RS) is a serious metabolic condition in malnourished patients, especially those with psychiatric disorders like anorexia nervosa. Rapid nutrient intake can cause metabolic issues, such as hypophosphatemia and hypokalemia, alongside significant psychiatric stress. Anxiety and treatment resistance may increase, especially in patients fearing weight gain, raising the risk of relapse.

Physical discomfort from refeeding, such as fluid retention, can worsen anxiety and complicate treatment. This may lead to extended hospitalization and poor treatment adherence. In psychiatric settings, inadequate management of RS can lead to agitation or self-harm. Preventive measures like controlled carbohydrate intake, thiamine supplementation, and electrolyte monitoring are crucial.

Multidisciplinary teams, including psychiatrists, psychologists, and nutritionists, are key to managing RS. Guidelines like those from NICE recommend gradual refeeding to reduce both metabolic and psychiatric stress.

Refeeding syndrome is a preventable yet potentially fatal condition. Early identification of at-risk patients and careful nutritional strategies are essential to reduce morbidity and mortality. Multidisciplinary teams play a crucial role in managing and educating patients, while further research is needed to inform clinical practices (6-7).

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Smith-Magenis Syndrome (SMS) is a neurogenetic disorder caused by deletions on chromosome 17p11.2 or mutations in the RAI1 gene. It is characterized by intellectual disability, behavioral disturbances like aggression, impulsivity, self-injury, and sleep disruptions. A hallmark feature of SMS is inverted melatonin production, leading to daytime sleepiness and nighttime insomnia, which exacerbate behaviors. Traditional treatments, such as antipsychotics and SSRIs, often show limited effectiveness and can cause side effects, including metabolic syndrome, sedation, and extrapyramidal symptoms.

Lithium has emerged as a promising alternative to manage treatment-resistant behaviors in SMS. Known for its mood-stabilizing properties in bipolar disorder, lithium modulates dopamine and serotonin, reduces aggression, and promotes neuronal plasticity. However, lithium requires close monitoring due to the risks of nephrotoxicity, thyroid dysfunction, and its narrow therapeutic index.

This study explores lithium’s role in managing severe behavioral disturbances in SMS, especially in patients unresponsive to conventional treatments. The objectives are: (1) to review the literature on lithium’s efficacy and safety in SMS and similar neurodevelopmental disorders, and (2) to present a clinical case of a 25-year-old SMS patient treated successfully with lithium after antipsychotics and SSRIs failed.

A literature review was conducted using PubMed and Web of Science, focusing on articles published between 2013 and 2023 on lithium in SMS and related disorders. Additionally, the clinical case of a 25-year-old male with SMS, exhibiting aggression and self-injury, was documented. After other treatments failed, lithium was introduced with regular monitoring of serum levels, renal, and thyroid function throughout six months.

Literature supports lithium’s efficacy in reducing aggression and impulsivity in SMS. Lithium modulates dopaminergic and serotonergic systems, stabilizing mood and reducing disruptive behaviors. In the clinical case, the patient improved within two weeks of lithium therapy. Over six months, aggression and self-injury diminished significantly, with no adverse effects and stable renal and thyroid function.

Lithium is an effective option for SMS patients with treatment-resistant behavioral disturbances, particularly aggression and self-injury. It offers a valuable alternative to antipsychotics and SSRIs, enhancing emotional stability and quality of life. However, careful monitoring is required to prevent toxicity. Further research is needed to confirm lithium’s long-term safety and efficacy in SMS.

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Postpartum stress and mental disorders have a high prevalence in the population. Postpartum depressed states, for example, potentially threaten care of and bonding with the children. Although mothers face specific needs, specialized treatment options are scarce. Online programs to inform on and treat postpartum stress and depression are, to present, not widely available, but have the potential to overcome some of the obstacles of postpartum women finding treatment.

To identify needs of this specific group, we conducted an online survey on women after childbirth, asking for acceptance of e-health programs, sociodemographic, medical and psychometric data.

In a large, anonymized online survey, 453 women have participated. We investigated 1) the acceptance of tailored e-mental health programs according to the UTAUT model in the respective women and 2) characteristics and needs of the specific populations. Based on our findings, we developed an online tool for stress reduction after child-birth based on relevant topics indicated by and data from the literature on specific needs of post-partum women.

In this talk, motivation for this project, research results and ongoing research will be highlighted and discussed.

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Alcohol Use Disorder (AUD) and its comorbidities can have a tremendous negative impact on various activities of daily living, including the capability to manage one’s finances. Adequate financial functioning is essential for an individual’s health and well-being and is key to leading an autonomous and independent life. Problems with financial functioning can have far-reaching personal and legal consequences, and may lead to financial insecurity or poverty, financial victimisation, placement under guardianship, and reduced opportunities for social and societal participation.

To evaluate the financial situation and the strengths and weaknesses in the everyday financial functioning of individuals with AUD.

The financial situation and financial performance of an AUD group (n = 52) were compared to a control group (CG) (n = 95), using the Financial Performance Scale (FiPS). In addition, associations between financial performance and everyday contextual factors (i.e., income, depressive symptoms (i.e., Beck Depression Scale - II), social support (i.e., Brief Perceived Social Support Questionnaire)) were explored.

As compared to the CG, the AUD group reported to have a significantly poorer financial situation, including lower income levels, more frequent debts, and fewer savings. Furthermore, the AUD group reported a significantly poorer overall financial performance (FiPS total score) than the CG, and significant group differences were observed for relatively complex financial tasks, such as financial goal setting and doing tax returns. The difficulties in financial performance of the AUD group were, however, considered as relatively mild, since most aspects of financial performance (i.e., FiPS item scores) did not differ between groups. In the total sample, a better financial performance was significantly associated with a higher income, more perceived social support, and fewer depressive symptoms.

Individuals with AUD reported a poorer financial situation and more difficulties with performing complex financial tasks compared to controls. These reported weaknesses may stem from cognitive and affective impairments associated with AUD, as well as from a scarcity of financial resources. Since a vicious cycle may exist between financial problems and AUD symptoms, it is relevant to enhance the financial well-being of those individuals with AUD who experience financial difficulties.

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