The postpartum period is critical for the onset of mood disorders. Three primary postpartum affective disorders are recognized: baby blues, postpartum depression, and postpartum psychosis, each differing in prevalence, presentation, and treatment. Obstetric factors like primiparity, complications during pregnancy and birth, Cesarean sections, and preterm births are associated with increased neuropsychiatric risks during the puerperium.

This study analyzes the demographic, clinical, and obstetric factors linked to postpartum psychiatric disorders and case management in women hospitalized at the Hospital of Psychiatry in Chisinau, Moldova, over a five-year period.

A longitudinal, retrospective study was conducted, reviewing medical records of 35 women hospitalized between 2019 and 2024. A literature review was also performed to identify relevant obstetric and clinical risk factors.

Patients ranged from 20 to 41 years old, with an average age of 29.8 years ±1,5 years. Out of reviewed cases, 42.9% were from urban areas, 25.7% had a family history of psychiatric illness, and 54.3% developed postpartum psychosis after their first birth, suggesting primiparity as a key risk factor. Psychosis onset ranged from three days to two months postpartum in 45.7% of cases, with 37.1% showing symptoms within the first two weeks. Comorbidities included cardiovascular diseases (20.0%), digestive disorders (14.3%), renal issues (8.6%), and autoimmune conditions (2.9%). Severe mental and behavioral disorders (F53.1) were diagnosed in 74.3% of cases, while 25.7% had milder forms (F53.0). First-time hospitalizations accounted for 88.6%, but 48.6% had prior hospitalizations, with later diagnoses evolving into paranoid schizophrenia, schizotypal disorder, and recurrent depression. Psychological consultation was provided in 48.6% of cases, using tools like PHQ-9, TAG, MMPI, BDI. Treatment varied significantly, with antipsychotics, antidepressants, and benzodiazepines prescribed, yet no standardized protocol was followed.

Primiparity is a significant risk factor for postpartum psychiatric disorders, with early onset often occurring within the first two weeks. This underscores the critical need for prompt recognition and intervention. Comorbid disorders add complexity to patient management. The variability in pharmacological and nonpharmacological treatment highlights a gap in evaluation and case management, potentially delaying timely diagnosis and treatment and it emphasizes the need for consistent and standardized guidelines. The evolving nature of diagnoses, reinforces the importance of ongoing monitoring, psychoeducation, and psychological support throughout the postpartum period.

None Declared

Behavioral addiction is well-established for gambling but still debatable for other pleasurable behaviors such as eating. Attachment style is defined as a psychological concept describing the dynamics of human interpersonal interactions. Studies investigating the influence of attachment style on food addiction are rare.

The aim of the study was to evaluate the association between food addiction and the quality of attachment

A cross-sectional study was conducted online with a non-clinical population. All participants completed an anonymous e-questionnaire containing sociodemographic data, background, substance use and self-reported weight and height. Attachment style was assessed with the Relationship Scale Questionnaire (RSQ). Food addiction was screened with modified Yale food addiction scale questionnaire (mYFAS 2.0).

A total of 114 individuals had fully responded to the questionnaire. The mean age was 32.28 ± 9.32 years with a sex ratio of 0.48. The mean BMI was 23.7 kg/m2 ± 5.5. Most of participants (64%) had an insecure attachment style and 36% had a secure one. The results of the mYFAS 2.0 showed that 11.4% of participants had a food addiction and 8.8% had a severe form. BMI was significantly associated with food addiction which was more common in participants who had a BMI greater than 22.2 kg/m2. A statically significant association between insecure attachment style and food addiction was found.

Our study showed the importance of studying attachment style in food addiction. More research is needed to prove the association between food addiction and different attachment styles.

None Declared

Autism Spectrum Disorder is usually diagnosed in early childhood, but an increasing number of adults are identified as autistic later in life (Huang et al., 2020). Many experience frustration due to missed early intervention opportunities. The lack of recognition of their condition during childhood or adolescence may have contributed to secondary mental health issues, such as anxiety, depression or low self-esteem, complicating the adjustment process after diagnosis (Bargiela et al., 2019). However, providing appropriate support can enhance their quality of life and promote better mental health outcomes.

To assess the patient’s clinical case to identify autism spectrum disorder in older adulthood.

A 23-year-old male patient complained of an inability to concentrate, stress and fear when around people, and difficulties in social situations. Objectively observed: stereotyped movements, noticeable anxiety, avoidance of eye contact, non-compliance with social rules, specific language use and slow thinking. The patient had no history of diagnosed psychiatric illness. Since childhood, he has disliked the feeling of clothes touching his body, physical contact with others, making eye contact. The patient also exhibited impaired social development, being unable to initiate and maintain relationships with peers. Stereotypical, repetitive movements, sensory processing deviations have been observed since childhood. The patient has various phobias from a young age. Psychological examination revealed insufficient attention with observed fluctuations, impaired attention-shifting ability. The pace is very slow, the thinking is characterized by an average level of generalization, concreteness, and stereotypy. Personality traits included rigidity, depression, compulsiveness, internal tension. Based on the clinical picture and psychological tests, the patient was diagnosed with F84.0 Autistic Disorder, according to the International Classification of Diseases, 10 th Revision. In this case, the following methods were used in the assessment: Kraepelin’s and Schulte’s methods, pictograms, the 4-1 method, the Childhood Autism Rating Scale.

The literature highlights that ASD involves difficulties in social interaction, repetitive behaviors, sensory sensitivities, and distinct thinking patterns. Up to 90% of individuals with ASD experience sensory irregularities, which is consistent with this case, as the patient shows social challenges, repetitive movements, slow thinking, and sensory issues. Diagnosing autism in adulthood can improve quality of life by fostering understanding and access to support. In this case, the patient’s past social and workplace difficulties may be attributed to autism, guiding the development of effective support strategies.

In conclusion, while a late autism diagnosis can be life-changing, it also comes with unique challenges that must be addressed through appropriate support.

None Declared

Xp11.22 duplication syndrome, a rare genetic condition first identified in 2009, has fewer than 100 documented cases in the literature. To date, little is known about the genotype-phenotype relationship in this rare genetic syndrome and there is a paucity of data specifically regarding catatonia in this condition.

The primary aim of this case report is to provide a comprehensive description of the clinical presentation, diagnostic approach, and management strategies employed in a case of catatonia occurring in the context of Xp11.22 duplication syndrome and ASD.

Methods of this case report include assessment of the patient via thorough psychiatric and medical evaluation, as well as additional information obtained through chart review and collateral sources.

Our patient, a 15-year-old Caucasian male, was diagnosed with Xp11.22 duplication syndrome at age 3 due to speech and motor delays. At 14, he experienced sudden behavioral and motor changes, including withdrawal, repetitive speech, slowed gait, and repetitive motor behaviors like “rewind” actions. Over 3 months, symptoms included emotional lability, self-injurious behaviors, and significant disruption to daily functioning. Outpatient management with olanzapine and quetiapine worsened agitation. Referred to a specialist, he was started on lorazepam up to 12 mg daily for suspected catatonia. ECT was considered, but further workup ruled out seizure disorder and autoimmune encephalitis. Pediatric neurology found no alternative etiology and recommended ECT. On admission, BFCRS score was 14, showing catatonic symptoms like automatic obedience, mutism, and immobility. Lorazepam was reduced to 2 mg three times daily, and amantadine 100 mg twice daily was continued. An acute ECT course of 12 bilateral treatments over four weeks reduced catatonic symptoms, improving mutism, motor speed, and daily activities. During a 56-day hospitalization, he received 7 maintenance treatments. Upon discharge, BFCRS decreased to 7, and he continued lorazepam and amantadine.

This case report underscores the complexity of managing catatonia in patients with Xp11.22 duplication syndrome and ASD, highlighting the potential need for multimodal treatment approaches. The significant improvement observed with the addition of ECT to the treatment regimen emphasizes the importance of considering this option in cases of refractory catatonia, even in patients with complex genetic and neurodevelopmental backgrounds. This case raises important questions about the underlying neurobiological mechanisms of catatonia in the context of Xp11.22 duplication syndrome and ASD.

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Hypericum spp., particularly Hypericum perforatum (such as St. John’s Wort), produce hypericin and hyperforin, secondary metabolites that play critical roles in the plant’s defense mechanisms. These compounds, characterized by their polycyclic and lipophilic properties, have evolved to deter herbivores and protect against pathogens. Understanding the evolutionary pressures that shaped these compounds enhances our knowledge of their biochemical roles.

This review aims to synthesize current knowledge on the evolutionary development of hypericin and hyperforin within the Hypericum genus, focusing on how these metabolites evolved to fulfill defensive ecological functions.

A comprehensive literature review was conducted, examining phylogenomic studies, structural analyses, and biochemical research related to the biosynthesis of hypericin and hyperforin. We reviewed relevant phylogenetic data to understand the diversification of these compounds across Hypericum spp.

The literature supports that hypericin and hyperforin evolved in response to selective pressures during the Cretaceous-Paleogene boundary, with their complex polycyclic aromatic structures optimized for defense. These structures, which include conjugated π-systems, are central to the compounds’ ability to deter herbivores and resist pathogens, reflecting an evolutionary adaptation that is conserved across the genus.

The evolution of hypericin and hyperforin within Hypericum spp. is a prime example of how secondary metabolites serve dual purposes in nature and human use. The phylogenetic and biochemical insights reviewed highlight the importance of these compounds as both ecological defenses and pharmacologically active agents.

None Declared

Personality disorders are often comorbid with anxiety and depression disorders, complicating the diagnostic process. Cancer patients with personality disorders who face the anxiety and discomfort associated with the diagnosis, symptoms, and medical treatment may encounter challenges. They might distort reality as a means of emotional self-preservation or display aggression.

This review seeks to delve into the challenges in cancer patients exhibiting dysfunctional personality traits or personality disorders.

A non-systematized literature review was carried out on PubMed and Google Scholar. The following terms were searched: (“personality disorders” OR “personality traits”) AND (“cancer” OR “cancer patients”).

Personality traits persistently influence behavior patterns, choices, environmental interactions, and stress responses. Personality can impact cancer development and progression through multiple avenues: by perpetuating unhealthy lifestyle behaviors rooted in personality traits; through negative affect such as depressive or anxious symptoms, as well as ineffective coping mechanisms; and by serving as an etiological factor for somatic diseases or mental disorders that predispose individuals to cancer. While some epidemiological studies have reported a positive association between personality and cancer development or progression, the majority find no significant correlation, leading researchers to conclude that there is no substantial link between personality and an increased risk of cancer.

Meeting the diverse challenges associated with cancer requires adaptability, flexibility, and resourcefulness. Research suggests that specific personality traits, like neuroticism and negative affectivity, are linked to lower quality of life among cancer patients, while extraversion and optimism are correlated with more favorable outcomes.

None Declared

The onset of the COVID-19 pandemic necessitated the declaration of a global emergency. The pervasive fear of contagion has transformed daily life practices, and lockdown measures globally implemented to mitigate virus transmission have led to a spectrum of adverse psychological effects, including anxiety, sadness, frustration, disorientation, and potential for post-traumatic stress disorder, significantly affecting mental health.

This study aims to evaluate the psychological effects of the COVID-19 pandemic on the well-being of trainee teachers.

A descriptive analysis was conducted on a cohort of 370 Moroccan trainee teachers, with a mean age of 28.30 ± 5.99 years. Data were collected using a self-administered questionnaire designed to assess the presence and extent of psychological distress, along with sociodemographic and professional characteristics, during the lockdown.

The findings revealed that 65.1% of the confined trainees experienced obsessive tendencies, and 40% reported that their daily activities were restricted, affecting their normal life pursuits. Furthermore, 68.3% expressed moderate to high stress levels due to various factors, such as financial and professional concerns, potential loss of family members, or personal hospitalization. Half of the trainees expressed concern for their future prospects and feelings of ennui during these unprecedented times.

The findings reveal the enduring psychological impacts of the COVID-19 pandemic on trainee teachers, with significant stress and psychological disorders noted. This emphasizes the critical need for targeted mental health support and proactive resilience-building within educational systems, not only aiding recovery but also preparing educators for future pandemics.

None Declared

Patients with somatization disorder frequently seek medical evaluations for unexplained symptoms, strongly believing they are physically ill and often rejecting psychosocial explanations. In Turkey, easy and low-cost access to healthcare and medications via the General Health Insurance system encourages frequent hospital visits. High patient loads and short consultation times hinder thorough assessments, complicating diagnoses like somatization disorder. Consequently, physicians may practice “defensive medicine,” over-ordering tests and medications to minimize risks. These practices reinforce patients’ beliefs in having an organic illness and increase the risk of polypharmacy.

This case discusses a patient with somatization disorder experiencing multiple hospital admissions and polypharmacy due to the dynamics of the Turkish healthcare system.

A 31-year-old woman was admitted after a suicide attempt, exhibiting depressive symptoms and psychosomatic complaints. Detailed examinations of her socio-demographic data, medical and psychiatric history, current complaints, medication use, and past hospitalizations were conducted.

Since age 16, the patient frequently presented with fainting, convulsions, nausea, and vomiting, undergoing extensive evaluations. She repeatedly visited emergency services for chest pain radiating to her left arm and jaw; coronary angiography found no cardiac pathology. Despite no organic cause, she was prescribed 15 different medications by various specialties, reaching 20 tablets daily, covering cardiovascular, gastrointestinal, endocrine, and respiratory systems. Due to family issues, divorce processes, and social stressors, she exhibited depressive and psychosomatic symptoms, attempted suicide 7 times, and was hospitalized in psychiatric wards 12 times. In her latest attempt, she ingested 15 fluoxetine tablets. Psychiatric evaluation revealed ongoing somatic complaints, and polypharmacy was adversely affecting her health. After consultations, unnecessary non-psychiatric medications were discontinued. Her treatment was adjusted to venlafaxine 300 mg/day, clozapine 50 mg/day, and mirtazapine 30 mg/day.

This case illustrates how structural issues in the healthcare system adversely affect patients with somatization disorder, increasing polypharmacy risk. Unnecessary tests and treatments reinforce beliefs in organic illness and complicate management. Healthcare professionals should approach such patients carefully, avoid defensive medicine practices, and consider early psychiatric evaluation. Policy-level changes are needed for the healthcare system to better address these patients’ needs.

None Declared

Medical staff is one of the main participants in psychiatric care quality management system. At the same time, it is not enough to ensure high level of staff qualifications only. It is also necessary to determine staff satisfaction with their professional activities, levels of staff well-being and of professional burden. That’s why, using factor analysis in the process of identification of factors affecting these parameters of psychiatric staff is an important task.

To work out factor models determining the main components affecting psychiatric staff professional burden and satisfaction of staff with provided psychiatric care; to justify proposals for improving medical staff professional activities and quality of care.

Adapted questionnaire «Assessment of the burden of psychiatric staff working in psychiatric institution» (WHO, 1994); Questionnaire «Assessing the satisfaction with quality of care by medical staff of psychiatric institution» (Solokhina et al., 2014). Factor analysis (principal component analysis with quatrimax rotation and factor selection according to the Cattell criterion) was used in the IBM SPSS Statistics 27 software environment. The study involved 73 nurses (age 44,55±11,56) of Moscow psychiatric hospitals № 1 and № 4. The nurses were included in the analyses as the most representative staff category closely contacting with patients.

Using factor analysis, a model identifying the most significant components affecting of the professional burden of the nurses and reflecting 50.9% of the sample variance was worked out. The parameters include: “physical and emotional problems”, “interpersonal problems”, “intrapersonal problems”, “stigmatization”, “experiencing difficult situations related to patients” (16.86%, 11.67%, 9.52%, 6.61%, 6.34 of the sample variances correspondingly).

The factor model of nurse’s satisfaction with psychiatric institutions activities includes “organizational” (33.66%), “procedural” (7.44%), “logistical” (6.92%), “support” (5.14%), “alternative forms of assistance” (5.05%) factors, which in total make up 58.8% of the sample variance.

Factor models are a powerful tool which permits to analyze complex information and to identify factors affecting important indicators in a quality management system. Therefore, factor analysis should be carried out regularly in order to prevent different risks of care quality violation. It is also important to introduce psychological support to medical staff and to improve team methods of work.

None Declared

The area of Sensory Integration has its origin in the 1960s, developed by the neuroscientist and occupational therapist Jean Ayres. Although the first studies focused on the relationship between learning problems and atypical sensory processing, today there are new applications in clinical practice. Sensory integration is defined as the neurological process responsible for organizing the sensations that one receives from one’s own body and from the environment, in order to respond and function adequately in relation to environmental demands.

This work has several objectives. On the one hand, review the concept of sensory integration, the definition and theoretical basis as well as the scientific evidence of this theory. On the other hand, review the use of sensory integration in psychiatric practice from the 1960s to the present day. Also, explain the experience of a child and adolescent psychiatry unit with the use of sensory integration as part of the treatment. Finally, new challenges, approaches and needs of psychiatry services will be considered for the implementation or improvement of this new work tool in a multidisciplinary team.

A bibliographic search has been carried out in the main sources of medical information such as pubmed, uptodate as well as in national and international journals. Likewise, the knowledge and clinical experience of the team has been reviewed.

In our clinical experience, the child and adolescent psychiatry device for intensive outpatient treatment where patients between 12 and 17 years of age with severe mental disorders attend, initially passed the sensory profile by occupational therapy to patients who presented behavioral or emotional symptoms. not consistent with the psychopathological examination. In view of the results and magnificent progress, this intervention began to be carried out systematically to the boys who joined the device. We present the case of a 15-year-old patient who attended the device due to emotional dysregulation and suicidal risk. During evolution, possible difficulties were seen in sensory integration that made it difficult for the patient to improve with psychiatric or psychological therapy alone. The patient was evaluated and treated by the team’s occupational therapist, specifically trained in sensory integration. It was evaluated with the sensory profile, with the results having a sensory sensitivity profile and auditory and tactile avoidance. The specific measures that were carried out were: sensory diet and environmental modifications.

Sensory integration is a therapy with sufficient clinical evidence to implement it in child and adolescent psychiatry services. Therapy should be performed by suitably trained and validated occupational therapists. This therapy must be included in a multidisciplinary approach to the patient and specific modifications that can be developed at home and at school are provided.

None Declared

Since the beginning of the full-scale war with Russia, 7.7 million Ukrainians have been forcibly displaced from their homes and are currently living in internally displaced persons (IDP) camps. According to the International Organization for Migration (IOM), the proportion of IDPs in Ukraine’s total population has reached 17.5%, indicating that one in six individuals has been displaced.

The purpose of the study is to investigate the clinical, psychological and pathological patterns of anxiety disorders of psychogenic genesis. The main group consisted of 93 IDP patients with anxiety disorders, both sexes, aged 20-55 years.

SCL-90-R; HAM-A, HAM-D; Spielberger-Khanin Scale and Questionnaire of neuropsychological stress by T.A. Nemchin.

It has been established that the clinical structure of anxiety disorders in the examined patients is represented by a mixed anxiety-depressive reaction (28.2±1.2% of the examined), panic disorder (36.4±1.3%) and generalised anxiety disorder (35.4±1.3%). At the same time, in the clinical structure of anxiety disorders in IDPs, along with the dominance of anxiety symptoms, there is a high severity of depressive manifestations. Based on data obtained in the course of our research, a multifactorial model of formation of anxiety disorders in IDPs was developed. The catalyst for anxiety disorders is the very fact of forced displacement, uncertainty of future, situations of loss, effects of combat stress, information stress and situations of increased responsibility.

High levels of anxiety, somatisation, depression, obsessive-compulsive disorders, interpersonal sensitivity, and phobic anxiety according to SCL-90-R scale are prognostically significant in formation of anxiety disorders; severe depressive and anxiety episodes according to the Hamilton Anxiety and Depression Scales; high levels of personal and situational anxiety according to the Spielberger-Khanin Scale and excessive levels of neuropsychological stress.

The basis for the formation of anxiety disorders in IDPs is a low level of resilience, which entails a high level of social frustration in this cohort. We have developed and tested a comprehensive personalised system for treatment of anxiety disorders in IDPs with differentiated use of psychopharmacotherapy, psychotherapy and psychoeducation.

None Declared

Domestic violence is a scourge that continues to spread, destroying family ties and increasing the prevalence of divorce in our Arab-Muslim societies. In our culture, women often find it hard to disclose domestic violence in general, but what about sexual violence? It’s the most under-reported form of violence in Tunisia. However, few studies have focused on sexual violence in the Tunisian context, or on the psychological repercussions of this form of violence.

To determine the prevalence and describe the different forms of sexual violence perpetrated by husbands against their wives and to evaluate marital satisfaction and its relation with sexual violence.

This is a descriptive and analytical cross-sectional study of 122 married women who consulted for medical expertise following domestic violence.

An anonymous survey was asked to these ladies. It included a section for collecting socio-demographic and clinical data on the woman and her partner, and a section for assessing the various forms of sexual violence.

We used the Azrin scale to evaluate marital satisfaction.

One hundred and twenty-two women victims of domestic violence were included in our study. Their average age was 35.66 years, it oscillates between 18 and 64 years. A family history of domestic violence was found in 32.8% of women (N=40). The battered family member was the mother in 41.5% of cases.

A history of childhood sexual abuse was found in 14.8% of women (N=18).

Half of the women (53.3%; n=65) were victims of sexual violence. Different types of sexual violence were reported with decreasing prevalence: forced intercourse (36.1%), unwanted intercourse (15.6%), unusual type of intercourse (31.1%) and pain during intercourse (4.9%).

Seventy-one percent (N=87) had poor marital satisfaction. On multivariate analysis using binary logistic regression, we found that sexual violence: an unusual type of relationship (p=0.04; OR=4.62) and the presence of psychological distress (p=0.04; OR=2.63) were independent factors associated with poor marital satisfaction.

Our study suggests that more attention should be provided to women victims of domestic violence in order to detect any form of sexual violence and provide them with the necessary psychological support.

None Declared

Thyroid and sex hormones play pivotal roles in the regulation of various physiological processes, including brain function. Dysregulation of these hormones has been increasingly associated with a range of neuropsychiatric disorders, including depression, anxiety, cognitive impairment, and mood disorders.

This review aims to systematically examine the correlation between thyroid and sex hormones disorders and the spectrum of emerging neuropsychiatric manifestations, enlightening the pathophysiological mechanisms.

A literature search was performed in many databases including PubMed, Web of Science, and Google Scholar for studies published in recent years. Eligible randomized controlled trials, observational studies, and systematic reviews examining neuropsychiatric outcomes in patients with thyroid or sex hormone disorders were included. Findings were synthesized both quantitatively, with meta-analyses where possible, and qualitatively, with thematic analysis for heterogeneous data.

The review identified a strong association between thyroid dysfunctions and neuropsychiatric disorders such as depression, anxiety, and cognitive decline. Hypothyroidism was consistently linked with depressive symptoms likely due to impaired serotonergic and dopaminergic neurotransmission, along with decreased hippocampal neurogenesis. Conversely, hyperthyroidism, characterized by elevated thyroid hormone levels, was associated with heightened anxiety, irritability, and emotional lability, possibly through dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and increased sympathetic nervous system activity.

In the context of sex hormone disorders, estrogen deficiency during menopause was correlated with a significant increase in behavioral and cognitive impairments, potentially mediated by reduced modulation of serotonin receptors, diminished synaptic plasticity, and increased neuroinflammatory responses. Similarly, testosterone decline in aging men was linked to mood and cognitive disorders, with evidence pointing to disruptions in androgen receptor signaling and alterations in γ-aminobutyric acid (GABA)ergic and glutamatergic pathways.

This review underscores the significant link between thyroid dysfunctions, particularly hypothyroidism and hyperthyroidism and mood disorders such as depression and anxiety, while also indicates that estrogen deficiency and testosterone decline contribute to cognitive impairments and emotional disturbances. These findings help the healthcare providers to recognize neuropsychiatric symptoms as potential indicators of underlying endocrine disorders.

None Declared

Chronic pain is a prevalent issue among breast cancer survivors, often causing significant distress, disability, and interference with daily activities. Affecting around 18% of the global population, chronic pain is the leading cause of years lived with disability. Among breast cancer survivors, it has become a key focus due to its high prevalence and impact on quality of life.

To assess the prevalence and characteristics of chronic pain in breast cancer survivors and examine its correlation with anxiety, depression, and interference with daily life activities.

This is a cross-sectional descriptive and analytic study conducted on 100 women treated for breast cancer at the medical oncology department of Fattouma Bourguiba University Hospital. The study spanned eight months (June 2021–February 2022). Pain characteristics were assessed, and anxiety and depression levels were measured using the Hospital Anxiety and Depression Scale (HADS). Pain-related catastrophic thinking was evaluated with the Pain Catastrophizing Scale (PCS), and family functionality was measured using the Family APGAR score.

The study involved 100 breast cancer survivors, with a mean age of 53.6 ± 10.1 years.

Our entire population confirmed having chronic pain for more than 3 months, most of them (53%) had it from 2 to 5 years

The median duration of chronic pain was 3 years [IQR: 2-5], with the most common pain locations being the breast area (72%) and upper limb (27%). Pain intensity was predominantly mild (62%), followed by moderate (34%), and severe (4%).

Chronic pain significantly interfered with daily activities, especially in patients with moderate to high pain intensity (p < 0.001), affecting both affective and activity clusters. The mean Pain Catastrophizing Scale score was 7.79 ± 5.25, indicating mild catastrophic thinking, which was most likely due to the low pain intensity experienced by the majority.

Anxiety levels were significantly correlated with higher pain intensity (p = 0.013), whereas depression, though elevated in patients with more severe pain, did not demonstrate a statistically significant association (p = 0.135).

The majority of participants were from highly functional families, with 88% reporting strong family support

Despite the prevalence of chronic pain, fatigue was not significantly related to pain intensity.

Chronic pain in breast cancer survivors significantly interferes with daily activities, particularly among those with moderate to high pain intensity. Anxiety is notably more prevalent in patients experiencing more severe pain. These findings underline the importance of comprehensive pain management strategies and psychological support for breast cancer survivors.

None Declared

A case report on the use of Brexpiprazole for the treatment of behavioral disturbance in dementia is presented.

A brief review of the benefit of Brexpiprazole treatment in the treatment of dementia is presented in a case report.

This is an 84-year-old female patient with newly diagnosed multifactorial cognitive impairment. The patient was brought to Mental Health because of the behavioral alteration presented. She reported delusions of harm, theft and a suspicious attitude in relation to moderate cognitive impairment, as well as the recent transfer to a nursing home. In addition, the nursing home had observed that he presented erratic wandering that affected the functioning of the residential environment. In response to this symptomatology, the patient was aggressive and physically heteroagressive towards the caregivers.

The patient, due to the clinical presentation, had been treated with benzodiazepines, which had worsened the episodes of agitation and confusion, interspersed with episodes of somnolence. Therefore, her treatment was modified by adding quetiapine and haloperidol, worsening her psychomotor restlessness and alertness.

When the patient was seen in the psychiatry department, she presented a high level of restlessness that corresponded to akathisia due to the haloperidol, as well as a fluctuating level of alertness that oscillated between wakefulness and somnolence. Despite the overmedication, according to the residency report, the patient maintained episodes of agitation and heteragresivity during wakefulness.

For this reason, it was decided to replace the antipsychotic treatment of quetiapine and haloperidol, progressively with brexpiprazole at 4mg DMD divided in two.

After two weeks of monotherapy with brexpiprazole, the side effects of the previous treatment disappeared, and the patient’s daily functioning improved. She remained alert, the suspicious attitude and the delusions of harm disappeared. The episodes of behavioral disturbances had also ceased.

For the treatment of behavioral symptoms in dementia, it is important to have an effective approach to the clinical management without causing adverse effects that can be severe in elderly people. Brexpiprazole is an atypical antipsychotic, being a 5HT1A and D2 partial agonist and a 5HT2A antagonist, and is an appropriate treatment in this age group.

None Declared

Violence is a major global health concern among patients with schizophrenia. However, the triggers of violent behavior remain unclear. In previous studies, familial risk factors are believed to be associated with mental disorders and violence. The relationship between parental bonding or childhood adversity and psychopathologic behavior (such as violence) has rarely been evaluated.

The study aimed to explore the relationship between violent behavior and childhood experience and to determine the role of the early child-parent bond in violence risk in patients with schizophrenia.

The study enrolled 287 patients with schizophrenia and 100 healthy controls. Patients were divided into 3 groups: patients with homicidal history (Group A), patients with violent behavior and without homicidal history (Group B) and patients without violent behavior (Group C). Childhood trauma questionnaire (CTQ), parental bonding instrument (PBI) and modified overt aggression scale (MOAS) were used to explore the violent behavior and childhood experience. All individuals participated voluntarily and provided informed consent. This study was approved by the ethics committee of the Academy of Forensic Science.

The findings indicated the proportion of males to be higher in the patient groups than in the healthy controls, especially in the group with homicidal history. Patients had a significantly higher prevalence of sexual abuse, emotional abuse and emotional neglect than the healthy controls. The emotional abuse and emotional neglect were found to be positively and negatively related to MOAS scores. Maternal over protection was found to be negatively related to the MOAS scores. On the CTQ subscales, emotional neglect was significantly associated with violence risk (OR=1.13, 95% CI=1.04–1.22). On the PBI subscales, maternal and paternal care (0.84, 0.74–0.94 and 1.30, 1.13–1.49) and over protection (1.18, 1.07–1.29 and 0.87, 0.81-0.95) were found to be significantly associated with violence risk. Maternal and paternal over protection were significantly associated with homicide risk (0.87, 0.78-0.97 and 1.10, 1.01-1.20).

The schizophrenia patients with violence might suffer lower paternal care and emotional abuse during the childhood. In terms of violence in schizophrenia patients, paternal over protection and maternal care might be a protective factor and emotional neglect, maternal over protection and paternal care might be a risk factor. In terms of homicide in schizophrenia patients, paternal over protection might be a risk factor and maternal over protection might be a protective factor. Therefore, childhood trauma and parental care and over protection could be a potential reference indicator for assessing violence risk in patients with schizophrenia.

X. Ling: None Declared, S. Wang: None Declared, N. Li: None Declared, Q. Zhang: None Declared, H. Li Grant / Research support from: This study was supported by National Key R & D Program of China [grant number 2022YFC3302001], National Natural Science Foundation of China [grant number 81801881], Science and Technology Committee of Shanghai Municipality [grant numbers 20DZ1200300, 21DZ2270800, 19DZ2292700].

Sexual functioning is an essential aspect of human existence. Sexual dysfunctions are prevalent and negatively affect the quality of life in the general population. Little attention has been paid to the sexual function of health workers.

The aim of our work was to evaluate sexual dysfunction among Tunisian doctors and to determine associated underlying factors.

A cross-sectional study was conducted online, from January to March 2024, via a pre-established questionnaire. Tunisian doctors, who had finished their medical studies, working in the public or private sector and who agreed to anonymously respond to the questionnaire were included. Sociodemographic, economic, clinical data and those related to the medical profession were collected. Sexual function was evaluated with the Arizona Sexual Experience Scale (ASEX).

A total of 80 individuals had fully responded to the questionnaire. The mean age of participants was 36.81 ± 7.49 years and 68,7 % (n=55) of them were male. Ninety five percent (n=76) were married and 77.5 % (n=62) had children. The mean working hours per week was 34.32 ± 5.32. A regular physical activity was practiced by 35 % (n=28) of individuals. The mean monthly income was 3592.5 ± 596 Tunisian Dinars. The results of the ASEX showed that 23,8 % (n=19) of participants, 23,6 % (n=13) of male participants and 24 % of female (n=6) participants had sexual dysfunction. Ten per cent of individuals (n=8) have previously consulted a sexologist. Longer working hours, lower monthly income, less physical exercise were significantly associated with increased risk for sexual dysfunction.

Sexual dysfunctions seem to be common among Tunisian doctors. Knowledge about their sexual functioning is important to promote their physical and mental health and to improve the care delivered.

None Declared

Blended therapy (BT) is defined as the use of digital tools combined with traditional face-to-face therapy. Despite growing evidence concerning BT in outpatient settings, there is not much data on BT in inpatient care. To our knowledge, this is one of the first studies to investigate the implementation of BT in the routine care of psychiatric inpatients.

Our objective was to identify factors potential barriers and facilitating factors influencing the implementation of BT in psychiatric inpatient settings.

We used a retrospective, exploratory qualitative research design and developed a semi-structured interview to collect our data. This enabled us to gain insights into the experiences of healthcare staff and patients. Participants were asked to reflect on the following themes we had pre-defined: resources, support, integration and sequential BT.

Therapists cited work overload with inadequate time adjustments and lack of ongoing training to sustain the use of BT in the long term as common barriers. A key finding of this study from the therapists’ perspective was also the importance of a clearly defined concept and setting for successful implementation. Patients valued the availability of satisfactory instructions for use, integration by therapists and a flexible setting. There were mixed opinions on sequential BT, with therapists mentioning in particular a lack of resources for patient care after discharge.

In summary, the results show that therapists reported more barriers in contrast to patients’ perceptions. This highlights that while understanding the patient’s perspective is important, healthcare professionals play the central role in implementing and maintaining BT.

None Declared