Lithium is a widely used treatment for mood disorders, particularly bipolar disorder, but its narrow therapeutic range often leads to toxicity. A major complication is lithium-induced neurotoxicity, which is generally reversible with dose adjustment or discontinuation. However, symptoms persisting beyond two months after cessation are deemed irreversible and may result in permanent neurological damage(Verdoux et al. Encephale 1991;17:221-4). The permanent sequelae, first recognized in the 1980s, are known as “Syndrome of Irreversible Lithium-Effectuated Neurotoxicity” (SILENT). SILENT is marked by irreversible neurological damage, including cerebellar dysfunction, dementia, parkinsonian syndromes, choreoathetosis, brainstem syndromes and peripheral neuropathies (Farouji et al. Cureus 2023;15).

This case report aims to highlight the rare SILENT syndrome and underscore the importance of early diagnosis and management of lithium-induced neurotoxicity.

Case 1: A 61-year-old male with a long-standing diagnosis of bipolar disorder, managed since age 18, presented in 2022 with speech and gait disturbances while on lithium therapy. His lithium level was elevated (2.31 mmol/L), and he underwent emergency hemodialysis after the suspected interaction of NSAIDs with lithium. Despite normal brain imaging, the patient experienced persistent symptoms of postural instability, ataxic gait, dysarthria and tremor over two years. Subsequent imaging revealed cerebral atrophy and ischemic white matter changes. Neuropsychological testing showed frontal-type memory deficits, leading to a diagnosis of Syndrome of Irreversible Lithium-Effectuated Neurotoxicity.

Case 2: A 71-year-old male with a 40-year history of bipolar disorder presented with tremors, bradykinesia, dysarthria and anorexia. Blood tests showed renal impairment (creatinine 2.3 mg/dL) and elevated lithium levels (1.7 mmol/L), likely secondary to chronic kidney disease. Lithium was discontinued, and valproate was initiated. Nine weeks later, he returned with increased energy, insomnia, impulsivity, auditory hallucinations, temporal disorientation, perseverative speech, and gait instability. Examination revealed agitation, a blank stare, mild dysarthria and gait imbalance despite normal routine blood tests.

Lithium poisoning is a common clinical issue. Elevated lithium levels can result from excessive intake, impaired excretion or drug interactions. SILENT syndrome, a rare complication of lithium therapy, leads to permanent neurological damage, including cerebellar dysfunction, ataxia, dysarthria and tremor (Konieczny et al. Alpha Psychiatry 2024; Mar.).

This emphasizes the importance of monitoring for drug interactions and conducting regular neurological assessments to detect and manage lithium-related complications early. The case underscores the need for heightened clinical awareness to prevent permanent lithium neurotoxicity.

None Declared

Mental healthcare systems in Europe differ greatly in terms of access and care settings. Whereas comparisons of the structures partly exist (e.g. REFINEMENT project), not much is known neither about the patient journeys for specific disease entities nor about outcomes of these differently organized systems.

The first objective is to review the existing literature on structural differences in mental healthcare sytsems in Europe. The second objective is to discuss options for studies that gather differences in patient journeys and outcomes for specific disease entities.

Narrative review about structural differences in mental healthcare in Europe and discussion of a study protocol for assessing patient journeys for 6 important disease entities (Severe Major Depressive Disorder, Schizophrenia, Behavioural disorders in Dementia, Borderline Personality Disorder, PTSD, Alcohol Addiction).

European mental healthcare systems differ greatly in terms of structures of mental healthcare provision. E.g. Belgium had 141 hospital beds per 100,000 inhabitants, Germany 131, the Netherlands 112, Switzerland 95, Austria 75, and Denmark 5 (eurostat, 2024a). However, what these numbers mean for the patient journeys and for the systems outcomes is unclear. We discuss an approach for examining prototypical patient journeys for the above-mentioned disorders and for comparing their outcomes in terms of quality of life and global psychosocial functioning.

We are looking for European partner institutions for establishing a mental health systems research network. The goal is to set up studies that allow to compare patient journeys and outcomes within the differing European Mental Healthcare Systems as a basis for mutual learning from best practice examples.

None Declared

Autoscopic Phenomena (APs) are rare perceptual experiences where individuals perceive a visual double or duplicate of their own body. It has been recognized since ancient times, but gained significant attention in the 19th century, both through its depiction in romantic literature and in neuropsychiatric studies; in the literature, their association with epilepsy and schizophrenia is very extensively documented. Recent research brought new insights into the neurobiology of these phenomena.

In this article, we aim to review the phenomenology and psycopathology of APs.

Narrative literature review.

From a phenomenological perspective, three main conditions can be identified. In Autoscopy, the person sees a double, but does not feel a connection with it, meaning that they can distinguish between themselves and the double. In Out-of-body Experience (OBE), the individual feels as though they have left their body and observe themselves from an external perspective. In Heautoscopy, the boundary between the self and the double is blurred, causing uncertainty about where one’s “self” is located, representing a middle ground between autoscopy and OBE.

Current research suggests that APs are linked to dysfunctions in the normal integration of body ownership, self-location, and perspective-taking, caused by lesions in regions responsible for integrating multisensory inputs (visual, proprioceptive and vestibular). All types of APs have in common a dysfunction specifically in the temporo-parietal junction (TPJ), a brain area involved in processing self-location and integrating sensory inputs to create a unified sense of self; other common areas include the insula and cingulate cortex.

Regarding to the different networks of APs, Autoscopy primarily involves abnormalities in the visual processing regions (as the occipital and parietal lobes), causing a visual perception of double; OBEs are caused by dysfunctions in areas responsible for self-location and vestibular processing (such as the medial prefrontal cortex), leading to a sensation of floating outside one’s body; lastly, Heautoscopy engages more widespread brain dysfunctions, including the regions involved in self-representation and embodiment, leading to ambiguity in self-location.

APs challenge our understanding of the bodily self and how identity is constructed, raising questions about how the brain creates a unified sense of being in a body and how this can break down under certain pathological conditions. Although much is unknown, one thing is for sure: these phenomena demonstrate that the sense of self is not fixed, and the study of its disruption, by exploring its phenomenology and psychopatology, may contribute to reveal the underlying processes involved in bodily self-consciousness.

None Declared

The results of achievements in mastering the program material of students of a special school by the end of the fourth year of study are characterized by a large variability in training, which allows us to assert the need to develop and apply special teaching techniques and methods, harmonize the academic workload

to study the mental capabilities and identify learning difficulties of fourth-grade students with mental disabilities in elementary school by the end of study

Two samples of fourth-graders (132 students) were identified: Group 1 - 100 students with mild mental retardation, Group 2 - 32 students with severe intellectual disabilities. Methods: observation, pedagogical experiment, cluster analysis

Clustering criteria: volume and level of assimilation of program material in academic subjects; achievement of subject and personal results.

In group 1 (75%), 3 clusters were identified by academic performance in the main academic subjects, which are uniform in terms of the variability of dynamics, which indicates the homogeneity of the group of students; however, the groups differ in the level of achievement of subject and personal results (sufficient, average, minimal).

In group 2 (25%), 3 clusters were also identified, which are variable, but do not duplicate each other, and have an individual spread of indicators in the dynamics of subject and personal results within each cluster, which indicates the heterogeneity of the group of students in each cluster

three levels of dynamics in the education of students with varying degrees of mental retardation were identified. The range in the variations of the results of the 2nd group of students with severe intellectual disabilities indicates the need for individualization of education, selection of partial programs taking into account the special educational needs of each student, and the development of special personalized approaches to education. Apparently, it is also necessary to select the optimal amount of academic workload and the level of complexity of the material studied, compliance with health-saving technologies in accordance with the individual psychological characteristics of the student

None Declared

Diabetes mellitus is the most common endocrine disease that occurs as a result of an absolute or relative lack of insulin and is accompanied by a number of different somatic, neurological and mental disorders. The aim of the study is to investigate the clinical, psychopathological and pathopsychological features of cognitive and emotional disorders in patients with type II diabetes mellitus.

In the course of the study, a comprehensive examination of 109 patients with type II diabetes mellitus of moderate to severe forms of disease (52 females and 57 males), aged 35.9 ± 10.1 years was conducted.

MMSE, Addenbrooke’s Cognitive Examination, Luria’s Memory Words Test-Revised, Symptom Check List-90-Revised, HAM-A, HAM-D, The State-Trait Anxiety Inventory Scale. It has been established that patients with diabetes mellitus have mild to moderate cognitive impairment, which is manifested by a reduction in verbal memory, a decrease in the speed of counting operations, minor difficulties in orientation and a slight drop in the perceptual and diagnostic sphere, a decrease in concentration and memorization of the information received, and a pronounced reaction of mental fatigue.

Presence of mild (51.2% of men and 49.8% of women) or moderate (49.8% and 50.3%, respectively) cognitive impairment according to MMSE and Addenbrooke’s Scale; decreased ability to concentrate and impaired working memory in patients with type II diabetes mellitus was noted.

Emotional disorders in patients with diabetes mellitus are represented by anxiety (33.4% of men and 35.2% of women), depression (26.6% and 33.1% of patients, respectively), astheno-hypochondriacal (27.3% of men and 19.1% of women), and hysteroform (12.7 and 12.6%, respectively) variants of psychopathological syndromes.

A comprehensive, personalized system for correction of cognitive and emotional disorders associated with diabetes mellitus has been developed and tested. System comprises four stages: diagnostic, therapeutic, rehabilitation and dynamic monitoring. It employs a range of therapeutic modalities, including pharmacotherapy, psychotherapy and psychosocial programmes.

The implementation of the developed system for correction and prevention of emotional and cognitive disorders in patients with type II diabetes mellitus contributes to an improvement in the quality of medical care for patients with type II diabetes mellitus, as well as an improvement in their quality of life and psychosocial functioning.

None Declared

This study focuses on studying the most common psychological and physiological phenomena of adolescents, which directly and indirectly affect adolescent behavior and emotions, especially school children, using the BESR-2 test. Youth and peer pressure, crime, family and school stress, drug use, alcohol use, smoking, rape, theft, etc., create anxiety and psychological causes for teenagers in our society. In order to prevent and reduce the negative impact on the behavior and emotional state of the youth, it is imperative to study the current problems and find better solutions. In relation to this social need, the purpose of this study is to conduct a pilot study on how to diagnose the behavior and emotional state of adolescents using the BERS-2 test.

When analyzing the relevant theories and principles of the BERS-2 test, the research selects appropriate methods and methodologies (1) review and analyze the theoretical basis of the author’s use of the test; (2) examine the internal reliability and convergent validity of the BERS-2; (3) use and examine internal reliability and convergent validity; and finally (4) identify research limitations and future research directions.

1,812 students from Ulaanbaatar and the local area, 1,812 teachers, and 1,812 parents, a total of 5,436 participants are participating in the pilot study. In this study, one of the most widely used strengths assessment tools in social services is the Behavioral and Emotional Rating Scale-2 (BERS-2), which includes separate rating scales for youth, parents, and teachers. Although the three assessment forms are similar, a few items have been slightly worded to better reflect the views of Mongolian youth, parents, and teachers. The Interpersonal Strengths subscale (14 items) measures a child’s ability to interact with others in social situations. Family involvement (10 items) assesses the child’s relationship with the family. The internal self-efficacy subscale (11 items) focuses on how the child perceives his or her own functioning. The school functioning subscale (9 items) assesses the child’s performance and abilities in school. The Power Influence subscale (7 items) measures a child’s ability to exert and receive influence from others.

The main results of the study are presented as follows.

1. 1. Cronbach’s alpha coefficient for test validity was 0.816.

2. 2. Behavioral and emotional indicators of the surveyed teenagers are 34.56% on average.

3. 3. In terms of self-esteem of teenagers, their behavioral and emotional indicators are 47.6% or average; parents - 33.3%; teachers are 29.6%.

it was observed that the superiority of emotions and attitudes is weak for middle class students. In other words, Mongolian children believe that it is necessary to develop emotional and behavioral strengths.

None Declared

Functional neurological disorder (FND) is diagnosed in approximately one-third of admissions to the general neurology outpatient clinic. Although it affects both gender in a wide age range, it occurs more frequently in women between ages of 35 and 50. As a common neuropsychiatric disorder affecting mostly young people at productive ages, FND also leads to an important socioeconomic burden. For this reason, clinical and research activities tended to increase recently in order to develop new neuroscientific approaches for the treatment of this disorder. Various new clinical centers that offer specialized and multidisciplinary treatment to FND patients, have been established around the world. Likewise, a study group was established in Hacettepe University Adult Hospital, where FND patients were started to be treated by a multidisciplinary team, by also considering the specific needs of our country’s population.

Here, we aim to share the phenomenological and clinical characteristics and treatment response of patients with functional neurological disorders (FND) who received short-term inpatient multidisciplinary treatment in a university hospital between 2020 and 2023.

FND study group at Hacettepe University Adult Hospital was founded by 2 neurologists, 2 psychiatrists, 1 psychologist and 2 physiotherapists.

Within the framework of the protocol, FND patients were first informed about the disease process by a neurologist and a psychiatrist and then followed up for further need for an inpatient multidisciplinary approach.

During hospital admission in the room reserved for FND patients in the neurology ward, the treatment protocol was implemented in such a way that each session included one hour of cognitive behavioral therapy-based psychotherapy and at least 2 hours of intensive physiotherapy including FND-specific approaches for at least 5 days.

Demographic and clinical characteristics of the patients were noted, their fitness levels before and after treatment were evaluated with a visual analogue scale, and the patients’ perceived improvement levels were also evaluated with VAS and recorded as a percentage.

The majority of patients were women (19/11).

The age range was wide, between 19 to 75 (average 44 years).

Patients were classified under four groups based on the predominant symptom (gait disorders:15, fixed dystonia: 9, swallowing and speech problems:3, sensorial problems:3)

The level of improvement perceived by the patients was the best in those with sensorial problems, and the worst in those with swallowing and speech problems (%40).

Those with the lowest level of perceived wellness in terms of general health were patients with dystonia component.

Multidisciplinary FND rehabilitation may provide different degrees of benefit to FND patients of different subtypes. Our results may have the potential to contribute to clinicians and academicians in predicting treatment outcomes.

None Declared

Some individuals with chronic pain using opioid analgesics may unknowingly experience mood improvement, which can lead to compulsive opioid use. To address this issue, the DOLMEN program was developed, involving a multidisciplinary team of clinical psychologists, psychiatrists, pain specialists, nurses, pharmacists, and geneticists for a comprehensive treatment approach.

Our objective was to describe the DOLMEN program and assess its effectiveness in improving emotional pain, psychiatric symptoms, functioning, quality of life, and pain management. The program also aimed to prevent medication errors through pharmacological guidance. We investigated genetic biomarkers related to clinical outcomes and evaluated patient satisfaction with the program.

We implemented a multidisciplinary pilot program and conducted an observational, unicentric, longitudinal, and ambispective study to evaluate its outcomes. The study included patients with chronic pain on high off-label opioid doses, those with mental disorders treated with opioids, and patients with pain refractory to standard treatments. Data were collected on psychiatric symptoms, substance use, CYP2D6, CYP2C19, and OPRM1 gene polymorphisms, and pharmacist interventions. To assess the intervention’s impact, a paired test analyzed changes in psychiatric measures and pain levels using the Visual Analog Scale (VAS) after structured psychoeducational sessions. A linear-by-linear association chi-square test examined associations between genetic polymorphisms and questionnaire results.

The sample consisted of 90 patients, the majority of whom were women (78.0%), with a mean age of 53.1 years. Among the participants, 23.0% exhibited problematic opioid use.

Significant improvements were observed in several clinical measures. The average Clinical Global Impression score improved from 3.7 to 2.58 (p=0.003), while the State-Trait Anxiety Inventory scores for state anxiety and trait anxiety decreased from 38.8 to 34.9 (p=0.0027) and from 40.1 to 35.8 (p<0.0001), respectively. The Beck Depression Inventory-II scores also showed a notable reduction from 33.1 to 27.8 (p<0.0001). Although improvements were seen in the EQ-5D-5L (from 41.1 to 50.2) and the EEAG (from 65.8 to 71.8), these changes were not statistically significant (p>0.05). Pain experience, as measured by the Visual Analog Scale, showed a reduction from 7.1 to 6.6 (p=0.0106). An association was identified between the OPRM1 polymorphism and the degree of problematic opioid use, as well as between the CYP2C19 genotype and the presence of depression (p<0.05). Additionally, pharmacists provided 64 recommendations to patients to prevent medication errors throughout the program.

The DOLMEN program demonstrated preliminary effectiveness in managing patients with chronic and emotional pain, as well as problematic opioid use.

None Declared

The term ‘psychiatric emergency’ refers to any situation in which certain psychopathological symptoms or behavioural disorders are perceived as disturbing, worrying or threatening by the patient, their family/social environment or other health/social actors, thus motivating the request for urgent care.

The aim of this poster is to analyse the data on psychiatric emergency care in 2023 at the Infanta Cristina University Hospital in Parla.

The computer record of all psychiatric care carried out in the hospital’s Emergency Department during 2023 has been reviewed.

During 2023, a total of 1231 psychiatric emergencies were registered, of which 136 (11.05%) belonged to the child and adolescent population and 1095 (88.05%) to the adult population (i.e., over 18 years of age).

Of the 136 attendances in the child and adolescent population, 93 (68.38%) were of people identified as female and 43 (31.62%) as male.

Of the 1095 attendances in the adult population, 641 (58.54%) were of people identified as female and 444 (40.55%) as male.

In both the child and adolescent population and the adult population, the most frequent reason for consultation was “anxiety” (25% and 32.05%, respectively). However, it should be noted that, in both populations, two of the most frequent reasons for consultation were “autolytic ideation” (19.12% and 16.25%, respectively) and “autolytic attempt” (19.85% and 12.05%, respectively).

Women went to the psychiatric emergency department more frequently.

The percentage of children and adolescents who attended the psychiatric emergency department was high.

Although the most frequent reason for consultation was “anxiety”, it is important to be able to reflect on the high figures of “autolytic ideation” and “autolytic attempt”.

None Declared

Individuals at Clinical High Risk of Psychosis (CHR-P) show increased risk for developing psychotic disorders. The relationship between the risk of developing psychosis and urbanicity has been previously described; however, there are divergent results regarding the relationship between positive psychotic symptoms and urbanicity.

The present study aims to analyze the clinical and sociodemographic differences between an urban and a rural population of youth with CHR-P.

The characteristics of the CHR-P program at La Fe Hospital (Valencia) are described and compared for the two populations in the study: a rural area comprising 10 towns with populations ranging from 200 to 29,000 inhabitants each, with an average of 12,600 inhabitants, and an urban area corresponding to the northern metropolitan area of Valencia. An analysis and comparison of the sociodemographic and clinical characteristics of the general population in both areas is also conducted.

Preliminary results are provided: The sample consists of 46 patients, 21 from the rural area and 25 from the urban area. The average follow-up for both groups was 8 months, with a transition rate to psychosis during this period of 19% (n=4) for the rural area group compared to 0% for the urban area group (p=0.04). Patients in the rural area group exhibited greater severity of positive psychotic symptoms with a higher positive PANSS score (14.19 ± 4.32) compared to the urban area group (11.12 ± 3.67), and this difference was significant (p=0.032). No statistically significant differences were found between the two groups for the rest of the variables.

The preliminary results of our study show greater symptom severity in individuals from rural areas. Demographic factors, resource provision, or delays in care might be related to this finding.

None Declared

Schizophrenia, affecting about 1% of the global population, is marked by positive, negative, and cognitive symptoms, leading to significant disability and a shortened lifespan due to physical health issues. Early intervention is crucial, as untreated psychosis can persist. This study examines changes in mRNA expression in the NRG-1/PI3K-AKT and DRD2 pathways in treated and untreated patients, hypothesizing that expression decreases and varies with treatment.

We aim to assess the impact of antipsychotic treatment on the expression levels of the PI3K/AKT/m-TOR signaling pathway, linked to the neurodevelopmental hypothesis of schizophrenia, and associated with the dopaminergic DRD-2 and glutamatergic NRG-1 systems. This study will examine mRNA expression of DRD-2, NRG-1, and PI3K/AKT/m-TOR in leukocytes from female schizophrenia patients before and after treatment. The findings may enhance our understanding of schizophrenia’s pathogenesis, identify potential genetic markers, and clarify the molecular effects of antipsychotic drugs.

Our study includes 25 healthy female volunteers and 25 female schizophrenia inpatients from Bakırkoy Prof. Dr. Mazhar Osman Mental Health and Neurological Diseases Training and Research Hospital. These inpatients met the experiment criteria, had not received treatment in the last 3 months, and were diagnosed with schizophrenia spectrum disorder according to DSM V criteria. After obtaining written consent, a sociodemographic form was completed. The Positive and Negative Symptom Scale (PANSS) was administered to eligible patients. Blood samples for DRD-2, NRG-1, and PI3K/AKT-1/mTOR mRNA expression analysis were collected from patients with PANSS scores of 95 or above before treatment and after scores decreased to 58 or below. Expression levels were determined by RT-PCR.

In untreated schizophrenia patients, NRG-1 mRNA expression was significantly lower, while PI3K and mTOR mRNA expressions were significantly higher compared to the healthy control group, with no change in AKT-1 mRNA expression as shown in Table 1. Compared to healthy controls, treated patients showed increased NRG-1 mRNA, unchanged PI3K and AKT-1 mRNA, and decreased mTOR mRNA as shown in Table 2. In treated patients, NRG-1 mRNA expression was significantly higher, and PI3K and mTOR mRNA expressions were significantly lower compared to untreated patients, with no change in AKT-1 as shown in Table 3. DRD-2 mRNA expression was undetectable in all groups.

Image 1:

Image 2:

Image 3:

NRG-1, PI3K, and mTOR may contribute to schizophrenia pathogenesis, with NRG-1 and mTOR serving as potential genetic biomarkers. Antipsychotics affect molecular pathways, but not AKT-1, and DRD-2 is not expressed in immune cells.

None Declared

Co-occurring substance use disorders (SUDs) among individuals with schizophrenia are a prevalent and complex psychiatric comorbidity, which is associated with increased symptom severity, worsened illness trajectory and high rates of treatment non-adherence. Recent evidence suggests that the use of depot antipsychotics may provide an effective treatment option for individuals with this dual-diagnosis.

Hypothesis testing: “Depot antipsychotics are associated with i) reduced hospitalizations, ii) improved quality of life and iii) improved patient functionality in dual diagnosis of psychosis and SUD”.

68 patients in community of Eastern Crete (Greece) participated (Male to Female ratio corresponds to 2.4:1). All of them manifested psychosis (24 with F.20 ICD-10 and 44 with F29.0 ICD-10). The median age was 41 years. 29.41% had dual diagnosis of psychosis and alcohol use disorders, 7.35% had dual diagnosis of psychosis and cocaine use disorders, while 26.47% had dual diagnosis of psychosis and cannabis Use disorder. 80.88% were on aripiprazole LAI, 8.82% on paliperidone LAI, 2.94 % on risperidone LAI and 7.35% on haloperidol LAI. For the evaluation of our hypotheses the instruments WHOQOL-BREF questionnaire and the CGI-S scale were used. The quality of life and the functionality of the patients and also the number of their hospitalizations were compared in each patient, before the initiation of the LAI medication and during the active treatment period. The minimum of follow-up period was 6 months.

In our sample of 68 patients with depot antipsychotics therapy administrated at least for 6 months: a) Hospitalizations decreased statistically significantly from 1.01 ±1.54 to 0.01±0.12 (Paired Samples Wilcoxon Signed Rank Test p-value<<0.001), b) The CGI-S score decreased statistically significantly from 5.72 ±0.88 to 2.94±1.33 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001), c) The score of the WHOQOL-BREF scale increased statistically significantly from 0.57 ±0.53, to 3.35±0.84 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001). The same sample with depot antipsychotic treatment administrated at least for 3 months: a) The CGI-S score decreased statistically significantly from 5.72 ±0.88 to 2.34±0.89 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001), b) The score of the WHOQOL-BREF scale increased statistically significantly from 0.57 ±0.53, to 2.3±0.89 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001).

Depot antipsychotics medication significantly reduces the number of hospitalizations, when patients with psychosis and substance use disorders remain in therapy at least for 6 months. In addition, the administration of depot therapy, at least for 6 months, improves the quality of life and the functionality of these patients.

None Declared

Generalized anxiety disorder (GAD) is a chronic and disabling disorder with an estimated lifetime prevalence of up to 7.8% in the US. MM120 (lysergide D-tartrate), a tartrate salt of D-lysergic acid diethylamide (LSD), is currently under development as a potential treatment for GAD. The mechanism of action (MOA) by which MM120 may elicit profound lasting psychological changes is not fully understood. Studies suggest that it has significant effects on functional brain activity across several networks, likely a result of serotonergic agonism mediated by 5HT2A activity and subsequent changes in neural network connectivity.

A series of Good Laboratory Practice (GLP) compliant studies were conducted to evaluate abuse potential of MM120.

In vitro assessments of MM120, and its main metabolite 2-oxo-3-hydroxy LSD, receptor binding activity were performed using Eurofins CEREP BioPrint. To examine single dosing effects, MM120 was administered by oral gavage to male Sprague Dawley rats (n=6/group) at doses of 0 (vehicle only), 0.5, 2.0, and 6.0 mg/kg. A Modified Irwin test evaluated shorter acting drug effects at 15, 60, 120, and 240 minutes post-dosing compared to pre-dose baseline, with long-term, single dose neurological effects studied in a functional observation battery (FOB) on the day of dosing and 24 hours post dose. To compare potential chronic MM120 effects, male and female Sprague Dawley rats were dosed daily for four weeks via oral gavage at 0 (vehicle only), 0.5, 2.0, and 6.0 mg/kg (n=10-15/sex/group) followed by a 4-week recovery phase. FOB was performed pre-dose, dosing day 27, and day 25 of recovery phase. Additional assessments included toxicological and toxicokinetic evaluations.

Receptor binding assay confirmed MM120’s MOA is mediated by the serotonin system and hallucinogenic effects are driven by agonism at 5-HT2A and 5-HT2C receptors. MM120 demonstrated agonist activity at 5-HT1A, 5-HT1B, 5-HT1D, 5-HT5A, 5-HT6, and 5HT7 receptors and only nanomolar affinity at D2 dopaminergic receptors. Single dose MM120 at 0.5 mg/kg, had no effects on behavioral or physiological states. Following 6 mg/kg MM120, vocalization was recorded in 1/6 rats 2-4 h post dose, and incidences of mild piloerection were recorded in 3/6 rats from 4 to 24 h post dose. In the chronic study, there were no MM120-related changes in basic or fine movements, total ambulation, total rears, or total distance traveled.

Binding studies suggest no indication for elements of abuse for MM120 even with binding at serotonergic and, to a smaller degree, dopaminergic receptors. in vivo studies with MM120 evaluated supratherapeutic doses and demonstrated no evidence of physical dependence or withdrawal after sustained, daily administration for four weeks.

J. Tripp Employee of: Mind Medicine, Inc., G. Smagin Employee of: Mind Medicine, Inc.

Relapse refers to the recurrence of psychotic symptoms following a phase of improvement or stability. It often leads to the disruptive re-hospitalization of patients. Notably, a history of relapse is a strong indicator of future relapses and poorer outcomes. According to the literature, relapse rates might be higher in men compared to women due to better response to medication in women. Cariprazine (CAR), a D3-D2 partial agonist, has shown effectiveness in preventing relapse compared to a placebo in stabilized schizophrenia patients

We aimed to investigate whether there is a difference in the efficacy of CAR in preventing relapse by sex.

A post-hoc analysis was conducted on data from a multicentre, randomized, double-blind, placebo-controlled, parallel-group study lasting approximately 96 weeks in adults with schizophrenia. The study included two phases: a 20-week open-label treatment phase and a double-blind treatment phase lasting up to 72 weeks. During the open-label phase, patients were stabilized on CAR at doses of 3.0-9.0 mg/day. Subsequently, they were randomized to either continue CAR (at fixed doses of 3.0, 6.0, or 9.0 mg/day) or switch to a placebo (PBO). Relapse was defined by a worsening of symptom scores on the Positive and Negative Syndrome Scale (PANSS), psychiatric hospital admission, aggressive behaviour, or suicide risk. In this analysis, patients were separately analysed based on their sex. Baseline characteristics, hazard ratios by sex during the double-blind phase were calculated.

Of 200 patients, 132 (66%) were male (M) and 68 (34%) were female (F). In the female group, 57% were receiving CAR treatment, while in the male group 47% were on CAR. The mean age of the patients was between 36-41 years. The open-label baseline PANSS scores were comparable. The adherence of patients during the double-label phase was similar in all four groups (98-99%).

More relapses were documented in the placebo groups (M: 47%, F: 48%) than in the CAR groups (M: 27%, F: 21%). In females, those who received CAR during the double-blind phase had 66% less risk for relapse (HR=0.34, 95%CI= 0.14-0.82) than those who were on placebo. Similarly, male patients on cariprazine had 49% less risk for relapse (HR=0.51, 95%CI= 0.28-0.91) than those receiving placebo. The Cox regression analysis between groups showed that sex of patients did not affect the risk of relapse significantly.

In summary, sex does not seem to significantly influence risk of relapse. CAR decreases the risk of relapse compared to placebo in both males and females.

C. Correll: None Declared, Z. Dombi Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., P. Herman Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., Á. Barabássy Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine.

While it is known that of those people who experience psychotic experiences, approximately 75% of them do so for the first time between the ages of 15 and 30 and that the majority are male, there has recently been increasing interest in the incidence of psychosis in other population groups.

The present study aims to analyse the sociodemographic data collected over a period of ten months in a First-Episode Psychosis Programme in a third level hospital, such as the Hospital Clínico Universitario de Valladolid.

It is a retrospective observational study. Patients have been recruited during ten months and those who presented an episode of the psychosis spectrum for the first time (according to DSM-V diagnostic criteria) were included. Different socio-demographic data regarding their age, sex, marital status and employment status have been collected at the time of their inclusion in the programme.

A sample of 23 patients was recruited, of which 26% were women (n=6) and 74% were men (n=17).

The mean age was 29.95 years.

Regarding marital status, 70% of the patients in the sample were single (n=16), 17% were married (n=4), and 13% were living with a partner (n=3). There were no divorced or widowed patients.

In terms of employment, 36% (n=8) of the patients were in employment at the time of admission to the programme. 26% (n=6) were studying, 21% (n=5) were unemployed, 13% (n=3) were on sick leave and 4% (n=1) were receiving a pension.

Socio-demographic data, in general, are as expected in a programme of these characteristics. However, it should be noted that the mean age of the patients recruited is above that most frequently described in the literature. However, we believe that it would be necessary to increase the sample size to be able to offer more robust results.

None Declared

Autism spectrum disorders (ASD) are underdiagnosed in women due both to diagnostic bias, and the quieter, less visible signs and symptoms of female autism. Distress generally only becomes manifest during mid childhood and adolescence, when mental illness gets misidentified as the primary cause. The symptomatic overlap of ASD and Borderline Personality Disorder (BPD) has been noted and at the cognitive level, ASD includes difficulties in reading others emotions and core cognitive features of BPD also include altered social cognition.

The aims of this paper are to present a case report of a patient diagnosed with BPD and ASD and to provide a summary of the current literature concerning this double diagnosis.

A description of the case is made and relevant articles were identified by searching the following terms: “borderline personality disorder” and “autism/autism spectrum disorders”. Research was restricted to articles concerning humans and published between 2014 and 2024 in English.

The case report describes a young female of 19 years old that was evaluated in an emergency context due to suicidal ideation and was then referred to both psychiatry and psychology. She was diagnosed with BPD and ASD in adolescence while she was seeing a child psychiatrist. In the consultations she reports marked emotional dysregulation, irritability, difficulties in tolerating some textures and increased sensitivity to noise and light, as well as frequent worries about peer relationships and self-image with a need to do things differently to fit in.

Despite some controversial results and lack of homogeneity in the methods used for the diagnostic assessment, subjects with BPD reported higher scores on tests evaluating the presence of ASD compared to a non-clinical population and hypothesized the presence of unrecognized ASD in some BPD patients or vice versa, while also describing a shared vulnerability towards traumatic events.

This case illustrates a common and complex clinical challenge, where the double doses of emotional dysregulation and disrupted social interchange overwhelm either ASD or BPD approaches considered separately. Diagnostic differentiation is crucial toward targeted therapeutic interventions (psychopharmacological and psychosocial). It is still difficult to draw accurate conclusions based on the recent literature. Research in sex/gender difference is still limited, with heterogeneous results, and further studies are needed to enlighten the clinical similarities and diagnostic overlap between ASD females and BPD.

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Medical school is known for high levels of anxiety, and mental health challenges. Psychological flexibility - the ability to accept difficult thoughts and emotions while acting in alignment with one’s values- can protect against these challenges. ACT has been shown to enhance psychological flexibility and reduce mental health symptoms in various populations. However, its impact on medical students has not been extensively explored.

This study aimed to assess whether a brief ACT intervention could improve psychological flexibility and related psychological outcomes in medical students.

Forty-two medical students from Istanbul Medeniyet University participated in a four-day ACT program. Inclusion criteria included active enrollment in a medical program and willingness to participate. Exclusion criteria were severe psychiatric disorders or ongoing psychiatric treatment.The intervention involved four days of ACT-based activities, including mindfulness, cognitive defusion, and value-based exercises. Each session lasted 90 minutes and was conducted in a group format. To assess the impact of the intervention, we measured psychological flexibility and related factors at baseline and after the program using the following tools: the Multidimensional Experiential Avoidance Questionnaire (MEAQ-30), AAQ-US, SF-25, Valuing Questionnaire (VQ) and the DASS-21. Paired t-tests were used to compare pre- and post-intervention scores, with statistical significance set at p < 0.05.

The ACT intervention led to significant improvements in psychological flexibility and related factors. The ACT intervention led to significant improvements in psychological flexibility and related factors. Specifically, Distress Aversion (MEAQ-30, subscale B) decreased significantly (p = 0.010), while Distress Endurance (MEAQ-30, subscale F) increased significantly (p = 0.008). Additionally, Anxiety (DASS-A) decreased significantly (p = 0.004), and Stress (DASS-S) also decreased significantly (p = 0.004). No significant changes were observed in other subscale scores, including those for SF-36, depression (DASS-D), and scores for AAQ-US and VQ. These results suggest that ACT may be particularly effective in reducing anxiety and stress while enhancing cognitive flexibility and acceptance.

This study suggests that even a brief, four-day ACT intervention can significantly improve psychological flexibility and reduce anxiety and stress in medical students. These findings highlight ACT’s potential as an effective tool for supporting mental health and resilience in medical students. Further research with larger sample sizes and longer follow-up periods is needed to explore the long-term impact of ACT interventions in academic settings.

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Dialectical Behavior Therapy (DBT) is a comprehensive evidence-based psychotherapy that focuses on teaching skills regarding the acceptance of circumstances and coping with emotional responses.

The objective of this study is to perform a systematic review and meta-analysis to investigate the efficacy of DBT in patients diagnosed with Bipolar Disorder (BD) in order to ascertain whether it improves the recurrence of manic and depressive symptoms.

A systematic search of the PubMed (MEDLINE), Embase, Web of Science, and Cochrane Library databases was conducted to identify studies that had applied DBT to patients with a diagnosis of BD.

A total of 343 patients were included in the study, comprising participants from eight randomized and non-randomized trials. Of whom, 196 patients (57.1%) underwent DBT and pharmacological treatment, while 147 patients (42.9%) were treated with alternative interventions. A total of 12 to 36 sessions of DBT were conducted across all trials, with a follow-up period ranging from three to 15 months. The age range of the participants was 15.8 to 49.3 years. All studies included patients diagnosed with BD type I (n=175), five articles included patients with BD type II (n=100), and two included patients with BD-NOS (Not Otherwise Specified) (n=68). The primary endpoint analyzed was the mean change in the Beck Depression Inventory-II (BDI-II), as reported by three of the included studies. The meta-analysis yielded no statistically significant results, with a mean difference of -4.49 (95% CI: -11.75, 2.76; I² = 6%; p = 0.22) (Figure 2). The analysis of the Young Mania Rating Scale (YMRS) revealed a mean of 5.96 in a total of 72 patients (95% CI: 0.29-11.64; I² = 97.39%; p < 0.001) (Figure 3).

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The DBT was observed to have a beneficial impact on mood episodes and symptomatic manifestations among adolescents and adults diagnosed with BD. Therefore, it may be postulated that the DBT could be employed in conjunction with pharmacological agents to mitigate the severity of symptoms and enhance the overall quality of life in patients with such a diagnosis.

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The adverse social impact of parental alcoholism on children’s development is well known and is primarily associated with difficulties in social adaptation, a higher risk of anxiety, depression, personality disorders, etc. At the same time, in the genesis of neuropsychiatric disorders in such children, parental alcoholism can be both a socio-psychological and biological factor, through its impact on germ cells, the developing fetus, and postnatal development. The dates of birth of the studied cohort of patients fell in the period of the late 1970s - first half of the 1980s - years of steady growth in alcohol consumption in the late Soviet Union, when, according to the USSR State Statistics Committee, the average resident of the USSR consumed (excluding production by the population, primarily moonshine) an average of 10.7 liters of pure alcohol per capita. Soviet tradition prescribed the mandatory presence of alcoholic beverages on the holiday table. At the same time, the longest and most widespread alcohol consumption in the USSR occurred on summer vacations and official state holidays, for which extraordinary non-working days were established. Along with traditional summer holidays (July and August), such periods were, the second half of February – the first half of March (passing from one to another, the celebration of February 23 (Soviet Army Day and March 8), the end of December/the non-working first half of January (a ten-day celebration of the New Year), the celebration of Revolution Day (the first half of October).

To investigate the possible role of increased alcohol abuse during the periods of conception of children who will later suffer from nervous anorexia and bulimia.

The approximate dates of conception (considering the terms of full-term pregnancy and the date of birth) of patients (N=191) with eating disorders (AN and NB) born before 1991 were analyzed in relation to the periods of traditional mass alcohol consumption in the late USSR.

The frequency of conception of future patients with eating disorders in the study group during periods of traditionally stable growth in alcohol consumption was 1.4–1.7 times higher (p < 0.01) than in other periods. A clear pattern emerged from the analyses. That is, eating disorders, like other chronic psychiatric diseases, are the product of multiple factors, however, alcohol abuse during conception clearly increases the risk of having daughters with AN and BN.

In conclusion, periconceptional alcohol consumption appears to significantly elevate the risk of offspring developing eating disorders, specifically anorexia nervosa and bulimia nervosa. The study reveals a marked increase in conception during peak alcohol consumption periods, suggesting alcohol’s potential role in the etiology of these disorders.

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Breast cancer represents a significant health concern among Iranian women, notably impacting their mental health. This has spurred considerable interest within health psychology, given breast cancer’s profound effects on both physical and psychological well-being.

This study aimed to explore the predictability of emotional disturbances through psychological, socio-cognitive variables, and to quantify their relative impacts among breast cancer patients.

Employing a descriptive and exploratory approach, this research involved 736 breast cancer patients aged 19 to 80 from Shahada Tajrish Hospital, Tehran during the first eight months of 2017. Participants were selected and screened based on specific inclusion and exclusion criteria. Measures included the Self-Empowerment Skills Scale, the Quality of Interpersonal Interactions Scale, and the Emotional Disturbance Scale. An emotion management therapy program was offered to motivate patient participation.

Analysis revealed significant associations between emotional disturbance and factors such as self-empowerment skills, quality of interpersonal interactions, and various demographic variables including age, education level, employment status, household headship, and gender. Notably, interpersonal quality and self-empowerment skills emerged as the most influential predictors.

The findings underscore the critical roles of interpersonal relationships, self-empowerment skills, and demographic characteristics in influencing the emotional well-being of breast cancer patients. It is recommended that psychologists emphasize these factors when assessing and promoting the mental health of this population.

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