Schizophrenia is one of the most disabling psychiatric disorders, with about 60% of patients also suffering from substance dependence—a rate significantly higher than in the general population. Mentally ill individuals have a suicide risk four times higher than healthy individuals, which doubles when comorbid mental disorders are present. Compliance with treatment in patients with schizophrenia is generally lower than in those with other psychiatric disorders, often due to a lack of continuity between psychiatric and addiction services.

This study aims to assess compliance in patients diagnosed with paranoid schizophrenia and substance dependence syndrome and compare it with compliance in patients diagnosed with paranoid schizophrenia without dependence.

The study included two groups: 15 patients with paranoid schizophrenia and 20 patients with paranoid schizophrenia and substance dependence. The average hospital stay for patients without substance dependence was 25.8 days, whereas it was 38.4 days for those with dependence.

Prolonged hospitalizations increase the economic burden on healthcare and introduce additional challenges, such as job loss, which heightens stigma and marginalization. The number of hospitalizations was also higher among patients with dependence, averaging 4.75 times over five years compared to 1.06 times in those without. Patients without dependence can often remain functional in society on monotherapy, requiring only one medication—a more convenient regimen. In contrast, patients with dependence typically require a combination of three or more medications, with a less flexible and more demanding dosage schedule. These regimens not only increase economic strain but also can worsen medication tolerance. This increases the risk of selective intake, reduced frequency, or complete discontinuation of medications, which often leads to rehospitalization. Frequent therapy adjustments may further erode patients’ adherence to new regimens, undermining their trust in the need to engage with psychiatric care.

As shown, compliance in patients with a “dual diagnosis” is a pressing issue in modern psychiatry. Addressing this complex problem requires multiple steps, including selecting appropriate therapies, addiction treatment, psychoeducation, and fostering a strong doctor-patient relationship in an outpatient setting. These measures collectively aim to reintegrate patients into society, reduce disease burden, improve quality of life, lower suicide risk, and decrease the frequency and length of hospitalizations.

None Declared

Psychosis is characterized by hallucinatory and delusional experiences. Although, it was mostly considered to be present among clinical populations, there is strong evidence it can also be found in the general population. Limited reviews currently exist on the quality of the assessment methods designed to evaluate psychotic-like experiences in the general population. None of them assessed whether the existing instruments measure the same construct and, consequently, neglected problems associated with the “jingle-jangle fallacy” (Weidman et al., 2017; Flake and Fried, 2020). This fallacy might account for contradictions in the literature, as well as, issues with generalizability of the results.

The goal of our study is to better understand the agreement between various instruments used to assess hallucinations and paranoia-like experiences.

We conducted a systematic search of the scales assessing hallucinations and paranoia-like experiences among the general population. Labels for the content analysis were created based on their definition in literature by the first authors and revised by another researcher. Three researchers coded each item independently of each other. We then estimated to which extent any item overlaps with any item from the other scale included in the analysis. We used Jaccard index to assess similarities between sets (from 0 with no overlap among scales) to 1 (complete overlap). The analysis was done in R and Excel.

For 263 items from 11 hallucination scales, we estimated 38 labels with a mean overlap of 0.19 (very weak). CAPS demonstrated the highest mean overlap of 0.26. The highest overlaps were observed between MUSEQ and CAPS (0.5), MUSEQ and SPQ (0.4), and between LSHS-R and RHS (0.4). For the paranoia scales, the analysis of 183 items drawn from 12 scales resulted in 18 labels. The mean overlap across these labels was 0.30 - a weak association. The PIQ exhibited the highest mean overlap at 0.42, whereas the PSQ displayed the weakest overlap with a value of 0.17.

The overlap between hallucination scales was very weak. This disparity may be due to different instruments adopt varying interpretations of the hallucination continuum (Laroi, 2012). The weak overlap in paranoia scales may be less problematic, as theoretical models and empirical data suggest a more clear continuum of suspiciousness within the general population (Freeman et al., 2005) that maps our results. It is necessary to establish certain common grounds regarding what experiences represent which sides of the continuum, both in their variability, and severity in the field.

None Declared

Social media has significantly changed the way we communicate, interact, and access mental health information for both the public and practitioners. Research indicates that rising rates of suicidal behaviors among adolescents may be linked to increased screen time on social media (Balt et al., 2023). Excessive use of online social networks can exacerbate self-harm and suicidal thoughts in vulnerable young people (Memon et al., 2018). Given Emergency Mental Health Professionals are most often in contact with suicidal patients, we developed a survey to gain a deeper understanding of their practices and attitudes toward social media platforms.

We aim to explore social media usage patterns among mental health practitioners in Singapore’s sole psychiatric emergency department, assess their views on the impact of social media as a mental health resource, and evaluate whether they believe suicide posts on social media should be treated with the same seriousness as traditional suicide notes.

The authors surveyed 58 mental health professionals - psychiatrists, nurses, psychologists, social workers, and pharmacists - who worked during 2023-2024. The survey, consisting of 19 multiple-choice questions, assessed attitudes toward mental health-related internet technologies and the perceived advantages and disadvantages of social media, based on a previous scientific paper titled “The Role of Social Media as a Resource for Mental Health Care”. Responses were measured on a Likert scale (1 = Strongly Disagree to 5 = Strongly Agree). SPSS 16.0 was used to analyze correlations between demographics and attitudes toward social media as a mental health resource.

Of the practitioners, 58.6% viewed social media’s impact on mental health as negative. Notably, 32.4% of those with less than one year of experience held this view, compared to just 8.8% of those with 6 to 9 years of experience. A significant negative correlation was found between actively following mental health content on social media and the belief that social media increases suicide risk among vulnerable individuals (P = 0.003, R = -0.389). However, years of work experience did not significantly correlate with this belief (P = 0.213).

The study finds that while mental health professionals generally view social media negatively, those who engage with mental health content online are less likely to associate it with increased suicide risk. Our limited literature review found no similar studies, and we aim to provide new insights into how familiarity with mental health content influences professional attitudes. Expanding the research beyond Emergency Department practitioners could reveal how demographic factors shape opinions on social media.

None Declared

Suicide is a significant public health issue, and its study has been approached from various perspectives. This work focuses on analyzing consultations related to suicide attended by the Psychiatry Service at the University Hospital of Salamanca during 2023. Suicide is defined as an intentional act with a fatal outcome, and its prevention is considered a priority in mental health.

General Objective: To assess the prevalence of suicide-related consultations within the total psychiatric emergencies attended in 2023.

1. 1. To identify demographic and temporal patterns in suicide-related consultations.

2. 2. To compare the prevalence of suicide-related consultations with other types of psychiatric emergencies attended during the same period.

The study is observational and retrospective, based on the analysis of psychiatric emergency records from 2023. Demographic variables such as gender and age were analyzed, as well as the cause of the consultations, classified as “suicide-related” or “other psychiatric causes.” Statistical tools were used to identify significant patterns and relationships.

1. 1. Gender distribution: 55.2% of the patients were women, and 44.8% were men.

2. 2. Age distribution: Most consultations involved adults (74.4%), followed by older adults (16.7%) and minors (8.9%).

3. 3. Cause of the consultation: 36.15% of the cases were related to suicidal behavior, while 63.85% were due to other psychiatric emergencies.

4. 4. Temporal pattern: There was an increase in consultations during the autumn months, particularly in September and November.

The study reveals that over one-third of psychiatric emergency consultations were related to suicide, underscoring the need to enhance prevention strategies and early intervention. The results also show significant differences by gender and age, as well as seasonal patterns that may be linked to emotional and social factors.

The findings emphasize the importance of identifying specific risk factors associated with gender and age, as well as reinforcing the training of emergency personnel to effectively intervene in cases of suicidal behavior. Moreover, attention should be given to months with higher incidence of suicide-related consultations, such as the autumn season.

None Declared

Complex post-traumatic stress disorder (C-PTSD) is closely associated with dissociative symptoms. Both of which are common responses to trauma and stress. Yet, not all individuals with C-PTSD experience high levels of dissociation. Currently, little is known about the bidirectional relationship between C-PTSD and dissociative symptoms.

This study aimed to examine whether C-PTSD and dissociative symptoms would predict each other over time.

A total of 340 participants (Mage=21.04 years; SD=2.00; 83.8% female) from Hong Kong and Taiwan completed the Multiscale Dissociation Inventory (MDI) and the International Trauma Questionnaire (ITQ) at two separate time points (M days apart = 129.4 days; SD = 7.91). Hierarchical multiple regression analyses were conducted to examine the relationship between C-PTSD and dissociative symptoms.

The analyses controlled for age, gender, education level, trauma exposure, and baseline severity of the dependent variables. Results indicated that when the MDI subscales were added into the model, baseline emotional constriction significantly predicted subsequent C-PTSD symptoms (i.e., total ITQ scores) (β=.126, p=.008), and significantly improved the model’s explanatory power (R²=.67, ΔR²=.029, ΔF = 4.772, p < .001). Nevertheless, when the same analysis was conducted, none of the six C-PTSD symptom clusters at baseline predicted the total MDI scores at follow-up (ΔF = 1.000, p = .425).

The study findings suggested that dissociative symptoms in general, and emotional constriction in particular, predicted subsequent levels of C-PTSD symptoms, while C-PTSD symptoms did not predict subsequent levels of dissociation. These results highlighted that proactive management of dissociative symptoms might be an important part of the treatment of C-PTSD. This study provided a foundation for future research to investigate the underlying mechanisms by which emotional constriction influences C-PTSD severity. Future research should also evaluate dissociation-focused interventions for people with C-PTSD.

None Declared

Quetiapine is a serotonin-dopamine antagonist widely used for the treatment of bipolar disorder and schizophrenia. Patients with bipolar disorder and schizophrenia are also at high risk of drug abuse. Illicit substances are often traced in such patients during manic and psychotic episodes. Urine drug tests are commonly used to detect illicit substance use during hospital admissions.

We report a case of an adult male patient treated with 600mg o.d. quetiapine who falsely tested positive for tricyclic antidepressants in a routine urine drug test

A male patient with a prior history of alcohol, cannabis and cocaine abuse acutely developed psychotic-like symptoms (persecutory delusions, psychomotor retardation, social withdrawal) and attempted to commit suicide. He was admitted to our psychiatric hospital, and he denied illicit drug use during the last 5 months.

The patient was treated with quetiapine monotherapy, progressively titrated up to 600mg o.d. As a routine procedure and because of his personal history of drug abuse, he has been subjected to a urine drug test, which revealed positive results for tricyclic antidepressants. Due to uncertainty whether he abused tricyclic antidepressants prior to this admission, a second test was ordered after two weeks of quetiapine monotherapy and close inpatient monitoring, which was also positive for tricyclic antidepressants.

Quetiapine has a three-ringed chemical structure which shares similarities with tricyclic antidepressants. in vitro tests proved cross-reactivity of quetiapine and tricyclic antidepressants with some commercially available immunoassays. However it is not clear if the cross-reactivity is due to quetiapine or its active metabolites. In any case, the interpretation of a urine test positive for tricyclic antidepressants should take into account the possibility of such cross-reactivity with quetiapine, especially in cases of suspected drug overdose when the urine test is used to deduct the possible offending drug. Moreover, this cross-reactivity might be eploited in cases of suspected non-adherence to quetiapine treatment.

None Declared

Mining work and environment are the hardest and most difficult jobs in the labor market, increasing the risk of physical and mental illness. A study was conducted to determine the level of stress in mine workers and evaluate the relationship between depression and stress.

To determine the level of stress in mine workers and evaluate the relationship between depression and stress.

Questionnaires were collected from mine workers using the stress detection test (SRQ) and depression detection test (PHQ9) developed by the World Health Organization for doctors.

2.2% (95) of the respondents are male and 7.8% (8) are female workers. Of these, 70.9% work night shifts, 24.3% do not work night shifts, and 4.8% occasionally work night shifts. Comparing the stress levels of the respondents by age, 1.9% (2) of 20-24-year-olds are moderately stressed, 3.9% (4) of 25-29-year-olds are moderately stressed, and 4.8% (5) are stressed. 30-34-year-olds have moderate stress, 1.9% (2) have high stress, 1% (1) of 35-39-year-olds have moderate stress, 1.9% (2) have high stress, and 1% (1) have high stress. 40-44 have moderate, 1% (1) high, and 1% (1) 45-49 have moderate stress. The depression status of the participants compared to the 20-24-year-olds was 1% (1) transient mood depression, 1% (1) moderate depression, and 25-29-year-olds self-correcting transient mood 4.8% depression (5), 4.8% moderate depression (5), 1% (1) moderate depression, 1% (1) severe depression, 5.8% (6) depressed, 4.8% ((5)) moderate depression, 1.9% (2) moderate depression, 35-39-year-old spontaneous self-correction (68%). 7) with depression, 1.9% (2) with moderate depression, temporary self-correction at the age of 40-44 1.9% (2) with depression, 1% (1) with severe depression, temporary at the age of 45-49 2.9% (3) have depression. According to this, it can be considered that 25-44-year-olds are at risk of depression with a high depression index.

The study concluded that 25-44-year-olds are at risk of depression with a high depression index, indicating that they are at risk of depression.

None Declared

Psychotic depression, a severe subtype of major depressive disorder with delusions or hallucinations, increases suicide risk due to distressing symptoms and hopelessness. Suicide attempts in psychotic depression can be severe and violent. Combining antidepressants and antipsychotics shows promise in reducing suicidal ideation and improving prognosis. This case presents a patient with a severe suicide attempt and self-harm in the context of psychotic depression, highlighting successful treatment with a combination of antidepressants and antipsychotics.

To present a case study of a patient with a depressive episode that progressed to psychotic features.

A comprehensive literature search was conducted to identify relevant studies on the treatment of depression with psychotic features. A case report was then developed, detailing the patient’s clinical presentation, diagnosis, and treatment regimen.

A 53-year-old male was hospitalized following a serious suicide attempt. The patient had a history of a recent work-related accident, leading to a depressive episode that progressed to psychotic features, including delusions of guilt and economic ruin, attempted suicide using a firearm, leading to significant self-inflicted injuries. Emergency surgical intervention was required for tendon and arterial damage. Psychiatrically, the patient exhibited profound hopelessness, delusional guilt, and active suicidal ideation. Following hospital admission, the patient was treated with a combination of sertraline, olanzapine, and mirtazapine, which resulted in significant improvement in mood, a reduction of delusions, and cessation of suicidal ideation over a three-weeks period. The patient returned to social activities and expressed interest in resuming his professional responsibilities, with no recurrence of psychotic symptoms or suicide attempts.

This case illustrates the severity of suicidal behavior in psychotic depression and the critical importance of combining antidepressants with antipsychotics for effective management. Research has consistently shown that psychotic depression carries a heightened risk of severe suicide attempts due to the intensity of delusions and hopelessness. Antidepressant-antipsychotic combinations, particularly those involving selective serotonin reuptake inhibitors (SSRIs) like sertraline, and atypical antipsychotics such as olanzapine, have demonstrated efficacy in reducing both depressive and psychotic symptoms, thereby mitigating suicide risk. In this case, the patient’s marked improvement and remission of psychotic features underscore the role of combined pharmacotherapy in stabilizing mood and preventing future suicidal behavior.

None Declared

Seeking treatment for infertility is an emotional process, often provoking symptoms of anxiety and depression in both men and women, especially when treatment fails (Milazzo et al, Plos One; 11). While religion may provide hope and comfort to men with infertility, it may also provoke anguish in those whose religious doctrines restrict certain treatments.

The goal of this study is to assess the role of religion in male patients’ ability to cope with their infertility.

An electronic survey was sent to male patients who presented for an infertility visit at an American urology clinic. Using a 4-point Likert Scale, participants reflected on their religion’s role in seeking treatment for infertility, their selection of treatment, and their ability to cope with their diagnosis. The Likert Scale results were analyzed utilizing T-tests via SPSS Software to assess answer variations across religions. Written responses were analyzed for common themes.

73% of respondents (n=288/395) identified with a religion (58.6% Christian, 29.5% Catholic, 11.8% Other Religion). Across all religions, participants reported that religion served as a significantly greater source of coping than of anxiety in their infertility treatment (2.56 vs. 2.03, t-value = 5.64, p-value = <.00001). In comparison with most other religions, Jewish participants (all non-orthodox) were significantly less likely to report their religion having any effect on their coping at all. Among those written responses that attributed their religion with their ability to cope, the most common key words were “prayer,” “comfort,” and words referring to religious community such as “pastor” (Table 1). Most written responses that indicated their religion had a negative emotional impact stated discomfort with a specific treatment or aspect of the treatment process. Of patients who discussed having disagreed with or gone against their religion’s views (7.9%), the majority were Catholic (n=13/17 (76.5%)).

Image 1:

Religion appears to be a source of coping more than anxiety for males with infertility. This is perhaps less applicable to non-orthodox Jewish patients. Providers of male-factor infertility treatment should practice sensitivity when presenting infertility treatment options as a minority of patients may experience cognitive dissonance when considering treatment at odds with their religious identity. However, in religious patients struggling with mental health due to their infertility, physicians can encourage spiritual health and connection with religious community.

None Declared

Diet-related support is urgently needed for people with serious mental illness underlying the role of nutrition in a biopsychosocial approach. Integrating healthy lifestyle practices such as a balanced diet and physical exercise could supplement and amplify the effects of existing pharmacotherapies and psychotherapies. Despite its considerable role, nutritional literacy of mental health professionals appears scarce. Specific nutrition training courses for mental health professionals are needed in order to increase awareness on nutrition as a well-being contributing factor in the biopsychosocial model.

The aim of this study is to investigate insight and attitudes on nutrition in mental health among a sample of psychiatrists and psychologists resident in Italy.

The survey was conducted from May to June 2024 and the questionnaire was anonymous and self-rated, accessible via Google forms. The sample comprised 110 Italian mental health professionals (adult and child psychiatrists, psychologists) who voluntarily completed the on‑line questionnaire.

110 participants (61 psychologists, 46 adult psychiatrists and 3 child psychiatrists) agreed to participate to our survey. 89.2 % (n= 91) of them worked in southern Italy.The majority of participants were female (77.98%) and reported working in a Mental Health Centre (n= 41, 37,27%), followed by psychiatric residential facilities (n=22, 20%), private practice (n= 19, 17.27%), hospital (n= 14, 12.73%), university research centre (n=4. 3.64%), other non specified institute (n=10; 9.09%). The numer of years of working as mental health professional was 19.27 ± 11.27 years. Adopting “sometimes” nutritional approach for the treatment of the patients was the answer mostly reported (n= 56, 51.4%) followed by “most of the time” (n= 28, 25.69%), “always” (n=11; 10.09%), “never” (n= 7, 6.42%), “almost never “(n= 7, 6.42%).

Despite the scientific evidence and some treatment guidelines in support of this relationship, the implementation of nutritional psychiatry into routine clinical practice remains limited. Integrating nutrition into the clinical practice of psychologists and psychiatrists and providing evidence-based nutritional advice represent an interesting mental health challenge to address in the coming years.

None Declared

We present the case of an 88-year-old woman with severe hearing loss and a history of hypertension, non-valvular atrial fibrillation (AF), hypothyroidism, and depressive episodes, admitted following a medication overdose in a context of depressive ideation. The patient reported auditory hallucinations, hearing the voice of her deceased mother; however, she did not exhibit delusional interpretations regarding these experiences, suggesting auditory Charles Bonnet syndrome. This rare phenomenon is primarily described in older patients without psychotic disorder and requires an interdisciplinary approach for appropriate management.

To describe the clinical progression of a probable case of auditory Charles Bonnet syndrome and analyze the importance of a multidisciplinary approach, particularly in coordination with neurology, to achieve optimal diagnosis and treatment in a geriatric context.

The case was addressed through a detailed psychiatric evaluation focused on psychopathological assessment and structured interviews to evaluate affective, cognitive, and behavioral symptoms. Neuropsychological assessment included the Phototest and Clock Drawing Test to rule out advanced cognitive impairment, as well as a cranial CT scan, which showed no significant abnormalities. The neurology consultation evaluated cognitive status, hearing loss, and its impact on the patient’s psychological state, while also ruling out other neurological disorders.

The patient showed favorable progress during admission, with mood stabilization and reduced anxiety. She exhibited long-standing depressive symptoms, including feelings of guilt and burden on her family. She acknowledged hearing her mother’s voice calling her and was able to critically assess the unreal nature of these hallucinations. The neurology consultation confirmed significant hearing loss, which contributed to her isolation and, possibly, to the development of auditory hallucinations (due to the lack of sensory input). No signs of advanced cognitive impairment were found.

This case highlights the importance of a multidisciplinary approach in managing elderly patients with unusual hallucinatory phenomena. Once psychotic symptoms were ruled out by psychiatry, the neurology consultation was essential to exclude cognitive impairment and contextualize the auditory hallucinations in relation to the patient’s hearing loss and emotional burden. The integrated intervention with her family facilitated a more comprehensive approach, including family support and psychoeducation, adjustments in psychopharmacological treatment, and recommendations to improve quality of life (including emphasizing the use of hearing aids) and social support; demonstrating the effectiveness of collaboration between psychiatry and neurology.

None Declared

Alcohol is a major risk factor for mortality and morbidity worldwide (Agabio et al., 2017). Women are affected by specific alcohol-related consequences, including a dose-dependent increased risk of breast cancer from relatively low levels of alcohol consumption, of which many women remain unaware (Agabio et al., 2022), and risk of foetal alcohol syndrome, in their offspring, if alcohol is consumed during pregnancy (Minozzi et al., 2024). Alcohol use disorder (AUD) is a severe and frequent mental disorder with devasting consequences (Agabio et al., 2017). In US, approximately one out of 4 women suffer for this disorder during their lifetime (MacKillop et al. 2022). Although effective treatments are available (Agabio et al., 2024), AUD is undertreated, with stigma being one of the main reasons for not seeking medical treatment (MacKillop et al. 2022) Women usually experience more severe barriers to AUD treatment than men, with pregnant women experiencing more severe barriers than non-pregnant women (Agabio et al., 2017). Another reason of the scarce use of medical treatment is constituted by the widespread belief that available medications are not effective, or rather, are not effective for all people with AUD. Although sex and gender differences have been described in the response to medications, AUD medications have been studied almost exclusively in men (Agabio et al., 2016). In addition, the number of women with AUD is increasing and services for treatment of AUD should (a) consider women’s specific needs, and (b) realize effective policies to reduce latency prior to accessing medical treatment for both men and women with AUD (Agabio et al., 2021). Nevertheless, recent studies show that only a small number of services have adopted a gender medicine approach in AUD treatment (Vignoli et al., 2024).

Agabio et al. Efficacy of Medications Approved for the Treatment of Alcohol Dependence and Alcohol Withdrawal Syndrome in Female Patients: A Descriptive Review. Eur Addict Res. 2016.

Agabio et al. Sex Differences in Alcohol Use Disorder. Curr Med Chem. 2017.

Agabio et al. Gender Differences among Sardinians with Alcohol Use Disorder. J Clin Med. 2021.

Agabio et al. Alcohol Consumption Is a Modifiable Risk Factor for Breast Cancer: Are Women Aware of This Relationship? Alcohol Alcohol. 2022.

Agabio et al. Efficacy of medications for the treatment of alcohol use disorder (AUD): A systematic review and meta-analysis considering baseline AUD severity. Pharmacol Res. 2024.

MacKillop et al. Hazardous drinking and alcohol use disorders. Nat Rev Dis Primers. 2022.

Minozzi et al. Psychosocial and medication interventions to stop or reduce alcohol consumption during pregnancy. Cochrane Database Syst Rev. 2024.

Vignoli et al. Needs of female outpatients with alcohol use disorder: data from an Italian study. Alcohol Alcohol. 2024.

None Declared

Bipolar disorders (BD) are among the most impairing of pediatric psychiatric disorders. Even though BD symptoms may begin in adolescence, they are frequently not diagnosed until adulthood. BD screening tests could aid diagnostic assessment in paediatric populations and are supported by The International Society for Paediatric Bipolar Disorders Task Force and empirical evidence.

This review synthesizes the evidence on the accuracy of BD symptom screening tests in distinguishing bipolar disorders from other psychiatric conditions or healthy cases in pediatric populations. Additionally, it examines a wide range of potential moderators that may influence diagnostic accuracy.

A systematic search was conducted across three databases (1980–2022), supplemented by searches of grey literature, citation chaining, and author contact. Data from relevant studies were combined using meta-analysis. A multilevel model was used to account for nested effect sizes, with 31 potential moderators tested in both univariate and multivariate models.

2,281 records were identified; 1712 titles-and-abstracts records were screened; 114 records were full-text screened; and 28 studies were included. The meta-analysis was based on all s=28 studies, 40 independent samples, k=115 effect sizes, and n=11,464 participants. Meta-analytic results showed that BD symptom index tests have high diagnostic accuracy in pediatric populations (g = 1.300; 95% CI: 0.982 - 1.619; p < .001) (see Fig. 1). Accuracy varied based on the comparison group, test content, test informant, and the specific scale or subscale used.

Image:

Screening tests focusing on mania-related symptoms, caregiver reports, and psychiatric comparison groups demonstrate clinical value in identifying pediatric BD. Also, other informants and symptom content combinations may not reliably identify pediatric BD. Importantly, tests derived from studies using psychiatric comparison groups, represent BD symptom non-specificity and BD symptom overlap with other disorders (eg. ADHD and depression), providing external validity and clinical utility. Screening tests with high accuracy and clinically useful are the GBI-73-P, MDQ-A-P and the YMRS-P.

None Declared

A growing body of research has demonstrated the positive effects of Acceptance and Commitment Therapy (ACT) delivered in the workplace on employees’ well-being and psychological flexibility. Delivering ACT in the workplace aims to enhance employee performance and reduce stress levels by promoting psychological flexibility, a skill to consciously live in the present, observing thoughts and emotions, and engaging in value-driven actions.

The short-term effects of a 5-week ACT-based psychological flexibility training program were tested.

Participants were 21 corporate employees (62 % women, Mage = 43.9 years, SD = 9.5) recruited from a large company in the financial sector. The six core processes of psychological flexibility were examined before the first training session and after the fifth training session of the 5-week training. Psychological flexibility, value-driven living, thought suppression, five facets of mindfulness and cognitive fusion were assessed.

Results showed a statistically significant difference in one core process of psychological flexibility, namely Contact with the present moment. Acting with awareness, Describing and Nonjudge showed significant difference before and after the training. Presumably, changes in Cognitive defusion and Non-reactivity are also evident, however results did not show significant difference.

The present research has provided further empirical evidence for the effectiveness of ACT-based psychological flexibility training with regard to three aspects of Contact with the present moment, which is a core process of psychological flexibility (Acting with awareness, Describing, and Nonjudge). The findings provide a basis for future research to investigate longer-term effects, including monitoring how participants in the research program practice the learnt techniques in their everyday lives.

Á. Magyary Grant / Research support from: ÁM was supported by the ÚNKP-23-2 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund., Z. Demetrovics: None Declared, Á. Zsila: None Declared, N. Mészáros: None Declared

Although there is recent growing attention on mental health and mental well-being across the globe, supports in this area of healthcare can be a challenge for immigrant and racialized groups with frequent experiences of hardship.

This study aimed to gather perspectives of immigrants and racialized community members on strategies central to support their mental health and well-being, with the aim of addressing research-to-practice gaps.

The study was co-designed in collaboration with a Community Action Table in Markham, Ontario, a setting with 93% of residents self-identifying as Canadian visible minorities (i.e., non-Caucasian descent). A mixed method Concept Mapping methodology was used to engage residents, service providers, and policymakers (n = 68) through three phases of data collection and interpretation.

Participants first brainstormed ways to support their mental health and well-being, generating 283 statements in three group sessions. A consolidated list of 68 statements was then prepared by removing duplicates and merging similar ideas. This list was shared with participants in three group sessions for the sorting and rating actvities: each participant made groups of statements based on a shared meaning and labelled the groups; and rated each statement on a scale of 1-5 for its importance and feasibility to act in next six-months to support the mental health and well-being of their community. The sorted and rated data was then analyzed statistically through techniques of similarity index and hierarchical cluster analysis to produce visual maps, which were shared with participants in the interpretation session for review and naming of clusters followed by open discussion. This led to a 9-cluster concept map comprising of Family Wellness, Awareness & Education, Cultural Sensitivity, Social Service Access, Community Building, Socioeconomic, Food Security, Healthcare Access, and Housing Stability. The rating data showed the clusters of Family Wellness, Housing Stability, Healthcare Access, and Awareness & Education were ranked high for the dimension of importance. In terms of feasibility to act in next six-months, the clusters of Awareness & Education and Family Wellness remained among the top three while the clusters of Housing Stability and Healthcare Access scored low – which was discussed by participants as requiring a multi-year action plan with short- and long-term goals.

Overall, participants viewed mental health and well-being as being closely tied to their living and working conditions while also focusing on family wellness and intergenerational dynamics. The gained insights emphasize a need for multi-sectoral response to support the mental health and well-being supports of immigrant and racialized communities.

None Declared

There has been an increasing socio-medical discourse on the humanitarian approach to the use of restraint in psychiatric inpatient units.

It is necessary to investigate the attitudes of psychiatric hospital staff toward the use of restraint in psychiatric inpatient units and to identify the factors influencing these attitudes.

This study examined the attitudes of psychiatric hospital staff toward the use of restraint in situations involving physical violence toward other patients, verbal violence toward other patients, physical violence toward staff, verbal violence toward staff, and disruption of the treatment environment. The study also investigated factors related to the considerations and perceived burdens (both legal and medical) associated with the use of restraint, comparing these findings with data from a survey conducted 10 years ago.Attitudes toward restraint were not significantly associated with gender, age, or years of service. However, staffs who exhibited less prejudice toward mental illness-related crime were less likely to find restraint necessary. Compared to 10 years ago, there was little change in the need for restraint in cases of physical violence (both toward patients and staff), but the need for restraint in response to verbal violence (toward both patients and staff) had decreased. The perceived burden, both legal and medical, associated with the use of restraint had increased.

Attitudes toward restraint were not significantly associated with gender, age, or years of service. However, staff who exhibited less prejudice toward mental illness-related crime were less likely to find restraint necessary. Compared to 10 years ago, there was little change in the need for restraint in cases of physical violence (both toward patients and staff), but the need for restraint in response to verbal violence (toward both patients and staff) had decreased. The perceived burden, both legal and medical, associated with the use of restraint had increased.

Psychiatric hospital staffs with less prejudice toward mental illness-related crime were less likely to perceive a need for the use of restraint. Compared to 10 years ago, the necessity of restraint in cases of verbal violence has decreased, which may be attributed to ongoing human rights education and increased legal and medical concerns. These findings provide important insights for future policy development aimed at promoting humanitarian approaches, such as non-restraint treatments.

None Declared

Frontotemporal dementia (FTD) is the second most common cause of early-onset dementia and is clinically characterised by progressive behavioural changes, executive dysfunction and language difficulties. FTD is often confused with Alzheimer’s disease and other psychiatric disorders. Clinical features of FTD include personality changes, agitation, loss of inhibition, apathy, social withdrawal and impulsivity. In some cases, the disease is accompanied by mood or psychotic symptoms, resulting in the diagnosis of an additional psychiatric disorder. (Gliebus G.(2014). SAGE open medical case reports,2, 2050313X13519977.). This article presents the case of a middle-aged woman who was diagnosed with an anxiety spectrum disorder before developing and being diagnosed with FTD.

A 57-years-old right handed female with previous history of anxiety disorder admitted to psychiatry clinic with restlessness, decreased sleep, and complain of constant non-purpose walking. Physical examination revealed bradymimia and grabellar reflex. Additionally in her psychiatric evaluation she had short-term memory impairment, disinhibition and verbal perseverations. She had been given multiple combinations of medications by outpatient providers and her restlessness only increased. At the time of admission she was taking mirtazapine,olanzapine and clonazepam. The initial impression was that she had akathisia, and her medications were tapered. She was then started on propanolol and lorazepam. After several days her symptoms had not changed.

In routine biochemical and hematological tests, electroencephalogram (EEG) were within normal limits. 18F-FDG PET/MRI revealed hypometabolism in the bilateral temporal-frontoparietal region, more pronounced in the frontal region which is consistent with FTD.

Trazodone was started to control behavioural symptoms and the dose was gradually increased to 150 mg/day. The dose of propranolol was increased to 80 mg/day, and lorazepam was tapered and discontinued. During the follow up with this treatment, there was an improvement in her restlessness and anxiety symptoms, but her memory problems were persistent.

Frontotemporal dementia may overlap and be confused with other psychiatric disorders. Therefore, a comprehensive history, physical and neurological examination are required to differentiate each clinical entity (Khan I, De Jesus O. (2023).Frontotemporal Lobe Dementia. In: StatPearls ). Additionally, the use of functional neuroimaging, such as 18F-FDG PET/MRI, enables the different distribution of pathology in dementing disorders to be highlighted, as can be seen in our case. This case report highlights the importance of re-evaluating patients with psychiatric diseases, especially when symptoms are resistant to treatment.

None Declared

Arachnoid cysts are intra-arachnoid space-occupying brain lesions, typically of a benign, congenital nature.Such cysts are quite rare, accounting for only 1% of all lesions in the intracranial space. In most cases, they are diagnosed accidentally by neuroimaging.Treatment-resistant schizophrenia (TRS) has a high burden both for patients and healthcare services. There is a need to identify treatment resistance earlier in the course of the illness, in order that effective treatment can be offered promptly. Recently, the co-occurrence of arachnoid cysts and schizophrenia has captured the popular attention about possible relevancy.

Through a case report and a review of the literature, we hypothesize that arachnoid cyst is the cause of resistance in a patient with treatment-resistant schizophrenia.

Starting from a case report, we conducted a literature review on “PubMed”, using key words “arachnoid cyst, arachnoid cyst and psychosis”, “arachnoid cyst and treatment-resistant schizophrenia”,

We present a 47-year-old who is single and unemployed. His past psychiatric history revealed a diagnosis of schizophrenia, having been admitted several times in different inpatient psychiatric wards. In the psychiatric examination, the presence of auditory hallucinations, dissociated thinking, and predominantly negative symptoms was observed. His symptoms showed only minimal responsiveness.He was diagnosed with TRS owing to the inadequate response to two sequential antipsychotic trials (with adequate dose, duration, and adherence).Our evaluation of TRS began with a thorough review of the patient’s psychiatric and treatment history. All nonpsychiatric causes, including untreated medical problems, that may contribute to ongoing psychotic symptoms have been ruled out. Physical examination and blood tests were unrevealing.Electroencephalography showed no signs of seizure activity. Following the evaluation process, a head CT scan showed a left paramedian cystic lesion at the level of the pineal gland. A cerebral MRI was performed in order to get a more detailed image. It confirmed the nature of the lesion and revealed the existence of an arachnoid cyst about 2.5 cm × 3.5 cm × 2.0 cm in size, centered on the quadrigeminal cistern with triventricular dilatation. This neurological tumor didn’t require neurosurgery.

Our case emphasises the importance of considering an organic cause like any space-occupying lesion in the brain (an arachnoid cyst in our case) for the induction of psychopathological symptoms, even those of treatment-resistant schizophrenia, which represents a major clinical challenge. This also underlines the interest of neuroimaging in the initial workup and supports the hypothesis of psychosis as a global network.

None Declared

North Kivu and Ituri in the Democratic Republic of the Congo (DRC) are among the provinces most severely affected by humanitarian needs. The security situation is highly unstable, with over 530,000 people displaced. Those remaining face urgent needs, and the conflict has severely impacted their mental health. An assessment of healthcare staff in local centers revealed significant distress due to both their exposure to patients in crisis and the surrounding violence and insecurity.

The aim of the protocol developed and proposed to healthcare staff was to implement preventive and curative phycological support actions designed to address all the psychosocial risks identified, as well as to alleviate emotional distress, improve well-being and strengthen the resilience mechanisms of healthcare centre staff.

A 5-session protocol was proposed to healthcare staff. The sessions focused on psychological distress specific to professional situations in the context of conflict and humanitarian emergencies: vicarious trauma and self-help strategies using emotional regulation exercises. We measured several dimensions of participants’ psychological and professional well-being at the start and end of the programme: the PCL-5 to assess post-traumatic stress symptoms, the HADS to measure levels of anxiety and depression, the Maslach Burnout Inventory (MBI) to assess three dimensions of burnout: emotional exhaustion, depersonalisation and personal fulfilment. Finally, the ProQoL scale was used to assess participants’ quality of working life.

Analyses of the scores differences between pre and post intervetion, among a pre-sample of 65 participants (21% women; 78.5% men) showed significant improvements. Anxiety and depression levels decreased significantly (HAD-A: t = - t = 7.71, p < 0.001; HAD-D: t = 7.30, p < 0.001). On the MBI, participants showed a significant reduction in emotional exhaustion (t = 5.83, p < 0.001) and depersonalisation (t = 8.85, p < 0.001) and an increase in the sense of personal accomplishment (t = -5.12, p < 0.001). The results also show a clear reduction in post-traumatic stress symptoms (PCL-5: t = 8.64, p < 0.001). On the ProQoL scale, compassion satisfaction also increased significantly (t = -5.70, p < 0.001), indicating that carers feel more gratified by their role despite the challenges they face. Secondary traumatic stress (t = 5.38, p < 0.001), and burnout (t = 2.82, p = 0.006)., although significantly reduced, remain areas of concern.

The intervention had significant positive effects on several dimensions of the psychological and professional well-being of healthcare workers, contributing to better stress management, increased satisfaction, and reduced burnout. These results highlight the importance of implementing support programs for healthcare professionals working in challenging contexts.

None Declared

Recent literature shows that childhood trauma might be associated with developing an eating disorder (ED) or borderline personality disorder (BPD) on the long term. These two disorders have a great comorbidity, and they share many common symptoms.

The aim of this study is to test if childhood trauma could be a transdiagnostic factor for both diagnostics, as well as analysing if trauma could be related to the severity of impulsive and instability symptomatology which characterize both of these diagnoses.

The sample consisted of 45 patients with a diagnosis of either ED (n=21) or BPD (n=24). Childhood trauma was assessed using the CTQ (Childhood Trauma Questionnaire). Impulsive-unstable symptomatology was assessed using the BIS (Barrat’s Impulsivity Scale), CSV (Feeling of Emptiness Questionnaire) and STAXI (State-Trait Anger Expression Inventory), HARS (Hamilton’s Anxiety Rating Scale), MADRS (Montgomery-Asberg Depression Rating Scale). Differences between groups were measured for the CTQ using the t test. The relationship between test results and trauma was measured via regression analyses.

Both groups had high scores of emotional and sexual abuse, and the BPD group also showed high scores in emotional negligence. There were no statistically significant differences between groups relating to trauma symptoms (see Figure 1) Moreover, significant relationships were found between childhood trauma and higher levels of impulsivity (R2adj = 0.14; p = .006), feelings of emptiness (R2adj = 0.15; p = .005), anxiety (R2adj = 0.13; p = .008) and depression (R2adj = 0.08; p = .037).

Image 1:

Out preliminary study shows that childhood trauma is a transdiagnostic factor between BPD and EDs, and it’s related to the aggravation of impulsivity and instability symptomatology.

None Declared