Opioid dependence is a complex condition that often requires long-term treatment and care. Methadone, a synthetic full opioid agonist, and buprenorphine, a partial agonist at the opioid receptor, are commonly used in substitution therapy for opioid dependence, typically administered as an oral liquid or sublingual tablet. Transitioning from high-dose methadone to buprenorphine for the treatment of opioid use disorder (OUD) poses a risk of precipitated withdrawal. This risk arises from introducing a high-affinity partial agonist (buprenorphine) at the mu-opioid receptor after it has been occupied by a lower-affinity full agonist (methadone). As a result, this transition is usually only performed for patients on low doses of methadone (<30-40 mg). Microdose induction has been proposed as a potential solution to facilitate a smoother transition to buprenorphine.

To present a case report of a rapid transition from high-dose methadone to buprenorphine depot, highlighting both the benefits and challenges of this process.

This case report describes a patient who was switched from 150 mg of methadone to 32 mg of sublingual buprenorphine using microdosing, and subsequently transitioned to a weekly 160 mg buprenorphine depot injection.

The patient was successfully transitioned to sublingual buprenorphine and later to buprenorphine depot without experiencing withdrawal symptoms. Even later, the patient reported no signs of withdrawal and was satisfied with the buprenorphine dosage. The patient attended monthly check-ups with the doctor; however, 15 days after the transition, he began consuming alcohol and soon after, started using cocaine.

This report supports the use of microdose induction for initiating buprenorphine, particularly for patients stabilized on high doses of methadone who may struggle with traditional buprenorphine induction methods. Although the patient remained abstinent from opioids, he quickly relapsed with alcohol and cocaine, issues that had not been present during his methadone treatment. Regular and more frequent therapeutic assessments are very important for many patients to prevent relapse.

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Women with a history of major depression are at risk of perinatal depression (PND). The associations between PND and other types of psychiatric disorders are less clear, although a recent GWAS revealed genetic correlations with almost all psychiatric disorders.

The aim of this study was to examine the association between PND and overall, and 17 type-specific, psychiatric disorders in a life course approach.

Leveraging Swedish nationwide health register and primary care data, we included all birthing women diagnosed with depression or prescribed for antidepressants during pregnancy or within a year postpartum, i.e., women with PND (n=122,720), during 2001-2022. Using incidence density sampling, we matched each case to 10 unaffected birthing women. We ascertained any diagnosis of psychiatric disorder over the lifetime from the National Patient Register. Using multivariable conditional logistic regressions, we estimated the association between PND and any, or subtypes of, psychiatric disorders dated before or after the PND diagnosis in a liftecourse approach. Moreover, we conducted a nested case control study to investigate the association of psychiatric disorders and subsequent PND, and a matched cohort study to investigate PND and subsequent psychiatric disorders.

In preliminary results, at a mean age of 31.0, we found that PND was highly associated with any other psychiatric disorders (adjusted odds ratio (aOR)=9.02, 95%CI 8.9-9.2). The association remained when excluding depression (aOR=6.2, 95%CI 6.1-6.3), and was comparable for psychiatric disorders dated before PND diagnosis (aOR = 9.0), whereas attenuated for diagnoses dated after PND (OR= 3.9). Most pronounced association was noted for bipolar, personality disorders, depression, and anxiety. The association was stronger in primiparous women and in women born ourside of Europe (p-for interaction <0.001).

Throughout life course, PND is associated with psychiatric disorders, particularly with bipolar disorder, personality disorder, depression and anxiety. These findings may shed light on shared genetic/risk factors between PND and other psychiatric disorders.

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The Greek National Observatory for Internet and Gaming Addiction (NOIAD) is a state-sponsored organization that will be setup in the University of Thessaly during this year following its inclusion in the Greek National Health Plan for Mental Health 2021-2030.

In this presentation of the setup and goals of NOIAD, a case will be brought forward for scientific collaboration across the European continent that could culminate in similar centers in different countries.

The main publication that NOIAD intends to produce annually will have the role of a national report or at least an update of the national situation. In addition to this report, the observatory is expected to prepare a number of studies or reports on individual problems or in response to questions from state institutions (eg Parliament, ministries). Implementation of an online platform (portal) of specialized but also popular knowledge that will aim to inform health professionals and the general population (parents, pupils/students, adults with an addiction problem) with different information profiles for each population. Information lectures, educational activities for minor students, organization of an annual interdisciplinary conference.

NOIAD’s principal goal is the planning and implementation of actions to address digital addictions through the collection of objective, reliable and valid information about the state of Internet and Gaming addiction prevalence and related research and clinical practice in Greece. NOIAD will provide a state-of-the-nation annual report and disseminate the relevant information and conclusions to health professionals, government bodies and the wider population. Furthermore, NOIAD will plan and provide local preventative actions in the wider area of Thessaly, especially regarding the high-school and university student population; these actions will serve as blueprints for similar activities across Greece.

Setting up a national center to provide with a complete picture of Internet Addiction and Gaming Disorder, pool together research output and coordinate preventative actions will assist with a fragmented research landscape and make better use of limited resources.

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Occupational burnout in education is a major problem, especially among elementary school teachers (ESTs) who have the dual task of imparting knowledge and nurturing children’s emotional intelligence. Research in recent years focuses on understanding, preventing and addressing teachers’ burnout.

We aimed to evaluate professional burnout levels among ESTs and identify associated factors.

We conducted a cross-sectional study among ESTs in southwestern Greece from September to December 2022. Participants answered to a self-administered questionnaire that included the Maslach’s Burnout Inventory Educator Survey (MBI-ES), socio-demographic, and other characteristics.

A total of 126 ESTs (63.5% kindergarten, 36.5% elementary school) participated in the study, 81% were female, 39.7% were 31-40 years old, and 51 (40.5%) had 11-20 years of work experience. The majority (63.5%) had a permanent job, mainly as a preschool teacher. Teachers experienced moderate to high levels of job burnout, as indicated by measures of emotional exhaustion (mean 30.03), depersonalization (mean 9.45), and feelings of low personal achievement (mean 46.42). Male teachers had higher levels of emotional exhaustion (50% vs. 46.1%) and female teachers had significantly higher rates of low personal accomplishment (80.4% vs. 66.7%). More experienced teachers showed higher emotional exhaustion (11-12 years: 58.8% vs. 6-10 years: 44.4%). Finally, kindergarten teachers were more likely to report low levels of personal accomplishment compared to other teachers (84% vs. 68.6%).

Elementary school teachers experience moderate to high levels of job burnout, which is influenced by factors such as gender, years of service, employment status, and phase of teaching. These findings can serve as a basis for prevention strategies and interventions to reduce the effects of burnout in elementary school teachers.

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Health-related anxiety, characterized by excessive worry about one’s health, often leads to significant distress and impairment. Thought suppression, the conscious attempt to control or avoid unwanted thoughts, is frequently associated with various psychological conditions, including anxiety disorders. Research suggests that individuals with anxiety may attempt to suppress thoughts related to their fears, potentially exacerbating symptoms.

The present study investigates the relationship between thought suppression and health-related anxiety, exploring how the tendency to suppress intrusive thoughts may influence health anxiety levels.

A cross-sectional survey design was employed, with participants drawn from a sample of medical students. The White Bear Suppression Inventory (WBSI) was used to assess the extent to which participants tend to suppress intrusive thoughts, while the Health Anxiety Inventory (HAI-18) was used to measure health-related anxiety. The HAI-18 evaluates the frequency and intensity of health-related worries and behaviors over the past six months.

The study recruited 213 medical students, of which 74.2% were female. The mean age of participants was 22.11 ± 2 years. Among the sample, 22.1% had a personal medical history, and 20.2% had a documented history of psychiatric disorders. Regarding family medical history, 59.6% of participants reported a familial history of medical conditions, and 21.6% reported a familial history of psychiatric disorders. Additionally, 39% of participants had family members who had been hospitalized for serious illness.

Health-related anxiety was observed in 26.3% of participants. A significant positive correlation was found between WBSI scores (thought suppression) and HAI scores (health-related anxiety) (r = 0.301, p < 0.001), suggesting that participants who reported higher levels of thought suppression were more likely to experience health-related intrusive thoughts and heightened anxiety about their health. Furthermore, individuals with higher health anxiety tended to have a stronger inclination to suppress thoughts, compared to those with lower levels of health anxiety.

The findings indicate a positive relationship between thought suppression and health-related anxiety among medical students. Specifically, students who engage in higher levels of thought suppression tend to report more frequent intrusive thoughts related to health and greater anxiety about their well-being. Future research could explore interventions aimed at reducing thought suppression as a potential strategy for alleviating health anxiety.

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Achieving excellent sport performance is based both on physical strength and mental endurance. Research demonstrated that children experiencing early maltreatment and traumatization are at an increased risk of high-risk behaviours, bullying, and mental and somatic disorders lasting into adulthood effecting academic and sport performance, relations and life management. Research found that individuals with a history of trauma had a significantly lower chance of being diagnosed with depression or anxiety if they had participated in team sports as adolescents. Also later in life, sport is very beneficial to cope with stressful life events.

We aimed to explore occurrence of early traumas in elite athletes and a control group using the Childhood Trauma Questionnaire (CTQ) and the Early Trauma Inventory Self Report-Short Form (ETISR-SF).

The sample included 57 subjects, 50.9% elite athletes and 49.1% leisure time athletes (controls). Participants (64.9% males, 35.1% females) provided demographic data (age 18-58 years, mean age = 31.96 years, SD = 8.920) and completed the ETISR-SF and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Analysis of Fisher’s Exact Test was performed for evaluating the occurrence of early traumatization.

The ETISR-SF and CTQ subscales scales did not show significant difference in any type of traumas in elite athletes compared to the control group (general traumas p=0.092, emotional abuse p=1.000, physical abuse p=0.592, sexual abuse p=0.297). Occurrence of each trauma type in the two groups were as follows. Elite athletes: sexual trauma (10.34%), physical trauma (55.17%), emotional trauma (44.83%), general trauma (55.17%); Controls: sexual trauma (21.43%), physical trauma (64.29%), emotional trauma (46.43%), general traumas (78.57%).

The occurrence of different type of trauma in our sample is in line with the literature. Physical and emotional abuse among athletes is high. Presumably, those athletes perform better who experience less trauma. The best way to produce resilient athletes is to provide a challenging and supportive sport environment, where athletes feel physically and psychologically safe in their experiences of success and failure.

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Coercive methods in psychiatry have been a matter of intense public debate for many years. Involuntary hospitalization (IH) for purpose of treatment is a major intervention with the purpose of providing care for individuals, who, during psychotic episodes, are not immanently dangerous to self or others but unable to take care of themselves and at risk of significant deterioration. The intervention is, however, not yet fully examined from patients’ perspectives.

To examine views and experiences of patients with schizophrenia, involuntary hospitalized in a psychotic state for purpose of treatment.

Nine patients were interviewed at discharge with a semi-structured instrument on the following: If IH can be justified in general and in the context of their own admission, how IH can be prevented, and finally, how they would react if confronted with a person in a similar condition as their own as described in their chart at the time of IH. The patients were reinterviewed after the interviewer had read their chart to obtain their reactions on others’ descriptions of their condition.

None of the patients considered their involuntary hospitalization necessary in its entirety or as an act of caregiving, and they believed that community support could have prevented it. Some described improvement in their condition attributed not to the hospitalization itself but to positive interactions with staff and other patients. They did not view their condition as psychotic but rather as angry, stressed, or even entirely well. They stressed that psychiatric patients should be able to refuse treatment in the same way as patients with somatic illnesses can.

We discussed the patients’ experiences and negative view of IH, how their opinions can be related to the concept of psychosis and insight, possibilities of increased community support, and ethical issues concerning caregiving when the person being cared for does not feel a need. A better understanding of the role of psychopathology and patients’ subjective experiences may provide a foundation for a patient-doctor dialogue on joint interventions in the future. More options for community support and acute outpatient interventions could be a possible way to reduce IH of patients, who are not dangerous to self or others.

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The administration of high-dose sertraline for the treatment of obsessive-compulsive disorder has been investigated as a potentially more efficacious strategy in cases of treatment resistance, compared to standard dosing regimen. Studies have also evaluated the safety and tolerability of doses as high as 650 mg/day (Levy et al. Compr Psychiatry 2024; 133:152486).

To highlight the importance of understanding the potential use of high-dose sertraline for the treatment of treatment-resistant obsessive-compulsive disorder.

Case report and literature review

This is a 50-year-old woman referred from the emergency department, where she presented with thoughts of death and was diagnosed with ‘Depressive Disorder. Impulsion Phobia without warning signs’ and treated with Sertraline 100 mg. During the first consultation, the patient reported the following symptoms:

• - Marked emotional overwhelm and hypervigilance.

• - Intrusive thoughts related to her father, generating significant guilt.

• - Thoughts in which she feels the desire to harm herself.

• - Compulsive need to check everything she writes, regardless of the context, to confirm she has not written anything bad about herself or her family.

• - Compulsive need to review past actions to ensure she did not say anything inappropriate (despite not having spoken).

• - Compulsive need to revisit conversations to ensure she had not said anything inappropriate, which eventually led her to stop speaking altogether.

• - Mixed insomnia due to anticipatory anxiety about the thoughts she might have during the night.

During this initial visit, a diagnosis of Obsessive-Compulsive Disorder with mixed obsessive thoughts and acts (ICD-10; F42.2) was made. The Y-BOCS was administered, with the patient scoring 19 for obsessions and 12 for compulsions (total score: 31, indicating severe OCD). The dose of sertraline was increased to 300 mg, and aripiprazole was added. However, aripiprazole had to be discontinued after 15 days due to poor tolerance, and risperidone was introduced, which also had to be discontinued after 15 days due to poor tolerance.

After four months of follow-up and monotherapy with sertraline, the patient presented with almost complete resolution of symptoms, a stable mood, calm demeanor, and regained control over her thoughts, along with the disappearance of the compulsive checking behavior. A Y-BOCS was administered again, with a score of 8 for obsessions and 5 for compulsions (mild severity).

The use of high-dose sertraline (250-400 mg/day) may be an effective alternative for maintaining monotherapy in patients with treatment-resistant obsessive-compulsive disorder. However, it is important to consider that previous studies have shown a better response but not a higher overall response rate (Ninan et al. J Clin Psychiatry 2006; 67:15-22).

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Suicidal poisoning represents a significant yet frequently underreported public health concern, particularly in regions where surveillance systems fail to fully capture the scope of the issue.

This study aims to bridge this critical gap by estimating the total number of intentional poisoning cases and evaluating the completeness of the national toxicovigilance system in the Tanger-Tétouan-Al Hoceima region of northwest Morocco.

This study analyzed data from suicidal poisoning cases recorded over a three-year period in the Tanger-Tétouan-Al Hoceima region. We sourced data from the Moroccan Poison Control Center (MPCC) and hospital registers in the region. The two-source capture-recapture method was employed to evaluate the completeness of the poisoning surveillance system.

A total of 824 suicidal poisoning cases were identified after removing duplicates, with 578 cases reported by MPCC and 286 cases from hospital records. Forty duplicates were found between the two sources. The capture-recapture method estimated a total of 4,133 cases (95% CI: 3,548-4,718), revealing that an additional 3,309 cases were not captured by the two data sources. The completeness of the surveillance was estimated at 13.98% for MPCC data and at 6.92% for hospital records.

Despite the presence of a toxicovigilance system in Morocco, significant deficiencies remain in its completeness. There is an urgent need to enhance this system by promoting greater awareness among healthcare professionals regarding the critical importance of spontaneous reporting of intentional poisoning cases.

None Declared

As reported by studies and against the general conception, psychiatrists are not immune to the mental health challenges. More specifically, -more than any other medical specialty- they are at high-risk for burnout, depression, even suicide. It is a striking fact that according to research, in a medical centre which was exclusively designated for healthcare professionals, 89% of psychiatrists struggled with mental health issues; while 8% faced substance abuse problems and only 2% complained for corporal matters. Furthermore, when suffering from depression or any other mental health disorder, psychiatrists fear that their personal data will leak among colleagues, that they will be unable to professionally evolve or that they will be shamingly judged, avoiding to seek medical help.

To explore the risk factors of poor mental health among psychiatrists and to highlight interventions to reduce the mental-health related stigma in this particular category.

A review of 39 articles -from 2010 to 2024- on PubMed and Google Scholar regarding mental health problems among psychiatrists.

Numerous risk factors of psychiatrists’ poor mental health have been identified, such as:

Female gender,

Younger age,

Race minority,

Prior mental health problems,

Residency or early career stage,

Working in non academic, multidisciplinary, inpatient, community, and government settings,

>50 h of work per week and/or more than 20 h of direct clinical face time per week,

Insufficient support from relatives, workplace, and colleagues,

Lack of supervision,

Lack of control over schedule,

Experiencing loneliness,

Experiencing work unsatisfaction,

Experiencing traumatic events such as patient’s suicide or receiving threats.

Action against mental health-related stigma among psychiatrists needs to be taken, such as destigmatizing campaigns designated to remind that psychiatrists -as normal human beings- can suffer from mental health problems in the same way a cardiologist could have a cardiac attack. Apart from destigmatizing mental health issues among psychiatrists, legislation in every country needs to be changed in order to protect psychiatrists from work overload, while security of mental health professionals must be maintained in every clinical setting preventing the reception of threats or even physical abuse. Additionally, female psychiatrists should be institutionally empowered through mentorship programs, sponsorship support, responsive caregiving programs, and innovational directions to manage implicit and explicit prejudices, sexual harassment, and remuneration discrepancies.

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Agitated Depression (AgD) is a unique subtype of depression marked by impulsivity, higher suicide risk, treatment resistance, and worse clinical outcomes compared to Non-Agitated Depression (Non-AgD). Despite these clinical distinctions, the underlying neuropsychological mechanisms that differentiate AgD from Non-AgD remain poorly defined.

This study aims to explore the neurocognitive correlates that differentiate AgD from Non-AgD.

The study cohort included 722 participants, divided into five groups: AgD, Non-AgD, subjects in a manic state (Mnc), euthymic subjects with bipolar disorder (Eu), and healthy controls (HC). All participants underwent a comprehensive neurocognitive assessment including the Wisconsin Card Sorting Test (WCST), the Interference Component of the Stroop Test (ST), the Semantic Fluency Test (SFT), the Trail-Making Test A and B (TMT-A, TMT-B), and Raven’s Progressive Matrices (RPM). Data were analyzed using one-way ANOVAs and Tukey post-hoc tests to compare cognitive performance across groups.

Non-AgD showed inferior performance compared to AgD on the WCST (non-perseverative errors: p=0.037; perseverative errors: p=0.010; categories identified: p=0.026), ST (p=0.000), TMT-A (p=0.046), and TMT-B (p=0.001). Non-AgD also underperformed Mnc at ST (p=0.002), SFT (p=0.025), TMT-A (p=0.007), TMT-B (p=0.005), and RPM (p=0.012). HC consistently outperformed AgD, Non-AgD, Mnc, and Eu individuals on all neurocognitive tests except for the WCST, where no significant differences were observed between HC, Eu, and AgD. Eu demonstrated superior performance on the WCST (p≤0.001), ST (p=0.000), and TMT (p=0.000) compared to Non-AgD, with no significant differences compared to AgD.

The findings reveal distinct neurocognitive profiles for AgD and Non-AgD. The excitatory mechanisms associated with AgD may contribute to enhance attentional resources and cognitive flexibility but also greater impulse control difficulties. The neuropsychological profile of Eu patients resembles that of AgD, suggesting residual cognitive differences compared to HC. This study enhances our understanding of AgD by highlighting the differences in cognitive profiles of AgD, Non-AgD, Mnc, and Eu, and emphasizing the need of considering neurocognitive factors in the characterization and treatment of AgD.

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The biopsychosocial model was first conceptualized by George L. Engel in 1977 in order to explain the contribution of biological, social and psychological factors in determining mental (and physical) illnesses. This model gained new attention in recent years: while many authors consider it as a complete framework, others highlight its clinical, scientific and theoretic vagueness. A revised biopsychosocial model is being proposed, including causal interactions within and between biological, social and psychological factors as the benchmarks of the complexity of mental disorders.

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Schizophrenia is a chronic mental disorder marked by positive symptoms such as hallucinations and delusions, and negative symptoms such as social withdrawal and apathy. While traditional pharmacological treatments effectively manage positive symptoms, they often fall short in addressing negative symptoms and social functioning. Yoga has emerged as a complementary therapy that may help improve both. However, its overall impact remains uncertain.

This review aims to synthesize evidence on yoga’s effectiveness in reducing positive and negative symptoms of schizophrenia and enhancing social functioning.

A systematic search was conducted in Scopus, Web of Science, and PsycINFO in September 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies were peer-reviewed randomized controlled trials (RCTs) assessing yoga’s effects on symptom severity and social functioning in schizophrenia. A fixed-effects or random-effects model was applied, with subgroup analyses performed. Standard mean differences (SMDs) and mean differences (MDs) were used for effect size estimation.

Sixteen RCTs were included, involving 862 participants. Yoga (n = 393) was compared to three control groups: treatment-as-usual (n = 152), other physical activities (n = 124), and waitlist (n = 193). Yoga significantly reduced overall symptom severity relative to control, as shown by a decrease in PANSS scores (MD = -6.61, 95% CI -13.21 to -0.0, p = 0.05, I² = 82%). It significantly improved positive symptoms relative to waitlist (SMD = -0.87 [-1.70, -0.03]) and treatment-as-usual (SMD = -0.65 [-1.21, -0.09]), with effects comparable to those observed with physical activity (MD = -1.30 [-3.09, 0.49]). There were no significant effects on negative symptoms, with SMDs of -1.59 [-4.18, 1.01] for the waitlist and -1.16 [-2.41, 0.09] for treatment-as-usual, and a MD of -1.32 [-3.60, 0.97] when compared to physical activity outcomes. Additionally, yoga did not significantly impact social functioning, showing SMDs of -0.44 [-1.56, 0.68] for the waitlist and -0.44 [-2.29, 1.41] for treatment-as-usual, and a MD of 2.30 [-0.74, 5.34] for physical activity.

This review shows that yoga is effective in reducing overall symptom severity compared to controls and improves positive symptoms relative to treatment-as-usual or waitlist, but not compared to physical activity. There were no significant differences in alleviating negative symptoms or enhancing social functioning. These findings suggest yoga may be a promising adjunctive treatment for positive symptoms of schizophrenia, especially when traditional treatments are insufficient. Further high-quality RCTs with standardized protocols are needed to confirm these results and establish optimal treatment parameters.

None Declared

The psychopathological consequences of the complex impact of the coronavirus disease COVID-19 become the basis for the deterioration of the mental state of persons with a history of mental disturbances.

To investigate the impact of the clinical and psychopathological consequences of COVID-19 on the course of mental disorders in patients with a history of mental disturbances.

95 patients with a history of mental disorders who have experienced COVID-19 were examined and made up the main group (F 32.0-32.2, 33.1, 33.2 – 31 patients, F 06.3, 06.4 – 33 patients, F 41.1, 41.2, 42.2, 45.3, 48.0 – 31 patients). The comparison group included patients with 3 or more episodes of mental disorders in the anamnesis, including the current one. Clinical-psychopathological, clinical-amnestic, psychometric (the Clinical Global Impression Scale (CGI)) and methods of statistical analysis were applied.

A comparison of the course dynamics of current mental disorders after COVID-19 and previous mental disturbances in the anamnesis of the studied patients was carried out according to the indicators of the duration and severity of mental disorders, as well as the duration of the remission that preceded them. The duration of current mental disorders after COVID-19 in the examined patients in most cases ranged from 2 weeks to 6 months (46.32% of persons); duration of remission preceding mental disorders after COVID-19 – from 6 to 12 months (47.37% of persons); the initial degree of severity of psychopathological manifestations according to the CGI-S scale – as “moderate disorder” (36.84% of persons). In comparison with the duration of remission preceding mental disorders in the anamnesis, it was found that in significantly more patients, the duration of remission preceding COVID-19 corresponds to the shortest interval from 6 to 12 months (р < 0.05). When comparing with the severity of mental disorders preceding COVID-19, it was established that a “pronounced disorder” was detected in significantly more patients after COVID-19 (p < 0.05). In comparison with the duration of mental disorders preceding COVID-19, no significantly difference was found, however, when comparing indicators of minimum duration from 2 weeks to 6 months (46.32% of cases with current and 58.18% with previous disorders), the reliability indicator was p = 0.0510.

The obtained data indirectly confirm the complex impact of the SARS-CoV-2 pandemic on the formation and exacerbation of mental disorders, indicate a tendency to increase the severity of mental disorders as a result of the coronavirus disease, and also give reason to put forward a hypothesis about an increase in the duration of mental disorders after COVID-19, which is likely will appear on samples with a larger number of observations.

None Declared

The term brain fog is increasingly used by patients and researchers, but is poorly-defined. Understanding the symptom is important, as it is highly-prevalent, and linked to poor quality of life, and social and occupational disability. Furthermore, it is reported in a broad and seemingly unrelated set of conditions including COVID, menopause, hypothyroidism, traumatic brain injury (TBI), chronic fatigue syndrome (CFS/ME), fibromyalgia, and systemic lupus erythematosus (SLE). Transdiagnostic similarities may indicate common mechanisms or therapeutic targets, and opportunities for translation of research findings.

We aimed to review research characterising brain fog across diagnoses and summarise findings on phenomenology, definitions, objective cognitive measures, and neurobiological correlates. We aimed to highlight transdiagnostic commonalities and differences, and make recommendations on terminology and future research.

We conducted a narrative review of biomedical research into brain fog. We chose a non-systematic approach due to the fragmentary nature of the literature and our exploratory aims.

Brain fog is associated with cognitive symptoms - predominately difficulties with attention, memory, and language, contributing to a subjective “fog” or lack of “mental clarity”. It overlaps with fatigue, and psychiatric symptoms, including anxiety, depression, and dissociation. It is chronic but often transient or variable. There are many transdiagnostic similarities, but research conducting direct comparisons is lacking. We argue that transdiagnostic commonalities in brain fog must arise at one of 3 levels - ambiguous language, common cognitive mechanisms, or common neurobiology. Neurobiological correlates appear heterogenous. Objective cognitive findings are mixed, between mild deficits in attention and memory and no deficits. Evidence for correlation between subjective and objective symtpoms is mixed. Many studies find objective deficits are mediated by associated symptoms such as fatigue, depression, or anxiety.

We suggest researchers avoid the term brain fog in favour of clearly-defined terms where possible. While brain fog appears to refer to a broad range of phenomena, it captures a characteristic assocation of fatigue, cognitive and affective symptoms, and mild objective deficits across diagnoses. Brain fog appears to overlap substantially with mental fatigue. Further research is needed, including direct transdiagnostic comparisons. Measures should include high-precision cognitive batteries, as well as measures of affect (e.g., GAD / PHQ9), fatigue (e.g., FAS), and metacognition, to enable the role of non-cognitive factors to be assessed and compared across conditions.

None Declared

Burnout among medical professionals, particularly psychiatry doctors, is a pressing concern. High-stress environments, heavy workloads, and emotional demands can lead to physical, emotional, and mental exhaustion. Pakistani psychiatry trainees face unique challenges, including intensive training, high patient volumes, and limited support. Despite its implications for patient care and doctor well-being, limited research exists on burnout among Pakistani psychiatry doctors.

To investigate burnout prevalence, contributing factors, effects, and coping strategies among Pakistani psychiatry trainees, informing evidence-based interventions to promote well-being and improve patient care.

A cross-sectional online survey was conducted among psychiatry doctors from 10 hospitals in Pakistan (July 26, 2024 – September 25, 2024). The questionnaire assessed demographic characteristics, burnout factors, effects, and coping strategies.

The survey revealed significant burnout factors, including insufficient support from colleagues/administration (42.3%), high workload (23.1%), personal life stressors (19.2%), long working hours (11.5%), and lack of control (3.5%). Burnout effects included physical health issues (30.8%), mental health issues (30.8%), relationship strain (25.4%), and reduced job satisfaction (23.1%). Participants employed various coping strategies, such as having fun/leisure activities (38.5%), time management techniques (29.2%), engaging in self-care activities (26.9%), setting boundaries at work (11.5%), and seeking professional help (3.9%). Notably, the majority of participants (80.8%) were trainees, highlighting the vulnerability of this group to burnout.

This study highlights the alarming prevalence of burnout among Pakistani psychiatry doctors, underscoring the need for targeted interventions to promote support, workload management, and work-life balance.

None Declared

Youth mental health is under significant strain, with long-lasting impacts on European citizens and societies. Alleviating this burden requires a preventive approach. We will review current preventive strategies for youth mental health, including school-based universal, selective, and indicated primary prevention interventions. Additionally, we will discuss novel care systems for youth mental health currently available across Europe and their potential for implementation in various settings.

None Declared

Schizophrenia is associated with impaired mentalizing abilities, often conceptualized through Theory of Mind (ToM) paradigms, which highlight deficits in understanding cognitive and affective mental states. Empirical findings suggest that affective ToM impairments reduce the likelihood of violence, while deficits in cognitive ToM may increase its propensity. However, phenomenological approaches challenge the primacy of ToM, suggesting that schizophrenia’s core disturbance lies in the embodied self, specifically in the domain of interaffectivity—the pre-reflective, affective resonance between self and others.

Interaffectivity, rooted in early embodied interactions, forms the foundation of social and emotional connectedness. In schizophrenia, disruptions in this fundamental capacity result in a disconnection from the social environment and a breakdown in shared affective states. This disturbance may contribute to violence by impairing empathic resonance and fostering misinterpretations of social cues.

Phenomenological approaches offer a critical lens for understanding these disturbances, emphasizing the embodied and relational aspects of schizophrenia. By shifting the focus from purely cognitive deficits to fundamental disruptions of interaffectivity, these approaches may provide a roadmap for developing interventions that address the precursors of violence, fostering a multifaceted understanding and management of schizophrenia.

None Declared