Opioid use disorder in patients with chronic pain poses a specific clincal challenge. Tapering opioids can initially increase pain, while continuing opioids is associated with tolerance and opioid induced hyperalgesia, resulting in inadequate analgesia. In the long run tapering of opioids or rotation to long-acting alternatives, such as buprenoprphine or methadone, have been associated with less pain and better qualtity of life. In this presentation, evidence for various tapering and rotation strategies will be presented, as well as the possiblities for integrated pain management and addiction care. After this session you will know how to prepare your patient with presciroption opioid use disorder and chronic pain for tapering of opioids, how to support your patient with tapering, including the pace of tapering and the use of supproting pharmacological and non-pharmacoligcal interventions. Finally, it will be discussed who is more likely to benefit from rotation to long-acting opioids, and why some patients might be better of without opioid tapering.

A. Schellekens Grant / Research support from: PI in several studies, funded by national governmental funding agencies.

The EPA Action Plan 2025-2027 aims to optimize mental health care in Europe, by focusing on several unmet needs still experienced by patients. New ways for treatment delivery and new settings of care, tailored diagnostic approaches, research on brain and on mental health, reduction of multimorbidity and mortality gap, promotion of prevention strategies in mental health and more attention on minorities’ mental health represent some of the milestones on which a roadmap for mental health in Europe may be based.

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Suicidal behavior is a complex phenomenon that affects all demographics, with children and adolescents being particularly vulnerable. It is associated with multifactorial conditions that must be considered for the development of more effective prevention strategies. The use of machine learning (ML) models to predict suicide attempts is becoming widespread, as they allow for the simultaneous testing of numerous factors, their complex interactions, and non-linearity in predictive model creation. The Millennium Cohort Study (MCS) is an observational, multidisciplinary cohort study that encompasses a wide range of dimensions, including psychological, genetic, biological, familial, social, and economic factors, as well as traumatic life events, family history, and medical history. This allows for the exploration of their relationship with suicidal behavior throughout individual development using ML models.

The aim was to develop a statistical method that applies ML models to retrospectively predict suicide attempts using structured tabular data from an adolescent cohort defined by the MCS.

The sample consists of 9,824 MCS participants (age 17) who were asked if they had ever purposely hurt themselves in an attempt to end their life. Of these, only 7.4% (725) responded affirmatively. Before starting the modeling phase and fine-tuning any algorithm, several stages were completed: data cleaning, feature extraction and engineering, and feature scaling and selection. We used a wide range of algorithms, from low-complexity (linear regression) to high-complexity (neural networks), while tracking their effectiveness, robustness, generalization, sensitivity, and accuracy.

Even though overall accuracy ranged from 0.83 to 0.87, we generally obtained low f1-scores (˜0.45-0.55) for the targeted class (suicide attempt) and high f1-scores (˜0.95) for the control class. Similar results were observed for precision scores; however, the recall scores were good for both classes, ranging from 0.67 to 0.87. The best performing models were logistic regression and neural networks.

These preliminary results shows that ML models trained with multidimensional data from a young cohort are sensitive in classifying individuals who have attempted suicide. We aim to improve the f1-score and area under the curve (AUC) metrics for the target class through several techniques: over/under-sampling, target encoding, class weight adjustments, ensemble methods, and various neural network architectures.

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This Symposium will consider the process of collaboration from the family persective.

EUFAMI is of the view that the involvement of families in the process of care and recovery is accepted in theory but is not sufficiently practiced. concerned and involved family members are often excluded from important decisions that affect their loved ones and ultimately affect the quality of care and recvovery.

There will be a brief introduction from a representative of EUFAMI followed by a presentarion from a family member. Issues such as involvement in earlt indentivication and assessment,diagnosis, planning of interventions and supporting the recovery process will be considered.Issues such as the rights of famililies, concerns abour relapss, patiient confidentiality and the sharing of infromaton will all be considered in the context of the delivery of mentsl helth care services in the community

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Childhood is a pivotal developmental phase, with experiences during this period significantly shaping future outcomes. Adverse Childhood Experiences (ACE), such as abuse, neglect, and household dysfunction, are linked to long-term adverse health outcomes, risky behaviors, and impaired cognitive function. These experiences can also negatively impact academic performance and life satisfaction. Despite the prevalence of (ACE), there is limited research in the Middle East.

The study aim to examines the relationship between Adverse Childhood Experiences (ACE), academic performance, cognition, and life satisfaction among Sultan Qaboos University students.

This cross-sectional study recruited undergraduate students from Sultan Qaboos University using self-administered surveys distributed via social media and college administrations. It assessed ACE scores, academic performance (GPA), cognitive function, and life satisfaction through validated instruments.

The study found that 26.5% of students had high ACE scores, with emotional abuse being the most common. Higher ACE scores were associated with a history of mental illness, urban residence, and lower family financial status. Significant negative correlations were found between ACE scores and life satisfaction, GPA, and cognitive function. Regression analysis revealed that higher ACE scores increased the likelihood of lower GPA and decreased life satisfaction, emphasizing the substantial impact of ACEs on university students’ well-being and academic performance.

Table 1: Multinomial Logistic Regression Results of GPA as Dependent Factor.

Table 2: multiple linear regression analysis SWLS as dependent variable.

The Study highlights the need for targeted interventions and support systems to address the diverse needs of students affected by (ACE). By understanding the long-term consequences of (ACE) and the mediating role of sociodemographic factors, educators, policymakers, and mental health professionals can develop strategies to promote resilience and well-being among young adults.

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Parenting style plays a crucial role in shaping a child’s development and behavior. Supportive parenting has been associated with positive child outcomes, while authoritarian or permissive styles may lead to less desirable behaviors. Breastfeeding, known for its numerous benefits to both mother and child, may also interact with parenting approaches to influence a child’s emotional and social development.

To explore (a) the parenting style of the participants, (b) their attitudes towards breastfeeding, and (c) the behavioral characteristics of their children.

A cross-sectional study was conducted using self-administered questionnaires completed by 862 parents—both mothers and fathers—who had received support from a private maternity and breastfeeding support center in Athens.

Mothers who adopted a more supportive parenting style had a more positive perception of their children’s behavior compared to more authoritarian, strict, or permissive mothers. Specifically, these supportive mothers viewed their children as less anxious (p = 0.015), more willing to share (p = 0.001), less irritable (p = 0.006), more affectionate (p = 0.009), more expressive of their emotions (p < 0.001), generally obedient (p < 0.001), better at maintaining attention (p < 0.001), less nervous in new situations (p = 0.019), and less easily frightened (p = 0.028). Fathers with a more supportive parenting style also perceived their children as sharing more readily (p < 0.001). Additionally, a longer duration of breastfeeding was associated with children who expressed their emotions more easily (p = 0.042) but were less obedient (p = 0.021). Finally, a more positive overall evaluation of the breastfeeding experience correlated with less agreement that the child is hyperactive (p = 0.020), irritable (p = 0.004), unreceptive to affection (p = 0.034), easily distracted (p = 0.004), and easily scared (p = 0.002).

These findings highlight the importance of supportive parenting and positive breastfeeding attitudes in promoting favorable behavioral outcomes in children. Health professionals can use this information to encourage parenting practices that foster healthy child development.

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Gonadotropin-releasing hormone (GnRH) agonists are the recommended treatment in non-localized prostate cancer. Psychiatric disorders induced by GnRH agonists are rare, but they can include depressive symptoms, irritability, anxiety and auditory hallucinations. Manic episodes are even less frequent.

With this case, we aim to remind, that although rare, affective episodes, particularly manic episodes, can occur with the use of GnRH agonists, namely triptorelin.

Case report.

A 72-year-old man, without relevant psychiatric medical history was admitted to the in-patient unit because of a Manic Episode. It was characterized by hyperfamiliarity, pressured speech, coprolalia, accelerated thinking, flight of ideas and a euphoric/ irritable mood. He also had delusional ideas of grandiosity and persecution, centered on his family.

The most common organic causes were ruled out, but it stood out that this patient was under treatment with a long-acting injectable formulation of triptorelin because of a recently diagnosed prostate adenocarcinoma.

Antipsychotics and mood stabilizer drugs were used, but symptoms were only partially remitted. Therefore, we decided to stop all medications, including triptorelin, and a gradual improvement in manic symptoms was observed.

Mood disorders can be an adverse effect of the use of GnRH agonists and, although the expected response to the psychotropic drugs was not observed, symptoms eventually remitted when the effect of Triptorelin wore off, about three months after patient’s last dose.

The literature recommends the use of mood stabilizers in the presence of affective symptoms after treatment with GnRH agonists, but some cases may need the GnRH agonists to be discontinued.

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Attention Deficit and Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterized by persistent patterns of inattention, hyperactivity, and impulsivity. Beyond these core symptoms, ADHD seems to present complex associations with certain personality traits and to share several clinical features with personality disorders (PDs), particularly those within Cluster B. This overlap of symptomatology may lead to diagnostic challenges and potential misdiagnoses. This paper reviews the literature on the relationship between ADHD and personality traits, highlighting overlaps with personality disorders and exploring their clinical and diagnostic implications.

The primary objective of this review is to understand the potential associations between ADHD and specific personality traits, focusing on the extent to which these traits overlap with clinical features of personality disorders.

A non-systematic literature review was conducted using major databases such as PubMed, Wiley and ScienceDirect targeting peer-reviewed studies published over the last two decades. The search terms included “ADHD,” “personality traits,” “personality disorders,” and “diagnostic overlap.” Relevant studies were selected based on their focus on adult ADHD and its association with personality traits and personality disorders. Review articles and cross-sectional studies were included.

The currently available literature reveals significant associations in the clinical presentation of ADHD and specific personality traits (changing accordingly to different models of personality assessment), as well as a relevant diagnostic overlap with Cluster B personality disorders, particularly Borderline Personality Disorder (BPD) and Antisocial Personality Disorder (ASPD). Shared features include impulsivity, emotional dysregulation, and difficulty in maintaining relationships. The presence of ADHD seems to increase the likelihood of personality pathology, with some studies suggesting a high co-occurrence of ADHD with traits of increased neuroticism and novelty-seeking, and decreased conscientious inhibition.

ADHD and personality disorders share multiple overlapping clinical features, making accurate diagnosis challenging and potentially delaying adequate treatment. Thus, as suggested in some of the articles reviewed, an integrative and dimensional approach to such clinical pictures may be more adequate, so to ensure a profound understanding of the difficulties presented by patients, aiming at providing accurate and tailored treatment. Further research is needed to refine diagnostic criteria and strengthen a standardized dimensional thinking to address this diagnostic ambiguity.

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The Mini-IPIP, a 20-item short form of the 50-item International Personality Item Pool-Five-Factor Model measure (Goldberg, 1999), with promising psychometric properties, The Mini-IPIP describes personality in terms of the Five Factor Model, namely Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. The Mini-IPIP appears to be an alternative to the Ten-Item Personality Inventory (TIPI), and the Big Five Inventory (BFI).

The study aims to investigate the psychometric properties of the Arabic version of the Mini-IPIP.

The Arabic version of the Mini-IPIP scales, and the TIPI was administered to1560 Kuwait university undergraduates (576 males mean age = 21.82±0.70 and 984 females; mean age = 20.95±1.31). The internal consistency reliability, factor structure, and convergent validity of the Mini-IPIP with TIPI & BFI were assessed.

Cronbach’s alpha was satisfactory for N (0.82), E (0.73), O (0.75), A (0.81) and C (0.80). Results revealed significant gender differences in N with a favor for females and in E, O & C with a favor for males. PCA showed that Mini-IPIP five factors explains 71.05 % of the total variance. The Mini-IPIP demonstrated good convergent validity with the BFI (r =71, .76, .77, .82, .67 for E, A, C, N, and O, respectively) and with the TIPI (r = .46, .49, .66, .69, .58 for E, A, C, N, and O, respectively).

The findings support the psychometric properties of the Arabic version of the Mini-IPIP as a useful tool for researchers needing a short assessment of the Big Five in research.

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Currently, there are few affordable, high-quality long-term care options available for a significant segment of people with serious mental disorders. This population includes adults characterized as poor insight, chronically ill, lacking autonomy, consuming drugs, and severe behavioural disturbances. These individuals frequently suffer from schizophrenia, bipolar disorder, toxic psychosis, severe personality disorders and substance abuse disorder, comorbidity being common. The void is ethically unacceptable and societally costly. Progressive reformers, consumers, civil libertarians, and health economists all advocated for a similar goal—the closure of publically funded psychiatric institutions. But deinstitutionalization has actually been trans-institutionalization. As psychiatric hospitals closed, patients with chronic psychiatric illnesses who lacked family support were moved into nursing homes or other forms of non-specialized residential care, occasionally visiting the psychiatric units of general hospitals. Many became homeless and intermittently used hospital emergency services for urgent care. Most disturbingly, prisons have become the largest mental health care facilities in some countries. The number of people affected may increase as a result of the crisis of the family institution, immigration and the epidemic of drug use.

Realistically, the deployment of both private and public resources is now imperative to provide appropriate care for a number of seriously mentally ill persons. They deserve a safe place to live with proper supports—not cycling between the streets, emergency departments, and prisons. Of course, psychiatric hospitals are a necessary but not sufficient component of a reformed spectrum of psychiatric services, where palliative psychiatry should have a role. A return to asylum based long-term psychiatric care will not remedy the complex problems of the mental health system, especially for patients with milder forms of mental illness who can thrive with high quality outpatient care. However, reforms that ignore the importance of expanding the role of such institutions will fail mental health patients who cannot safely live alone or care for themselves.

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Maternal perinatal depression may increase the risk of neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD), in children, either directly or through indirect pathways involving adverse birth outcomes.

This study assesses the risk of ADHD in offspring born to mothers with perinatal depressive disorders, examining both the direct and indirect pathways through adverse birth outcomes such as low birth weight, low APGAR scores, and preterm birth.

The study employed a retrospective cohort design, utilising administrative-linked health data from New South Wales. Maternal perinatal depressive disorders and offspring ADHD were identified using the International Classification of Diseases (ICD-10) codes. A generalised linear model with a binomial distribution and a log link function was applied to estimate the direct association. Additionally, a mediation analysis examined the mediational effect of low birth weight, low APGAR scores, and preterm birth on the association between maternal antenatal depressive disorder and ADHD.

After adjusting for potential confounders, offspring of mothers with antenatal, postnatal, and perinatal depressive disorders are respectively 2.10 times (RR = 2.10, 95% CI = 1.75–2.53), 1.81 times (RR = 1.81, 95% CI = 1.41–2.31), and 2.16 times (RR = 2.16, 95% CI = 1.84–2.54) more likely to have ADHD compared to their counterparts. The impact of maternal antenatal depressive disorder on offspring ADHD was mediated by preterm birth, but not by low birth weight or low APGAR scores. The proportion of the total effect mediated by preterm birth was only 0.73%, indicating this mediation effect was very minimal, about 45 times smaller than the direct effect.

Our study revealed that maternal perinatal depressive disorders are associated with an increased risk of offspring ADHD, with very minimal or no mediating effects from adverse birth outcomes. Therefore, implementing early intervention strategies aimed at improving maternal mental health is crucial to reducing the risk of ADHD in children.

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Background: The United Nations defines Human Trafficking as “the recruitment, transportation, transfer, harbouring, or receipt of people through force, fraud or deception, with the aim of exploiting them for profit,” and says it is practiced everywhere in the world. Studies show that women who have been trafficked for sex have higher levels of fear, are more isolated, greater trauma and mental health needs than other victims of crime, high rates of physical and sexual violence, memory loss, sexually transmitted diseases, and traumatic brain injuries. The present study attends to explore the mental health profile of a cohort of trafficked women from Egypt.

Studies show that women who have been trafficked for sex have higher levels of fear, are more isolated, greater trauma and mental health needs than other victims of crime, high rates of physical and sexual violence, memory loss, sexually transmitted diseases, and traumatic brain injuries.The present study attends to explore the mental health profile of a cohort of trafficked women from Egypt.

This study included detailed mental health assessments of 42 trafficked women in and around Cairo in Egypt. Data was collected by social workers. Assessments, Diagnosis and interventions were done by the author with the help of two clinical psychologists.

This snapshot study shows very convincingly that there’s a high burden of mental ill health among the trafficked women.Suitable therapeutic interventions may provide effective management and prevention of further deterioration of mental health issues of these vulnerable trafficked women.

This snapshot study shows very convincingly that there’s a high burden of mental ill health among the trafficked women.Suitable therapeutic interventions may provide effective management and prevention of further deterioration of mental health issues of these vulnerable trafficked women.

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Addressing severe mental illness requires assertive community intervention. The “Assertive Program – Step by Step”, implemented in 2016, involves a mental health team in the Sintra region (Lisbon). Through a case manager model and regular patient contact, an Individualized Care Plan is developed to ensure treatment continuity, coordinate psychosocial interventions, and reduce both the frequency and duration of hospital admissions. The goal is to contribute to clinical improvement, enhance social functioning, and improve the quality of life for individuals with severe mental illness through several measures: regular psychiatric consultations; promotion of adherence to psychopharmacological treatment; individual or group psychological support; participation in rehabilitation programs; psychoeducational programs for patients and families; and facilitation of general medical consultations and social support.

This study aims to characterize the sociodemographic profile, occupational status, and number of hospital readmissions among patients followed by the Assertive Program, and to reflect on the relevance of these interventions in preventing relapses.

A retrospective analysis of data collected from the clinical records of patients enrolled in the Assertive Program in September 2024, with a minimum follow-up period of one year.

In September 2024, a total of 29 patients were enrolled in the Assertive Program, with 19 receiving follow-up for more than one year. The average age was 36.4 years, and 68.4% were male. The majority of patients were either single (68.4%) or divorced (21.1%), and most were not working, with 52.6% being unemployed and 5.3% retired. The predominant diagnosis was schizophrenia (52.6%), followed by Bipolar Affective Disorder (31.6%) and Psychosis Not Otherwise Specified (10.5%). The average number of total hospital admissions was 2.9 (maximum 12, minimum 0). After joining the Assertive Program, 68.4% (n=13) of patients were not readmitted to the hospital. Of those readmitted (31.6%; n=6), most had a diagnosis of schizophrenia (n=4) and were unemployed (n=5).

This study highlights the specific sociodemographic profile of patients with severe mental illness, who appear to be predominantly single and unemployed. The proposed program may help reduce the number of relapses in the care of this patients. Hospital readmissions appear to occur primarily among unemployed patients, underscoring the need for close, personalized follow-up, with a focus on improving occupational functionality.

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Suicide attempts during dissociative fugue states pose distinct challenges in assessing self-harm risk. Dissociative fugue is characterized by sudden, unplanned travel away from familiar surroundings, coupled with amnesia for personal identity and significant changes in behavior. This case report describes a 31-year-old male who attempted suicide during a dissociative fugue episode.

To present a case of a suicide attempt during a dissociative fugue state, highlighting the unique challenges in assessing self-harm risk, and examining the role of substance use and prior psychological trauma in influencing patient behavior.

This case report describes a single patient. The methodology involves a comprehensive examination of the patient’s clinical presentation, including diagnostic work-up, treatment adjustments, and outcomes.

A 31-year-old male was admitted to the emergency department after intentionally ingesting 25 diazepam tablets. Eight months earlier, he had survived a suicide attempt via carbon monoxide poisoning, also during a dissociative fugue state. These fugue episodes were marked by sudden, unplanned disappearances, memory loss, significant behavioral changes, and temporary loss of personal identity. The latest episode followed an emotional conflict with friends, leading to a three-day disappearance, during which the patient traveled to various locations, frequented pubs, and slept in his vehicle. He attempted suicide on the final day by overdose. Medical assessments, including physical and neurological exams, blood tests, and cranial computed tomography (CT) scans, showed no abnormalities. The patient admitted to using alcohol and cocaine, but urine toxicology revealed no other substances. During psychiatric evaluation, he denied any current or past suicidal ideation and exhibited no psychotic or manic symptoms. He reported mild affective decline over recent months and a complex life history, but did not meet the DSM-5 criteria for post-traumatic stress disorder (PTSD).

The key diagnostic challenge in this case is distinguishing between substance intoxication and dissociative fugue. Although the patient was intoxicated with alcohol and cocaine during parts of the episode, intoxication was not consistent throughout the entire period. Moreover, the onset of symptoms was abrupt and triggered by an emotional conflict. Given the patient’s history of dissociative fugue and the nature of the current symptoms, dissociative fugue remains the most plausible diagnosis. This case highlights the complexity of managing self-harm risk in patients with dissociative symptoms, where suicide attempts complicate the development of effective safety plans and pose significant challenges to intervention strategies.

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Postcoital dysphoria (PCD) refers to feelings of sadness, anxiety, or irritability following sexual intercourse, even when it is consensual and satisfying. These emotions can last from minutes to hours and affect both genders.

Historically, sex was mainly viewed as a means of reproduction, with pleasure often regarded as secondary. However, during the sexual revolution of the 1960s and 70s, perceptions shifted, recognizing sex as a source of pleasure and emotional connection. Today, despite a focus on mutual satisfaction, some individuals still experience post-sexual distress, highlighting the complexity of human sexuality. As a source of important distress, PCD calls for exploration of therapeutical agents.

To examine the prevalence of postcoital dysphoria (PCD) and explore potential therapeutic agents.

A non-systematic literature review using the keywords “postcoital”, “dysphoria” and “tristesse” limited to articles published in English from the PubMed®/MEDLINE® database.

Seven relevant studies were identified regarding postcoital dysphoria (PCD). In a study of 1,208 males, 40% reported experiencing PCT at least once, with 20% experiencing symptoms in the past month, and 3–4% regularly. PCT was linked to psychological distress, childhood sexual abuse, and sexual dysfunctions.

Among women, a UK survey of female twins found that 3.7% reported recent PCT symptoms, while 7.7% had long-term symptoms. Another study indicated that nearly 50% of female university students experienced PCT at least once, with no correlation found between PCT and relationship intimacy.

In the LGBTQIA+ population, a survey of 172 adults revealed PCD prevalence of 42% among men attracted to men and 81% among bisexual/fluid individuals. Significant correlations were observed between sex life satisfaction and PCD in this group. Regarding treatment, one single case report described a patient without psychiatric comorbidities treated successfully with escitalopram (10 mg), with symptomatic relief.

The reviewed studies highlight the prevalence and factors contributing to postcoital dysphoria (PCD) across diverse populations. Among men, up to 40% experience PCD at least once, with contributing psychosocial factors. In women, PCT prevalence varies, with no clear link to relationship intimacy. In the LGBTQIA+ community, PCD is notably high, affecting 42% of MSM and 81% of bisexual/fluid individuals, with sexual dissatisfaction and perceived discrimination as key correlates. Treatment options remain unexplored, with only one case report showing positive results using escitalopram. These findings suggest PCD is a complex conditions influenced by psychological, sexual, and societal factors. More research is needed to understand the underlying mechanisms and explore effective treatments, particularly for minority populations and those without psychiatric comorbidities.

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Burnout is an occupational phenomenon that may be a risk factor for several mental health disorders. It is defined by three dimensions namely emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). The nursing workforce experiences high levels of burnout taking a toll not only on their mental state but also their intent to stay leading to issues on shortage.

This study aims to assess association of burnout and its dimensions to intent to stay of medical nurses working in a private tertiary hospital in the Philippines.

Analytical cross-sectional study using secondary data conducted by the Nursing Services Group of the private tertiary hospital last March 2023. A survey was done on nurses’ perceptions of their working condition using Maslach Burnout Inventory and McCain’s Intent to Stay tools. Variables were assessed through simple and multiple linear regression analyses.

On simple linear regression, burnout, civil status, years of experience, and years of tenure revealed significance in their respective categories. EE and DP dimensions showed negative association to intent to stay. On multiple linear regression, only burnout (p< 0.000 and -0.028) and those married with children (p< 0.000 and -0.028) had significant association. EE consistently showed negative association however, DP and PA had positive association to intent to stay. In most literatures, DP is associated to lower intent to stay as it is equated to cynicism or detachment in interpersonal relations which can manifest as negative or inappropriate attitudes towards clients, irritability, loss of idealism, and withdrawal (Maslach et al. World Psychiatry 2016; 15 103-11). However, in this study, nurses who were more detached had surprisingly higher intent to stay which may show how cynicism can be protective. It is a cognitive method of creating a protective distance to prevent them from letting their job performance suffer especially when dealing with the physical and emotional exhaustion, and feelings of ineffectiveness caused by excessive and prolonged stress (Akyurt et al. Medical Science and Discover 2023; 10 918-928).

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Consistent with global studies, burnout is associated to lower intent to stay among nurses. However, it is beneficial to have more research looking further into the comprehensive role of cynicism in burnout. In this study, nurses have built some level of cynicism that is able to preserve themselves in negative situations. However, with no proper management, depersonalization can aggravate ultimately leading to feelings of inadequacy and lower intent to stay. A deeper and more contextualized understanding about this phenomenon may help administrators improve existing operations and policies that can help foster a healthier working environment for the nurses.

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In general, Autism spectrum disorders (ASDs) are considered lifelong disorders but recent data suggests that after treatment, symptomatic improvement and even loss of diagnosis can be achieved in some cases. Although there is not yet a consensus, the term ‘optimal outcome’ is generally used for this group of children. Literature on optimal outcome contributes in evaluating treatment efficacy and in identifying factors influencing good prognosis.

The aim of this study is to describe a group of children who achieved optimal outcome and compare sociodemographic and clinical features with the cases still being followed up with the diagnosis of High Functioning Autism (HFA).

This study consists of 60 cases aged 4-18 years who were diagnosed with Autism Spectrum Disorder according to DSM-IV (before 2013) or DSM-5 criteria by clinicians in Dokuz Eylul University Faculty of Medinice Hospital Child and Adolescent Psychiatry Department Outpatient Clinic and during follow-up considered optimal outcome and cases who still meet the diagnosis of High Functioning Autism. The necessary data were collected through retrospective examination of the medical records and during clinical interviews. Comorbid psychopathologies were assessed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) semi-structured interview. Childhood Autism Rating Scale (CARS) were applied to evaluate the severity of the symptoms. Intelligence and developmental test results were recorded if available in the medical records for cognitive assessment.

The optimal outcome (OO) group was diagnosed and started special education at a significantly earlier age than the HFA group (p=0.001). The duration of pre-school education was also significantly higher in the optimal outcome group (p=0,023). Symptom severity assessed by CARS at both the time of diagnosis and the current situation was significantly lower in the optimal outcome group (p<0.001, p<0.001). There was no significant difference between the two groups in terms of early verbalization skills and WISC-R scores.

In our study we defined a group of children who lost their diagnosis of autism after special education. Early diagnosis and initiation of special education and less severe ASD symptoms at the time of diagnosis were found to be important factors contributing to optimal outcome.

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Traumatic losses are prevalent during armed conflicts and known to be a risk factor for prolonged grief disorder (Shevlin et al., 2024). Social support and psychoeducation are protective factors for prolonged grief disorder (Al-Gamal et al., 2018). Ukrainians are known to avoid seeking help or support after exposure to traumatic events (Quirke et al., 2021). Not much is known about help-seeking and supporting behavior following the loss of a loved one amidst the ongoing war in Ukraine.

The aim of this exploratory study was to assess the experiences, needs, and help-seeking behavior of those in bereavement and those supporting them during the war in Ukraine.

An online questionnaire was designed by co-authors; data was collected in November 2023 via phone calls among users of the Opinion Internet panel by Factum Group Ukraine. Inclusion criteria were: a) Ukrainians aged 18-55; b) Internet users residing in Ukrainian cities with more than 50,000 residents before the full-scale invasion; c) those who currently live in Ukraine or abroad. The survey evaluated respondents’ experiences of enduring the loss of a loved one and supporting persons in grief after the full-scale invasion of Ukraine, as well as the need for support and information about the grieving process.

Fifty-three percent of survey respondents (n=400) were female. A quarter of the respondents lost a loved one since February 24, 2022 (15% due to death, 14% due to violent death, 5% missing in action), while 9% refused to respond.

Among those in bereavement, the majority (63%) reported that it was vital for them to better understand their own grief process. One-third reported the need for additional support in coping with the loss. One-fifth (21%) of those experiencing loss sought support as the experience became unbearable. Among those seeking professional care, there was a difference in the frequency of approaching different specialists. Twenty percent of the respondents reported that they did not seek help but were willing to.

The majority of respondents (62%) reported supporting a person who experienced loss. However, only 49% of them felt confident enough to do so. The majority (82%) of respondents said that they considered it important to have information on ways to support loved ones in grief.

Despite the fact that a third of people required support and care while experiencing a loss, only 1 in 5 approached mental health professionals or other healthcare specialists. Half of those who wanted to support their loved ones did not feel confident enough. Raising awareness among the population about the process of coping with loss, normalizing seeking support, and providing possible options for supporting people in grief is of high importance for the people of Ukraine affected by the full-scale war.

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Perinatal psychiatry is a rapidly evolving subspecialty focused on diagnosing, recognising early, and treating mental disorders in pregnant and postpartum individuals, up to two years after childbirth (timeframes vary globally). The field has gained attention as governments around the world work to meet the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (health and well-being) and SDG 5 (gender equality), aiming to improve maternal, infant, and child health outcomes.

In most countries, perinatal mental illness is managed by family doctors, midwives, and general adult psychiatrists, although some countries have developed specialist community and inpatient perinatal mental health services. The goal is effective treatment to improve pregnancy outcomes, parental mental health, social functioning, and child development. Studies show that infants of mothers with untreated perinatal depression and psychosis are at higher risk of long-term mental health disorders and poor social and educational outcomes. Early detection and efffective and acceptable interventions are key to breaking this cycle.

This presentation will address global advances and ongoing challenges. Significant progress includes increased awareness, emerging specialist services, novel pharmacological treatments with improved safety profiles, expanded evidence-based psychosocial interventions, and a focus on maternal suicide prevention, a key driver of maternal mortality. However, major challenges remain: perinatal suicide is a leading cause of maternal death, poor quality of evidence for prescribing in pregnancy and lactation, long-term morbidity due to untreated mental illness is often overlooked, and access to care is limited especially in low- and middle-income countries. Social stigma and structural barriers also prevent many from seeking help. Addressing these issues requires a global, multidisciplinary approach, integrating public health initiatives, policy changes, workforce training, and research innovations to ensure equitable access to high-quality perinatal mental health care worldwide.

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Takotsubo cardiomyopathy, or broken heart syndrome, is a rare condition characterized by a temporary decrease in the left ventricle ejection fraction. Takotsubo was first described in Japan in 1990. 90% of cases occur in women over 67 years of age. Although the clinical presentation is similar to acute myocardial infarction, normal coronary arteries are usually detected upon cardiac catheterization. The etiology is not defined yet, but all the studies conclude that physical or emotional stress generates a release of catecholamines that produces a transient left ventricular apical dysfunction.

Obsessive-compulsive disorder (OCD) is characterized by recurrent intrusive thoughts, images or impulses. These obsessions provoke distress (typically anxiety) and compulsions which can be described as repetitive behavioral or mental acts that the person feels compelled to perform. If they don’t perform the compulsions, the anxiety rises.

To highlight the importance of treating mental illness to promote health in a multidimensional way.

We review the currently available literature on Takotsubo cardiomyopathy and its emotional triggers. We also study OCD as a stress factor and the characteristics of this pathology. Finally, we present a case report of a 37-year-old woman, with no previous contact with Mental Health Services. She had developed since the Covid 19 pandemic a severe obsessive-compulsive disorder, which was neither diagnosed nor treated. In the 36th week of pregnancy, after several days without leaving her home due to the limitations of her OCD, she went out into the street, which caused her considerable stress. The next day she suffered from Takotsubo cardiomyopathy or broken heart syndrome, with added analytical signs of preeclampsia, for which a cesarean section was also performed.

In this case, the patient had been suffering from severe obsessive-compulsive symptomatology for approximately 4 years, which had worsened during pregnancy. This caused her a significant level of stress and anxiety, which in the absence of psychiatric treatment, could have endangered her life and that of the baby.

Mental illness tends to have serious medical consequences for patients, that could be prevented with proper treatment of their psychiatric pathology.

None Declared