Minority groups in terms of sexual orientation are exposed to specific stressors, unlike the stressors of the general population. Discrimination, stigma, prejudice and violence are more common in minority groups in terms of sexual orientation than heterosexuals, and they affect mental health negatively. Minority stress factors such as perceived discrimination, self-stigmatization and internalized homophobia have negative effects on mental health.

External and internal minority stressors, which are associated with social anxiety like many mental illnesses, are also associated with self-esteem and quality of life. Minority stress factors should also be well understood in order to understand the consequences they cause. In this study, it was aimed to examine the relationship between discrimination and internalized homophobia experienced in gay and bisexual men with social anxiety, self-esteem and quality of life.

85 participants who defined themselves as gay or bisexual man were included in the study.The study is cross-sectional and descriptive, and the participants were reached by the snowball method.Sociodemographic and clinical data form, including the experienced discrimination questions prepared by the researcher, Internalized Homophobia Scale, Libowitz Social Anxiety Scale, Social Interaction Anxiety Scale, Rosenberg Self-Esteem Scale, World Health Organization Quality of Life Scale Short Form Turkish Version (Whoqol-bref Tr) has been applied.The relationship between experienced discrimination in the sample and internalized homophobia; social anxiety, self-esteem and quality of life were examined separately.

It was found a significant relationship between experienced discrimination and social anxiety levels, an inverse relationship was found with self-esteem. A same-way relationship was found between internalized homophobia and social anxiety levels, while an inverse relationship was found with self-esteem. Experienced discrimination and internalized homophobia were both found to be inversely related to quality of life.

In our study, it was found and discussed that experienced discrimination in gay and bisexual men was positively related to the level of social anxiety, and negatively related to self-esteem and quality of life;similarly there was a positive relationship between the level of internalized homophobia and the level of social anxiety, and a negative relationship between self-esteem and quality of life.When these results are evaluated, it is understood that discrimination experiences and negative mental consequences should be taken into account when evaluating homosexual and bisexual men who are minorities in terms of sexual orientation in mental health clinics and practices, psychological support process, preventive mental health practices and policies to be developed.

None Declared

Depression is a common comorbidity in patients with eating disorders. Epilepsy significantly impacts mood and personality, with up to one-third of epilepsy patients experiencing psychiatric comorbidities. The coexistence of eating disorders, epilepsy, and depression presents a clinical challenge due to complex neurological, psychiatric, and psychosocial interactions. Despite well-established links between these conditions, little literature explores their convergence in a single patient.

We describe a case of anorexia nervosa (AN) in a premorbidly well woman who subsequently developed idiopathic generalized epilepsy. She then developed depression and an intractable urge to end her life solely because she felt “fat”. We discuss the complex relationship between these conditions and propose hypotheses that may explain this interaction.

Informed consent was obtained from Ms. O to access her medical records for this case report. We reviewed her medical history, psychiatric evaluations and treatment interventions.

Miss O is a 24-year old ex-nursing student with no past psychiatric history and was described as a bubbly young girl. She first presented in Nov 2018 with AN (BMI 14.0) achieving weight restoration by Aug 2019 after developing binge-eating episodes. In Jan 2020, she was diagnosed with epilepsy. Shortly thereafter, she developed severe depression, accompanied by personality changes, self-harm behaviours, and intractable suicidal ideations. She attributed her suicidality to her body image disturbances and perceived weight gain. She continues to restrict and purge but her weight has stabilized around BMI 20-22. Since then, she has had 13 admissions for suicide attempts and 7 for managing depression. Her treatments included antidepressants, mood stabilizers, antipsychotics, electroconvulsive therapy, repetitive transcranial magnetic stimulation and intravenous ketamine but her condition remained treatment-resistant.

We propose several hypotheses to explore the interactions between AN, epilepsy, and treatment-resistant depression. These include hypothalamic-pituitary-adrenal axis dysregulation and neuroinflammation, potential common neurological pathways between AN and epilepsy, the possible development of personality disorders, and cognitive distortions where disordered eating and suicidal behaviours serve as maladaptive control mechanisms. We also explored concepts like epileptic personality, interictal dysphoric disorder, and the interplay between antiepileptic drugs and mood.

These hypotheses collectively highlight the complex mechanisms that likely underlie Ms. O’s comorbid AN, epilepsy, and treatment-resistant depression emphasizing the need for integrated, multidimensional treatment approaches. Further research is essential to develop targeted interventions for such challenging comorbidities.

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Since October 2004, antidepressants have had a black-box warning indicating that they are associated with an increased risk of suicidal thinking, feeling, and behavior in children and adolescents. On 2nd May 2007, the United States Food and Drug Administration ordered that all antidepressant medications carry an expanded black-box warning stating an increased risk of suicidal symptoms in young adults aged 18 – 24.

The initiation of antidepressants in the young adult population present unique patient safety considerations and medicolegal risks for physicians. Unlike the triadic doctor-parent-patient relationship in a child or adolescent patient, the doctor-patient realtionship in a young adult is a dyadic one. Hence, enlisting the help of a trusted adult to supervise the young person who has been newly initiated on antidepressants is more challenging.

In this poster, we explore the unique ethical considerations in initiating antidepressants in the young adult population and the steps clinicians may take to mitigate their medicolegal risk in treating this population. The ethical considerations of autonomy, beneficence and non-maleficence are analysed. The measures an individual clinician may take in clinical decision-making and follow-up to mitigate medicolegal risk are also discussed.

A literature search was conducted to determine the clinical considerations and prescription patterns in prescribing antidepressants to young adults. The legislation surrounding medication prescription in major jurisdictions were explored. Current literature on medicolegal risk management was studied to come up with recommendations on mitigating medicolegal risk when initiating antidepresants in young adults.

Initiating antidepressants in a young adult is a collaboratively undertaken medical decision. A thorough evaluation is required to determine if antidepressant initiation is warranted. Young adults initiated on antidepressants must be closely monitored for increased suicidality. The clinician should offer to psychoeducate a member of the young adult’s support network on his diagnosis and treatment, and apprise this person of the black box warning. . If there are imminent grave risks to the young person or others, confidentiality may have to be broken. Clear detailed documentation of the clinical considerations and discussion with the young person is essential.

Initiating antidepressants in young adults presents clinicians with unique patient safety and medicoleagl risk concerns. Steps in clinical decision-making and follow-up may be undertaken by clinicians to mitigate this risk.

None Declared

Affective instability (AI) is a psychophysiological symptom reported in many neurological and psychiatric conditions. It has assumed more relevance in the psychiatric literature as a criterion for borderline personality disorder (BPD). Although extensively clinically used, its definition remains vaguely defined, and it ends up being used interchangeably with affective lability or emotional dysregulation, and it is often mistaken for mood lability, as described in bipolar disorders. To accurately diagnose this symptom and document variations in emotional experiences, it is essential to identify the factors associated with AI.

We aim to review the current definitions and conceptualizations of AI to provide more accurate use of the term.

Narrative literature review.

Current definitions of AI highlight the oscillation of emotions, often described as a series of intense emotional highs and lows that can shift within hours or even minutes, making it challenging for individuals to maintain a stable emotional baseline, significantly affecting an individual’s relationships, self-identity, and coping mechanisms. It is a complex construct, encompassing affective valence, affect amplitude, affective shifting with random patterning, reactivity thresholds to environmental triggers, and affective dyscontrolled modulation. Neurobiological research suggests that dysregulation in emotional processing areas of the brain, such as the amygdala and prefrontal cortex, may contribute to these rapid emotional shifts.

AI is a multifaceted construct with significant implications for mental health. The current definitions and conceptualizations underscore the complexity of emotional regulation and the need for a holistic approach to understanding and treating individuals experiencing these emotional fluctuations. Continued research into the neurobiological, psychological, and environmental underpinnings of affective instability will enhance the understanding of this phenomenon and improve treatment strategies for affected individuals.

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Eating disorders (EDs) can significantly worsen one’s physical and psychological well-being. In the professional environment, EDs may have serious consequences on the psychological and physical health of workers.

Our study aims to screen EDs and psychological health among workers.

We conducted a descriptive, analytical, cross-sectional survey among workers from an electricity company. We collected sociodemographic and professional characteristics. We screened EDs using the SCOFF questionnaire (Sick, Control, One stone, Fat, Food). Psychological health of our participants was assessed using the Hospital anxiety and depression scale (HADS).

Our study included 497 workers with an average age of 42.2 ± 11.1 years. Among them, 381 were male (76.7%) and 72.2% were married. Two hundred twenty-two participants engaged in physical activity, and 44.1% were smokers. The average job tenure was 15.2 ± 10.8 years. According to the SCOFF questionnaire, 35.6% of participants showed signs of possible eating disorders (EDs). Additionally, 12.5% of participants were found to be anxious, and 13.9% were depressed. The likelihood of EDs was higher among those with depression. Factors associated with an increased probability of EDs included feeling slowed down, experiencing anxiety symptoms like ‘butterflies’ in the stomach, and losing interest in personal appearance.

Eating disorders are common among workers, with notable rates of anxiety and depression also observed. It is essential to raise awareness about the importance of a healthy, balanced diet to support mental well-being and, in turn, improve workplace productivity.

None Declared

Schizophrenia (SCZ) is a mental disorder with as yet undefined aetiology and pathogenesis. It is currently considered as a neurodevelopmental disorder and one of the main causes of disability globally, with a prevalence of approximately 1%. About one in four individuals with SCZ is diagnosed with comorbid Cannabis Use Disorder (CUD). Aberrations in brain connectivity have been identified as contributing to the pathophysiology of SCZ.

To our knowledge, no resting-state functional magnetic resonance imaging (rs-fMRI) study has compared continued cannabis use in SCZ patients with CUD (SCZ-CUD+) vs. patients with SCZ without cannabis use (SCZ-CUD-). We hypothesised that continued cannabis use, could result in greater impairment of clinical and cognitive symptoms and in altered connectivity in the Salience Network (SaN), in striate/extended amygdala-cortical areas, and in those involved in planning and emotional control. Studying connectivity in patients with SCZ and CUD could elucidate the mechanisms underlying the development of psychotic symptoms and vulnerability to substance use relapse.

We included 14 SCZ-CUD+ and 20 SCZ-CUD- patients. All were assessed cross-sectionally through the Neurological Evaluation Scale, the Brief Assessment of Cognition in Schizophrenia, the Positive And Negative Syndrome Scale and the Clinical Global Impressions Scale-Severity, and underwent brain rs-fMRI with a 1.5 T scanner to explore functional connectivity (FC). Imaging protocol: All patients underwent a brain 1.5 T MRI scan (GE Signa Voyager) with 32-channel phased-array head coil. Beside the conventional morphological sequences, the functional MRI protocol included: 1) rs-fMRI obtained with a gradient-echo echo-planar imaging (EPI) sequence. Each scan session lasted for 6 min. 2) Structural imaging involved a sagittal three-dimensional sequence employing a magnetisation prepared rapid gradient echo (MPRAGE) over the whole brain.

CUD in SCZ patients was associated with higher impulsiveness and excitement, and lower negative symptoms and neurological soft signs (Fig.1). SCZ-CUD+ and SCZ-CUD- groups differed little on cognitive performance, except for Symbol Coding, where SCZ-CUD- outperformed SCZ-CUD+. Rs-fMRI, compared to SCZ-CUD-, showed reduced FC in patients with SCZ-CUD+ between regions of the salience network, including anterior cingulate and prefrontal cortices, and between right insula and dorsolateral prefrontal cortex and precuneus (Fig.2, Fig.3).

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Using rs-fMRI, we revealed differences in FC within the SaN between SCZ-CUD- and SCZ-CUD+. Continuous cannabis use reduces FC in cortical circuits, impacting connections already impaired in SCZ. In SCZ-CUD+ patients, altered self-relevance attribution and insular dysfunction may increase drug-related impulses and impair cognitive control.

None Declared

Cognitive impairments in schizophrenic patients are present from the first psychotic episode and remain relatively stable over time. These cognitive impairments primarily affect memory, attention, executive functions, and social cognition.

The aim of this study was to assess cognitive functions in schizophrenic patients by comparing them to healthy controls.

Methods: We conducted a cross-sectional, descriptive, and analytical case-control study. It included 15 schizophrenic patients and 15 healthy controls. The study was carried out at the Psychiatry « c » Department outpatient unit at Hedi Chaker University Hospital in Sfax, Tunisia. Both cases and controls underwent interviews to answer predefined questionnaires. We used the Screen For Cognitive Impairment in Psychiatry (SCIP) scale in its literary Arabic version for the assessment of cognitive functions.

The average scores for the total SCIP (ST) and its five subscales (Verbal Learning Test-Immediate (VLT-I), working memory (WMT), verbal fluency (VFT), verbal learning-Test-delayed (VLT-D), and processing speed Test (PST)) were 37.40, 12.87, 14.27, 3.93, 2.47, and 3.93, respectively, for the cases, and 47.27, 15, 18.13, 5.40, 4.33, and 4.40, respectively, for the controls. The cases had significantly lower total SCIP scores than the controls (p=0.05), specifically in the WMT (p=0.02) and VLT-D (p=0.01) subscales. There was no significant difference between the two groups in the VLT-I (p=0.241), VFT (p= 0.202), and PST (p=0.598) subscales.

This study found that cognitive deficits in schizophrenic patients primarily involved impairments in working memory and verbal learning-delayed recall. Early screening for cognitive impairments in these patients should be systematic to specify the deficits and to hasten the integration in the neurocognitive training programs.

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The connection between well-being and various sociopsychological factors such as age, gender, education level, and more is a growing and significant area of interest in today’s studies.

The aim of this study is to examine the relationship between sociodemographic factors, life satisfaction, levels of anxiety, and religiosity. To achieve this goal, the study explored whether religiosity has an effect on anxiety and life satisfaction on the one hand, and whether sociodemographic variables influence the centrality of religion in participants’ lives on the other.

To ensure honest responses, the surveys were filled out anonymously. Statistical analyses were conducted using the SPSS program, applying Pearson Correlation and Analysis of Variance (ANOVA) to determine if there was a correlation between sociodemographic data and questionnaire scores.

In the Analysis of Variance (ANOVA) of total STAI-G scores and religiosity, a significance level of 0.010 was observed, while the Post-Hoc Test suggested that this significance may be found between atheist participants and those who identified with a religion other than Islam, Christianity, or Judaism, with a value of 0.019. Additionally, there is a strong significant correlation of 0.018 between participants’ native language and total CRS-10 scores, which may imply that native language, encompassing important factors like cultural background, can influence participants’ religious beliefs and practices. Lastly, a significant correlation of 0.041 was found between alcohol consumption and total CRS-10 scores. This correlation could indicate that religious participants are more likely to consume less alcohol compared to non-religious participants, possibly due to their religious beliefs.

This study highlights the importance of examining the connections between sociodemographic factors, life satisfaction, anxiety, and religiosity in relation to mental well-being. The findings aim to provide useful guidance for the evolution of interventions that focus on and enhance well-being and continuity, while emphasizing the quality of life experienced by patients from diverse cultures and backgrounds.

None Declared

Discrepancies often arise between experts and non-experts regarding their roles in making end-of-life (EOL) decisions within the Intensive Care Unit (ICU). Such decisions are frequently contentious in clinical settings, with wide-ranging consequences in legal, ethical, psychological, social, and clinical contexts.

The aim of this study was to systematically review the global perspectives of physicians, nurses, family members, and the general public on who “should” be involved in decision-making for adult ICU patients, as well as to identify potential influencing factors.

Adhering to the PRISMA 2020 guidelines, a comprehensive literature search was performed across PubMed, EMBASE, and CINAHL databases. A data extraction table was developed, validated through discussion and implemented by two independent researchers. The extracted data were subsequently analyzed descriptively.

Thirty-three studies were included, documenting variations in findings across different geographical and temporal contexts. Most participants in these studies were healthcare professionals. Despite evidence of paternalistic tendencies, physicians generally showed a growing inclination toward a more collaborative decision-making model. Similarly, the views of other population groups leaned towards patient and family involvement, with nurses additionally supporting their own participation. Six categories of influencing factors were identified, with legal/regulatory considerations and participant demographics emerging as the most significant.

The overall representation of participants’ perceptions highlights a broader tendency towards collaborative decision-making. Τhis requires coordinated efforts from both clinical practitioners and policymakers to establish a decision-making framework that is inclusive, context-sensitive, and adaptable to the legal and cultural specifics of each region. To this end, emphasis should be placed on national-level interventions that address these issues directly, as opposed to broader, supranational approaches that may lack the necessary nuance.

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Although the collaborative partnership of the psychiatrist, patient and family is vital to recovery from a mental disorder, many patients and their family members are not satisfied with the communication with the psychiatrist. They believe that they are not actively involved in creating a treatment plan and that they do not have enough information about the diagnosis and treatment.

Objective of the study is to improve the communication skills of young psychiatrists for collaboration with patients and their families.

Recognising the pressing need to address dissatisfaction with communication, we implemented the EUFAMI Prospect Common Ground three-way communication program, which we adapted for our study. We measured the increase in communication skills using a self-assessment questionnaire.

Participants: three groups of patients diagnosed with severe mental illness, family members, and young psychiatrists have been working in small groups separately and together in large groups.

Our study’s results are promising. The majority of participants expressed satisfaction with the training method. Their feedback highlighted acquiring new communication skills, which they believe will strengthen the collaborative relationship between patients, family members, and psychiatrists.

A training program for improving communication skills for young psychiatrists proves to be useful for improving the creation of a therapeutic relationship of cooperation with patients and their family members.

None Declared

People with mental health conditions frequently encounter diet-related challenges that contribute to the onset of physical comorbidities, further diminishing their quality of life and life expectancy. To date, diet-related problems often are not adequately addressed in mental health care for reasons like overshadowing.

Psychosomatic rehabilitation clinics are a potential setting for tackling these problems as the admission takes place beyond acute crisis and as multi-professional teams, including dietitians, are available. However, little is known so far about the extent to which this potential is being exploited.

In summer 2024, we conducted 22 qualitative interviews with physicians, dietitians and other staff members at six psychosomatic rehabilitation clinics in Germany to explore the current state of action in handling diet-related risks in psychosomatic rehabilitation clinics.

Interviewees elaborated on their eexperiences with the prescription and utilization of diet-related interventions in psychosomatic rehabilitation and their subjective assessments of the potential added value of screening tools in care planning. Preliminary analyses indicate that diet-related problems have not yet been systematically captured in the rehabilitation process. Due to a lack of time, a comprehensive nutrition-related assessment is hardly possible and therefore the diet-related activities tend to be one-size-fits-all services.

The findings of the qualitative study endorse the implementation of a multi-faceted screening tool, such as the NutriMental screener. By this way, diet-related problems of service users might be recognized at the beginning of inpatient rehabilitation and being addressed appropriately during the inpatient stay by selecting suitable rehabilitation measures, especially dietary interventions.

None Declared

Cytopenia is a common hematological issue in HIV/AIDS patients. Despite early disease identification and less toxic HAART reducing its prevalence, persistent thrombocytopenia remains. SSRIs, prescribed for depression in this population, can also cause thrombocytopenia. This review explores the potential combined impact of HIV and SSRI treatment on thrombocytopenia risk.

The objective of this study is to evaluate thrombocytopenia incidence in HIV/AIDS patients and those receiving SSRIs, and to provide clinical recommendations for monitoring in individuals affected by both conditions.

A comprehensive literature review was conducted using PubMed, MEDLINE, and the Cochrane Library. Studies on thrombocytopenia in HIV/AIDS patients or discussing SSRI-induced thrombocytopenia were included. Data on incidence and clinical management were extracted and synthesized to form a cohesive understanding of risks and recommended practices.

Thrombocytopenia (<150,000 platelets/μl) is a sentinel event frequently seen in HIV/AIDS patients, often prompting further evaluation. A 1982 study reported thrombocytopenia in up to 40% of AIDS patients pre-HAART. Recent data from the CHORUS cohort (1997-2006) showed a decreased prevalence of thrombocytopenia to 14%. However, 23% of those with severe thrombocytopenia (<30,000 platelets/μl) remained symptomatic despite HAART. A BC-CfE study found a 0.6% prevalence of symptomatic thrombocytopenia among HAART-treated patients (1996-2012), highlighting non-HIV causes. SSRIs can cause thrombocytopenia by interfering with platelet serotonin uptake, reducing platelet function and lifespan. Several case series reported isolated thrombocytopenia following SSRI introduction. While the concurrent use of SSRIs and HAART’s effect on thrombocytopenia risk is unclear, careful consideration and monitoring are necessary.

The relative risk of thrombocytopenia from the combined effect of HIV/AIDS and SSRI treatment has not been definitively established. HIV/AIDS patients on SSRIs should be carefully monitored due to the known hematological impacts of both the disease and medication. Regular monitoring of platelet counts is crucial, especially in those with advanced or poorly controlled HIV. Consider alternative psychiatric treatments with lower hematological risks where possible. Effective management requires interdisciplinary collaboration to address these patients’ complexities. This review underscores the importance of vigilant monitoring and individualized treatment strategies for HIV/AIDS patients on SSRIs to manage and mitigate the potential risk of thrombocytopenia.

None Declared

The ACT team consists of mental health professionals with a wide range of expertise, including psychiatrists, psychologists, nurses, social workers, and peer specialists. The goal of ACT is to help patients achieve and maintain stability in the community, and to reduce the need for hospitalization and other forms of institutional care and reduce the barriers to care by bringing the care to the Patient.

Upon discharge from the Psychiatric Hospital Patients are often sent home with more than one antipsychotic oral medication and are at times on two long-acting intramuscular preparations.

This is an example of polypharmacy which refers to the concurrent use of multiple medications to treat a single patient, polypharmacy is often used to manage patients with complex mental health conditions who may require multiple medications to address their symptoms.

The AIM of the study is to determine the number of patients followed by the ACT team in the Bronx who are on 2 or more antipsychotics as compared to those on monotherapy who were re-hospitalized within 1 year of discharge.

This is a retrospective study on patients who are followed by Bronx ACT team affiliated with the Institute for Community Living (ICL) in NYC from February 2022 to February 2023. The study compared the number of re- hospitalizations of patients on 2 or more Antipsychotics as compared to those on Monotherapy from February 2022- February 2023. were a thorough review of charts of the 68 Clients being followed by the ACT team was done.

Out of 68 patients being followed by the ACT team; 9 Patients were on 2 antipsychotics/ LAI (Long Acting Injectable) of which 5 patients were on 2 oral antipsychotics, 1 Patient on 3 oral antipsychotics, and 3 Patients on two long-acting intramuscular depot preparations of which five 5(3 for psychiatric related issues and 2 for medical reasons) out of 9 (55.55%) of this population were hospitalized in the 12-month reporting period of February 2022 to February 2023. As compared to 27 (45.7%) patients on monotherapy who were also hospitalized in the last 12-month reporting period.

All remaining 32 (54.2%) clients on monotherapy had no hospitalizations in the 12 months reporting period.

Patients who warrant the need to be followed by The ACT are majorly those who require intensive follow-up in the community and are mostly non-adherent with their medications and prescribing multiple antipsychotics that usually not taken should be carefully considered.

Due to the nature of the study no definite conclusion could be drawn regarding causality between APP and hospitalizations within the 12- month reporting period.

None Declared

Patients with Attention-Deficit/Hyperactivity Disorder (ADHD) are at a higher risk of suicidal behavior. Impulsivity, emotional dysregulation, and co-existing mental health conditions contribute to this risk. Early identification and comprehensive support are vital in mitigating these issues.

The aims of our study are to characterize which factors promote suicide attempt in patient with ADHD.

Our study is conducted on patients (>18 years) referred to the adult ADHD outpatient service of the Psychiatric Clinic of Ancona (Università Politecnica delle Marche, Italy). The Diagnostic Interview for ADHD in adults (DIVA 5.0) was used for diagnosing ADHD. The following rating scale were administered: Temperament Evaluation in Memphis, Pisa and San Diego (TEMPS-M), Coping Orientation to the Problems Experiences-new Italian version (COPE-NVI), Temperament and Character Inventory-Revised (TCI-R).

76% (n=170) of all screened patients were diagnosed with ADHD in adulthood. 7.3% (n=12) of patients with ADHD attempted suicide. A significant higher frequency of suicide attempts was observed in those with borderline personality disorder as a comorbidity (p=0.004), in those with other psychiatric comorbidities (p=0.031), in those who are receiving treatment from the pathological addiction outpatient service (p=0.011), and in those who use stimulants (p=0.018) or opioids (p=0.019). A multivariate linear regression was observed between number of suicidal attempt (R2=0.357; F(5,52)=5.779; p<0.001) and TCI-R transpersonal identification subscale (B=0.022; p=0.021), TCI-R harm avoidance subscale (B=-0.008; p=0.001), TCI-R impulsiveness subscale (B=0.023; p=0.012), TCI-R disorderliness subscale (B=-0.024; p=0.045) and COPE-NVI turn to religion subscale (B=-0.033; p=0.005). A logistic regression analysis was performed to ascertain the effects of all types of TCI-R subscale, on the likelihood of enacting suicide attempts. The logistic regression model was statistically significant, ▫▫2(1)=4.210, p=0.04. The model explained 14% (Nagelkerke R2) of the variance in patients with ADHD who committed suicide and correctly classified 90.3% of cases. Enacting a suicide attempt was significantly predicted TCI-R pure-hearted conscience subscale (exp(B)=0.843, p=0.062).

Comorbidities, addiction treatment, substance use, and personality traits significantly influence the likelihood of suicidal behavior. In addition, it is highlighted that impulsivity, lack of responsibility and caution, those who feel a strong connection with nature and the universe, being rigid, not having transcendental-oriented coping strategies, and being opportunistic are factors promoting suicide in patients with ADHD.

None Declared

Schizophrenia is a severe psychiatric disorder characterized by positive (delusions and hallucinations), negative and disorganization symptoms. According to the influential dopamine hypothesis, positive symptoms of schizophrenia are linked to increased dopamine transmission in subcortical regions, particularly the striatum. Kapur’s aberrant salience theory further suggests that hyperdopaminergia leads to increased and disorganized reward prediction error signalling, leading to the misattribution of significance to irrelevant stimuli, which contributes to the development of delusions. Negative symptoms have been argued to reflect reduced reward prediction error signalling.

To design an optimized monetary incentive delay (MID) task for use in fMRI studies of schizophrenia patients. For this, a pilot study was conducted in order to test the effects of monetary incentives on task performance in schizophrenia patients and healthy controls.

Nine healthy controls and seven patients with DSM-5 schizophrenia completed the MID task, including a training and test phase. This task evaluates reward processing by presenting cues that predict either rewarding or non-rewarding outcomes before a target that requires a speeded response. We investigated the effect of these cues on task performance (accuracy and reaction times) through a repeated measures ANOVA that compared rewarding and non-rewarding cues with a between-subjects factor for diagnosis.

The patients with schizophrenia exhibited slower RT and lower accuracy compared to healthy controls (main effect of group, RT p = 0.008, accuracy p = 0.047). There was also a significant main effect of condition, with better accuracy and shorter RT in the rewarded condition in both the patients and controls (accuracy p = 0.01, RT p = 0.003). However, there was no significant group*condition interaction. Both the patients and the controls showed significant improvements in task performance when rewards were offered, compared to when no rewards were provided.

Our MID task shows expected performance effects in patients with schizophrenia, producing effects comparable to those observed in healthy controls. This MID task design is therefore suitable for examining and understanding symptom profiles associated with reward processing, such as delusions and negative symptoms.

None Declared

Schizophrenia is a complex and highly heterogeneous psychiatric disorder, and it is crucial to understand the different pathophysiology among patients to realize precision psychiatry.

This study aims to evaluate the potential of plasma microRNAs (miRNAs) as clinical biomarkers to stratify schizophrenia patients based on molecular profiles and understand the heterogeneous pathophysiology.

We measured the Positive and Negative Syndrome Scale (PANSS) scores, which are severity scores of clinical symptoms of schizophrenia, along with levels of 179 plasma miRNAs in 26 schizophrenia patients experiencing acute psychosis. We applied hierarchical clustering analysis for the plasma samples on miRNA levels to explore patient subgroups. We then conducted miRNA set enrichment analysis, literature-based text mining and manual literature survey on characteristic miRNAs for each patient subgroup to interpret the heterogenous pathophysiology. This study has been approved by the Ethical Research Practice Committee of Daiichi Sankyo Co., Ltd.

The schizophrenia patients were stratified into three subgroups based on the plasma miRNA profiles. One of these patient subgroups showed a tendency to have relatively high PANSS scores. This patient subgroup was characterized by distinctively low levels of four miRNAs. The enrichment analysis revealed an enrichment of ‘Immune Response’ pathways associated with these four miRNAs. Consistent with the enrichment results, literature-based text mining confirmed that these four miRNAs were frequently associated with ‘inflammation’ and IL-1β, IL-6, and TNFα in the literature. We also identified literature-based experimental evidence demonstrating that these four miRNAs reduce IL-1β, IL-6 and TNFα. These results suggest that the patient subgroup with high PANSS scores has relatively high inflammation.

miRNAs may potentially be clinical biomarkers that reflect both the symptoms and molecular pathology of schizophrenia, and they may be able to identify patient subgroups with relatively high inflammation. Such patient stratification based on molecular profiles is expected to be a key tool to realize precision psychiatry, e.g., prescribing right drugs for right patients.

T. Miyano Employee of: Daiichi Sankyo Co. Ltd., T. Mikkaichi Employee of: Daiichi Sankyo Co. Ltd., K. Nakamura Employee of: Daiichi Sankyo Co., Ltd., Y. Yoshigae Employee of: Daiichi Sankyo Co., Ltd., K. Abernathy Employee of: Sirtsei Pharmaceuticals, Inc., Y. Ogura Employee of: Daiichi Sankyo Co., Ltd., N. Kiyosawa Employee of: Daiichi Sankyo Co., Ltd.

Cognitive impairments represent core features in schizophrenia, impact the functional capacity of patients, and are highly predictive of poor functional outcomes. There is a huge unmet need for improvement of these impairments, and the development of new therapies is conditioned by understanding underlying pathophysiology that is not clear enough. Kynurenic acid (KYNA) is the major matabolite of kynurenine (KYN) pathway (KP) of tryptophan (TRP) degradation, which acts as the inhibitor of NMDA and α7-nicotinic receptors that are crucial for cognitive functioning. Excessive antagonism of these receptors by KYNA is hypothesized to contribute to cognitive deficits while data indicate that proinflammatory cytokyines activate this TRP catabolic cascade.

The objective of this study was to assess correlation between blood levels of TRP, KYNA, KYN, KYN/TRP ratio, IL-8, IFN-γ, IL-1β and cognitive functioning in clinically stable schizophrenia patients.

We measured plasma concentrations of TRP, KYNA, KYN, IL-8, IFN-γ, IL-1β and conducted assessment of cognitive functioning in domains of verbal memory, working memory, attention and processing speed, motor speed, verbal fluency, and executive functions using Brief Assessment of Cognition in Schizophrenia Scale (BACS) in 64 clinically stable schizophrenia (SCZ) patients. Patients were matched by age, sex and body mass index and exclusion criteria included obesity class 2 or higher, any concomitant organic mental or neurological disorder, acute or chronic inflammatory disease, and use of immunomodulatory drugs or psychoactive substances.

A significant positive correlation was observed between BACS verbal fluency subtest score and kynurenine levels (p<0.05), along with a significant negative correlation with IL-β levels (p<0.05). There were no other significant correlations of blood levels of TRP, KYNA, KYN, KYN/TRP ratio, IL-8, and IFN-γ, and cognitive impairments in domains of verbal memory, working memory, attention and processing speed, motor speed, and executive functions.

While the relationship between KP metabolites and cognitive functioning in schizophrenia in domains of verbal and working memory is more reported, specific correlation between KYN levels and verbal fluency observed in our study is less studied and understood. Furthermore, negative correlation between IL-1β levels and verbal memory performance is a valuable finding and can be further explored in the context of suggested detrimental role of IL-1β on hippocampal neurogenesis. Our findings should be interpreted cautiously and corroborated in larger studies with parallel measurement of preferal and central levels of analyzed parameters since there are data that suggest that peripheral concentrations of TRP, KYNA, KYN, IL-8, IFN-γ, IL-1β do not mirror those in the central nervous system.

None Declared

The gap between staff resources and population needs for psychiatric treatment and support, as well as the geographical gap between services delivered in rural areas and in cities is a major challenge for the Danish society as well as globally.

The current project will investigate video consultations (VC) in the context of developing a full-scale home-based mental health service for users with severe mental illness (SMI) necessitating multidisciplinary and municipal support. Digital patient reported outcome (PRO) monitoring can strengthen shared decision making in consultations, and is frequently applied for users with SMI, but it is not regularly combined with VC.

TELMA (Telemedical Monitoring Application) is a national IT system that makes it possible to monitor a patients’ health status in their own home. TELMA includes several questionnaires and the option to connect telemedicine devices that can send vital data such as sleep quality or heart rate measurements directly to the app using Bluetooth. A number of affiliated, cross-sectoral teams who monitors the patient’s health status can view the patient’s responses and data. By mapping the needs and preferences of patients and staff along with an initial trial of the application of TELMA-PSYK for home-based treatment in psychiatry, this study will pave the way for the development of fully digital, person-centered, sector integrating home-based treatment.

This study aims to explore barriers and opportunities to home-based treatment for users with severe mental illness as seen by stakeholders, staff, management and users in mental health services and municipalities.

TELMA-PSYK will be examined in a small-scale feasibility study.

Twenty users with SMI and their regional and municipal staff will be invited to participate in the study. A qualitative study based on phenomenological enquiry will capture the respondents’ experiences of VC and their concerns for and opportunities of full-scale home-based mental health service with PRO recording.

Qualitative data will be interviews examining the users’ experience of three months’ home-based service provision, and the corresponding staffs’ experience of the user’s treatment course and the intervention. Qualitative data will be analyzed with reflexive thematic analysis.

It is expected results from the feasibility study will be ready by March 2025.

It is expected conclusions from the feasibility study will be ready by March 2025.

None Declared

Psychiatric disorders in the workplace represent a major challenge for occupational medicine, affecting workers’ health and their professional capacity.

The study aims to analyze the socio-professional characteristics, risk factors, clinical evolution, and work fitness of patients with psychiatric disorders in the workplace.

A retrospective analytical study was conducted on 62 medical files from the Institute of Health and Safety at Work (ISST) in Tunisia, covering the period 2023-2024. Sociodemographic, professional, medical data, and fitness decisions were extracted. Descriptive statistical analyses were performed to identify significant correlations.

The study included 62 cases. The average age was 44 years. The sex ratio was 0.8.

The most represented sectors were industry (29%), healthcare (24%), and education (11%). Depressive syndrome was the most frequent diagnosis (55%), followed by anxiety disorders (29%) and bipolar disorder (10%). Psychosis was found in 6% of cases.

A significant correlation between the industrial sector and the prevalence of depressive syndrome was found (p<0.01).

The predominant occupational risk factors included stress (51.6%), shift work (22.6%), and exposure to chemicals (16.1%). A positive correlation was observed between exposure to chemicals and the onset of anxiety disorders (p=0.03).

Analysis of fitness decisions showed that 41.9% of cases were deemed fit with accommodations, 29% temporarily unfit, 19.4% fit without restriction, and 9.7% permanently unfit.

This study highlights the high prevalence of psychiatric disorders in the workplace and their significant impact on work fitness. The results underscore the importance of implementing targeted prevention strategies to preserve workers’ mental health and maintain their professional fitness.

None Declared