The cognitive model of psychosis suggests that psychotic symptoms may arise due to biases in information processing. Cognitive biases such as jumping to conclusions (JTC), belief inflexibility (BI), selective attention to threat (AT), and external attribution (EA) are dysfunctional ways of thinking in which distortions are observed in data collection, processing and interpretation. Cognitive biases are known to be associated with the occurrence of positive psychotic symptoms, but evidence for the influence of other cognitive processes on this relationship remains lacking.

This study aimed to examine the relationship between cognitive biases and psychotic symptoms in schizophrenia spectrum disorders and the cognitive factors hypothesized to influence this relationship, such as intolerance of uncertainty and insight.

65 patients with schizophrenia spectrum disorder were included. Sociodemographic data form, Davos Assessment of Cognitive Biases Scale (DACOBS), Intolerance of Uncertainty Scale (IUS) Anxiety Sensitivity Index-3 (ASI-3), and Beck Cognitive Insight Scale (BCIS) Positive and Negative Syndrome Scale (PANSS) and Beck Anxiety Inventory were applied. Ethics committee approval was obtained (no: 2023-40). Statistical analysis was performed with SPSS 25.

The mean age of the participants was 39.27 ± 12.21 years. 63.1% were male (n: 41) and 36.9% (n: 24) were female. Disease duration was 16.95 ± 12.80 years. Hierarchical regression analysis determined that PANNS positive scores were predicted by DACOBS external attribution subscale and IUS, ASI-3 and BCIS scores had a moderator effect (F: 3.51 p<0.001).

Our results showed that external attribution bias is the only cognitive bias associated with positive psychotic symptoms. Intolerance of uncertainty and anxiety sensitivity also play a role in the prediction of positive psychotic symptoms. Targeting intolerance of uncertainty and anxiety sensitivity with cognitive interventions may be useful in the treatment of positive psychotic symptoms in schizophrenia spectrum disorders.

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Clinical practice involves many stress factors for nursing students. Stress in clinical practice causes positive or negative outcomes for students. Students show physical, emotional and behavioural reactions to stress. Therefore, progressive muscle relaxation and breathing exercises with music can be a method that students can easily learn and apply, reducing stress and negative bio-psycho-social responses.

This study aimed to examine the effects of progressive muscle relaxation and breathing exercises accompanied by music on the stress levels of undergraduate nursing students and their bio-psycho-social responses to stress.

This randomized controlled study was conducted at a university in Turkey with ethics committee approval. A total of 154 undergraduate nursing students were randomized, 77 in the intervention group and 77 in the control group. 44 of the students were sophomores, 52 were third-year students, and 58 were fourth-year students. Progressive muscle relaxation and breathing exercises were applied to the intervention group for six weeks with music. No intervention was applied to the control group during the research period. Research data were collected using the Personal Information Form, the Perceived Stress Scale for Nursing Students, and the Biopsychosocial Response Scale for Nursing Students. The scales were applied to the intervention and control groups before the exercises, at the end of the six-week exercises, and two weeks after the exercises ended. Data were collected between October 2022 and January 2023. Shapiro-Wilk test was used in the analysis of normality of data; Independent Samples t-test, Dependent Samples t-test, and Analysis of Variance were used in the analysis of variables.

In the pre-test measurements of the groups, it was found that there was no significant difference in terms of the students’ stress levels in clinical practice and bio-psycho-social response scores (p>0.05). In the post-test and follow-up measurements, it was seen that the stress and bio-psycho-social response scores were significantly lower in the intervention group than in the control group (p<0.05). There was also a significant group*time interaction between the groups in terms of stress and bio-psycho-social response scores (p <0.05).

The findings showed that the intervention helped students reduce their stress levels and negative bio-psycho-social responses to stress, and the effects were found to be sustained in the short term. These positive results are promising in the use of progressive muscle relaxation and breathing exercises with music as an effective and easy method to reduce the stress level and negative physical, emotional and behavioral responses to stress in the clinical practice of undergraduate nursing students.

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Fatigue is one of the most significant factors impairing functionality in patients with multiple sclerosis (MS). Research has demonstrated that psychological factors, in addition to neurobiological ones, play a crucial role in fatigue among MS patients. Previous research has demonstrated that emotional neglect and emotional abuse are associated with fatigue in patients with MS (Pust et al. Front Psychiatry 2020; 11:811). While the role of emotion dysregulation as a mediator between adverse childhood experiences and long-term effects of childhood trauma has been studied, this relationship has not been previously examined in patients with MS.

This study aims to investigate the association between adverse childhood experiences and fatigue and to examine the mediating effect of emotion dysregulation in patients with MS.

Patients with MS followed in the Neurology Outpatient Clinic at Marmara University, who were evaluated during their clinical examination to be cognitively competent and without any physical disabilities that would prevent them from completing the forms, were included in the study. Adverse childhood experiences were assessed using the expanded version of the Childhood Trauma Questionnaire (CTQ-33), emotion dysregulation was measured by the 16-item Difficulties in Emotion Regulation Scale (DERS-16) and fatigue was evaluated using the Fatigue Severity Scale. The impact of CTQ subscale scores on fatigue and the mediating role of emotion dysregulation were analyzed using SPSS with Process Macro v4.2.

A total of 119 patients completed the survey, with a mean age of 37.45 years, and 71.4% of the participants were women. Emotional abuse and emotional neglect were associated with fatigue in patients with MS. The effect of emotional abuse on fatigue was mediated by emotion dysregulation, with the total effect being 0.81 (95% CI [0.04, 1.58]), the direct effect -0.12 (95% CI [-0.86, 0.63]), and the indirect effect 0.93 (95% CI [0.50, 1.55]). Similarly, the relationship between emotional neglect and fatigue was also mediated by emotion dysregulation, with the total effect being 0.66 (95% CI [0.10, 1.22]), the direct effect -0.05 (95% CI [-0.60, 0.49]), and the indirect effect 0.71 (95% CI [0.39, 1.10]). These results indicate that emotion dysregulation fully mediates the effects of both emotional abuse and emotional neglect on fatigue in patients with MS.

Our findings indicate that the link between fatigue severity and emotional neglect or abuse in MS patients is fully mediated by difficulties in emotion regulation. Consequently, it is suggested that interventions aimed at enhancing emotion regulation strategies may potentially mitigate the effects of adverse childhood experiences on MS-related fatigue. Further research, especially focused on intervention strategies, is needed in this area.

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Burnout is a pervasive issue among psychiatry residents, with long-term consequences for both individual well-being and the quality of care provided to patients. The role of emotional competencies, including emotional regulation, self-awareness, and mentalization, is increasingly recognized as critical in mediating burnout outcomes, according to the job demands-resources model of burnout.

The study objective was to investigate predictors of burnout and burnout correlates in a sample of psychiatry trainees.

This study examines longitudinal data from the QASP project (Questionnaire and Assessment of Stress and Performance in psychiatry residents), which also aims to assess the relationship between emotional exhaustion, depersonalization, and personal accomplishment in medical residents across multiple centers in Italy. Using a mixed longitudinal model, we explored predictors of burnout and its correlates, in particular mentalization deficits, emotional dysregulation, and attachment insecurity.

The study involved 827 psychiatry residents enrolled across different psychiatry training programs in Italy, enrolled in two waves: 2022 and 2023. To date, 351 follow-up assessments were retrieved. Emotional exhaustion showed a rapid increase during the early years of residency, then stabilizing in later years (Figure 1).

The results also indicated a strong relationship between increased exposure to violence and elevated burnout dimensions. However, coping strategies were observed to evolve and refine during residency training, with psychiatry trainees displaying a shift from avoidance to problem-focused approaches over time. Residents were also more likely to report less attachment insecurity after one year of training (Longitudinal Mixed Models - Figure 2).

Interpersonal competencies, sustained by mentalization skills, were observed as following a coupled longitudinal trajectory with burnout, so that an increase in interpersonal competencies was associated with a lower elevation in burnout dimensions (Figure 3).

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Our findings suggest that enhancing emotional personal and interpersonal competencies could mitigate burnout, improve training outcomes, and potentially increase later workforce retention among psychiatry trainees. These results underscore the need for interventions targeting emotional competencies and mentalization during psychiatric training, such as focused clinical supervisions by senior staff members. Such interventions could enhance residents’ resilience, promote effective coping mechanisms, and ultimately improve the quality of psychiatric care.

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Precision of language in neuropsychiatry is vital for the accurate understanding of complex psychopathological phenomena. Many expressions used in psychiatry, especially those of German origin, reflect nuanced descriptions of patient behaviors, cognitive impairments, and emotional states that are not easily captured by modern terms. These linguistic tools provide a window into the intricate dynamics between the mind and body, helping clinicians interpret and navigate the subtleties of neuropsychiatric conditions.

This review aims to explore how specific expressions in neuropsychiatry, derived from clinical German terminology, contribute to a deeper understanding of patient experiences and enhance the precision of clinical assessment. By examining these linguistic elements, the paper seeks to illustrate their relevance in diagnosing and treating neuropsychiatric disorders, particularly where conventional language falls short.

Through a conceptual analysis, this review delves into the historical development and clinical application of several key terms originating in German psychiatry. Terms such as “Gegenhalten,” which describes paradoxical resistance in catatonia, and “Weltschmerz,” a term encapsulating existential despair, are examined within clinical contexts. The review also discusses other terms such as “Mitgehen,” referring to automatic obedience, and “Vorbeireden,” which highlights disorganized speech patterns. The review draws upon classical psychiatric literature and modern clinical observations to demonstrate how these terms inform diagnosis and treatment strategies.

The use of these specific linguistic constructs offers neuropsychiatrists valuable insights into the subjective experiences of patients, often highlighting behaviors and emotional states that would be otherwise overlooked. For example, “Gegenhalten” allows for the differentiation of motor dysfunction in catatonia, while “Weltschmerz” provides a unique framework for understanding a type of depression that transcends typical diagnostic boundaries. Similarly, “Vobeirreden” aids in the recognition of cognitive disorganization, and “Mitgehen” underscores deficits in volitional control. These terms provide clinicians with greater clarity and precision in diagnosis and therapeutic approaches, bridging the gap between patient experiences and clinical evaluation.

This review underscores the importance of language in the accurate interpretation of neuropsychiatric disorders. It demonstrates how these terms enrich the diagnostic process and offer deeper clinical insights into patient behaviors and symptoms. The nuanced language of neuropsychiatry not only enhances understanding but also serves as a tool for more targeted and effective interventions. Ultimately, this approach encourages clinicians to consider the broader impact of linguistic precision in both diagnosis and treatment planning.

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Methadone is typically administered as a racemic mixture of two enantiomers (50% Dextro, 50% Levo methadone) and is used for chronic pain management and as maintenance therapy for opioid dependence. Levomethadone, when used alone, shows similar efficacy but with fewer side effects, particularly a safer cardiac profile with less QTc prolongation. In maintenance therapy for heroin dependence, the effective dosage of levomethadone ranges from 40 to 70 mg per day.

Our case concerns a 42-year-old patient who has struggled with substance abuse since the age of 17. Admitted to the Psychiatric Unit of Cesena Hospital for a reduction of Lormetazepam (previously consuming 80-100 mg/day), he was found to be taking 200 mg of levomethadone daily. This dosage is typically administered for pain management rather than as maintenance therapy for heroin dependence. Although the man was consistently consuming high doses of psychoactive medications, exceeding the ranges commonly reported in the literature, he did not exhibit significant adverse effects or signs of sedation during his hospital stay. This observation led us to consider the possibility of a genetic alteration in cytochrome enzymes that could enable ultra-rapid drug metabolism.

During the hospital stay, it was possible to safely reduce the benzodiazepine therapy by switching from oral lormetazepam to intravenous diazepam and subsequently to oral diazepam.The patient also underwent a pharmacogenetic test that analyzes the polymorphisms of 60 different enzymes using cells obtained from saliva.

In the reported case, the use of L-Methadone has allowed over the years a full control of withdrawal symptoms and cravings from opioid drugs, a greater compliance with treatment and a lower risk of general and cardiological side effects than racemic methadone administered in equivalent therapeutic doses in past years.

It has also been made possible, through in-patient treatment, to carry out a progressive withdrawal from Lormetazepam in total safety.

Pharmacogenetic testing targeting CYP3A4 and CYP2B6 enzymes did not reveal significant alterations, contradicting our initial hypothesis.

The originality of this case is basically due to the lack in the literature about clinical cases treated with such a high dose of Levomethadone (200 mg/day) as substitution therapy for opioid addiction and to the investigation of the salivary pharmacogenetic testing to eventually support the hypothesis that the patient could be a rapid or ultrarapid metabolizer.

Moreover, we have sought to clarify the correct use of levomethadone in individuals at high risk of death due to conditions that may increase the risk of Torsades de Pointes.

The pharmacogenetic analysis excluded rapid metabolism, suggesting a role for P-glycoprotein (PGP) in influencing the absorption of methadone and the variability of plasma concentration.

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While the relationship between social anxiety disorder SAD and various sociodemographic factors has been explored, there is a notable gap in research examining the prevalence of SAD in visually impaired individuals. Vision loss could influence social interactions and thus may alter the typical presentation or severity of social anxiety.

This study aims to compare self-esteem and social anxiety disorder (SAD) levels between visually impaired and sighted individuals and to explore the relationship between social anxiety and various sociodemographic factors.

A case-control study was conducted from March to June 2017 in Riyadh, Saudi Arabia, involving 62 participants (24 visually impaired and 38 sighted). Participants completed a demographic form, the Liebowitz Social Anxiety Scale (LSAS), and the Rosenberg Self-Esteem Scale (RSES). Data analysis included descriptive statistics, t-tests, and ANOVA to compare psychological outcomes between groups.

The mean age of visually impaired participants was significantly higher than that of sighted participants (24±2.8 vs. 22.4±2.2 years, p=0.013). No significant differences were observed between the two groups in terms of gender, marital status, or education level. The RSES scores indicated no significant difference in self-esteem between visually impaired and sighted individuals (18.13±2.66 vs. 17.42±2.04, p=0.244). Similarly, LSAS scores did not significantly differ between the two groups (32.63±24.19 vs. 36.68±22.68, p=0.506).

The findings suggest that visually impaired individuals do not have significantly different levels of self-esteem or social anxiety compared to their sighted peers, indicating that visual impairment may not directly contribute to lower self-esteem or higher social anxiety. Future research should involve larger, more diverse samples and longitudinal studies to further explore these relationships.

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In research, recruitment challenges are common and lead to delays and reduce sample size and power. People with schizophrenia are often described as hard to reach and retain in research, and in particular, studies targeting people with chronic comorbidities such as diabetes, meet difficulties related to recruitment.

This study aims to describe challenges and strategies to recruitment of Danish adults with schizophrenia and type 2 diabetes to a cross-sectional survey study about psychosocial health and support.

The recruitment process was tracked in a register where all relevant information was synthesized systematically. This included information on how eligible participants were identified and invited for the study and reasons for declining. Two recruitment strategies were applied for recruiting participants to complete a questionnaire: 1) Through mental health professionals in psychiatric outpatient clinics in Region Zealand, Denmark, and 2) Through phone calls to eligible participants. Descriptive analyses of the recruitment data were conducted.

Three types of challenges were found and described: 1) Identifying eligible participants, 2) Challenges with having mental health professionals to recruit, and 3) Participants’ lack of ability to complete a questionnaire. The challenges were met by several practical approaches: 1) Identifying eligible participants though electronic health records and medication types, 2) Inviting participants through phone calls, and 3) Letting participants receiving help for completing the questionnaire from a care coordinator, family/friend or researcher when needed. Approximately 15% of all eligible participants declined to take part, which indicate high willingness to participate.

Exploring different types of challenges was important for understanding the actual difficulties in recruitment, for using approaches to meet the challenges, and for detecting the high willingness to take part.

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Manic episodes, a defining feature of bipolar disorder, are often triggered by significant psychosocial stressors. In Tunisia, marriage carries deep religious, societal, and familial significance, creating considerable pressure that may act as a precipitating factor for the onset of bipolar disorder. This case series presents three patients who experienced their first manic episode in the immediate aftermath of their wedding.

To highlight the role of marriage as a significant trigger for the first manic episodes in patients with no previous psychiatric history, within the specific socio-cultural context of Tunisia.

These case reports were compiled through clinical observations and interviews with the patients and their families. All three cases involved newlywed males who developed manic symptoms shortly after marriage, requiring hospitalization.

• - Case 1: A 30-year-old male with no personal or familial psychiatric history presented with manic symptoms 5 days after his wedding. Symptoms included expansive mood, irritability, insomnia, grandiose and persecutory delusions, hyperactivity, and logorrhea. He was hospitalized and treated with lithium and risperidone. After 3 weeks, he was discharged and has remained symptom-free for 1 month.

• - Case 2: A 33-year-old male with a paternal history of schizoaffective disorder developed mania the day after his wedding, following alcohol use and sleep deprivation. His symptoms included psychomotor agitation, destruction of objects, verbal aggression, logorrhea, tachyphemia, delusions of grandeur and persecution, insomnia, and hyperactivity. He was treated with clonazepam, lithium and haloperidol. Clonazepam was discontinued before discharge, and haloperidol after 3 months. He had been episode-free for 3 years, then he had a manic episode and was hospitalized for 2 weeks. Now he’s been symptom-free for 2 months

• - Case 3: A 31-year-old male with no personal or familial psychiatric history presented with manic symptoms 7 days after his wedding, including insomnia, expansive mood, grandiose delusions with auditory hallucinations (he believed God told him to have a son who would be the next prophet), hyperactivity, and logorrhea. He was treated with diazepam, lithium, and risperidone. He was discharged after 4 weeks, with diazepam discontinued before discharge and risperidone after 6 months. He has remained episode-free for 1 year.

These cases highlight the significant cultural pressures surrounding marriage in Tunisia, which can serve as a potent trigger for manic episodes in individuals without prior psychiatric history. Early identification and intervention with antipsychotics and mood stabilizers proved effective in all cases. These findings emphasize the importance of psychiatric vigilance in similar socio-cultural settings to manage the onset of bipolar disorder in response to life stressors.

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Neuroimaging studies show that schizophrenia is linked to reduced grey and white matter volumes and increased cerebrospinal fluid. Cannabis use, a widely known risk factor for psychosis, is associated with poorer clinical outcomes, although the mechanisms underlying this association remain unknown.

This study aims to explore the effect of cannabis use on brain volumes in individuals with a first episode of psychosis, comparing users and non-users.

A cross-sectional study with 207 participants was conducted at the Cantabria Early Psychosis Intervention Program (ITPCan) in Santander, Spain, from January 2020 to July 2024. Clinical, sociodemographic, and cannabis use data were collected. Structural magnetic resonance imaging (sMRI) scans were obtained using a Philips 3.0T MRI machine with T1-weighted sequences. Voxel-based morphometry (VBM) analysis was conducted using the CAT12 toolbox to assess relative volume measures of white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF), accounting for individual differences.Statistical analyses were performed by SPSS 23.0, with a significance of 0.05, including mean comparisons and multivariate analysis of covariance controlling for age, sex, and educational level.

Out of the total sample, 106 patients underwent sMRI, including 44 men and 62 women, with an average age of 36.9 years. In terms of education, 47.2% had achieved basic level, while 52.8% had higher education. Regarding cannabis-related variables, 28 participants (26.5%) were identified as users; the average age of initiation was 17.1 years, with consumption occurring around 6.5 days per week and 6. 7 joints per day.

Non-user group showed slightly higher mean CSF and WM volumes compared to users (CSF=18.65 vs. 17.56; WM=36.49 vs.35.99), but these differences did not reach statistical significance (p= 0.154; p = 0.265). In contrast, cannabis users showed a significantly greater relative mean GM volume (46.37 vs. 45.12, p = 0.037). However, these differences did not reach statistical significance after adjusting for age, sex, and education.

Cannabis use is associated with greater GM volumes among individual with a first episode of psychosis. However, these differences did not remain significant after adjusting for age sex and education. GM differences could largely be attributed to the age disparity between both groups, with cannabis users being significantly younger than non-users (27 vs. 40.8 years).

Further research into the underlying mechanisms and long-term studies are needed to provide a clearer understanding of how cannabis use affects brain structure over time.

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The number of elderly people requiring social and health care support in the last years of life is constantly increasing. The consequence is a significant increase in the number of guests in assisted nursing homes. The elderly patient, collaborating with healthcare professionals, becomes the protagonist of the entire care process. The places and times of care, together with the lived experience and the emotions felt, are just some dimensions of humanization, dignity of care and dignified care. This recognition of the patient experience within the definition of quality of care is associated with better clinical outcomes and patient safety. Patient Reported Experience Measures (PREM) are psychometrically validated questionnaires returned directly by patients and aim to provide a standardized assessment of individual care experiences.

Assess the emotionality, dignity, depressive symptoms of the elderly patient without significant psychiatric disorders at the time of admission to a place of care.

Sixty-seven elderly subjects (28 F, 38 M) were recruited in some elderly residential facilities (total mean age (yrs)(±SD): 75.64 ±5.96)

age ≥ 65 years; MMSE ≥20; absence of overt diagnosis of psychiatric or neurodegenerative disorders (evaluation with SCID-5-CV). All patients were given a PREM questionnaire at the beginning and during the care pathway. All patients were administered at baseline (T0), after 6 months (T1) and after 1 year (T2) the following evaluation rating scales:

• - Mini-Mental State Examination (MMSE) (only T0); Patient Dignity Inventory (PDI); Geriatric Depression Scale (GDS); Global Assessment of Functioning (GAF); Quality Life Index (QLi)

The data were statistically analyzed with the EZAnalyze 3.0 software for the Excel platform.

Tables 1 and 2 show the results obtained with each scale analyzed. On the PDI scale, the ANOVA results indicate that at least two of the repeated measures differed significantly [Mean scores ± Std. Dev: (T0) 63.388 ± 22.042; (T1): 57.313 ±21.159; (T2): 49.985 ±17.418]. The data obtained with the GDS scale showed no variation during the observational period. Although the differences were not statistically significant, the data indicate that no increases in depressive symptoms were observed. I results obtained with the QLi showed that the ANOVA results indicate that at least two of the repeated measures differed significantly [Mean scores ± SD: (T0) 3.358 ± 1.164; (T1): 6.075 ±1.222; (T2): 6.657 ±1.213]. Similar results were observed with the GAF scale.

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Intervention programs that allow older residents to express their emotions and observations are not only beneficial for corporate welfare, but also promote a sense of empowerment and involvement. Our small observational study has shown that these programs can significantly improve residents’ quality of life and protect against the onset of depressive symptoms.

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Clozapine is indicated for resistant schizophrenia as monotherapy. However, the response is inadequate in 40-70% of patients. In this context, the combination of clozapine with a second antipsychotic or a mood stabilizer is a strategy frequently used to potentiate its effects (Barlatier, A. (2014) Human Medicine and Pathology. [Doctoral thesis, University]). However, the level of evidence for these practices remains low, and data on the prevalence of such combinations in France are limited. Against this backdrop, collaboration between a national multi-professional network operating in various public and private mental health establishments (the PIC network) and a regional psychiatric research federation (FERREPSY Occitanie) enabled the study of the prevalence and modalities of these associations in a large panel of French psychiatric establishments.

Estimate the prevalence of co-prescriptions of antipsychotics and mood stabilizer with clozapine for patients hospitalized in full-time psychiatry.

Observational cross-sectional study conducted on a given day in December 2023 in 30 participating centers that are members of the PIC network and/or FERREPSY.

The computerized records of 795 patients were analyzed by the referring pharmacists at the participating centers. 78.4% of patients had at least one antipsychotic in association with clozapine. 64.5% of antipsychotics associated with clozapine were conventional antipsychotics. Among atypical antipsychotics, aripiprazole was combined with clozapine in 9.9% of patients, amisulpride in 10.7%, risperidone in 8.2%, olanzapine in 4.3% and quetiapine in 3%. For mood stabilizer, the combination of clozapine with valproate was the most commonly used combination (23.64% of patients), ahead of lithium salts (15.6% of patients) and lamotrigine (10.1% of patients).

The combination of psychotropic drugs with clozapine remains a majority practice, which seems to have little connection with existing literature data.

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Major depressive disorder (MDD) is a severe psychiatric condition with a high risk of suicide. Research on MDD and suicidality has identified structural and functional abnormalities in the cortico-limbic network as candidate biomarkers, but little is known about the temporal dynamics of these brain regions. Recently, abnormal amygdala habituation to emotional stimuli has been highlighted as a reliable fMRI phenotype linked to emotional dysregulation and increased suicide risk.

Our study aimed to assess amygdala habituation to emotional stimuli in MDD and explore differences between suicide attempters (SA) and non-attempters (nSA). Additionally, we examined the relationship between amygdala habituation and depressive symptoms.

414 MDD patients (239 SA, 175 nSA) selected from the UK Biobank underwent fMRI during a block-designed emotion processing task, including faces and shapes conditions. We obtained bilateral amygdala activation for each block using FSL. Habituation was quantified using two methods: the regression approach (REG) and First minus Last block (FmL). One sample T-tests were used to investigate whether habituation rates significantly differed from zero. Group differences were analysed using Mann-Whitney U-tests. Generalized linear models (GLM) were applied to examine relationships between habituation and depression severity, controlling for age, sex, group (SA vs. nSA), and handedness.

In both MDD and SA groups, no significant habituation was observed for either emotional or non-emotional stimuli (pFDR>.05). However, the nSA group showed significantly positive habituation rates for left amygdala in both conditions and for right amygdala in faces condition using REG (pFDR<.05), suggesting a possible sensitization process. Moreover, nSA showed significantly higher habituation rates than SA in all conditions with REG (pFDR<.01). GLM analyses revealed no significant associations with depression severity.

Our results suggest that MDD is characterized by a lack of amygdala habituation to emotional stimuli, potentially offering new insights into its pathophysiology. This biomarker may help in developing novel therapeutic strategies targeting the amygdala and its regulation within the cortico-limbic system.

The current study was supported by the Italian Ministry of Health, GR-2019-12370616.

None Declared

The relationship between childhood adversity and psychosis has been the focus of extensive research in recent years. Studies suggest that individuals who experience significant adversity during childhood,such as abuse,neglect,or trauma, hava an increased risk of developing psychotic disorderser later in life.

Enviromental factor have been shown to play a signitficant role in the development of psychosis,often interacting with genetic predispositions.Nevertheless the relation between childhood trauma and social vulnerability in adulthood in patients with a first episode of psychosis (FEP) patients has not been studied.

The aim of this work is to study social factors in patients with childhood trauma and their impact on the development of a FEP.

The sample was divided into 3 groups, controls,first episode psychosis patients with childhood trauma (FEP with CT) and first episode psychosis patients without childhood trauma (FEP without CT). 135 controls and 190 patients with FEP (58.42% with CT) were assesed through questionnaires on traumatic experiences, life stress events and a socio-demographic interviews. The likelihood of experiencing life stress events in the past year, social vulnerability,affective issues and substance use were examined using logistic regression models.

Four covariates demonstrated a significant association with the clinical group with CT: being without a partner (p < .01), unemployment (p < .01), a history of psychiatric conditions (p < .01), and migration status (p < .01). However, stressful events in adulthodd were not found to be significant.

While childhood trauma does not seem to directly trigger re-traumatization in adulthood, it may contribute to place FEP patients in socially vulnerable circumstances that could lead to the development of psychotic symptoms.

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Detection for individuals at ultra-high risk for bipolar disorder (UHR-BD) is crucial due to the exploration of potential biomarkers at the early stages of bipolar disorder, including language abnormalities. Formal thought disorder (FTD) is an important symptom that can be observed in BD, which may be mildly noticeable during the early stages of the disease. Automated methods have demonstrated the ability to evaluate FTD in psychotic disorders and can also be employed to evaluate FTD in the speech of individuals at UHR-BD.

This study aimed to investigate the differences in language between UHR-BD and healthy controls (HC) using natural language processing (NLP) methods.

We collected speech samples from 20 individuals at UHR-BD and 20 HC during descriptions of eight Thematic Apperception Test (TAT) pictures, which were then manually transcribed. After transcribing the text, word2vec was used to convert it into vectors. The semantic similarity between words was calculated using a moving window approach to windows of words sized 5-10. Finally, the mean and variance of similarities were determined.

The variances of similarities in the windows of 5 to 9 were increased in UHR-BD (p=0.004, p=0.005, p=0.01, p=0.02, and p=0.037, respectively). There was no significant difference regarding the mean similarity.

To our knowledge, this is the first study to evaluate language with NLP methods in individuals at UHR-BD. Our findings showed that the variance of semantic similarity differed between the two groups. This indicates NLP methods may be used in the UHR-BD group to detect FTD.

None Declared

PNEA- Psychogenic Non-Epileptic seizures resemble epileptic seizures, have no electrophysiological correlate or clinical evidence for epilepsy, whereas there is positive evidence for psychogenic factors that may have caused the seizure. The clinical presentation usually includes convulsive movements, tremor of the whole body, or just some of the parts, loss of awareness, unresponsiveness and sometimes amnesia. ( N.M.G. Bodde, J.L. Brooks, G.A. Baker, P.A.J.M. Boon, J.G.M. Hendriksen, O.G. Mulder, A.P. Aldenkamp, Psychogenic non-epileptic seizures—Definition, etiology, treatment and prognostic issues: A critical review, Seizure, Volume 18, Issue 8, 2009, Pages 543-553, ISSN 1059-1311, https://doi.org/10.1016/j.seizure.2009.06.006.). We were called for a psychiatric consultation for a 35 year old female patient who presented to the Emergency service of our hospital with a history of severe headache unresponsive to painkillers, seizures and a panic attack. A few days prior to this visit she was hospitalized in the Department of Neurology of a different hospital under suspicion of hydrocephalus.

The objective of our psychiatric consult was to determine whether the clinical presentation of seizures and headache could be caused by underlying psychological disturbances, rather than by somatic symptoms.

We reviewed the patient history and previous medical findings and treatment. Additionally, the patient underwent a series of diagnostic tests, with the most important one being video EEG monitoring.

On the MINI diagnostic questionnaire, she met the criteria for Mixed anxiety and depressive disorder and Dissociative and conversion disorder. Psychological testing confirmed a tendency to somatization, and development of secondary psychiatric symptoms on top of the existing physical symptoms. Also, continuous EEG recording for the duration of four days detected only functional seizures, and with other non-pathological findings, among others, through MR of the brain and MR angiography, confirmed the working diagnosis of PNEA.

The mutual cooperation between neurology specialists and liaison psychiatrists is vital in cases like this when there is an unclear cause of the symptoms. Accurate determination of the underlying cause of disturbances enables adequate treatment of the patient.

None Declared

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that highly impacts children’s development, representing a significant challenge in pediatric healthcare. Parents of children with ASD are nowadays considered as real partners in their children’s care. Several parent-mediated interventions (PMIs) have proven to produce sustained improvements in autism symptomatology and social communication. However, widespread access to this type of intervention is still very limited mostly due to geographic and logistic constraints. The use of technology is therefore increasingly considered with the use of videoconferencing and online training modules. In this context, our team developed a novel parental coaching via E-learning (E-coaching) intended for parents of pre-school children with ASD.

The ongoing randomized controlled trial aims to evaluate the feasibility and preliminary efficacy of our E-Coaching program compared to a standard coaching and a control group with no PMI.

The present study is a monocentric randomized controlled trial with three arms (E-coaching, Standard coaching, Control) of 33 children (N=99). Feasibility was assessed across recruitment, acceptability and implementation using semi-structured interviews. The primary outcome will be the quality of parent-child interaction, measured using a range of behavioral observations and by monitoring parent and child gaze using two head-mounted eye-tracking systems during semi-structured standardized play sessions. Secondary outcomes will include child’s developmental level through neuropsychological testing, and parental wellbeing through several standardized parent-report questionnaires.

We present preliminary evidence supporting the feasibility and acceptability of the intervention, with participants reporting positive benefits on parent-child interaction. Preliminary observational data on the first families provided support for an improvement on parent-child interaction immediately after the end of the E-coaching intervention, as well as an increase of parental wellbeing.

We found initial feasibility for our E-coaching program, suggesting that parent-mediated E-learning interventions may be a promising format to implement with ASD families. Further evaluation to assess efficacy of the intervention is warranted and underway. If validated, E-coaching will enable us to reach a larger number of families and to have an early and meaningful impact on the developmental trajectory of these children, and on their quality of life.

None Declared

In the general population, the lifetime prevalence rates for obsessive-compulsive disorder (OCD) range between 1.9% and 3.3%. In patients with schizophrenia, the prevalence rates of OCD range between 7.8% and 26%. Accurate diagnosis has prognostic and treatment implications.The empirical basis regarding the optimal treatment for comorbid OCD in patients with schizophrenia is almost nonexistent.

We report a successful treatment course of intensive CBT for a patient with OCD comorbid with schizophrenia and reflect on the difficulties in the management and treatment of these cases.

We describe a case report in which OCD emerged gradually after the remission of positive symptoms of schizophrenia. The CBT involved psychoeducation, case formulation, cognitive restructuring, and exposure and response prevention.

The case is a 24-year-old male, single, with no comorbid somatic diseases. He was admitted to our psychiatric ward for self-muttering activity and delusion of thought broadcasting from the past year. A diagnosis of schizophrenia was made. We started risperidone gradually titrated to 6 mg/day. During his follow-up period, he reported having repetitive and intrusive thoughts of blasphemous nature despite well-controlled psychotic symptoms. He acknowledged these thoughts as originating in his own mind but was unable to stop them on his own accord. He also reported obsessions related to contamination and disgust. This led to compulsive hand washing and avoidance behaviour of some objects, which was both distressing and time-consuming. The diagnosis was revised to comorbid schizophrenia and OCD. Antipsychotic was changed from risperidone to amisulpride 800 mg daily in combination with paroxetine up to 60 mg/d. Since paroxetine was already optimized, the next step taken was to substitute it. He was then medicated with amisulpride, and clomipramine slowly increased up to 225 mg/d. There was no significant clinical improvement, regardless of the dose. Cognitive behavioural therapy (CBT) was commenced later. Medication was kept stable during the baseline, treatment, and follow-up period. Fourteen 1-hour sessions of CBT, including exposure and response prevention, were delivered each week over a period of 14 weeks. At the end of the intensive treatment, he reported a significant reduction in obsessions and compulsions. His score on the Y-BOCS dropped from 34 to 8 (76%) before treatment to 4-month follow-up.He reported that the decrease in OCD symptoms was associated with a significantly higher quality of life.

CBT appears to offer a valuable opportunity to reduce symptom severity in patients with OCD comorbid with schizophrenia.Further research within this field and systematic clinical evaluations are highly desirable.

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Just as our bodies have immune systems to defend against harmful biological agents, our souls also need psychological “immune competencies” to cope with stress. These competencies include effective emotional, psychological, social and spiritual functioning, resilience, creative and executive efficiency, self-regulation and savoring, the ability to enjoy positive experiences.

The aim of the present study was to investigate whether the mental health competencies, the symptoms of mental disorder, or the interaction of the two have a stronger predictive power on subjective well-being among Hungarian adult psychiatric patients.

The psychiatric sample of 129 patients (44 men, 85 women) was recruited in a cross-sectional design in four Hungarian health care facilities. Participants completed the Symptom Checklist-90-Revised, the Mental Health Test and six well-being questionnaires.

Mental health competencies are stronger predictors of the three indicators of well-being (β = 0.61; 0.79; 0.51 p < 0.05) than mental disorder symptoms (β = 0.17; 0.12; 0.25, p < 0.05). Including both mental health competencies and mental disorder symptoms in a regression model more accurately predicts indicators of well-being (BIC = 310; 359.7; 170; AIC = 289; 337.3; 148.3; R2 = 0.74; 0.52; 0.58, p < 0.05) than either the effect of the two separately (BIC = 310.3; 365.4; 170.2; AIC = 291.1; 345.8; 151.1; R2 = 0.73; 0.48; 0.56, p > 0.05) or the effect of their interaction (BIC = 314.9; 363.6; 173.6; AIC = 290.3; 338.4; 149.1; R2 = 0.74; 0.52; 0.57, p > 0.05). Mental health competencies were positively (B = 0.88; 1.64; 0.54, p < 0.05) while mental disorder symptoms were negatively (B = -0.50; -0.28; -0,17, p < 0.05) related to indicators of subjective well-being.

The results underscore the potential of mental health competencies as protective factors that can enhance well-being and restore daily functioning even in the presence of mental disorder symptoms.

None Declared

Night-shift work significantly impacts sleep quality among nurses, leading to various adverse health outcomes.

This study aimed to assess the link between night-shift work and sleep quality among nurses.

The study was conducted with a sample of nurses in university hospitals of Sfax. Two groups of staff were defined based on their work schedule: the first group(G1) consisted of those working day shifts, either a regular morning schedule or alternating between morning and afternoon shifts, while the second group (G2) included those working night shifts, either fixed night shifts or alternating between morning, afternoon, and night shifts. Data collection was carried out using an anonymous self-questionnaire developed via an online interface hosted on Google Forms. Sleep disorders were screened using the validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI).

The study population consisted of 114 nurses, with 37 nurses in G1 and 77 in G2. The average age of the workers was 33.8 years ± 7 years with extremes of 23 and 55 years. The average duration of night work was 5.9 years ± 4.64 years, ranging from a minimum of 1 year to a maximum of 25 years. The overall PSQI scale score was on average 6.86 ± 3.2. Based on this scale, 62% were classified as poor sleepers. In bivariate analysis, night-shift work was associated with a bad sleeper profile (p= 0.027, OR=2.44, IC95% [1.09-5;46]). However, day-shift work protected from the bad sleeper profile (p=0.04, OR=0.4, IC95% [0.18-0.91]).

The study highlights the negative association between night-shift work and sleep quality among nurses. it is essential for healthcare organizations to implement strategies that address the unique challenges faced by night-shift nurses, such as promoting better sleep hygiene and providing support resources.

None Declared