Given the increasing rates of antipsychotic use in multiple psychiatric conditions, greater attention to the assessment, monitoring and documentation of their side effects is warranted. While significant attention has been provided to metabolic side effect monitoring, comparatively little is known about how clinicians screen for, document and monitor their motor side effects (i.e. parkinsonism, akathisia, dystonia and tardive dyskinesia (TD), collectively “extrapyramidal symptoms” or EPS).

This review aims to systematically assess the literature for insights into current trends in EPS monitoring practices within various mental health settings globally.

In line with our preregistered protocol (PROSPERO: CRD42023482372), we systematically searched the OVID Medline, PubMed, Embase, CINAHL and PsycINFO databases for studies published from 1998 to present day. Figure 1 shows a detailed flowchart of the selection process. Included studies were assessed for quality using a modified version of the Quality Improvement Minimum Criteria Set (QI-MQCS) and findings summarized using narrative synthesis. All stages of the review process are reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

A total of 22 studies met our inclusion criteria. Studies occurred in varied settings and employed a range of study designs. The APA and NICE guidelines were most commonly used to guide practice. Baseline monitoring rates in adult settings ranged from 0 to 54%, and 3.7 to 100% in child & adolescent settings. In studies reassessing EPS monitoring rates following practice improvement initiatives, virtually all demonstrated benefits. Screening processes and instruments varied, ranging from standardized rating scales (such as the AIMS for TD screening) to locally developed tools. In some studies, no structured tool was identified. Monitoring rates were higher when structured processes and tools were used.

Image 1:

This review demonstrates significant heterogeneity in clinical practice for the screening, documentation, and monitoring of EPS in patients prescribed antipsychotic medication in mental health settings globally. Adherence to existing guidelines was found to be poor in most settings, with practice improvements observed in virtually all settings where quality improvement initiatives were implemented. The best improvements were seen to occur after services introduced structured EPS screening tools with regular education on their use.

R. Aubry: None Declared, T. Hastings: None Declared, M. Morgan: None Declared, J. Hastings: None Declared, M. Bolton: None Declared, M. Grummell: None Declared, R. Shorr: None Declared, S. Killeen: None Declared, C. Coyne: None Declared, M. Solmi Consultant of: MS has received honoraria/has been a consultant for AbbVie, Angelini, Lundbeck, Otsuka.

Medical students are persistently exposed to specific conditions that may have detrimental effects on mental health, such as stressful academic routine, demanding and heterogeneous curriculum, sense of competition and daily exposure to illness and death. Accumulating evidence highlights high levels of cynicism and emotional exhaustion among these subjects. Indeed, the prevalence of burnout syndrome in medical students may reach peaks up to 88% in some studies. Thoughts of stopping medical education, negative life events, lack of support, dissatisfaction, and poor motivation represent the main predictors of burnout in this group. Such findings highlight the need to develop prevention initiatives targeting the future generation of medical doctors. Moreover, implementation of psychosocial interventions delivered from medical schools could be helpful to improve coping strategies and resilience styles of students.

None Declared

Mental disorders result from a complex interplay of genetic and environmental factors. However, the multiplicity of exposures and the complexity of mental health phenotypes pose a major challenge. The ‘exposome’ paradigm offers a holistic view of the environment that contrasts traditional hypothesis-driven approach in psychiatry. Within this framework, exposome-wide studies provide a novel tool to systematically identify phenotype-exposure relationships, offering an innovative perspective to map the exposome of mental health.

To map environmental factors associated with psychiatric diagnostic domains and symptom dimensions in the UK Biobank cohort. In this study, we aim to identify exposures unique to specific mental health outcomes, as well as those shared across conditions.

We analysed UK Biobank participants with complete Mental Health Questionnaire data (N = 157,298). Outcomes were classified as either psychiatric domains or symptom dimensions. After quality control, 294 environmental, lifestyle, behavioral, and economic variables were included. An Exposome-Wide Association Study (ExWAS) was conducted per outcome in two equally split datasets, applying Bonferroni correction for multiple testing (P < 1.70 x 10^-4). Missing exposure data was imputed using Multiple Imputation by Chained Equations. Variables associated with each outcome were then tested in a multivariable model.

In diagnostic domains, ExWAS analyses identified 26 to 165 significant factors. Multivariable analysis revealed 10 to 65 significant associations, with traumatic events, physical complaints, and sleep disturbances emerging across domains. Cannabis use was associated with common psychiatric disorders (ORs: 1.10-1.79), while computer use was uniquely linked to neurodevelopmental disorders (OR = 1.23). Eating disorders showed stronger correlations with food-related exposures. In symptom dimensions, ExWAS identified 46 to 180 significant factors. Multivariable analysis revealed similar exposure groups to those in diagnostic domains. Notably, self-harm was uniquely associated with childhood adoption (OR = 1.39).

This comprehensive mapping of exposome revealed that several factors, particularly in the domains of those previously well-studied were shared across mental health phenotypes, providing further support for transdiagnostic pathoetiology. Our findings also showed that distinct relations might exist. Continued exposome research through multimodal mechanistic studies guided by the transdiagnostic mental health framework is required to better inform public health policies.

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Sleep health is s an essential aspect of a healthy lifestyle, and sleep problems are prevalent among individuals with mental disorders. However, this relationship appears complex to explore with classic observational studies, due to bidirectional effects and residual confounding. Additionally, the different measures of sleep quality and the diversity of mental disorders make comprehensive assessment challenging.

In the current study, we aimed at investigating the causal relationship between six sleep factors, derived from twelve indicators, and thirteen mental disorders. Specifically, we examined the impact on Alzheimer disease, attention-deficit and hyperactivity disorder (ADHD), anorexia nervosa, anxiety disorder, autism spectrum disorder, alcohol use disorder, bipolar disorder (BD), cannabis use disorder (CUD), major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder, suicide attempt, and schizophrenia (SZ).

Using Genomic Structural Equation Modeling, we estimated genome-wide associations for six sleep factors in the UK Biobank. Next, we examined bidirectional causal relationships with mental disorders in the Psychiatric Genomics Consortium, using Two-sample Mendelian Randomization (MR). Results are presented as inverse-variance weighted betas (B) with 95% confidence intervals (95%CI), representing log-odds for sleep-to-mental disorder causality (forward MR) and linear regression coefficients for mental disorder-to-sleep causality (backward MR).

Our investigation confirmed previous evidence of a six-factor model of sleep, comprising alertness (AF), circadian preference (CPF), efficiency, duration (DF), regularity, and insomnia (IF). MR analyses showed bidirectional causal relationship between IF and ADHD (B:0.747[95%CI:0.392;1.10] and B:0.029[95%CI:0.020;0.040] for forward and backward, respectively). Unidirectional causal effects were found for BD on AF (B:-0.113[95%CI:-0.153;-0.072]), SZ on AF (B:-0.057[95%CI:-0.077;-0.037]), BD on CPF (B:-0.066[95%CI:-0.104;-0.027]), CPF on ADHD (B:-0.074[95%CI:-0.113;-0.035]), BD on DF (B:0.038[95%CI:0.026;0.050]), SZ on DF (B:0.022[95%CI:0.016;0.029]), IF on CUD (B:0.764[95%CI:0.130;1.40]), and IF on SZ (B:-0.504[95%CI:-0.802;-0.206]).

This study provide evidence that mental disorders negatively affect sleep quality rather than vice versa. These findings highlight the need to improve detection of sleep problems in mental health care settings and support efforts to identify intervention targets to improve sleep health among individuals with mental disorders.

None Declared

Growing evidence suggests that inflammation plays a critical role in the early stages of psychosis, potentially contributing to disease onset and progression. Several studies have identified elevated levels of pro-inflammatory cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), in individuals at clinical high risk (CHR) for psychosis and in those with first-episode psychosis (FEP). However, inconsistencies across studies highlight the need for further research to clarify the relationship between immune dysregulation and psychosis onset.

This talk reviews the current literature on inflammatory markers in early psychosis and their potential implications for pathophysiology, early detection, and treatment strategies. Notably, inflammation may serve as a promising biomarker for identifying individuals at risk and monitoring disease progression. Additionally, anti-inflammatory interventions are being explored as potential adjunctive treatments for psychosis.

Beyond the review of existing evidence, we will present original data from the PREGAP study conducted at the Early Intervention \Service (EIS) of Basurto University Hospital. This dataset includes inflammatory marker assessments in CHR and FEP individuals, providing novel insights into immune alterations in early psychosis.

Understanding the role of inflammation in psychosis could open new avenues for personalized medicine, early intervention, and improved treatment outcomes. Future research should focus on large-scale longitudinal studies to confirm the clinical utility of inflammatory markers and identify potential therapeutic targets.

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Hypochondriasis was included in DSM-III up to DSM-IV TR in the category of „somatoform disorders,” and ICD-10 concurred with this classification. However, in the last editions of the DSM (i.e., 5 and 5TR), this entity has been transformed into „illness anxiety disorder” (IAD) based on its main clinical feature- the fear of having or contracting a serious disease, although no medical evidence to support such an assumption exists. ICD-11 preserves the term „hypochondriasis” but places it between „obsessive-compulsive or related disorders.” Approaching patients with hypochondria or IAD is reputedly difficult due to the difficulty of maintaining a therapeutic relationship, the sensitivity of these patients to medical data that deny their assumptions of being somatically ill, and their tendency to continuously search the information that validates their belief about their own health.

To conduct a literature search to assess the efficacy of psychotherapeutic interventions for patients with IAD.

This review included three databases (Google Scholar, PubMed, and Web of Science/Clarivate) that were searched from their inception until June 2024 for papers published in English corresponding to the keywords “hypochondriasis,” or illness anxiety disorder,” and “psychotherapy*.”

Cognitive-behavioral therapy (CBT) was used successfully in case reports of IAD when integrated into case management. In a clinical trial, CBT plus fluoxetine led to better results than either intervention alone after 24 weeks. Systematic reviews and meta-analyses showed CBT, cognitive therapy, behavioral therapy and behavioral stress management may significantly reduce hypochondriacal symptoms versus waiting list. The therapeutic approach for IAD was focused on restructuring the catastrophic anticipations, exposure to feared stimuli, and learning relaxation techniques, replacing avoidance and reassurance-seeking with adaptive coping skills and problem-solving techniques. Mindfulness-oriented therapy, group therapies, and acceptance and commitment therapies have also been explored in this population, but the level of quality is low.

CBT remains the only psychotherapy that proved efficacious for patients with IAD, but most of the data retrieved is derived from case reports and small trials. Changes in the terminology and conceptualization of hypochondriasis/IAD may negatively interfere with the possibility of selecting homogenous groups for clinical studies.

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Job satisfaction and psychological distress are pivotal elements in the overall well-being of healthcare professionals, whose work environment is inherently challenging and stressful. High levels of job satisfaction are essential for the health, motivation, and performance of the workforce, and for ensuring high-quality patient care and the effective functioning of the healthcare organization. Conversely, psychological distress among healthcare workers can result in burnout, a reduction in the quality of care provided, and an increase in turnover rates. This study examines the complex factors influencing job satisfaction and psychological distress, with the aim of providing a comprehensive understanding that can inform the development of interventions and policy changes within healthcare settings.

The purpose of this study is to explore the factors that contribute to job satisfaction and psychological distress among medical and nursing staff. By identifying conditions that lead to increased satisfaction or distress, the research seeks to propose actionable strategies to improve the working environment and reduce psychological strain among healthcare workers.

This research employed a quantitative approach utilizing a specifically designed questionnaire that incorporated the DASS21 (Depression, Anxiety, and Stress Scale) and the K6+ scale for measuring psychological distress. The sample consisted of 132 healthcare professionals, selected through the snowball sampling method. The questionnaire was based on a comprehensive review of the literature and included measures to assess job satisfaction, anxiety, stress, and psychological distress.

The findings indicate that the majority of healthcare workers perceive limited opportunities for job advancement and salary increases. Furthermore, communication within organizations is perceived as moderate, and employees report that their efforts are not adequately recognized or rewarded. These factors are associated with both job dissatisfaction and increased psychological distress, as measured by the DASS21 and K6+ scales.

The findings of this study highlight the imperative for systemic reforms within healthcare organizations to enhance job satisfaction and mitigate psychological distress among healthcare personnel. It is recommended that strategies include the creation of more transparent pathways for career advancement, the fostering of a supportive and communicative work environment, and the implementation of recognition programs that validate and reward employee contributions. It would be beneficial for future research to investigate the long-term impact of such interventions in order to ascertain their efficacy in maintaining positive changes within healthcare settings.

None Declared

Alcohol use disorder is a significant Public Health issue with substantial socioeconomic impact, morbidity, and mortality. Achieving therapeutic success remains challenging due to frequent treatment dropouts, relapses, and readmissions. It is estimated that 20-40% of patients discontinue detoxification treatment prematurely, with some studies highlighting the influence of psychiatric comorbidities, polysubstance use, unemployment, and impulsivity. Premature discontinuation increases the risk of medical complications and worsens prognosis. Although anti-craving medications have demonstrated efficacy in preventing relapse, they remain underprescribed.

This study aims to identify and analyze determinants of readmissions, particularly in patients with a history of treatment dropout, and propose strategies to enhance therapeutic success.

A two-year retrospective analysis was conducted on readmitted patients, with a focus on previous dropouts, within the 12 months prior to their last hospitalization for alcohol detoxification at ULS São José - Hospital Júlio de Matos. The analysis included sociodemographic data, comorbidities, anti-craving therapy, integration into therapeutic communities (TC), and post-discharge outcomes.

A total of 37 patients were identified with readmissions in the past 12 months. Of these, 9 (24.3%) had left their previous admission against medical advice, most of whom had experienced 4 or more admissions. There was a similar gender distribution, with all patients being single or divorced, 66.7% unemployed, and the same percentage experiencing economic hardship. Two-thirds had psychiatric comorbidities. None had recently received anti-craving medication, and only 2 (22.2%) had prior involvement with a TC. During their readmission, 44% were discharged to a TC or Day Center, and 2 left again against medical advice.

It was found that many frequent users discharged themselves against medical advice from previous hospitalizations. These patients showed a high prevalence of socioeconomic problems and psychiatric comorbidities, with none receiving anti-craving therapy. In the future, it will be essential to analyze the reasons for these dropouts to improve the effectiveness of treatment during hospitalization. It is concluded that therapeutic plans must be personalized and tailored to the patients’ multiple needs to ensure better adherence.

None Declared

Brain health impacts everyone, in Europe and beyond. Whether it is the continued quest for cures and treatment for those living with brain conditions or the protection and fostering of healthy brains for our future generations, the challenges are unprecedented. To elevate brain health on the national, EU, and international policy agendas while making the most of existing initiatives, the European Brain Council (EBC) kicked off the No Health Without Brain Health campaign in the European Parliament during the 2024 Brain Awareness Week ahead of the 2024 European Elections.

This campaign is structured around two priority policy asks: the creation of a European Parliament Intergroup on Brain Health and Research and increased support to the creation of EU and National Brain plans. One year after the official kick-off, the campaign demonstrated that, when united, the brain community can reach a significant number of policymakers and make its voice heard to drive tangible policy changes.

The presentation “No Health Without Brain Health: Prioritising Brain Health in the European Union to Leave No One Behind” in this joint workshop will showcase success stories, address challenges and share good practices in EU-wide brain health initiatives. It will highlight the importance of collaboration and breaking down silos in preparing for the brain-healthy transition of our societies. Additionally, it will address the burden of brain disorders, neurological and mental alike, in a comprehensive and collaborative manner.

None Declared

The emergence of social media platforms like X has created a unique space for mental health discussions. This study aims to analyze the language and themes used in social media discussions to appreciate sentiments about PMS and PMDD by looking at a sample of the most popular tweets on platform X.

We hypothesize that this content can provide insight into public perceptions and guide educational campaigns.

An advanced Twitter/X search for “PMS” and “PMDD” was conducted, filtering for English content. The top 100 tweets for each search term were explored through two different sentiment analysis tools which include Dr. Daniel Soper’s Sentiment Analyzer Tool and Text2Data Application Programming Interface (API) Natural Language Processing (NLP) Analysis. Tweets were also analyzed using a word cloud generator to identify the most frequently used terms. Connecting words were eliminated from the final output.

Negative sentiment was more prevalent than positive among the tweets for PMDD, with an overall sentiment analysis of an average of -24.3 per the Daniel Soper Sentiment Analyzer tool, suggesting a negative and serious tone. The most frequently appearing terms in these tweets were “month” (mentioned 17 times), “bad” (16), “love” (15), “feel” (14), “MAFS” (14), “support (14). Per Text2Data’s API NLP analysis, the top 150 words had a negative sentiment of -0.59 with a magnitude of 1.69. Negative sentiment was more prevalent than positive among the tweets for PMS, with an overall sentiment analysis of an average of -15.2 per the Daniel Soper Sentiment Analyzer tool, suggesting a somewhat negative and serious tone. The most frequently appearing terms in these tweets were “new” (11), “price” (10), “oxford” (9), “feel” (14), “people” (9), “want” (9). Per Text2Data’s API NLP analysis, the top 150 words had neutral sentiment of +0.15 with a magnitude of 1.59.

This study emphasizes a less negative sentiment associated with PMS compared to PMDD. It also highlights how more emotionally charged terms were used among tweets discussing PMDD compared to PMS. This may reflect public perception of the two conditions. Additionally, social media can be a way to gauge public interest and perception of medical topics.

None Declared

Service disengagement is a major problem for “Early Intervention in Psychosis” (EIP). Understanding predictors of engagement is also crucial to increase effectiveness of mental health treatments, especially in young people with First Episode Psychosis (FEP). No Italian investigation on this topic has been reported in the literature to date. The goal of this research was to assess service disengagement rate and predictors in an Italian sample of FEP subjects treated within an EIP program across a 2-year follow-up period.

The goal of this research was to assess service disengagement rate and predictors in an Italian sample of FEP subjects treated within an EIP program across a 2-year follow-up period.

All patients were young FEP help-seekers, aged 12–35 years, recruited within the “Parma Early Psychosis” (Pr-EP) program. At baseline, they completed the Positive And Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF) scale. Univariate and multivariate Cox regression analyses were carried out.

489 FEP subjects were enrolled in this study. Across the follow-up, a 26 % prevalence rate of service disengagement was found. Particularly strong predictors of disengagement were living with parents, poor treatment adherence at entry and a low baseline PANSS “Disorganization” factor score.

More than a quarter of our FEP individuals disengaged the Pr-EP program during the first 2 years of intervention. A possible solution to reduce disengagement and to facilitate re-engagement of these young patients might be to offer the option of low-intensity monitoring and support, also via remote technology and telemental health care.

None Declared

Suicide is a major public health concern, especially among older adults. Early identification of individuals at risk of suicide is crucial for early intervention, which significantly improves prevention efforts. Early identification of individuals at risk of suicide is crucial for prevention.

This study aimed to develop a model for predicting suicidal ideation in community-based older adults using deep phenotype data with machine learning classifiers.

A study investigating suicidal ideation in community-based older adults utilized a mobile assessment bus to collect data from 358 participants. Deep phenotype data, including Patient Health Questionnaire-9 (PHQ), Generalized Anxiety Disorder-7 (GAD), World Health Organization Quality of Life (WHOQOL), Perceived Stress Scale-10 (PSS) questionnaires, and 32-channel EEG recordings using the 10/20 system, were acquired. Of these participants, 238 completed all assessments. Suicidal ideation was defined by a score of 1 or higher on the ninth question of the PHQ-9. Data from both groups were compared, and features with an effect size of 1 or greater (Cohen’s D) were selected for further analysis. Cohen’s D. Machine-learning classifiers, including Support Vector Machine (SVM), Random Forest (RF), and Linear Discriminant Analysis (LDA) were employed to predict suicidal ideation using a 7:3 training-test split repeated 100 times to obtain performance metrics.

Scores on the PHQ, GAD, and WHOQOL scales differed significantly, while the PSS data showed variations in all items except one between the group with suicidal ideation and the group without. Notably, analysis of the EEG data from eight brain regions identified disparities in 108 out of 248 features. Among all data, ten features with Cohen’s D values exceeding 1 were identified, primarily consisting of questions directly related to themes of negative emotions. Using these features, the classification model achieved an AUC of 0.8913, demonstrating strong predictive performance for suicidal ideation.

Our findings demonstrate the potential of deep phenotyping, even in community-based settings, to predict suicidal ideation in older adults. These insights can inform the development of suicide intervention systems. Additionally, refining predictive models to encompass broader mental health symptoms could solidify deep phenotyping as a crucial tool for early intervention in public healthcare.

None Declared

It has long been believed that a correlation exists between mental illness and artistic ability. This idea dates to antiquity, with Aristotle famously stating, “No great mind has existed without a touch of madness”. Recent studies suggest that writers and artists show a higher incidence of depressive disorders (DD) and bipolar disorder (BD) compared to the general population. However, we know that not all artists suffer from mental illness, and most individuals with mental illness are neither artists nor creative geniuses. Thus, numerous questions emerge regarding the true relationship between psychopathology and creativity.

In this study, we sought to explore the correlation between psychopathology and creativity.

In this literature review, research articles on the relationship between creativity and psychopathology are presented.

There is evidence that the genetic predisposition to BD, as well as milder forms of the disorder, is associated with increased creativity. A meta-analysis of 28 studies found a significant positive correlation between the risk of bipolar disorder and creativity (r = 0.224). Mild to moderate manifestations of the disorder can often serve as a source of inspiration, driving creative work. However, this creativity only flourishes when individuals are able to channel their emotional instability and cognitive disorganization into coherent and productive forms. In contrast, severe forms of the disorder tend to inhibit creativity, largely due to impaired concentration and disorganized thinking. Regarding DD, the research presents mixed findings. Some studies suggest a link between depression and lower creativity. A meta-analysis of 39 studies found a weak negative correlation between depressive mood and creativity (r = -0.064). However, other researchers argue that both positive and negative emotions can fuel artistic creativity. The Dual Pathway to Creativity Model supports this view, proposing that creativity—defined as the generation of original and valuable ideas—arises from cognitive flexibility and cognitive persistence. According to this model, dispositional or situational factors can influence creativity by enhancing either flexibility, persistence, or both. Negative mood states, for example, may enhance creativity by fostering persistence.

The relationship between psychopathology and creativity is complex. A genetic predisposition to BD, especially in milder forms, may enhance creativity, but severe cases often impair it due to cognitive difficulties. For DD, the link to creativity is more conflicted. While depression is generally associated with reduced creativity, some models suggest both positive and negative emotions, including those from depressive states, can foster creativity by affecting cognitive flexibility and persistence. In summary, the connection between psychopathology and creativity is multifaceted, with various contributing factors.

None Declared

Many patients suffering from schizophrenia have symptoms suggesting depression during the course of their illness. It can appear both in the prodrome of a psychotic decompensation and in the acute phase, as well as after its resolution. But is it part of the disease itself? Is it an experiential reaction to the assumption of the sickness or is it an independent entity? Can it be produced or exacerbated by antipsychotics?

This case study aims to analyze the clinical presentation of depressive symptoms in a patient with schizophrenia.

A review of the literature on affective symptomatology which may occur in psychosis.

A 34-year-old male with a history in Mental Health since the age of 16, with diagnosis of paranoid schizophrenia. He has presented at least 5 depressive episodes and several severe self-harming attempts. He is on treatment with olanzapine, clonazepam, quetiapine and aripiprazole.

During a follow-up, he reports intensification of low mood in the last few weeks due to sentimental break-up, clinophilia and social isolation. He spends the day in his room with the curtains lowered, he has neglected his personal hygiene, and verbalizes thoughts of death. He shows poor functioning, slowed thinking and lack of energy.

His mother reports that he has had self-aggressive behaviors, such as hitting his face and eating his faeces. Sensory and perceptual disturbances are not excluded. Given the current depressive affective state and risk of commiting suicide, it is decided to admit him to the hospital and to start treatment with fluoxetine.

A few weeks after hospital discharge, he continues with poor functioning and isolation, but his mood is better and his thoughts of death have disappeared.

Although clear differentiation between depressive and psychotic symptomatology has been classically described, both symptoms are often associated. Affective symptoms can be part of different stages of the disease, secondary to medication, due to insight phenomena or part of schizoaffective disorder and psychotic depressions.

Depressive symptomatology can also be confused with the presentation of negative symptoms. They both share clinical manifestations such as anergy, social isolation and lack of interest; but while in depression there is a sad mood, in negative symptons there is emotional flattering. Also, positive symptomatology can simulate social withdrawal, usually seen in depression.

Depression in an acute phase has historically been related to a better prognosis, although several studies indicate that depression in a chronic phase causes a higher risk of suicide and relapses. Therefore, early diagnosis and treatment are essential.

In our case, the patient suffers from major affective symptoms regarding his life situation, which may be overlapped by isolation due to a likely positive symptomatology, without dismissing possible negative symptomatology as a result of many years of evolution of his disease.

None Declared

The burnout develops gradually, unnoticed by the person, and its symptoms may appear after several years and leads to serious mental and behavioral changes. The processes underlying burnout are largely unknown due to the lack of specialized studies aimed at identifying specific biomarkers. Based on this, it is necessary to detect the first, critical moment - the first symptoms of burnout.

We aimed to examine the EEG frequencies changes relating to severity of Anxiety Tension stage of Emotional Burnout.

In this study 752 participants, students and staff of Taras Shevchenko National University of Kyiv (Kyiv, Ukraine) were involved (209 males, mean age = 19.2, 543 females, mean age = 18.28). We used the 84-item Boyko’s Syndrome of Emotional Burnout Inventory to measure the emotional burnout formation. We analyzed separate artefact-free EEG segments in all frequency bands from 0.2 to 45 Hz during resting state (3 min, closed eyes condition). In order to identify the EEG signs of emotional burnout the normalized power spectral densities (PSD) were calculated on the segment from 61 to 70 seconds of recordings.

The revealed burnout-related (Anxiety Tension stage) variables in the spectral characteristics of the EEG characterized by the significant changes in the theta 2 (frontal area and left temporal-parietal cortex), alpha 2 (right parietotemporal cortex) and beta 1 subbands (left frontal-central-right parietal axis).

These data pointed to the influence of Anxiety Tension development mostly on the processes associated with short-term memory and focused attention.

None Declared

Few breast cancer radiotherapy studies include either patients with a hearing impairment or non-English speakers. Literature about healthcare and cancer care in general provided insights into reports by patients of disparities. Given technological advancements, it is reasonable to believe communication barriers should be surmountable, prompting a survey of radiotherapy departments to assess the status quo.

A survey was conducted of all UK National Health Service (NHS) radiotherapy departments in England. A questionnaire was designed to determine if a deep inspiration breath hold (DIBH) technique was used for breast cancer radiotherapy, the equipment that was used and whether patients with a hearing impairment or other language barriers received the same treatment.

A total of 22 radiotherapy departments responded to the survey. All respondents reported using DIBH as a heart-sparing technique; 100% (n = 22) reported offering DIBH to non-English speakers and 73% (n = 16) DIBH to patients with a hearing impairment. 45% (n = 10) stated that they use verbal instruction only, and 23% (n = 5) a combination of both verbal and visual aids and references.

The study highlights some novel efforts in radiotherapy departments to increase equitable access to DIBH; however, the results indicate that verbal communication methods still dominate practice, and these are not inclusive of all hearing-impaired patients. Such methods would also require translation for non-English speakers. The study suggests that more work needs to be done before equitable access is achieved for patients with a hearing impairment or other language barrier.

VEXAS syndrome is a newly recognized multisystem inflammatory disorder characterized by recurrent fevers, skin manifestations, and systemic symptoms, often leading to significant morbidity. While the physical aspects of this syndrome are increasingly documented, the psychiatric implications, particularly depressive symptoms, are less explored. This case study aims to elucidate depressive symptoms in a patient diagnosed with VEXAS syndrome, examine how these symptoms relate to prolonged diagnostic uncertainty, and assess the impact of receiving a definitive diagnosis on the patient’s mental health.

To evaluate the presence and severity of depressive symptoms in a patient with VEXAS syndrome. To analyze the psychological impact of prolonged diagnostic uncertainty on the patient’s mood. To investigate the effect of receiving a definitive diagnosis and a comprehensive treatment plan on the patient’s emotional well-being.

This case report describes a 61-year-old male patient with VEXAS syndrome, admitted for further evaluation of his condition. He presented to the psychiatry service with complaints of low mood and morning asthenia. A thorough psychiatric assessment revealed a history of psychiatric hospitalization 30 years prior and ongoing treatment for an adjustment disorder since 2007. The assessment utilized standardized scales to measure depressive symptoms and documented the patient’s emotional state and coping mechanisms throughout his medical journey.

The patient experienced persistent low mood episodes since the onset of organic symptoms in 2019, exacerbated by multiple misdiagnoses and inadequate treatments. After receiving a diagnosis of VEXAS syndrome in July 2023, he reported significant improvements in mood and a reduction in suicidal ideation. He attributed these changes primarily to the clarity provided by the diagnosis and the development of a new treatment plan, rather than solely to adjustments in his antidepressant medication (sertraline, 100 mg). Although he tolerated the medication well, he emphasized that the sense of being understood significantly enhanced his motivation. Additionally, the patient reported vivid nightmares over the last two weeks but denied current suicidal thoughts.

This case highlights the complex relationship between prolonged diagnostic uncertainty and depressive symptoms in chronic inflammatory diseases like VEXAS syndrome. The findings suggest that a definitive diagnosis and clear treatment strategy are crucial for improving mental health and overall well-being. This underscores the importance of a multidisciplinary approach that prioritizes both physical and psychological needs, enhancing the quality of care for patients navigating such complex conditions.

None Declared