Depression among older adults is a significant public health issue that often goes underrecognized, despite its profound impact on their quality of life and mental well-being. With advancing age, many individuals encounter challenges such as loneliness, chronic illness, and bereavement, which heighten their vulnerability to depressive symptoms. These symptoms are not only detrimental to overall health but are also strongly associated with an increased risk of suicidal behaviours. Although these suicidal behaviours are preventable, much research should be done to disentangle development pathways in older adults.

The aim of this research is to identify the symptomatic profiles of depression in the elderly population and to relate this profile to suicidal outcomes.

We utilized data from the “Edad con Salud” cohort study, a longitudinal household survey conducted on a nationally representative sample in Spain (aged 18+ years). Participants who could not be personally interviewed and those under 50 years old were excluded, resulting in a final sample of 3,533 participants (54.31% female, age = 66.42(10.27)). Suicidal behaviours and depressive symptoms were assessed using the Composite International Diagnostic Interview (CIDI 3.0). A Latent Class Analysis (LCA) was performed at base level to identify participant profiles based on 8 depressive symptoms. We followed this with a survival analysis to assess differences between profiles in the progression of suicidal ideation and attempts in the different waves. Finally, Cox regression was used to examine the impact of sociodemographic and clinical covariates on suicidal behaviours.

The three-cluster model provided the best fit. The first class (72.52%) included most participants without depressive symptoms; the second class (13.67%) included participants with three symptoms (depressive mood, diminished interest or pleasure and fatigue); and the third class (13.81%) included participants with all eight symptoms (see Image 1). Survival analysis revealed significant differences between the groups over time for both suicidal ideation (χ2=1332, p < .01) and suicide attempts (χ2=215, p < .01), with the third group having the highest number of cases. Cox regression indicated that suicidal ideation was associated with the second (HR = 5.38) and third classes (HR = 59.8), age (HR = 0.97), and loneliness (HR = 0.91), among other variables. Suicide attempts were associated with the second (HR = 6.08) and third classes (HR = 25.3), age (HR = 0.92), and loneliness (HR = 1.02).

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Participants with depressive symptoms, even at a subclinical level, have an increased risk of suicidal behaviours, especially when other risk factors such as loneliness are present.

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The Flemish Association of Psychiatry developed due care guidelines for medical assisted dying in cases of severe and unbearable psychiatric suffering, which were adopted by the Order of Physicians. In principle, there are therefore more than enough well-known recommendations on how to handle a request for termination of life from a patient with psychiatric issues.

Nevertheless, occasionally something goes wrong due to misinterpretation of the legal criteria or due to careless actions by the consulting or performing physician.

In 2010, a female patient died by euthanasia because of unbearable mental suffering, which was unacceptable for her family. The family decided to initiate a court case to have the inaccuracies in the decision-making process and the execution of the euthanasia evaluated by a judge. In 2020, three involved doctors, including a psychiatrist, were prosecuted for this euthanasia. An analysis of the court case and the media coverage of this case will be discussed.

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BEHAVIORAL ADDICTIONS AS A REPETITIVE PATTERN OF BEHAVIOR WITH DECREASE IN SELF-CONTROL AND A POWERFUL DESIRE TO CARRY OUT IT, DESPITE THE NEGATIVE CONSEQUENCES; WITH ACCOMPANYING SYMPTOMATOLOGY OF IRRITABILITY, CONCERN AND ANXIETY.

ANALYZE THE RESULTS ON REPORTS OF BEHAVIORAL ADICTIONS

IN THE REPORTS ON BEHAVIORAL ADDICTIONS, ESTUDES (SURVEY ON THE DRUG USE IN SECONDARY EDUCATION IN SPAIN, 14-18 YEARS OLD) AND EDADES (SURVEY ON ALCOHOL AND DRUGS IN SPAIN) WE FOUND THE FOLLOWING:

• - MANY MINORS PARTICIPATE IN GAMBLING GAMES.

• - THE USE OF THE INTERNET, GAMBLING WITH MONEY AND VIDEO GAMES ARE VERY COMMON PRACTICES.

• - ONLINE BETTING GAMES ARE MORE PREVALENT IN YOUNG PEOPLE.

• - WITHIN THE PATHOLOGICAL GAME, A GREATER PREVALENCE OF BEHAVIOR IS OBSERVED RISK.

• - WITHIN THE ABUSIVE USE OF THE INTERNET, GREATER CONSUMPTION OF CANNABIS AND ALCOHOL.

REGARDING THE TREATMENT, THE USEFULNESS OF COGNITIVE PSYCHOTHERAPY IS RECOGNIZED. BEHAVIORAL AND THE USE OF PSYCHODRUGS SUCH AS NALMEFENE AND NALTREXONE.

ADDICTION TO THE INTERNET AND VIDEO GAMES COULD BE RECOGNIZED AS PSYCHIATRIC DIAGNOSES WHEN THEY LEAD MORE COMPLEX CHARACTERISTICS. SOME STUDIES PROPOSED TO TAKE INTO ACCOUNT THE EMOTIONAL NEEDS AND THE IMPULSIVITY, WHILE OTHERS, TALK ABOUT THE NEURO-BIOLOGICAL-GENETIC COMPONENT OF ADDICTIONS.

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Although Autism Spectrum Disorder (ASD) is frequently reported as a comorbidity in adults with Attention Deficit Hyperactivity Disorder (ADHD), diagnosing this additional condition in clinical practice remains challenging. Missing this diagnosis can significantly impact treatment and reduce the quality of life for these adults. In child and adolescent psychiatry, attention is also given to the source(s) that influence the symptoms and complaints of ASD and ADHD, both in diagnosis and treatment.

This lecture highlights the importance of identifying the source(s) of symptoms and complaints in adult patients, with or without ADHD, in an outpatient urban setting. Better mapping of these source(s) helps distinguish the symptoms of ASD from those of ADHD, refining both diagnosis and treatment. Unsurprisingly, ASD is often not even considered a potential comorbid condition in adults. In this lecture, we share practical experiences with adult outpatients and discuss the source(s) that frequently emerge, which aid in differentiating ASD symptoms from those of ADHD.

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Emotional dysregulation is an unhealthy emotional response to stimuli and a common reason for adolescent hospitalization. Linked to disorders like depression, borderline personality disorder, childhood trauma, and eating disorders, understanding its underlying causes may improve outcomes and prevent relapse.

The aim of this study is to characterize emotional dysregulation among adolescent impatient.

Our study involves inpatients (16-24 years) hospitalized at our Transitional Psychiatric ward in Ancona (Università Politecnica delle Marche, Italy). The used rating scale were: Temperament Evaluation in Memphis, Pisa and San Diego (TEMPS-M), Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale-11 (BIS-11), Toronto Alexithymia Scale-20 (TAS-20), Aggression Questionnaire (AQ). Descriptive analysis, simple and multivariate linear regression analysis were conducted.

97 adolescent patients were admitted from February 2022 to March 2023. The mean age of the sample is 17.3±1.9. The mean score to the BPRS is 43.9±10.3. The 70.7% (n=70) of the sample are females and the 79.8% (n=79) lives with their parents. Disruptive, impulse-control, and conduct disorders are the prevalent disorders in the sample (32.3%, n=32). The 21.1% (n=21) was diagnosed with depression, the 13.2% (n=13) with bipolar disorder and the 9.1% (n=9) with psychosis. According to the DERS, patients with emotional dysregulation are the 82,2% (n=37) of the sample. The 25.3% (n=24) of the sample could be classified as alexithymic. The most represented temperaments in the sample are the dysthymic 24.4% (n=11) and cyclothymic 22.2% (n=10). The mean score of the DERS is 122.33±29.5, the mean score of the TAS-20 is 58.9±166 and the mean score of the AQ is 78.7±30.1, the mean score of the BIS-11 is 65.2±19.1. A simple linear regression between DERS and AQ (R=0.536, R2=0.287, F(1)=15.284, p<0.001), TAS-20 (R=0.502, R2=0.252, F(1)=12.819, p=0.001) and BIS-11 (R=0.534, R2=0.285, F(1)=15.128, p<0.001) was observed. A multivariate linear regression was observed between the DERS (R=0.917, R2=0.842, F(1)=25.708, p<0.001) and the subscale about physical aggressivity of the AQ (β=2.065, p=0.008), the dysthymic subscale of the TEMPS (β=1.87, p<0.001), the hostility subscale of the AQ (β=-3.321, p<0.001), the subscale about difficulty identifying feelings of the TAS-20 (β=1.598, p=0.001), the total score of the AQ (β=0.5, p=0.006) and the subscale about cognitive impulsivity of the BIS-11 (β=1.024, p=0.047).

The results suggest a link between emotional dysregulation, impulsivity, aggression, and alexithymia. Notably, emotional dysregulation appears in those with a dysthymic temperament, marked by high aggression, difficulty identifying feelings, cognitive impulsivity and low hostility. Further research is needed to explore these findings and develop treatment strategies.

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Successful implementation of patient engagement (PE) and mHealth could reduce inappropriate catheter use and Catheter-associated urinary tract infections (CAUTIs). Insight into patient acceptance, impact on PE and quality of care, potential barriers and facilitators to the implementation of an mHealth intervention could improve the impact of both current and future infection prevention programs.

Implementation of the smartphone app “Participatient” was evaluated in four Dutch hospitals. Patient questionnaires assessed the acceptability of the app and its impact. Healthcare professionals (HCPs) were interviewed to evaluate the implementation process.

Acceptability constructs were evaluated positively. PE and quality of care were rated high before and after implementation. All 22 HCPs perceived barriers, eg incomplete training for HCPs and unclear communication on roles; and lack of promotion by ward professionals. The principal facilitator was the HCPs’ positive attitude toward PE.

App users perceived the Participatient app as acceptable, which fulfills a precondition for implementation. The implementation strategy evaluated in the present study was designed to fulfill all the conditions considered crucial for implementation. Nevertheless, the level of adoption remained low, and HCPs still imputed their failure to promote the use of the app to insufficiencies in training and communication and to a misfit between the app and their existing workflow. These findings underscore the need to verify whether there may be additional, less evident barriers to the adoption of mHealth tools that support PE in general, and more specifically, to the adoption of Participatient to engage patients in preventing CAUTIs.

As part of our comprehensive early intervention program for psychotic disorders (RIPEPP), we have been conducting psychodynamic group psychotherapy for family members since 2005. This type of therapy intended for family members of patients that are motivated for psychological work and the correction of maladaptive forms of family interactions. The 90-minute sessions are held every two weeks under the guidance of a psychiatrist – group analyst.

At the beginning of this new experience, we applied group analytical principles in the group. Due to the large drop out and specific dynamics, we gradually changed the therapeutic technique and became more flexible and supportive.

During the years of therapy, with the strengthening of group cohesion, it was gradually possible to switch again from a more flexible and supportive method to the classic group analytical technique.

In this presentation, we will show vignettes from the therapeutic process.

An overview of the need to modify the group-analytic technique in the treatment of family members of individuals with psychotic disorders.

Following the protocol of group sessions.

Over the course of the therapeutic process, the group members become more ready for group analytical work, which is adapted and applied in sessions in which they openly talk about themselves, their feelings and partner relationships. The modification of the group analytic technique is still at work with a continuously present psychodynamic understanding.

A group-analytic approach is applied in the treatment of family members of individuals with psychotic disorders. The frequent occurrence of dropouts among group members highlighted the need to modify the group-analytic technique, with the potential to revert to the classical method by strengthening group cohesion and improving family dynamics.

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Neuropsychiatric symptoms (NPS), prevalent in individuals with mild cognitive impairment (MCI), are linked to functional decline, accelerated dementia progression, and reduced quality of life. In clinical practice, molecular imaging plays a key role in diagnosing cognitive and behavioral issues with high accuracy.

This study aims to analyze the correlation between NPS and molecular imaging findings in MCI-diagnosed patients.

A retrospective, descriptive study was conducted with MCI patients who had undergone Amyloid PET scans (APscan) between January 2019 and October 2024 at Infanta Leonor Hospital in Madrid. Data included demographics, neurological diagnoses, Global Deterioration Scale (GDS) scores, NPS (e.g., depression, psychosis, behavioral and sleep disturbances, anxiety, suicidal thoughts), and PET-FDG/APscan results. Statistical analysis was performed using Dataset and SPSS 22.0.

A total of 72 patients were included. The main characteristics of the sample are shown in table 1. Among these patients, 65.28% exhibited NPS; notably, 49.3% had depression, 23.61% behavioral disturbances, 19.44% sleep disorders, 16.67% anxiety, 4.17% psychosis, and 2.82% suicidal ideation. In patients with a positive APscan, 29.79% had NPS, including 34.29% with depression and 66.67% with psychosis. Patients with abnormal FDG-PET scans showed higher NPS prevalence (65.96%), particularly behavioral disturbances (64.71%), sleep disorders (57.14%), and depression (62.86%).

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This study underscores the high incidence of NPS in MCI patients, noting that NPS may exacerbate patient distress, contribute to autonomy loss, and increase institutionalization risk. Furthermore, molecular imaging patterns can help predict MCI progression to dementia and highlight NPS as potential predictors and outcomes of these biological changes.

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Prementrual disorders (PMD) affect millions of women in reproductive age worldwide. Understanding the potential link between PMD and its comorbidities, including autoimmune disease (AD), is crucial for ultimately improving women’s health. Although hormonal fluctuations seem involved in the development of PMD and some AD, the relationship between PMD and AD remains unclear.

Hence, we aimed to investigate the bidirectional association between PMD and AD.

Leveraging Swedish nationwide and regional registers, we conducted a nested-case control study and a matched-cohort study. Among 3,630,028 eligible women of reproductive ages during 2001-2022, we identified 104,972 incident PMD, their unaffected full sisters, and 10 unaffected matched women per case. We extracted 41 types of AD diagnosis recorded in the registers. Using conditional logistic regression and Cox regression models, we estimated the odds ratio (OR) and hazard ratio (HR) with 95% confidence interval (CI).

Women with AD had a 12% increased risk of subsequent PMD (95% CI 1.10-1.15) compared to unaffected women, and a 6% increased risk compared to their unaffected full sisters (95% CI 1.01-1.11). Women with PMD had 23% (95% CI 1.20-1.26) and 17% (95% CI 1.10-1.24) elevated risks of subsequent AD compared to unaffected women and full sisters, respectively. Among parous women, a stronger bidirectional association was observed for those both exposed to PMD and perinatal depression (nested case-control OR:1.46, 95%CI 1.38-1.54; matched cohort HR:1.49, 95%CI 1.34-1.66) compared to only PMD (nested case-control OR:1.04, 95%CI 1.00-1.07; matched-cohort HR:1.14, 95%CI 1.07-1.21). The strongest bidirectional association with PMD was found for autoimmune thyroid disease and celiac disease.

Our findings illustrate a bidirectional association between PMD and AD, in particular among parous women with a history of perinatal depression. If confirmed in future studies, healthcare professionals need to be vigilant about the risk of AD in women with PMD and vice versa.

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War is the most powerful psychosocial stressor affecting all segments of modern Ukrainian society.

It was conducted a comprehensive examination of 176 patients of both sexes: Group I consisted of 101 military personnel; Group II - 97 volunteers; Group III - 95 IDPs in order to develop a system of personality-oriented treatment of stress-related disorders in persons affected by war.

Clinical and psychopathological examination, which included a structured interview and patient’s observation aimed at studying influence of socio-psychological and biological factors on development of post-stress disorders. Psychodiagnostic method include use: M-PTSD; HADS; HAM-A, HAM-D; Questionnaire of neuropsychological stress by T.A. Nemchin; State-Trait Anxiety Invertory; Methods of diagnosing coping behaviour in stressful situations; Impact of Event Scale-Revised; Clinical Administered PTSD Scale-CAPS; Traumatic Stress Questionnaire; Colombian Suicide Intentions Severity Scale; Methods for determining suicide risk and assessing self-awareness of death in patients with depressive disorder (Kozhyna H.M., Zelenska K.O., 2015); Methods for ‘Diagnosing the level of social frustration (Wasserman L.I., modified by Boyko V.V., 2002).

Clinical structure of stress-related disorders was presented by PTSD and adjustment disorders. Clinical structure of PTSD was represented by anxious, dysphoric, asthenic and somatoform syndromes. System of personality-oriented treatment was developed, including differentiated use of psychopharmacotherapy, psychotherapy and psychoeducation; creation of re-adaptive atmosphere; formation of health-centered lifestyle and based on a salutogenic approach. Pharmacotherapeutic component of developed program included differentiated, targeted use of SSRIs, SNRIs, antipsychotics, tranquilizers and anxiolytics. Psychotherapeutic program was based on identification of dominant resource channels for overcoming stress and finding inner stability using integrative model of psychological survival after severe stress, Basic Ph. Psychotherapeutic support included trauma-focused CBT for all patients, EMDR therapy with additional use of Pucelik Consulting Group’s PTSD Self-Management Program for servicemen patients in Group I; individual crisis therapy for patients in Group II; and interpersonal therapy for patients in Group III. For anxious depressive reactions, CBT and art therapy were used for all patients; with the additional use of problem-solving therapy for patients of Group I; Group II - individual crisis therapy; Group III - mindfulness techniques, relaxation training.

Effectiveness of developed system of personality-oriented treatment of stress-related disorders was proved, and positive dynamics of mental state, reduction of psychopathological symptoms, increased resistance, reduced levels of social and psychological frustration were established.

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Sibutramine is an anorexigenic drug that has been used to treat obesity. After its commercialization, FDA ordered the suspension of its prescription in USA because of the adverse effects. It has structural similarities to amphetamine and is a serotonin-noradrenaline reuptake inhibitor. The primary metabolites are responsible for the activity and inhibit the reuptake of noradrenalin and serotonin from the synaptic cleft. This substance can interfere with one of the known mechanisms of psychosis increasing dopaminergic transmission and leading to potential psychomimetic effects.

The main objective in this paper is to obtain a critical evaluation of the literature regarding psychosis and sibutramine. There has been done a bibliographic review in databases such us SCOPUS, Web of Science, UptoDate and PubMed. This review was realized under certain criteria and keywords. The motivations behind this research were generated after an unusual clinical case (in symptomatology’s presentation). Sibutramine is a compound, which is not commercialized in the UE, so the diagnosis of the toxic psychosis was more complicated than the average psychedelics drugs.

To develop this review, numerous databases were chosen: PubMed, Scopus, UpToDate and Web of Science. However, only in PubMed we have obtain relevant results. For descriptors we have used two terms: “psychosis” and “sibutramine”. In this database, 27 results were obtained. With the criteria previously designed, which were free text access and works published in the last 20 years, only ten of them met all the criteria. With these ten articles, a systematic and qualitative analysis has been done, focusing on the ones which described similar cases.

The sibutramine psychosis is difficult to identify. Frequently is mixed up with other substances in dietary supplements, which can appear as harmless. So, as clinics, we need to be careful, always considering this information in the clinical records. This case was peculiar; a 24 years old woman was consuming sibutramine as a compound in one supplement she was taken for losing weight. Three weeks prior to the consult the symptons started with an erotomaniac delusions, accompanied by disruptive behaviour, mood swings (dysphoria) and irritability. She was hospitalized and treated with antipsychotic medication (aripiprazole) showing a full recovery in five days.

Sibutramine can cause severe mental health disorders. As a compound of dietary supplements, can be easily acquired through online stores. Our work as clinics is to be vigilant of this kind of substances because of the danger that can generate. More studies should be done, to acquire knowledge of the psychobiological mechanisms involved in these cases. The prognosis seems to be positive, but there are certain risks in patients with unknown vulnerability factors.

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Adult patients with Autism Spectrum Disorder (ASD) exhibit a range of behaviours that can be disruptive to the medical care of themselves and other patients and as a result, are at higher risk of being sedated. Symptom severity is heterogenous. Some patients are completely non-verbal, some require assistance with basic activities of daily living, and others function independently with only mild difficulties. Roughly two thirds of patients with ASD have a comorbid psychiatric diagnosis, with the most frequent comorbidities being ADHD, anxiety and depressive disorders or intellectual disability. These comorbidities complicate the management of these patients, and may further increase their agitation and distress.

The present study aims to determine whether adult patients with ASD who present with acute psychiatric illnesses receive more sedatives in the emergency department.

43 adult patients with a previous diagnosis of ASD who were referred to the mental health team at a single, large emergency department in metropolitan Victoria over the year of 2021 were identified and matched with an equal number of controls within the same cohort. Sedative medications were converted to diazepam and chlorpromazine equivalent doses.

There were 41.9% female participants among cases and controls. The mean age of patients with ASD was 26.7 (SD = 7.9), which was similar to the mean age of controls of 27.4 (SD = 7.6). The mean hospital length of stay was 13.4 hours (SD 8.6) among cases and 14.0 (SD 7.0) among controls. A higher proportion of patients with ASD received benzodiazepines at 60.5% compared to 46.5% among controls, with a difference that was not statistically significant. A lower proportion of 30.2% of patients with ASD received antipsychotics compared to 44.1% among controls, with a difference that was not statistically significant.

This study shows evidence that patients with ASD are more heavily sedated in the emergency department compared to patients who present similarly but do not have a prior diagnosis of ASD. While the observed increased dose of benzodiazepines was modest, it does represent a potentially increased degree of harm to patients with ASD. We strongly recommends that every attempt should always be made to reduce the use of sedative medications in favour of other techniques for behavioural management. These include verbal de-escalation, reducing sensory stimuli, one-to-one nursing, prompt security presence and the involvement of family or friends. Since patients with ASD are at a higher risk of receiving sedatives, efforts should be made to recognise their patterns of behaviour and difficulty, to understand them and formulate constructive and safe ways to manage their behaviour.

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New antidepressant treatments are needed that not only demonstrate strong efficacy but also act quickly, are safe for long-term use, and are well-tolerated by patients. Accelerated intermittent Theta-Burst Stimulation (aiTBS) is a promising form of noninvasive brain stimulation in the treatment of depression (1). iTBS stimulation is a time saving and cost-effective technique, and could provide long-lasting improvement of treatment-resistant depression (TRD) (2). Currently, there is limited evidence regarding the role of aiTBS within treatment algorithms for TRD compared to placebo.

This is a single-center, double-blind, randomized, placebo-controlled pilot intervention study, designed to evaluate the efficacy and safety of aiTBS for TRD.

Stimulation will be administered in 10 daily sessions, one session every 50 minutes, over 5 days, for a total of 50 sessions. Each session will consist of 3 minutes of stimulation at a frequency of 50 Hz, delivering 600 stimuli per session, with an intensity of 120% of the motor threshold targeted at the left dorsolateral prefrontal cortex.

Participants must be adults aged 18 to 75 years (inclusive), and meet the criteria for TRD, unresponsive to two antidepressants at an adequate dose and for an adequate duration with a stable dose for at least 4 weeks. Assessments, including HDRS, PHQ-9, EQ-5D-5L, SDS, CGI-S, and MGH-ATRQ, will be conducted at the baseline visit, at the end of the treatment, one and three months after the treatment.

Accelerated protocols are an emerging area of interest in the treatment of TDR, but several issues remain to be clarified, including the durability of their effects, safety, and feasibility of implementing these protocols in outpatient settings in routine clinical practice.

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Six clinical cases of patients with premenstrual dysphoric syndrome treated in Mental Health with SSRIs are presented.

The aim is to briefly review the pharmacological approach to premenstrual dysphoric syndrome through the presentation of a series of cases.

Six cases of female patients are presented, with a mean age of 35.4 years, two of whom were nulliparous. All of them had no history of mental health problems. They had regular cycles and had no relevant medical or gynecological history. They reported that for the last three years they had been more irritable, emotionally labile, feeling apathetic and sad, with difficulties in concentration and a feeling of loss of self-control, which made interpersonal relationships difficult, especially at work.

The patients denied that they had previously experienced these symptoms throughout their lives.

Analyses were carried out, with estrogen and progesterone levels, without obtaining significant alterations.

The MADRS and HAMILTON scales were administered to all of them on the 14th day of the cycle, as well as on the 5th day of the cycle. A mean of 9.2 was obtained on the MADRS on the 5th day of the cycle, compared to 15.6 on the 14th day, while the HAMILTON obtained a score of null-mild anxiety on the 5th day and moderate anxiety on the 14th day.

After this comparison, treatment with fluoxetine at a dose of 20mg DMD was started only from the day of ovulation to menstruation, withdrawing this treatment for the rest of the cycle. Again, both scales were compared and the results obtained were more similar on the 5th and 14th day of the cycle.

To avoid hormonal treatment and thus the moderate side effects it presents, premenstrual dysphoric syndrome can be treated by taking SSRIs at low doses, only for 15 days of the cycle.

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Electroconvulsive therapy (ECT) is a widely recognized and effective treatment for severe psychiatric conditions, including major depressive disorder, treatment-resistant depression, and some psychotic disorders. Although ECT is highly effective, administering it to patients with cranial metal implants—such as plates, screws, clips, or electrodes—presents potential safety challenges. Metal implants, particularly those made of ferromagnetic materials, may interact with the electrical currents in ECT, which can lead to heating, shifting of the implant, or other adverse effects, thereby raising safety concerns.

To review the safety and clinical considerations of electroconvulsive therapy in patients with cranial metal implants. This literature search aims to identify evidence on risks, contraindications, and guidelines to support safe and effective treatment in this population.

We conducted a literature search on PubMed to investigate the application of ECT in patients with cranial metal implants. The search included keywords “electroconvulsive therapy” and “ECT” combined with the terms “cranial metal implants,” “head metal implants,” and “metallic skull plate” interchangeably. We included only case reports. We used this approach to gather relevant studies addressing the safety, efficacy, and considerations of electroconvulsive therapy in individuals with metal implants in or near the skull.

The literature search identified 11 case reports documenting the successful administration of ECT in patients with cranial metal implants. Across these cases, ECT was performed without adverse events related to the implants, and treatment outcomes were reported as effective in managing psychiatric symptoms. Most reports emphasized careful planning and individualized assessment to minimize risks, particularly regarding implant location and material composition. Safety measures included conducting pre-treatment imaging to evaluate implant positioning.

The connection between cranial metal implants and ECT necessitates careful consideration of safety protocols to prevent potentially hazardous interactions. While metals such as titanium are generally not problematic for this therapy, it is essential to consider the type of metal, its location, and its magnetic properties before applying this technique. Our clinical experience also shows positive outcomes in patients with cranial metal implants, demonstrating safe and effective administration with proper evaluation and precautions. Further research and establishing safety guidelines will be crucial for optimizing treatment and minimizing risks for patients with metal implants.

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Sleep disorders are very common in children with neurodevelopmental disorders such as autism. Poor sleep can have detrimental effects on cognitive processes, attention, memory, language, and regulation of mood and behavior. Many people with autism have difficulty correctly processing sensory information that reaches them from both the environment and their own body. Depending on how the person with autism perceives the sensations, these can impact on sleep, causing nighttime awakenings or poor sleep conciliation. It is vitally important to evaluate nighttime rest and have knowledge of appropriate tools to improve sleep in patients with ASD.

In this work we aim to evaluate, in a child-youth population diagnosed with ASD who have been admitted to our ASD Day Hospital during the year 2024, the prevalence of sleep disorders and their characteristics. As well as generating strategies to improve sleep conciliation and factors to take into account or avoid that may be affecting our patients.

A review is carried out of the clinical history of patients admitted to the TEA Day Hospital during the year 2024. Sleep problems are analyzed, as well as their relationship with stress. Results and measures to improve the quality of night rest in these patients are presented.

From January to September 2024, a total of 26 patients with autism have been treated at the ASD Day Hospital of the University Hospital of Mutua Terrasa, in the following programs: intensive, eating problems and low functionality. Of these, 32% were women, with an average age of 11.64 and an average stay of 40 days.

More than half of the patients had sleep problems, where the majority had more than one. Among the most frequent: difficulties falling asleep (12), maintenance insomnia (8), frequent awakenings (4), night terrors (6), and the need for the presence of parents and/or sensory interventions to be able to fall asleep (12).

The main interventions carried out have consisted of: establishing adequate sleeping habits, avoiding naps, avoiding highly stimulating activities, feeling tired beforehand, adapting environmental conditions to the needs of the child and giving proprioceptive information before sleeping.

Among the most commonly used drugs we found atypical antipsychotics: olanzapine, risperidone. Some antidepressants: mirtazapine and occasionally benzodiazepines. The vast majority of children took melatonin.

Sleep disorders are highly prevalent in patients with ASD, but correct intervention can improve comorbid symptoms such as anxiety, stress and discomfort, which are largely related to poor sleep.

Sensory-perceptive interventions are essential to improve nighttime rest in children with ASD

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Schizophrenia is a severe psychiatric disorder characterized by disturbances in perception, thinking, affect, behavior, and negative symptoms. Depression in patients with schizophrenia worsens disease outcomes by increasing suicide risk, complicating the clinical picture, and reducing social functioning quality. Treatment is challenging, as monotherapy with modern antipsychotics is not always successful. Adding antidepressants may improve outcomes, but the effectiveness of such augmentation often requires further evidence.

This study aimed to examine the effects of combining second-generation antipsychotics (SGA) with vortioxetine, a novel multimodal serotonergic antidepressant, on various aspects, including quality of life, anhedonia, cognitive function, and overall symptom improvement in schizophrenia patients.

We conducted a comprehensive search of PubMed, Embase, Cochrane and Web of Science databases up to September 2024 for studies using Vortioxetine with standard treatments for schizophrenia.

We screened 371 studies and our review included six studies gathering 508 patients. Study type, sample sizes, and follow-up time varied across studies (Figure 1). All studies involved adding Vortioxetine to existing antipsychotic treatments, with dosages ranging from 5-20 mg/day. Study durations varied from eight to 48 weeks. Common scales across multiple studies included: PANSS (Positive and Negative Syndrome Scale), WHOQOL-BREF (World Health Organization Quality of Life Assessment), CDSS (Calgary Depression Scale for Schizophrenia), and various cognitive function tests (e.g., WCST, Verbal Fluency Test, Stroop Task). Overall, the studies reported positive effects of vortioxetine in schizophrenia patients (Figure 2): Improved quality of life, Reduced anhedonia, Enhanced cognitive function, Improved depressive symptoms, Reduced negative symptoms. Most studies reported good tolerability of vortioxetine with minimal side effects.

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The findings suggest that Vortioxetine may be a promising adjunctive treatment for schizophrenia, potentially improving various domains including quality of life, cognitive function, negative symptoms, and depressive symptoms. However, larger and more robust studies are needed to confirm these findings.

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Negative consequences of acute and chronic stress caused by information overload, environmental problems, natural disasters, man-made disasters, military clashes, and acts of terrorism have become increasingly evident in recent decades. They can lead to a painful “breakdown” of socio-biological adaptation mechanisms, a decrease in adequacy in assessing the environment, and, as a consequence, the formation of disturbances in the psycho-emotional sphere, manifested in the development of behavioral disorders (aggression and depression). Therapy for behavioral disorders does not provide a complete cure, apparently due to the formation of a “vicious circle” that can only be broken by normalizing the regulatory relationship between the central nervous system and the immune system. One way to solve this problem is to develop new methods of therapy based on immunological approaches. The method of choice may obviously be immunotherapy with autologous immune cells with a certain, including in vitro modulated, functional activity.

The aim of the study was to investigate the possibility of obtaining a positive psychoneuroimmunomodulatory effect in aggressive and depressive-like animals by transplanting immune cells, the functional activity of which was in vitro modulated by a psychoactive substance (PAS).

Male (CBAxC57Bl/6)F1 mice aged, in which aggressive or depressive-like states were formed under the influence of long-term social stress, were used as donors and recipients in the experiments. Immune cells for transplantation were obtained from a suspension of donor’s splenocytes, cultured in vitro with PAS (chlorpromazine or caffeine, respectively) and then intravenously administered to syngeneic recipients. In the control group of animals, cell preparation and transplantation were carried out under similar conditions, except that the latter were cultured without the presence of PAS. In recipients the parameters of the nervous and immune systems functional activity were recorded.

Transplantation of in vitro PAS-modulated splenocytes to recipients with stress-induced behavior patterns resulted in targeted changes in their motor and exploratory activity in the Open field test, motor activity in the Porsolt test, and decreased anhedonia in recipients with a depressive-like phenotype, recorded against the background of changes in the content of a number of pro- and anti-inflammatory cytokines IL-1β, IL-2, IL-4, IL-6, IL-10, IFNγ, TNFα in pathogenetically significant brain structures. In recipients, a positive change in the parameters of the immune system functional activity were also revealed.

The possibility of immunoediting stress-induced forms of behavior by transplanting in vitro PAS-modulated immune cells, which have a positive psychoneuroimmunomodulatory effect in the body of syngeneic recipients, has been demonstrated.

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Worldwide, social media and touch screen device use has rapidly increased over the past decade and are particularly popular among young people. To obtain more insight in the potential negative associations with compulsive social media use and touch screen devices in Dutch children, we assessed its relation with self-reported well-being and cognitive function in primary school children. We found social media to be negatively associated with life satisfaction and increasing touch screen device use with increased reaction time. This suggests that the compulsive social media use and touch screen device use have negative consequences on mental well being and cognitive performance already at a young age. Therefore the use of social media in children under the age of 15 years should be restricted or forbidden.

None Declared