India is facing a growing mental health burden, with significant disparities in access to services despite the introduction of the National Mental Health Program (NMHP) and the Mental Healthcare Act (MHA). While these policies aim to improve mental health care, their implementation remains inconsistent due to a range of challenges. Understanding these barriers is crucial to enhancing mental health services across the country.

This study aims to identify the key challenges impeding the effective implementation of existing mental health policies in India, with a focus on rural-urban disparities, resource constraints, and sociocultural factors.

A comprehensive literature review was conducted, examining peer-reviewed articles from databases such as PubMed, Scopus, and WHO policy documents, and reports from government and non-governmental organizations. Data was analysed to assess the primary obstacles related to funding, workforce shortages, stigma, policy integration, and infrastructure issues. Qualitative insights from key stakeholders in mental health services were also included.

The review revealed five primary challenges. Firstly, the insufficient financial allocation for mental health programs, leading to limited-service availability; secondly, a shortage of trained mental health professionals, particularly in rural areas; thirdly, a pervasive stigma surrounding mental health, hindering service uptake; fourthly, the poor integration of mental health care into primary health systems; and lastly, the bureaucratic inefficiencies and lack of infrastructure. These challenges disproportionately affect rural populations, exacerbating the urban-rural divide in mental health care delivery.

The effective implementation of mental health policies in India is undermined by systemic challenges such as inadequate resources, workforce gaps, and sociocultural barriers. Addressing these issues requires targeted interventions, including increased investment in mental health services, enhanced training programs, stigma reduction campaigns, and better integration of mental health care into general healthcare frameworks. A coordinated, multi-level approach is essential to overcoming these barriers and achieving meaningful improvements in mental health outcomes across India.

None Declared

Major Depressive Disorder (MDD) significantly impacts global disability and quality of life. Some variables such as the trait anxiety and experiencing stressful life events (SLEs) are usually related to the MDD. However, the relationship between these variables in depression needs further investigation. Emerging research suggests the STAI-trait could be a nonspecific measure of negative effect and increase susceptibility to stress-induced depression.

This study assesses the State-Trait Anxiety Inventory (STAI) trait scores and SLEs, depressive symptoms, outcomed and functionality in MDD patients, with the hypothesis that STAI-trait may predispose individuals to stress-induced depression.

A prospective observational study was conducted with 25 MDD patients recruited at Hospital Universitari de Bellvitge. The STAI-trait and SLE exposure were measured during the initial visit. Depression symptom and outcome variables were assessed in three sequential clinical evaluations.

Preliminary findings show a significant association between anxiety trait and SLEs, high STAI-trait scores correlated positively with increased SLEs. This, correlating with more severe MDD symptoms and a complex disease course.

These findings support the notion of the STAI-trait as a possible mediator between life stressors and depression.

They highlight that increased STAI-trait anxiety might lead to greater vulnerability to stress and its potentially depressive effects, underscoring the need to consider this trait in clinical practice and the development of preventive strategies.

None Declared

Organic solvent-induced psychosyndromes (OSP) constitute a major occupational health concern, particularly in industrial sectors involving frequent use of chemical products. This neurotoxic disorder can have significant consequences on workers’ health and their ability to maintain professional activity.

This study aims to analyze the epidemiological, clinical, and occupational characteristics of organic solvent-induced psychosyndromes diagnosed in the workplace, as well as to evaluate their impact on work fitness.

A retrospective study was conducted based on medical records collected at the Institute of Occupational Health and Safety (ISST) in Tunisia during a period of 5 years from 2019 until 2024. Socio-professional data, risk factors, diagnoses, progression, and fitness decisions were analyzed with a focus on OSP cases. The severity of the psychosyndrome was assessed using the Raleigh classification and the WHO criteria.

The study identified 11 cases of organic solvent-induced psychosyndromes. The average age of patients was 41 years. The gender distribution showed 6 women and 5 men.

The professional sectors were distributed as follows: chemical industry (n=4), textile industry (n=3), electronics (n=2), and other sectors (n=2).

The main solvents involved were xylene (n=7), toluene (n=6), hexane (n=5), and cyclohexane (n=4), with multiple exposures in 8 cases. The average duration of occupational exposure before diagnosis was 14 years ranging from 5 to 30 years. An ineffectiveness of protective measures was found in 6 patients.

The most frequently reported symptoms included memory disorders (n=9), attention disorders (n=8), and mood disorders (n=7).

The most common type of psychosyndrome was type 2B (n=8).

Regarding work fitness, nine cases required removal from solvent exposure, including six through job transfer and three through workplace accommodation. Two cases were declared unfit for their current position.

This study highlights the impact of organic solvent-induced psychosyndromes on workers’ health and emphasizes the need for better protective measures, early screening, and regular medical monitoring.

None Declared

Since the beginning of the health crisis caused by COVID-19, the impact of the pandemic context on the mental health of healthcare professionals has been widely studied. However, few studies have assessed psychological manifestations in healthcare workers affected by COVID-19.

Determine the prevalence and factors associated with depressive symptoms in healthcare workers with COVID-19.

This is a cross-sectional analytical study of health professionals at Farhat Hached University Hospital with COVID-19 over a 6-month period from September 2020 to February 2021. Depressive symptoms were screened using the Depression Subscale of Hospital Anxiety and Depression Scale (HADS-D).

Our study included 477 healthcare professionals. The mean age was 39.9 ±10.8 years, with a predominance of women (sex ratio =0.27). Almost a third of the participants were nurses (32.1%), followed by doctors (27.9% of cases). Most of the healthcare workers affected developed a pauci-symptomatic form of the infection (73.8%), with an average confinement time of 14.9±6.9 days. On returning to work, 74 staff (15.5%) noticed that their colleagues were withdrawing from work. According to the HADS-D scale, depressive symptoms were observed in 19.1% of cases. The predictive factors were gender (p<10-3), age (p=0.016), the symptomatic form of COVID-19 (p= 0 ,038), the duration of confinement (p<10-3) and the withdrawn attitude experienced by colleagues on returning to work (p<10-3).

Our results showed that psychological suffering, particularly depression, among care staff depended on several predictive factors. Psychological support during and even after the period of confinement is therefore necessary

None Declared

An increasing number of patients with treatment-resistant depression (TRD) are treated with a novel form of transcranial magnetic stimulation (TMS): the intermittent theta burst stimulation (iTBS). In this retrospective naturalistic study, we analyzed the outcome of iTBS treatment in patients with treatment-resistant depression.

To investigate the impact of history of esketamine treatment in the current depressive episode on response to iTBS.

In this study, we included 66 hospitalized patients (57.6% female; mean age, 52.7 years) from the University Department of Psychiatry, University of Münster. Prior to iTBS treatment, 10 patients were treated with esketamine (60% female; average age, 49.8 years) and 56 were not (57% female; average age, 53.25 years). A Chi-squared test was utilized to investigate the impact of history of esketamine treatment on response to iTBS.

The overall response rate was 51.5%. Prior to iTBS, 15% of the patients were treated with esketamine in the current episode. In the patient group with history of esketamine treatment (ESK+), 40% of the patients responded to iTBS. In the patients without history of esketamine treatment (ESK-) in the current episode, the response rate to iTBS was 53.6 %. However, history of esketamine treatment in the current episode had no significant impact on iTBS outcome (P = 0.505; χ2 = 0,626; df = 1). The difference in baseline disease severity between the groups was not statistically significant (CGI-S 6.3 (ESK+) vs 6.1 (ESK-), P = 0.281; F = 1.184; df = 64). The total rate of treatment dropouts was 3%.

History of esketamine treatment in the current episode was associated with worse outcome of iTBS. This finding was not statistically significant. iTBS may be an effective (40% response rate) and safe treatment for patients who did not respond to esketamine therapy.

M. Tonkul: None Declared, B. Baune Consultant of: Received speaker/consultation fees from AstraZeneca, Lundbeck, Pfizer, Takeda, Servier, Bristol Myers Squibb, Otsuka, LivaNova, Biogen, Angelini, and Janssen-Cilag., E. Kavakbasi Consultant of: Received speaker and advisor honoraria from LivaNova and Janssen-Cilag.

Bipolar disorder is a chronic mood disorder that often coexists with a range of psychiatric and physical comorbidities. Among these, eating disorders (ED) have emerged as a significant concern due to their impact on the course and prognosis of BD.

This study aims to investigate the prevalence of ED in stabilized bipolar patients and identify clinical and demographic factors associated with this comorbidity.

We conducted a cross-sectional, descriptive, and analytical study of patients followed for bipolar disorder at the psychiatry outpatient unit at the Hedi Chaker University Hospital in Sfax. The questionnaire included sociodemographic data, medical and psychiatric history, and anthropometric characteristics. Eating disorders were assessed using the Eating Attitude Test 40 (EAT-40).

Our study included 93 patients. The mean age was 41.49±12.33 years, with a M/F sex ratio of 2.58. Among the patients, 58.1% were married, 45.2% had secondary education, and 47.3% were unemployed. Personal somatic history was reported by 35.5% of participants, and 11.8% had psychiatric comorbidities alongside bipolar disorder.

The mean body mass index (BMI) was 27.4 kg/m² (SD=5.96). Of the patients, 29% were overweight, and 31.2% were obese. The prevalence of eating disorders was 18.3%.

EAT-40 scores were significantly associated with age (p=0.018), female gender (p<10⁻³), living alone (p=0.031), lack of formal education (p=0.009), history of medical comorbidities (p<10⁻³), weight (p=0.05), and BMI (p=0.003).

The significant associations between EAT-40 scores and sociodemographic factors underscore the need for targeted screening and interventions in this population. Early detection and management of eating disorders in bipolar patients are crucial to improving clinical outcomes and overall quality of life.

None Declared

Chlorpromazine is historically the first antipsychotic drug. It has played a decisive role in the development of neuropsychopharmacology. However, it can induce adverse effects, sometimes fatal.

To study the relationship between acute cytolytic hepatitis and treatment with chlorpromazine.

We report the case of a patient treated for schizophrenia who developed an acute cytolytic hepatitis after taking chlorpromazine.

We report the case of a 22-year-old woman with no significant medical history, has been diagnosed with schizophrenia who was admitted to our department for physical hetero-aggressiveness.

The clinical examination and laboratory tests performed on admission were normal. The patient was treated with 15 mg of haloperidol and 30 mg of diazepam and 50 mg of chlorpromazine.

On the twelfth day, the patient developed a fever of 38.4°C and abdominal pain. Laboratory tests revealed predominant hepatic cytolysis with elevated ALAT (ASAT: 372 IU/L; ALAT: 463 IU/L), with hepatic cholestasis (PAL: 156 IU/L; GGT: 238 IU/L). Total bilirubin and prothrombin levels were normal with no evidence of jaundice or pruritus

The ALAT/PAL ratio was 8.8 > 5, indicating cytolytic hepatitis. The rest of the clinical and biological examination was completely normal.

Drug-induced hepatitis was suspected and the three drugs were stopped after consultation with the regional pharmacovigilance center in Sfax. The biological control showed a decrease in transaminases (ALAT=5.4*N, ASAT=1.3*N) 3 days after stopping the treatment. Viral serology (hepatitis A,B and C) was negative and liver ultrasound showed hepatomegaly suggestive of drug-induced hepatitis.

Haloperidol-induced cytolysis was initially suspected, and the prescription of chlorpromazine was authorized. Due to the patient’s instability, she was treated with chlorpromazine at a dose of 25 mg*3/d. Twenty-four hours after administration of this neuroleptic, the patient presented a worsening of hepatic status: ALAT=20*N, ASAT=14.4*N, PAL=2.6*N, GGT=19*N. The ALAT/PAL ratio was 7.6, indicating cytolytic impairment requiring immediate discontinuation of chlorpromazine.

The pharmacovigilance investigation blamed chlorpromazine and contraindicated its use. The evolution was characterized by an improvement of the hepatic balance three days after discontinuation of chlorpromazine.

Normalization of transaminases was achieved within 3 weeks. GGT and PAL were normalized after 2 months of discontinuation.

Chlorpromazine was classified as probable (C2S3I3B3(R+)). The score was calculated according to the French Bégaud method.

Edema is not a common side effect of typical antipsychotics. However, it is crucial to emphasize that this effect can occur. Clinicians are advised to watch for edema in all patients taking antipsychotics.

None Declared

Climate change is one of the main global challenges of the 21st century due to its consequences for the environment, the economy and health. Given that human behaviour exists at the forefront of many of the environmental issues we face, it is crucial to effectively measure pro-environmental behaviours (PEB). Stanley et al. (2021) proposed the PEB Scale (PEBS), a bifactorial measure including eight items asking about personal behaviours and eight collective actions that revealed good psychometric properties. To the best of our knowledge, there is no instrument that validly assesses these parameters in the general Portuguese population.

To analyze the psychometric properties of the Portuguese version of PEBS and to explore its relationship with individual factors.

A community sample of 599 Portuguese adults (64.6% women; mean age=34.40±16.18) answered to the Portuguese preliminary version of PEBS and to the validated instruments: Climate Change Distress and Impairment Scale/CC-DIS, Big3 Perfectionism Scale–Short version/BTPS-SF, HEXACO-60 and Toronto and Coimbra Prosocial Behaviour Questionnaire/ProBeQ. SPSS 29 and AMOS-29 were used for Exploratory Factor Analysis (EFA; with a subsample of n=291) and Confirmatory Factor Analysis (CFA; n=308), respectively.

EFA revealed a 3-factor solution with an explained variance of 60.52% confirmed by parallel analysis. With CFA, fit indices were found to be acceptable for first and second-order models (X²/df=4,0741; CFI =.8638; TLI=.8382; GFI=.8515; RMSEA= .0887, p<.001). Cronbach’s alphas were of .871 for the total scale (16 items), .857 for F1 (Collective actions/CA; 5 items), .832 for F2 (Personal behaviours/PB; 8 items) and .736 for F3 (Political actions/PA; 3 items). PEBS correlated with CC-DIS (r=.48 with total PEBS, r=.42 with CA and PB and r=.21 with PA, p<.01), ProBeQ (r=.24 with total PEBS, r=.12 with CA, r=.37 with PB and r=-.14 with PA, p<.01), Narcissistic Perfectionism (r=.08, p<.05 with CA and r=.20, p<.01 with PA), Honesty-Humility (r=-.15, p<.01 with PA), Emotionality (r=-.12, p<.01 with PB and r=.09, p<.05 with PA), Extraversion (r=.09, p<.05 with CA and r=.12, p<.01 with PA), Agreeableness (r=.11 with total PEBS, r=.12 with CA and r=.14 with PA, p<.01) and Conscientiousness (r=.09, p<.05 with total PEBS). When the correlated variables were inserted as predictors in linear multiple regression models where CA, PB and PA were dependent variables, they explained 19.8% (R2=.198), 24.6% (R2=.246) and 14.9% (R2=.149) of their variance, respectively (all p<.001).

PEBS shows adequate psychometric properties, therefore, it can be used to measure PEB in the Portuguese population, namely, to analyze the efficacy of pro-climate interventions and campaigns. These initiatives should take into consideration the role of individual factors (such as personality traits) in PEB.

None Declared

Lambert-Eaton Myasthenic Syndrome is an autoimmune neuromuscular junction disorder characterized by proximal weakness, autonomic dysfunction, and areflexia associated with antibodies against voltage-gated calcium channels. Psychotic symptoms can take place in many auto-immune neurological disorders, but their occurrence in myasthenic syndromes has rarely been observed.

We report a case of a 21-year-old female with primary autoimmune Lambert-Eaton Myasthenic Syndrome due to anti-voltage-gated calcium channels antibodies subtype P/Q, who developed psychotic symptoms three years after motor symptom onset.

The patient attended regular psychiatric follow-ups over three years.

With monthly administration, these psychotic symptoms improved after every cycle of intravenous immunoglobulin therapy. The patient displayed partial insight into the mental symptoms. Different causes of reversible psychosis were excluded, such as autoimmune encephalitis and paraneoplastic syndrome, though the patient tested positive for the anti-voltage-gated calcium channels antibodies subtype P/Q. Owing to muscle strength worsening and psychotic episodes, the patient was put on several treatments, including one admission to a Neurology unit. The patient then experienced psychotic exacerbation, leading to treatment with olanzapine at 20 mg/day. Psychotic symptoms persisted but were less severe, with greater intensity at night. After two years, the patient’s condition showed significant improvement, with olanzapine increased to 25 mg/day.

This is, to our knowledge, the first described case of psychotic symptoms associated with Lambert-Eaton Myasthenic Syndrome. We speculate that voltage-gated calcium channel antibodies could have a role in developing mental symptoms. However, further hypotheses are discussed. Although the patient had received corticosteroid therapy before symptom onset, the timing and dosage make corticosteroid-induced psychosis unlikely. A primary psychotic disorder, such as schizophrenia, is considered improbable due to the atypical nature of the psychotic symptoms. This case underscores the need for further research on the neurobiological mechanisms linking VGCC antibodies to psychiatric symptoms.

None Declared

Infertility represents a serious biopsychosocial crisis. Faced with infertility in a society that emphasizes parenthood as a desirable role, and driven by their own desire to become a parent, a person is forced to (re)define themselves as an adult and find their place in society. Research shows that women are more affected by this issue. Firstly, medical treatment for infertility is more uncomfortable for women than for men. Moreover, in most societies, women are considered the responsible partner for reproduction. The experience with this problem can be traumatic enough to become a reference point for identity and for attributing meaning to other experiences in one’s life.

This research aimed to examine the mediating role of psychological problems caused by infertility in the relationship between self-stigma and the degree of integrating trauma (i.e. infertility) into one’s identity, on the one hand, and the level of depression, on the other.

The study involved 197 women with difficulties conceiving who had not yet become mothers, aged between 27 and 47 years (M=37.7; SD=5.1). The following questionnaires were used: the Female Infertility Stigma Instrument (ISI-F), designed to assess self-stigma in women facing infertility. The Centrality of Event Scale (CES) measures integrating trauma into one’s identity (adapted here to measure the integration of infertility into one’s identity). The Psychological Evaluation Test for Infertile Couples (PET), is aimed at assessing psychological problems in various aspects of life caused by infertility, and the Patient Health Questionnaire (PHQ-9), is used to assess the degree of depression.

The results show that the zero-order correlations between the predictors, mediators, and criterion are positive and significant. Mediation analysis shows that problems caused by infertility mediate the relationship between self-stigma and the level of depression (indirect effect: ß=.292, p< .001, 95%CI = .199 - .411), and between the integration of trauma (i.e., infertility) into one’s identity and the level of depression (indirect effect: ß=.147, p<.001, 95%CI = .083 - .226). In both cases, full mediation is observed. Tables and figures will be added to the poster if accepted.

The results indicate that the degree of internalized stigma and the integration of infertility into one’s identity are significant for a person’s adjustment to this problem and that, together with the level of psychological problems caused by infertility, have an effect on mental health. The study underscores the “traumatic” potential of infertility and the effect of this issue on identity and mental health. The findings could also serve as guidelines for designing psychological interventions, which should focus on the problem of self-labeling, self-blame, and the redefinition of oneself as an adult.

M. Mitrović Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, N. Ćirović Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, J. Opsenica Kostić Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, I. Janković Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, M. Guberinić Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, M. Spasić Šnele Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe, M. Trenkić Grant / Research support from: This research was supported by the Science Fund of the Republic of Serbia, #GRANT No 1568, Identity Crisis in Women Facing Infertility: Mixed Methods Approach – InsideMe.

Suicidal tendencies are among the most common problems faced by adolescents who encounter difficulties, issues, or challenges affecting various aspects of their psychological and social lives, often leading to high suicide rates. Bipolar disorder, various depressive disorders, substance abuse disorders, psychosis, and eating disorders are among the most common leading causes of suicide and suicidal tendencies among adolescents. Dialectical Behavior Therapy (DBT) is an integrative therapy employing a combination of techniques. DBT aims to assess the individual’s ability to regulate emotions, manage relationships effectively, tolerate distress, reduce maladaptive responses, and decrease impulsive and self-destructive behaviors.

The current study aims to investigate the effect of using Dialectical Behavior Therapy (DBT) techniques in reducing suicidal tendencies (ST) among adolescents of both genders who suffer from bipolar disorder. Additionally, to verify the sustained effectiveness of these techniques in reducing suicide risk among adolescents.

A one-group experimental design was used. The study sample consisted of a (31) adolescents with high or moderate levels of suicidal tendencies who were diagnosed with bipolar disorder. Initially, the Bipolar Disorder Scale was used to identify adolescents exhibiting symptoms of the disorder for more than 6 months. This was followed by administering the Suicidal Tendencies Scale. Individuals with high or moderate suicidal tendencies scores on this scale were selected to participate in the study. They then underwent 23 sessions of psychotherapy based on DBT. After the completion of the therapy program, the Suicidal Tendencies Scale was administered again, and a third administration took place two months after the completion of the program. The research tools included a DBT-based therapy program consisting of 23 sessions, with an average of 3 sessions per week, each lasting 45-60 minutes.

The results indicated a significant improvement among adolescents after the completion of the program. Participants reported benefiting from the program, expressing reduced feelings of despair and increased hope and optimism about life. The adolescents’ scores on the Suicidal Tendencies Scale decreased after the program ended compared to their scores before the program. Additionally, their scores remained lower two months after the program ended compared to their pre-program scores. This indicates a positive impact of the counseling program in reducing suicidal tendencies among adolescents, as well as the sustained effectiveness of the program.

Dialectical Behavior Therapy (DBT) is effective in reducing suicidal tendencies and can be applied effectively to a range of other psychological disorders. It is essential to manage suicidal tendencies among adolescents to help decrease suicide rates.

None Declared

Climate change and pollution are deeply interconnected phenomena that pose significant risks to overall health, given their proven impact on the functionality of various human organs and systems. With increasing urbanization, global toxicity is expected to rise in the near future. It is therefore crucial to understand how environmental pollution affects mental health, particularly in rapidly growing urban areas.

This systematic literature review aims to explore the biological mechanisms linking exposure to environmental pollutants, climate change, and the onset and/or exacerbation of severe mental disorders.

A search was conducted in the PubMed, Scopus, and APA PsycInfo databases, following PRISMA guidelines. Studies on humans and animal models examining the association between environmental pollutants, climate change, and mental disorders were included. A total of 48 articles were considered, comprising studies on humans (16 studies) and animal models (31 studies), along with one article that included both models.

Human studies revealed that exposure to particulate matter (PM 2.5 and PM10) increases the risk of depression and psychotic relapses through mechanisms involving inflammation, oxidative stress, and disruption of the hypothalamic-pituitary-adrenal axis. In animal models, pollution was shown to impact brain function by activating inflammatory responses, causing oxidative stress, damaging the hippocampus, and dysregulating neurotransmitters. Additionally, one study highlighted that climate change is associated with mood disorders by inducing changes in gene expression and psychophysical adaptation responses.

The findings indicate that environmental pollutants and climate change can affect human mental health through complex biological pathways. Understanding these mechanisms is essential for developing prevention and intervention strategies. The One Health approach, which recognizes the interconnectedness of human, animal, and environmental health, is crucial for addressing the challenges posed by climate change and pollution.

None Declared

Digital studies based on the continuous monitoring of patients in their natural environment help to refine the suicidal phenotypes. Studies using ecological momentary assessment revealed the existence of different patterns of suicidal ideation (SI) based on both their severity and variability. Specifically, variable SI may be a frequent pattern of suicidal ideation that appears to be related to some clinical features (social withdrawal, impulsive aggression, suicide attempts), rooted in childhood trauma and serotonergic dysfunction and associated with the reactivity to stressful life events. Some individuals, in response to stress could experience both psychological pain and decision-making impairment in social contexts, leading to suicide risk. Then, the description of the suicidal pattern may help to define clinically and biologically homogeneous groups of at-risk patients.

In this sense, experimental studies where patients are submitted to a social stress task reported that patients who were more sensitive to a social stress, as measured with a higher salivary cortisol response, were less depressed, more impulsive, and made suicide attempts with a higher intent. Investigating the regulation of the immune inflammatory response to the social stress task, we recently reported that suicide attempters and ideators showed less dynamic inflammatory stress responses in comparison to psychiatric controls, and that platelet activation responses to stress were blunted in individuals with suicidal ideation. Last, we will present new data of cardiovascular and emotional responses to the virtual Trier Social Stress Test in women with a history of depression and with or without a history of suicide attempt. Combining digital and experimental studies could help to refine the suicidal phenotypes and reduce the heterogeneity of suicidal behaviors that are led by different processes, in order to develop specific therapeutic approaches for a better suicide prevention.

None Declared

Anesthesia technicians play a crucial role in operating room ensuring the conduct of anesthesia procedures and monitoring patients. However, the demanding nature of their work involving irregular hours, alertness, extended hours in addition to the exposure to anesthetic agents may influence their performance and vigilance.

The aim of this study was to assess signs of sleepiness among anesthesia technicians (AT) and evaluate its associated factors.

We conducted a cross-sectional study among AT in two University Hospitals in Sfax, Tunisia, between January and July 2024 during periodic health assessment visits. Sociodemographic and professional data were collected. The Epworth Sleepiness Scale (ESS) was used to assess signs of sleepiness.

Our population consisted of 60 AT with a mean age of 47.9±7.1 years. Two participants (3.3%) were males. The mean seniority was 24±7.5 years in healthcare and 10.4±8.1 years in the current ward. Forty-five AT (75%) reported using Halogenated Anesthetics. Ninety-five percent of the population had shift work. Fatigue and daytime somnolence were reported by 73.3% and 45% of the population respectively. The median ESS score was 6 Interquartile range IQR [2.25;6]. Excessive sleepiness was found in 21.7% of the population. The ESS score was higher among AT who used halogenated anesthetic, but no significant association was found (p=0.2) in the bivariate analysis.

Assessing vigilance among AT is necessary to maintain patient safety. Organizational factors such as long hours and environmental factors such as effective evacuation system for halogenated agents could cause fatigue and sleepiness in operating room.

None Declared

Immune checkpoint inhibitors are being used in patients with advanced malignancies. Although it can effectively treat tumors, 30–60% of patients could experience immune-related adverse events such as encephalitis with antibodies against the NMDA receptor.

We present a case of a 57-years-old man with no prior mental health history who was diagnosed of kidney cancer and received treatment with checkpoint inhibitors. He developed incoherent speech, visual hallucinations, delusional megalomania, disorientation, sleepiness and a low-grade fever of 37.7ºC. He was admitted in Neurology unit and diagnosed of autoimmune limbic encephalitis in a patient treated with checkpoint inhibitors.

To describe a case of a psychotic episode associated with autoimmune limbic encephalitis in a patient treated with checkpoint inhibitors.

Clinical assesment and bibliographic review of pertinent literature.

During his admission in Neurology ward, the patient was suspicious, inattentive, aggressive with healthcare staff and he developed incoherent speech with visual hallucinations.

MRI suggested bilateral limbic encephalitis and the antibody test in cerebrospinal fluid were positive for NMDA receptor.

The psychotic episode was treated with olanzapine up to 20 milligrams and the limbic encephalitis with rituximab with a good response.

The case presented is consistent with other reports of psychotic symptoms and development of encephalitis associated with antibodies against the NMDA receptor.

The diagnosis of anti-NMDAR encephalitis is usually delayed.

The differential diagnosis should be established with primary psychiatric disorders.

None Declared

Background: Lifestyle factors are linked to differences in brain aging and risk for Alzheimer’s disease, underscored by concepts like ‘cognitive reserve’ and ‘brain maintenance’. The Resilience Index (RI), a composite of 6 factors (cognitive reserve, physical and cognitive activities, social engagement, diet, and mindfulness) provides such a holistic measure.

This study aims to examine the association of RI scores with cognitive function and assess the mediating role of cortical atrophy.

Baseline data from 113 participants (aged 45+, 68% female) from the Healthy Brain Initiative were included. Life course resilience was estimated with the RI, cognitive performance with Cognivue®, and brain health using a machine learning derived Cortical Atrophy Score (CAS). Mediation analysis probed the relationship between RI, cognitive outcomes, and cortical atrophy.

In age and sex adjusted models, the RI was significantly associated with CAS (β= -0.25, p = 0.006) and Cognivue® scores (β= 0.32, p < 0.001). The RI-Cognivue® association was partially mediated by CAS (β= 0.07; 95% CI [0.02, 0.14]).

Findings revealed that the collective effect of early and late-life lifestyle resilience factors on cognition are partially explained by their association with less brain atrophy. These findings underscore the value of comprehensive lifestyle assessments in understanding the risk and progression of cognitive decline and Alzheimer’s disease in an aging population.

R. Ezzeddine: None Declared, D. Oshea: None Declared, S. Camacho: None Declared, L. Besser: None Declared, M. Tolea: None Declared, J. Galvin Employee of: Cognivue (Chief Scientific Officer of Cognivue). Cognivue devices are used for research conducted at the center., C. Galvin: None Declared, L. Wang: None Declared, G. Gibbs: None Declared

Spinal cord injury (SCI) is a severe trauma that leads to disability and decreased social activity. Recently, the number of patients among children has been growing. In Russia, the share of spinal cord injury in the structure of all injuries is 18.3%.

Post-traumatic consequences include neurological, motor and somatic disorders, as well as psychological ones. Psychological support for children with severe SCI is an important link in comprehensive rehabilitation at all its stages. There are data in the literature on the psychological state after spinal cord injuries, but this is in adults.

to study psychological problems in adolescents after severe spinal cord injury in the early stages of rehabilitation.

50 patients (12-18 years old) admitted for treatment and rehabilitation on the 1st-3rd day after spinal cord injury. Psychological diagnostics included: clinical interview; Anxiety and Personality Disorders Inventory (Spielberger 1983, adapted by Khanin); Beck Depression Inventory (Beck 1961, version for adolescents); Recovery Locus of Control (Partridge, Johnston 1989).

All patients (100%) had psychological problems of varying severity: 80% of adolescents - high level of reactive anxiety; 28.3% - low motivation for rehabilitation; 33.3% - depression (of which 30% - reactive depression; 3.3% - masked depression). Symptoms could be combined and observed in the same patient.

Children with high levels of personal anxiety in combination with reduced levels of motivation had difficulties in adaptation to rehabilitation.

All patients (100%) require psychological support in order to correct emotional background and motivation. Differentiated specialized assistance, including psychological, will increase the effectiveness of rehabilitation. This will help to adapt adolescents with post-traumatic deficiency to the changed conditions of life, improve its quality and return them to their previous social environment.

None Declared

The proposed research work aims to carry out a review of the data of the Assertive Community Treatment Program of Segovia, analyzing its importance in certain profiles of psychiatric patients.

Review of data from the Segovia Assertive Community Treatment Program from 2020-2024: age, sex, nationality, marital status, level of education, diagnosis, family history, substance use, population, socio-family situation, economic situation, follow-up and admissions in Mental health, social health coordination and disability.

Data from the Segovia Assertive Community Treatment Program from 2020-2024.

The majority of patients participating in the Segovia Assertive Community Treatment Program between 2020-2024 were Spanish men between 20 and 60 years old. All patients were single, except three separated and one married. Approximately half of them lived alone and the other half with their family of origin. Most had basic education and half were employed. Regarding the consumption of toxic substances, most of them smoked tobacco and some also consumed alcohol or cannabis, and a small number cocaine. Many of them received a financial benefit and had social-health coordination.

The most common diagnosis is schizophrenia, followed by schizoaffective disorder and delusional disorder, most with psychiatric family history. Other diagnoses that the patients presented were: bipolar disorder, personality disorder and obsessive-compulsive disorder. Some of them also had disabilities.

It is important to highlight that 94.12% of patients live in rural areas, many of them more than 30 minutes away by car and with faced great difficulties with public transportation. Many of them were more previous admissions to Psychiatry and an irregular follow-up in Mental Health, but very few had readmissions during the Program. The majority of patients had psychopharmacological treatment, and 7.14% of them had injectable antipsychotic treatment.

A large percentage of patients in the Assertive Community Mental Health Treatment Program are people who live in a rural environment, with a long distance from the nearest mental health center and with difficulties using public transportation, which is why this program is very useful. In these patients to achieve clinical stability, since these patients had irregular follow-up in Mental Health consultations and had numerous admissions to Psychiatry.

None Declared

To ensure rational drug use, there is a need to continously monitor the use of medication for attention deficit hyperactivity disorder (ADHD) among children and adolescents.

The aim was to describe the use of ADHD medication among Danish children and adolescents.

We used data on filled prescriptions of ADHD medication to Danes aged 5-17 years between 2010 and 2020. We calculated the incidence rate, and prevalence proportion, and described treatment duration, age at initiation, prescriber type, and concurrent use of psychotropic medication. Analyses were stratified by age and sex.

The incidence rate of ADHD medication use followed a u-shaped pattern among boys from 2010-2020. This was most pronounced for boys 10-13-years old, with an incidence rate of 0.62 per 100 person-years in 2010, decreasing to 0.35 in 2013, and rising to 0.59 in 2020. The incidence rate among girls increased continuously from 2010 to 2020. The prevalence proportion increased in girls from 0.65% in 2010 to 1.04% in 2020 and in boys from 2.22% in 2013 to 2.65% in 2020. Girls started ADHD medication later than boys (median age 13 vs 11). Child- and adolescent psychiatrists issued 90% of initial prescriptions in 2010 with an increasing proportion over time. Sixty-four percent of 5-9-year-olds and 43% of 10-13-year-olds were covered by an ADHD prescription after five years compared to 27% of 14-17-year-olds. Approximately 20% users in 2020 had concurrent use of other psychotropic medication.

Use of ADHD medication increased in Denmark from 2010-2020. The steady increase in use among girls likely reflect an increased awareness of ADHD in girls. However, the delayed treatment onset in girls should be a focus of attention.

None Declared