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

Depression is one of the most common mental health disorders in children and adolescents. In India, many parents resist psychotropic medication for children due to potential side effects, highlighting the need for non-pharmacological interventions like yoga.

The current study investigates the impact of additional yoga therapy on depressive symptoms, global functioning, and parental stress among children and adolescents diagnosed with Major Depressive Disorder (MDD) on children seeking treatment at the Department of Psychiatry of a tertiary care medical institute in India.

This study included 80 participants aged 6 to 17 years. After taking written informed consent from the parents and assents from the adolescents, they were randomized into two groups: one receiving yoga Therapy alongside treatment as usual (TAU) and the other a waitlist control group receiving only TAU. Assessments were done on both children and their parents, and the instruments included were Centre for Epidemiological Studies Depression Scale for Children (CES-DC), the Children’s Global Assessment Scale (CGAS), the Clinical Global Impression scale (CGI), and the Depression Anxiety and Stress Scale (DASS) for parents. Follow-up assessments occurred at 6 and 12 weeks.

In the experimental group, CES-DC scores showed significant improvements, with p value < 0.01 at 6 weeks and < 0.01 at 12 weeks. Global functioning scores also improved, recording p values of < 0.01 at 6 weeks and < 0.01 at 12 weeks. The control group also exhibited results, with CES-DC p values of < 0.01 at 6 weeks and < 0.01 at 12 weeks. Global functioning scores revealed p values of < 0.01 at 6 weeks and < 0.01 at 12 weeks. However, there were no significant differences in the improvement in CES-DC score and functioning in the experimental and control group at the end of 6 weeks and 12 weeks. At the baseline, at end of 6 weeks and at the end of 12 weeks, there were no significant differences in parental depression, anxiety, and stress score.

Yoga therapy was beneficial for the children and adolescents with major depressive disorder. However, there were no significant differences in the improvement in depression and functioning in the experimental and control group.

B. Patra Grant / Research support from: The Department of Science & Technology, Govt of India under its scheme “SATYAM”, R. Sagar: None Declared, G. Sharma: None Declared

In the health field, healthcare workers (HCWs) need to be fulfilled to improve the quality of care. The mental health of these workers can affect the practice of their lifestyle habits.

Our study aims to assess the relationship between mental health and lifestyle habits among HCWs.

We conducted a descriptive, analytical and cross-sectional survey among HCWs using a self-administrated questionnaire. We collected socio-professional data. We assessed mental health using the depression anxiety and stress scale (DASS 21).

Our study included 200 healthcare workers, 71% of whom were female. The average age of participants was 42.9 years, with an average job tenure of 14.2 ± 10.1 years. We found that 12.5% of participants were smokers, 5% were former smokers, and 20.5% were passive smokers. Three participants were alcoholics, and none used drugs or chewed Neffa. Additionally, 32% of the population engaged in sports, with an average duration of 4.5 ± 2.9 hours per week.

According to the DASS21, 63% of participants exhibited symptoms suggestive of anxiety, 65.5% showed signs of stress, and 39.5% had depressive symptoms. We found that participation in sporting activities was associated with reduced anxiety (p = 0.04).

Our findings highlight a correlation between reduced anxiety and practicing sporting activities. It is crucial to encourage HCWs to maintain regular physical activity to promote an active lifestyle, reduce stress and improve mood in order to enhance the quality of care.

None Declared

Public perceptions regarding marriage in individuals with bipolar disorder are often influenced by societal stigma and misconceptions. These views can shape attitudes towards their suitability for long-term relationships. Misunderstandings about mental illness often create barriers to social acceptance.

This study aims to explore the general population’s perceptions of marriage involving individuals with bipolar disorder and assess how these views relate to broader affirming attitudes towards mental health.

Across sectional study was conducted via an online formulary shared on social media. It included a detailed description of clinical symptoms and outcomes of bipolar disorder along with 13 questions assessing the perception of the participants about marrying an individual with bipolar disorder. A battery for measurement of affirming attitudes was used, it comprised 3 self-report measures: The Empowerment scale(ES), the Recovery scale(RS) and the self-discrimination scale(SDS).

A total of 304 participants were included, with the majority aged between 20 and 30 years, 71 participant indicated that they were living with someone diagnosed with a psychiatric disorder. Results show that opinions on marriage for individuals with bipolar disorder are mixed. While 50.3% believe such individuals can marry, there is significant doubt about marriage improving symptoms with 63.5% disagreeing that it helps, and 61.8% rejecting the idea of marriage as a cure. Moreover, 53.0% believe that marriage could worsen symptoms. 55.9% would not personally agree to marry someone with this condition. Similarly, 58.6% would not approve of a relative marrying someone with bipolar disorder. However, despite these concerns, 80.6% agree that people with bipolar disorder have the right to make their own decisions concerning marriage.

Additionally, participants who expressed a refusal to marry someone with bipolar disorder (p<10^-3) had significantly higher RS scores. Moreover, participants who believed that individuals with bipolar disorder are dangerous to their partners exhibited significantly higher ES scores (p=0.036). Furthermore, a significant result was observed among participants who disagreed that individuals with bipolar disorder are capable of making decisions regarding marriage, these individuals demonstrated elevated scores on all three scales: RS (p<10^-3), ES (p=0.02), and SDS (p=0.01).

This study highlights the ongoing challenge of societal stigma towards individuals with bipolar disorder, particularly regarding marriage. While there are encouraging signs of changing attitudes among certain demographic groups, broader efforts are needed to foster a more inclusive and supportive societal perspective on this topic.

None Declared

Alterations in cognition and social cognition in bipolar disorder and schizophrenia have been largely documented. However, to which extent these alterations overlap between the disorders and how they are relevant to early stages as well as to risk conditions remains unclear. To shed light on this topic, 59 patients with Bipolar Disorder (BD), 118 patients with schizophrenia (SCZ), two independent cohorts of Healthy Controls (HC1=95, HC2=195), as well as individuals at Clinical High Risk (CHR=35) and at First Episode of Psychosis (FEP=29) were characterized for a series of cognitive and socio-cognitive features, which were entered in a machine learning analysis as a cognitive, a socio-cognitive, and a combined cognitive and socio-cognitive (stacking) classifier. Such classifiers were probed to discriminate at the single subject level BD vs. HC1 and SCZ vs. HC2. Then, those with the greatest diagnostic power in categorizing BD vs. HC1 were challenged to predict discrimination between SCZ vs. HC2, and vice-versa. Thus, decision scores for such models were compared with those obtained when they were applied to FEP and CHR. Results indicated that stacking classifiers were the best in discriminating HC1 vs. BD (Balanced Accuracy - BAC = 80%) and HC2-SCZ (BAC = 84%). Furthermore, the HC1-BD staking classifier successfully discriminated HC2 from SCZ (BAC=77.4%), and vice-versa (BAC=83.1%). Decision scores for SCZ and BD overlapped with those obtained when stacking models were applied to FEP, identifying a “patient-like” pattern. Differently, when such combined signatures were applied to CHR individuals, they were classified neither as patients nor as HC. Findings suggest an overall overlap of cognitive and socio-cognitive anomalies classifying schizophrenia and bipolar disorder, which is also relevant to early stages of disease. In this general context, disease-specific core abnormalities characterize SCZ and BD. Personalized rehabilitative programs may be oriented to primarily manage disease-related cognitive and socio-cognitive “hub” alterations, but always within a broader assessment.

None Declared

Nursing staff occupy a profession that requires significant mental, emotional, and affective demands. These caregivers are particularly vulnerable to psychosocial risks that can have significant impacts on their mental and physical health, as well as on the quality of care they provide.

To describe the psychosocial risk factors at work among nurses at SAHLOUL university hospital.

This is a descriptive cross-sectional study conducted among the nursing staff of SAHLOUL university hospital. Data was collected using a self-administered questionnaire. Data analysis was performed using SPSS 26 program.

A total of 95 nurses participated in the study. Almost all the nurses surveyed (95.8%) reported that their work constitutes a significant mental load. More than one-third of respondents (34.7%) frequently faced cases of death during their work. Most of the nurses surveyed (93.7%) felt demotivated regarding their work. Just over half of the nurses surveyed (51.6%) reported having been victims of a violent situation from a patient during their professional career. Regarding the results relative to the Karasek scale, we note that our population tends to utilize skills more than to be autonomous (35.56 vs. 34.36). Social support is generally low among our study population with an average score of 25.37±2.57.

There is psychosocial, and particularly professional, repercussions on the psychological state of healthcare personnel, which means that care workers’ mental health needs to be addressed. Occupational health services must detect the suffering of care workers and improve the psychosocial environment.

None Declared

Schizophrenia (SCZ), bipolar (BD) and major depression disorder (MDD) are severe psychiatric disorders that are challenging to treat, often leading to treatment resistance (TR). It is crucial to develop effective methods to identify and treat patients at risk of TR at an early stage in a personalized manner, considering their biological basis, their clinical and psychosocial characteristics. Effective translation of theoretical knowledge into clinical practice is essential for achieving this goal. We describe the methodology of the PROMPT project that aims at the development of a precision medicine algorithm that would help early detection of non-responder patients, who might be more prone to later develop TRD. In addition, we demonstrate other ongoing comprehensive protocols in Precision Psychiatry, such as the Horizon Europe funded PsychSTRATA consortium. To address these objectives, the PROMPT project which is organized in 2 phases will involve 300 patients with MDD already recruited in phase 1, comprising 150 TRD and 150 responders. In phase 2, a new naturalistic cohort of 300 MDD patients will be recruited to assess, under real-world conditions, the capability of the algorithm to correctly predict the treatment outcomes. Moreover, in this phase a shared decision making (SDM) process in the context of pharmacogenetic testing is explored and various needs and perspectives of different stakeholders toward the use of predictive tools for MDD treatment to foster active participation and patients’ empowerment are evaluated. In addition to this effort, the Psych-STRATA consortium addresses a major research gap in Precision Psychiatry through a seven-step approach. First, transdiagnostic biosignatures of SCZ, BD and MDD are identified by GWAS and multi-modal omics signatures associated with treatment outcome and TR (steps 1 and 2). In a next step (step 3), a randomized controlled intervention study is conducted to test the efficacy and safety of an early intensified pharmacological treatment. Following this RCT, a combined clinical and omics-based algorithm will be developed to estimate the risk for TR. This algorithm-based tool will be designed for early detection and management of TR (step 4). This algorithm will then be implemented into a framework of shared treatment decision-making with a novel mental health board (step 5). The final focus of the project is based on patient empowerment, dissemination and education (step 6) as well as the development of a software for fast, effective and individualized treatment decisions (step 7). Both the PROMPT study and the PsychSTRATA project have the potential to change the current trial and error treatment approach towards an evidence-based individualized treatment setting that takes TR risk into account at an early stage.

None Declared

Although workplace mental health screening is often implemented to aid early identification of mental health symptoms and facilitate access to treatment, supporting evidence is limited.

We aimed to evaluate the effect of independently conducted, confidential, online mental health screening, paired with automated tailored feedback recommending referral services, on help-seeking and psychological distress.

We conducted a cluster-randomised controlled trial with firefighters from an Australian fire and rescue service. Randomisation occurred by station (N = 264). Firefighters at stations allocated to the intervention group received tailored information detailing suitable mental health services based on their Kessler-6 psychological distress score (K6). The control group received generic feedback on services irrespective of K6 score. The primary outcome was help-seeking at 3-months post-intervention for those with at least moderate levels of psychological distress at baseline (K6 ≥14). The study was registered with Australian New Zealand Clinical Trials Registry (no. ANZCTR 12621001457831).

Of the 459 firefighters screened, 141 (30.72%) scored ≥14 on K6. Among this subgroup at 3 months, no differences were observed in rates of overall help-seeking between the intervention and control groups (P = 0.31). In contrast, levels of psychological distress remained high in the intervention group but declined in the control group (t[111] = 2.29, 95% CI: 0.24, 3.23, P = 0.024). The difference in psychological distress associated with workplace mental health screening equated to an effect size of −0.42 (95% CI: −0.04, −0.79).

Our findings suggest that independent, confidential online mental health screening, paired with tailored online feedback and information on available treatment, does not significantly increase help-seeking and may sustain psychological distress over time compared with receiving generic information. As such, it should not be implemented to promote help-seeking and reduce levels of psychological distress. These findings are relevant for workplaces, mental health researchers and practitioners alike, highlighting the potential risk and potential harm of mental health screening conducted in this way on individuals.

Catatonia is a severe neuropsychiatric condition with distinct motor, behavioural, and affective abnormalities that can manifest suddenly and dramatically. While it is commonly associated with psychiatric disorders, catatonia can also emerge in the context of various medical conditions, including malignancies.

This report details the case of a 68-year-old female with lymphoma who developed sudden-onset catatonia, highlighting the complexities of diagnosing and managing this rare complication.

The patient presented with symptoms of unresponsiveness and aphasia, acutely in the department just a few hours after the nurses reported, she had been confused during the night shift and had visual hallucinations. First the neurologist was consulted. Neurological examination revealed unresponsiveness to verbal or pain stimuli, flaccid muscle tonus, no plantar response, normal reflexes, staring gaze, blinking and resistance to open eyelids. Corneal and oculocephalic reflex including cardiorespiratory functions were normal. Due to the acute nature of the symptoms and history of iatrogenic subdural hygroma a trial with anticonvulsant was performed, with no improvement. CT scan, MRI scan and EEG were unremarkable. Results of the lumbar puncture ruled out any inflammation, infection or lymphoma infiltration.

Since the clinical findings did not correlate with test results, the neurologist consulted the psychiatrist. The patient was promptly treated with lorazepam 2 mg intramuscularly, which is the first-line treatment for catatonia. Within 2 hours of initiating treatment, there was a noticeable improvement in her responsiveness. Over the next 24 hours, she regained the ability to speak and follow commands. The decision was made to continue lorazepam 2 x 1 mg per day plus 2 x 1 mg if needed. After three days the consultation psychiatrist came to do a checkup and found the patient talking slowly and quietly, with some anxiety symptoms, but no apparent mood disorder or delusions or hallucinations. The patient was prescribed antidepressants and continued lorazepam treatment. The psychiatrist tried to decrease the lorazepam dose before the patient discharge, which resulted in worsening of her mental state. Lorazepam dose was again raised to the previous effective dose. She was discharged with sertraline 50 mg and lorazepam 2 x 1 mg. The patient had a checkup a month after being discharged. At the checkup she presented not only without any signs of catatonia, but in complete remission of any mood or anxiety or psychosis symptoms. At that point, the lorazepam dose was reduced, with the intention of keeping only the antidepressant therapy.

Catatonia is a rare and serious complication for patients with lymphoma, and recognizing it constitute a challenge as demonstated by this case. However the lorazepam challenge test still remains a great diagnostic treatment.

None Declared

Burnout and mental health issues have become increasingly prevalent among psychiatry trainees and early career psychiatrists, posing significant challenges to their well-being. This presentation explores the multifaceted relationship between psychiatry training environment and the occurrence of burnout, characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. Factors contributing to the severe burnout in psychiatry trainees include long working hours, lack of supervision, and not having regular time to rest (Jovanović N. et al., 2016). Other potential factors described include the high demands of clinical responsibilities, emotional strain from patient interactions, and inadequate support systems. Encountering possible suicidal patients and coping with patients’ violence are other factors that can have a strong influence on psychiatry trainees and early career psychiatrists’ clinical activity, especially in the absence of appropriate training in the field and supervision (Chumakov E. et al., 2022; Longo G. et al., 2023). Studies indicate that a significant proportion of psychiatry residents experience symptoms of mental distress (Pitanupong J. et al., 2024; Toni F. et al., 2024) with depression being an important source of impaired mental well-being. Furthermore, the stigma surrounding mental health within the medical community often discourages trainees from seeking help, exacerbating feelings of isolation and distress. There’s no question that poor mental health can affect not only psychiatry trainees and early career psychiatrists’ personal health but also their professional development and patient outcomes. In this presentation the implications of these issues for the psychiatry field will be discussed. There’s a growing demand for advocacy for comprehensive training programs that integrate wellness strategies, enhance supervision, and promote open conversations about mental health. By fostering a supportive environment and prioritizing self-care, the psychiatry community can mitigate the risks of burnout and mental disorders among peers, ultimately leading to a more resilient workforce and improved patient care. This presentation underscores the need to support the mental health of future psychiatrists and ensure the integrity of mental health services.

None Declared

Nightmares have been linked to childhood trauma and an increased risk for mental health problems, such as depression. Meanwhile, there is a high comrobdity of nightmares and insomnia. Yet relatively few studies have compared the clinical presentations of nightmares in different clinical groups. Additionally, considering the close association between childhood trauma, insomnia, and depression, there might exist potential unique interactions between childhood trauma and clinical diagnoses on nightmare experience.

This case-control study aimed to compare nightmare-related parameters (i.e., frequency, distress, severity, and impairment), and childhood trauma among adolescents with depression only (DG), insomnia only (IG), and healthy control (HG) groups. We explored the interaction between diagnosis and childhood trauma on nightmare parameters.

Participants completed a clinical interview to ascertain their eligibility. Data on demographic and clinical information, childhood trauma as assessed by the childhood trauma Questionnaire (CTQ) , and nightmare-related parameters, including nightmare frequency, nightmare distress, nightmare severity, and nightmare impairment, were analysed in the current study. Analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA) were used to examine the group differences, and regression analysis was used to examine the interaction effect on study variables.

Adolescents with insomnia (N = 31; age 16.84 ± 1.88 years; female: 54.8%), female: 55.2%), depression (N = 22; age 17.50 ± 2.18 years; female: 54.5%) and healthy controls (N = 31; age 16.84 ± 1.88 years; female: 54.8%) were recruited. Compared to the HG, the IG and DG had greater nightmare distress (IG: p = .024; DG: p =.005) and nightmare impairment (IG: p = .007; DG: p = .031), but not nightmare frequency. However, only DG showed significantly higher nightmare severity (p = .038). No other significant differences were found in nightmare parameters between IG and DG (all p > .05). For childhood trauma, only DG showed significantly higher scores in emotional abuse (p =.013), emotional neglect (p = .021), and physical neglect (p = .012). No interaction effect of childhood trauma and clinical diagnosis was found on nightmare-related parameters (all p > .05).

This study showed that adolescents with insomnia or depression exhibited greater nightmare-related distress and impairment. Higher nightmare severity may be a unique characteristic in adolescents with depression but not for insomnia. Despite the depression group reporting significantly more childhood traumatic experiences, the potential interaction effect between diagnosis and childhood trauma was not observed on nightmare-related parameters. Future research may examine the relationship between the relevant variables in a larger sample size using a longitudinal design.

Y. Li: None Declared, H. F. Sit: None Declared, Y. L. Wong: None Declared, S. X. Li Grant / Research support from: This work was funded by Seed Fund for Basic Research, The University of Hong Kong and General Research Fund (Ref. 17613820), Research Grants Council, University Grants Committee, Hong Kong SAR, China.

Mental health disorders are a leading cause of disability in European Union countries. Previous evidence highlighted the role of socioeconomic inequalities on unmet mental health care needs, varying by income or education. Being both reducing inequalities’ gaps and mental health promotion current goals of European Union (EU), it is essential to understand the differences between EU countries and the role of socioeconomic factors on this.

The study aims to assess the socioeconomic inequalities on unmet needs for mental health care in EU countries in 2019.

This was a cross-sectional study using data from the 2019 European Health Interview Survey across 26 EU countries. The main outcome considered was the proportion of self-reported unmet needs for mental health care due to financial reasons. Inequalities for income, education and degree of urbanization were assessed by calculating the rural-city, primary-tertiary education and lowest-highest income quintiles, respectively.

The proportion of self-reported unmet need for mental health care in 2019 ranged between 1.1% (Romania) and 27.8% (Portugal), with a median of 3.6%. Regarding income inequality, all countries except Hungary (ratio=0.88) showed highest share of unmet need among inhabitants with the lowest income quintile. The country with the highest inequality was Greece with a ratio of 23.8. Regarding education inequality, 15 out of 26 countries showed that less educated inhabitants had highest unmet needs of mental health care, with values ranging from 0.5 in the Netherlands and 7.2 in Bulgaria. As for degree of urbanization, rurality showed lowest unmet needs for 21 out of 26 countries, with the highest ratio being 2 in Romania.

The study highlights significant and wide socioeconomic (income, education, and urbanization) inequalities in unmet mental health care needs across EU countries.

While income inequality plays a similar role across EU countries with the poorer quintile showing higher unmet needs due to financial reasons, EU is divided on the role that education plays. On the opposite side, there is also a tendency across the EU for rural areas showing lower unmet needs for mental health care. Policymakers should prioritize strategies to ensure financial access to mental health services, as well as promoting mental health literacy and improve service availability for vulnerable populations.

J. V. Santos Conflict with: This article was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020), V. Pinheiro: None Declared

Diagnosing psychiatric conditions that involve the intentional or unconscious production of symptoms remains a significant challenge in clinical practice. This presentation examines a clinical case that highlights the difficulties in distinguishing between Factitious Disorder, Conversion Disorder, and Simulation. A 34-year-old woman was admitted with sudden onset of neurological symptoms, including pseudo epileptic crises. Her symptoms fluctuated inconsistently with clinical observation and failed to correlate with established neurological patterns, raising the suspicion of Conversion Disorder. However, further investigation revealed inconsistencies in her medical history and a pattern of seeking unnecessary treatments, suggesting the possibility of Factitious Disorder. Additionally, external incentives, such as the potential for financial compensation, prompted consideration of Simulation. The case presents a diagnostic dilemma that underscores the overlapping features of these conditions.

Neuroimaging may provide valuable insights into the case, supporting the exclusion of neurological pathologies but also subtle changes in brain activity in the areas involved in emotional regulation and self-representation, which may suggest the involvement of underlying psychological factors common in both Conversion and Factitious Disorder.

This case exemplifies the critical nosological challenges in differentiating between Factitious Disorder, Conversion Disorder, and Simulation. It highlights the importance of a comprehensive clinical approach, including neuroimaging, thorough psychological assessment, and consideration of psychosocial factors. The discussion aims to deepen understanding of these complex disorders and promote more accurate and nuanced diagnostic practices in psychiatry.

None Declared

Bipolar disorder, like other severe mental illnesses, is considered to be a condition with an increased risk of unsafe sexual practices [1]. Unsafe sex in bipolar disorder has been empirically linked to manic episodes due to symptoms of hypersexuality, cognitive impairment and substance and alcohol abuse.

Unprotected sex poses health risks for both sexes in terms of sexually transmitted diseases, but for women it also means a risk of unplanned pregnancy. Unplanned pregnancies can have negative consequences for the health, social and psychological lives of women and children [2].

Translated with DeepL.com (free version)

To assess reproductive health and unplanned pregnancies in patients with bipolar disorder followed and hospitalised at the Arrazi psychiatric hospital in Salé.

This was a descriptive cross-sectional study using a questionnaire including sociodemographic and clinical criteria as well as questions on the sex life of patients with bipolar disorder type I or II, questions on contraception, and on pregnancies and their outcomes.

Inclusion criteria: women with bipolar disorder type I or II.

Exclusion criteria: psychosis, intellectual disability.

The average age of the participants was 33 years. 68% were married and 57% had children. The majority were unemployed (87%). 85% had a substance use disorder. 61% had type I bipolar disorder and 44% were hospitalised, with the remainder receiving outpatient treatment. Almost all the patients were sexually active at the time of the study, and 88% had only one sexual partner. 77% were using contraception, mainly the pill. The average age of first pregnancy was 22 years. 66% of pregnancies were unplanned. 89% gave birth and 11% had abortions.

Bipolar disorder, like other serious mental illnesses, is considered to be a condition with an increased risk of unsafe sexual practices. Female patients with bipolar disorder have an early age of onset of sexual activity. This leads to frequent unplanned pregnancies. These unplanned pregnancies can have negative consequences for the health, social and psychological life of women and children. Clinicians must be aware of reproductive health and take steps to improve access to family planning when treating young women with bipolar disorder, in order to avoid negative consequences.

None Declared

Quality of life (QoL) is a comprehensive concept encompassing an individual’s satisfaction with various aspects of life, including material, social, spiritual needs, intellectual and physical development, and safety. During the COVID-19 pandemic, the quality of life in Russia declined due to environmental and social disruptions. Behavioural self-regulation, which reflects an individual’s ability to manage internal and external conditions, plays a key role in adapting to challenging situations. Thus, exploring the relationship between QoL and self-regulation styles can provide insight into adaptive behaviours under pandemic conditions.

The study aimed to explore the interconnections between quality of life and self-regulation styles in humanities students and people living with HIV during the second wave of COVID-19.

Data were collected from January to July 2021 via a Google form. Participants included 35 Russian university students in humanities and 59 HIV-positive patients. Self-regulation styles were measured using V.I. Morosanova’s “Style of Self-Regulation of Behaviour” questionnaire, and quality of life was assessed with the WHOQOL-BREF, adapted for Russian respondents.

In the group of students positive correlations of physical and psychological well-being with programming (rs = 0.405, p < 0.05); self-perception — with programming (rs = 0.522, p < 0.01), evaluation of results (rs = 0.586, p < 0.01) and general level of self-regulation (rs = 0.389, p < 0.05); microsocial support — with evaluation of results (rs = 0.336, p < 0.05) were found. In the patient group, physical and psychological well-being were associated with outcome evaluation (rs = 0.343, p < 0.01); self-image — with modelling (rs = 0.605, p < 0.01), outcome evaluation (rs = 0.467, p < 0. 01), flexibility (rs = 0.444, p < 0.01) and overall level of self-regulation (rs = 0.439, p < 0.01); microsocial support — with modelling (s = 0.366, p < 0.01); social well-being — with modelling (rs = 0.442, p < 0.01) and flexibility (rs = 0.346, p < 0.01).

The study found that self-perception was the most frequently correlated factor with self-regulatory behaviour in both students and HIV-positive group, indicating that satisfaction with life, sense of purpose, and emotional stability contribute to self-regulation even in challenging conditions. However, social well-being was a unique influencing factor for people living with HIV, highlighting a dependency on material and societal conditions that was less pronounced in student’s group. This suggests that HIV patients are more sensitive to social and environmental stability, whereas students rely more on internal self-regulatory mechanisms for adaptation.

None Declared

Alcohol dependence is a chronic condition associated with multiple relapses, leading to recurrent admissions to inpatient units. The success of treatment is closely tied to the psychosocial rehabilitation of these patients, as a means to ensure long-term abstinence.

We aim to characterize the psychosocial profile of frequent users of an Inpatient Alcohol Detoxification Unit in Lisbon and to reflect on the need for psychosocial interventions to prevent relapse risk.

A retrospective analysis of data collected from the clinical records of patients admitted two or more times within one year to an Alcohol Detoxification Unit in Lisbon, during the period between January 2022 and December 2023.

During the study period, 37 patients with two or more admissions in a year were identified. The average age was 51.9 years, and 67.6% were male. It was found that 48.6% of the patients were divorced or separated; more than half of the patients were unemployed at the time of admission (62.2%), and nearly half were experiencing financial hardship (48.6%). In terms of integration into rehabilitative and abstinence maintenance structures, 40.5% had attended the Day Care Center of the Hospital Center, and only 5.4% had been part of a Therapeutic Community (TC). Before their last admission, 8.1% of the patients had been referred to a TC, 10.8% to the Day Care Center, and 51.4% to outpatient care, while 24.3% left against medical advice. In contrast, during the last admission in the study period, 13.5% were referred to the Day Care Center, and 35.1% to a TC.

The results highlight the need for psychosocial intervention and rehabilitation in patients with alcohol use disorder. Treatment should include a multidisciplinary approach that takes into account socioeconomic support and integration into rehabilitative structures, as these promote long-term abstinence and therapeutic success.

None Declared

Although the importance of advance care planning (ACP) for individuals with adult congenital heart disease (ACHD) has been established, there is no consensus regarding the optimal age to initiate ACP discussions. We asked ACHD patients their opinions about the timing of the first ACP discussion.

Adult patients seen in an outpatient ACHD clinic from April to August 2018 completed a self-administered questionnaire that evaluated opinions regarding the content and timing of ACP discussions, end-of-life communication preferences, and anticipated emotional responses to ACP discussions.

Ninety-five patients participated. Median age was 34.8 years (Q1 – Q3: 28.4 - 47.1 years), 53% (n = 50) were female, and 91% (n = 86) had great or moderate disease complexity. Although 75% (n/N = 69/92) thought ACP was important, only 37% (n/N = 35/94) had completed advance directives. Most (79%, n/N = 72/91) preferred ACP conversations early, either before getting sick (44%, n = 40/91) or when first diagnosed with a life-threatening illness (35%, n = 32/91). Responses varied regarding the appropriate age for first ACP conversations: 28% (n/N = 25/88) chose options ≤ 15 years, 23% (n/N = 20/88) 16–17 years, 32% (n/N = 28/88) 18–20 years, and 17% (n/N = 15/88) ≥ 21 years old.

ACHD patients value ACP discussions and think they should occur early in the disease course, before patients face a life-threatening disease complication, yet most think these conversations should wait until later adolescent or young adult years. ACP readiness should be assessed to determine the optimal timing of ACP discussions.