In 1760, Charles Bonnet, a Genoese naturalist and philosopher, described the case of his grandfather, who experienced vivid, elaborate, and recurrent visual hallucinations and who also suffered from visual impairment. Bonnet himself later developed visual impairment and experienced similar symptoms. Since then, there have been multiple reports and cases in the European literature regarding this syndrome.

Auditory Charles-Bonnet syndrome describes a rare condition presenting with sensorineural hearing loss, which can result in auditory-musical hallucinations in the absence of an acoustic stimulus. It has been reported in patients with diseases such as psychiatric disorders and organic brain diseases. However, the most common are idiopathic musical hallucinations that occur along with deafness in elderly people. Musical hallucinations that accompany hearing loss may reflect impaired brain function.

We present the case of a 84-year-old woman with a long-standing history of depression, who also presents mild bilateral pantonal sensorineural hearing loss with associated subjective tinnitus, without other associated somatic and/or psychiatric symptoms. In addition, a CT study of the head was performed which revealed severe fronto-temporal cortical atrophy.

The treatment remains the subject of extensive research. Some authors have reported that hearing aids, antiepileptic drugs, benzodiazepines and antipsychotics can alleviate musical hallucination, which in the case of our patient was eradicated, so the contribution of this case could enrich the current bibliography.

This is unfrecuently presentation of Charles Bonnet symdrom.

None Declared

Autism Spectrum Disorder is a neurodevelopmental condition characterized by deficits in social communication, restricted and repetitive patterns of behavior. In recent years, there has been a growing interest in using virtual reality technologies for social skills training in individuals with ASD. Virtual reality offers the opportunity to create immersive and interactive virtual environments where participants can practice and enhance their social skills in a safe and controlled setting.

To analyze the quality of using virtual reality as a treatment method for patients with autism spectrum disorder to improve their social skills.

Through a descriptive systematic review, studies in Spanish and English from the years 2021 to 2024 were analyzed, selected from the databases PubMed, Scielo, and Lilacs, using the keywords: “Virtual reality”; “Autism spectrum disorder”; “Social skills”. Articles that did not address virtual reality as the main training method, were off-topic, or did not present results from this method were excluded.

Children and Social Skills

Programs like FaceMe use gamified environments to teach facial expressions, while tools like GameBook use interactive scenarios and augmented reality to reinforce these skills. VR’s ability to track and analyze eye movement patterns offers insights into social behavior. Programs like “Virtual Farm” and VR games such as Zentastic have demonstrated positive effects, with children engaging in various virtual social scenarios. Programs like VRESS use immersive scenarios to teach social skills that provide real-time feedback on behavior can help individuals develop self-awareness and adjust their interactions.

Adults and Social Skills

Adults with autism face challenges in non-verbal communication, understanding social cues, and forming relationships, which can lead to social isolation. VR offers simulations for practicing social interactions, enhancing communication, empathy, and conflict resolution. Programs like VRESS use immersive scenarios to teach social skills, and tools that provide real-time feedback on behavior can help individuals develop self-awareness and adjust their interactions.

The development of virtual reality systems for social skills training in individuals with autism spectrum disorders represents an innovative and promising approach to assisting in the development of these skills in both children and adults with autism. Virtual reality offers a more engaging and effective training experience, allowing users to practice social skills in a controlled environment tailored to their individual needs. Despite the promising results, there are still challenges to be faced, such as methodological issues and the need for awareness and training of health and education professionals.

None Declared

Autism spectrum disorder (ASD) and schizophrenia (SCH) are distinct diagnoses. However, they share common features such as high heritability, neurodevelopmental origins, and difficulties in social communication. Despite this, the etiology and precise pathophysiology of both conditions remain unclear, and no biomarker can definitively distinguish between them. In addition to higher-level cognitive and social-communication skills, autonomic regulation capacity is crucial for emotional regulation in social situations, which has been shown to differ in ASD and SCH according to the literature.

Our study, part of a larger research project, aimed to explore autonomic regulation in ASD and SCH by investigating heart rate (HR) and heart rate variability (HRV) as key markers of autonomic nervous system functioning. We measured these parameters during rest, relaxation (body scan), and cognitive tasks to assess changes in autonomic regulation capacity across different conditions.

Participants underwent an electrocardiogram (ECG) recording during a longer EEG experiment. We analyzed heart rate and HRV data from 114 participants (NASD= 38, NSCH= 37, and NNTP= 39), with a particular focus on the RMSSD parameter as a key marker of parasympathetic regulation. We hypothesized that HRV would be lower in ASD and SCH groups compared to neurotypical controls (NTP), with the differences between groups diminishing during tasks. The experimental setup avoided additional stressors outside of the social context of the study.

As hypothesized, we found significant differences in RMSSD between groups during the initial resting state (eyes open F(2,111)=6.314, p=0.003, ηp2=0.102, eyes closed (EC): F(2,98)=6.800, p=0.002, ηp2=0.122). Although HRV was nominally lower in the ASD group (EC: MASD= 26.10), only the SCH group (EC: MSCH= 19.77) showed a significant difference from the NTP group (EC: MNTP= 32.78) based on post hoc comparisons. Contrary to expectations, HRV did not significantly change in the SCH and NTP groups during tasks. However, in the ASD group, HRV increased after body scan relaxation and, notably, during cognitive tasks (group main effect in repeated measures ANOVA: F(2,105)=6.068, p=0.003). This suggests that the structured nature of the task may have a calming effect, observable in autonomic regulation.

Our findings indicate distinct autonomic regulation patterns in ASD and SCH, with structured situations potentially having a calming effect, particularly in individuals with ASD. In the next phase of our research, we will systematically examine the relationship between electrophysiological parameters and key symptoms such as attachment insecurity, mentalization deficits, disorganization, and the severity of clinical symptoms, all of which have significant implications for clinical conditions and everyday functioning.

None Declared

The potential role of inflammatory and immune pathways in ADHD pathophysiology and pathogenesis has received considerable recent attention. Some of these pathways are long-studied in ADHD because of known or suspected mechanisms of high frequency comorbidities, such as obesity, sleep disorders, cardiovascular system disorders/migraine, atopic illnesses, and several autoimmune diseases. Aberrant cellular functioning, aberrant glial functioning, and/or aberrant mitochondrial dysfunction have all been implicated in mechanistic studies. While we separate these mechanisms conceptually, in reality they are intertwined and communicate with each other in a multi-directional complex of mechanisms.

To introduce the relationships among inflammation, immune mechanisms and ADHD, and provide a high level overview of current and cutting edge research in this area. We will review data linking ADHD with inflammation and immunologic mechanisms, recent findings on the genetic underpinnings of medical comorbidity in ADHD, and the relationship between maternal inflammation and genetic risk for ADHD in offspring.

This is a focused, narrative review of recent literature in the field.

Epidemiological, genetic, and biomarker data converge to illuminate the pleiotropic role of immune mechanisms in the pathophysiology of ADHD. Suspected mechanisms include both innate and adaptive pathways. Epigenetic vulnerabilities interact with environmental factors to confer greater risk for health problems among individuals with ADHD. Likewise, many of these same risk factors also carry increased risk for ADHD.

This information exemplifies the close relationship between psychiatric and medical conditions and/or their risk factors. The high heritability of the immune system and associated immunological dysfunctions provides a novel approach to understand the mechanisms through which gene-environment interactions may contribute to the occurrence and clinical presentation of ADHD.

None Declared

Adolescence is a unique stage of cognitive, psychosocial and physical growth and development. This period is often associated with increased evening tendency, as well as increased risks for mental health and sleep problems. Insomnia is amongst the most common sleep problem in youths and is commonly associated with impulsivity and anxiety symptoms. Previous research suggested the comorbidity of insomnia and eveningness as a significant risk factor for anxiety symptoms in adolescents. Meanwhile, there has been some evidence suggesting that insomnia and eveningness are respectively associated with impulsivity. Nonetheless, the relationships among eveningness, impulsivity and anxiety in the context of insomnia remained unclear.

To investigate how circadian preference moderates the association between impulsivity and anxiety symptoms in adolescents with insomnia.

Adolescents aged 12-20 years old diagnosed of DSM-V insomnia disorder were recruited. They completed self-reported questionnaires, including the Morningness-Eveningness Questionnaire (MEQ) for assessing circadian preferences, Insomnia severity indexes (ISI) for assessing insomnia symptoms, the General Anxiety Disorder (GAD) scale to measure anxiety symptoms, and the Barret Impulsiveness Scale (BIS) for assessing impulsivity. Participants completed an objective cognitive task (the Balloon Analog Risk Task, BART) to measure risk-taking behavior. Their sleep was objectively assessed by 7-day actigraphy.

Eighty-eight participants were recruited into this study (age:18.20 ± 1.61 years). Among them, 44% of the participants were identified as eveningness type (MEQ < 42). There were no significant differences in anxiety symptoms and impulsivity based on both self-reported and behavioral task between circadian preferences (all p > .05). Circadian preferences was found to significantly moderate the association between self-reported impulsivity and anxiety symptoms after controlling age and sex factor (p = .009) but not the association between risk-taking behavior and anxiety symptoms (p > .05). Specifically, higher self-reported impulsivity was associated with more severe anxiety symptoms in adolescents with insomnia and eveningness (p = .006). No significant association was found between self-reported impulsivity and anxiety symptoms in non-eveningness group (p > .05).

The findings suggested the role of circadian preference in moderating the association between impulsivity and anxiety symptoms in adolescents with insomnia. Further research may explore different aspects of impulsivity and examine the causation between eveningness, insomnia, impulsivity and anxiety among adolescents in a longitudinal design.

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

Mental illness is a kind of change in mental health status which affected thought, feeling, emotion, behaviors, and so on. Labor work training is one of common rehabilitation programs in psychiatric medical institutes in Taiwan. This rehabilitation program has been implemented for many years, being an important indicator of psychiatric hospital accreditation. However, we couldn’t analysis and apply effectively.

We aim to investigate different labor work training performances of the patients with mental illness in a public psychiatric center in Taipei City. Furthermore, we can apply in shared decision making and modifying the labor work training project according to the data results.

In this cross-sectional study, 89 participants with mental illness who were stably engaged in labor work training for at least 1 month were included in Taipei City Hospital Songde Branch. Descriptive statistics will be used in characteristic of population, incentive record and score of the comprehensive occupational therapy evaluation scale (COTES). We used one-way ANOVA to test the difference of work behavior scores in different labor work training.

This study results showed that the percentage of participants in the cleaning labor group, manual group, and sales & delivery group were 15% (N=13), 49% (N=44), and 36% (N=32) respectively. The most people engaged in the manual group. The average total score of psychiatric patients’ work behavior was highest in the sales & delivery group (p<.05). There were significant differences at scores of work behavior items, including motivation (p=.006)、duration (p=.001), responsibility (p=.002), comprehension (p=.002), technique (p=.005), and fine motor coordination (p=.005).

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In comparison, the patients with mental illness in the sales & delivery group are better at work behavior. According to the analysis of the result data, when the therapist and the patient make shared decisions, they can discuss appropriate labor work training based on the patient’s work behavior.

None Declared

Sustained attention deficit is a core feature of schizophrenia, however, its between-subjects and within-subject fluctuations are little understood. Moreover, although the pertinence of sustained attention for daily functioning has been widely discussed in the literature, research has not consistently demonstrated this association in schizophrenia. One possible reason is a use with non-ecological tasks for evaluation of SA, which may not fully capture real-world attentional demands. Indeed, existing tools demonstrate low ecological validity.

This study aimed to develop daily-life task-based test of SA - Ecological Sustained Attention Task (Eco-SAT), and investigate its reliability and criterion, construct, and ecological validity in schizophrenia.

Eco-SAT was developed based on well-established CPT paradigm (320 trials presented for 500-3000ms, 12 min) simulating vacuum cleaning task. Twenty-one individuals with schizophrenia (age: M=42, SD=12.5; female: N=12, 57%) and 34 matched by age and gender healthy controls completed the Eco-SAT, non-ecological CPT, measures of cognition (MATRICS consensus cognitive battery: BACS, TMT, RBVMT & CFT), schizophrenia symptoms, and daily functioning using Observed Tasks of Daily Living test (OTDL, functional capacity) and Adults Subjective Assessment of Participation in daily life in an interchangeable order during one session.

Eco-SAT demonstrated excellent test-retest reliability for Average RT (ICC = 0.84). Schizophrenia patients performed Eco-SAT significantly worse than controls on Average RT (U=545, p < 0.01), and variance RT (U=518, p < 0.01). Eco-SAT showed correlations with non-ecological SA task (all parameters; 0.45<r<0.75, p<.001), MATRICS sub-tests of BACS (d prime, average RT, RT variance: -0.54<r<0.3, p<.5), TMT-B (average RT: r=0.3, p<.05), RBVMT (average RT, RT variance: -0.5<r<-0.4, p<.01), and CFT (average RT, RT variance:-0.35<r<-0.34, p<.001), positive schizophrenia symptoms (hit rate: r=0.3, p<.05) and the OTDL (RT variance, d prime, hit rate: -0.35<r<0.3,p < .05).

The study provides initial evidence of the psychometric properties of the Eco-SAT, an ecological measure of sustained attention in schizophrenia. Criterion validity was established for all Eco-SAT indices, while reliability, construct validity, and ecological validity were demonstrated for specific indices. The results suggest that average RT and RT variance are the most trustworthy indices. Although further research is required, these findings indicate that this ecological measure may offer a more accurate way to assess attentional deficits in real-world activities, enhancing our understanding of attentional mechanisms in schizophrenia for both research and clinical applications.

None Declared

The existentialist approach to psychopathology emphasizes the need to understand the conditions that allow for the emergence of psychological disorders, referred to as “conditions of psychopathologization.” This perspective, rooted in phenomenological methodology, rejects deterministic biomedical models, favoring a holistic view that considers the subject’s lived experience, freedom, and choice. Drawing on the work of Jean-Paul Sartre, this study aims to analyze how existential conditions such as past events, personal choices, and social contexts contribute to the development of psychopathological states.

The primary objective of this research is to explore the existentialist understanding of psychopathology, particularly focusing on Sartre’s contributions to making psychopathological experiences comprehensible.

Narrative review of relevant literature.

The findings highlight that psychopathological conditions often arise when individuals are alienated from their own projects of being. These conditions are shaped by personal histories, societal structures, and choices made in “bad faith” (self-deception). Past events, such as family dynamics, social oppression, and traumatic experiences, play a critical role in shaping the individual’s choices and actions. Sartre argues that when individuals distance themselves from their authentic desires and intentions they experience existential alienation, which manifests as psychopathology. A key result is the understanding that psychopathology should not be seen as a mere malfunction of the brain, as suggested by the biomedical model. Rather, it is a comprehensible event in the subject’s individual and social history. The deviation from an authentic life project is central to understanding the origin of psychological disorders.

Sartre’s existentialist framework offers significant contributions to the field of psychopathology by making psychological suffering comprehensible through the lens of personal freedom and choice. The rejection of a purely biomedical or deterministic approach allows for a more nuanced understanding of the individual’s psychological struggles as part of their broader life context. Psychopathology is thus seen as a breakdown in the relationship between the subject’s life project and their historical or existential situation, where the individual either chooses to distance themselves from their authentic self or is forced to do so by external contingencies. Sartre advocates for a “reciprocal” clinical relationship that recognizes the patient’s subjectivity, transforming the clinical space into one of genuine listening and understanding. This existentialist clinical model focuses on the subject-in-situation.

None Declared

In the past, traumas have always occurred and continue on a social and individual level in humanity’s journey to this day. While there were world wars, atomic bombs dropped on Hiroshima and Nagasaki, Nazi concentration camps, the events of September 11, the events in Bosnia and Herzegovina, and the Iraq wars, today the Ukraine war, the Israeli-Palestinian conflict and many more continue on a national and regional level, and are increasing day by day on an individual level.

The aim of this study is to offer a different perspective on mood changes in individual and social life after trauma.

In this study, qualitative and quantitative research methods were used.

From the perspective of quantum thought, matter is energy and this is expressed with Einstein’s famous formula e=mc2. From the perspective of quantum thought, an external effect on a system in equilibrium causes a temporal displacement, a new form of existence in that system. For example, when an external effect is applied to a system A, the new energetic position of the system A will be A’, and its temporal dimension will be t at the beginning, but will become t’ as a result of the interaction. This t’ can be called temporal displacement. Just as the disruption of the voodoo biological clock on an individual level causes psychological and emotional changes, it is possible that post-traumatic temporal displacement - this can be any kind of trauma - will cause mood changes and disorders in mood states on a social and individual level.

The aim of this discussion is to perceive how the breaks in the temporal and energy processes of societies and individuals can create changes in their emotional states in the context of quantum philosophy. In terms of quantum thought, every intervention made to the system from outside or inside causes a temporal shift and energetic changes in the system. This temporal shift should not be understood as a disruption of the biological clock, but should also be perceived as a new energy and a new form of existence in the time cycle of the system after the trauma.

None Declared

This presentation will provide an overview of existing research on crisis-support training in virtual reality, highlighting both the opportunities and challenges of utilizing this training method. It will review current research trends in the field, identify gaps in knowledge, and propose directions for future research initiatives. Studies on crisis-support training that utilize a virtual reality training approach for professionals working with children and adolescents will also be presented.

None Declared

Epilepsy is a common disease that is mostly treated with antiepileptic drugs (AEDs). The sexual dysfunction (SD) side effects related to the use of AEDs have not received sufficient attention.

The aims of this study were to assess the prevalence of SD and to study the role played by the AEDs among patients with epilepsy.

A cross-sectional and analytic study was conducted from September to December 2023, among patients with epilepsy follow up in the neurology outpatients of the University Hospital in Gabes (Tunisia), received AEDs, married for at least six months and sexually active. We collected the therapeutics data including type and number of prescribed AEDs and medication adherence, using pre-established form. SD was measured using the Arizona Sexual Experience Scale (ASEX) questionnaire.

Forty-five patients were enrolled (68.9% male and 31.1% female). The average age was 46.76 years (SD=12.39). The majority of patients had a low socio-economic status (64.4%). Carbamazepine and phenobarbital were the most commonly AEDs prescribed (57.8% and 53.3% respectively), especially as monotherapy (62.3%). Poor medication adherence was observed in 13 patients (28.9%). The frequency of SD among patients, based on ASEX questionnaire, was 44.4%. The factors associated with SD included carbamazepine and phenobarbital prescription (p=0.036 and p=0.045 respectively), double or multiple drug therapies (p=0.006) and poor medication adherence (p=0.033).

SD is very common in patients with epilepsy. This seems to be related to AEDs such as using of carbamazepine and phenobarbital, polytherapy and poor medication adherence.

None Declared

Lung cancer is one of the most frequent forms of cancer worldwide. Its prevalence has increased substantially the last decades. About 85% of all cases are non-small-cell lung cancer, which can be further divided in other subtypes. The use of targeted therapies and immune check-point inhibitors in the last years has improved survival, such is the case of tyrosin-kinasa inhibitors as lorlatinib. This molecule can reduce neoplastic growth when ALK rearrangement is present.

To review the literature about psychiatric adverse effects of lorlatinib.

A narrative review of the evidence was performed. The search was focused on described psychiatric adverse effects in patients with lung cancer who have received lorlatinib as antineoplastic agent.

We report the case of a 54-year-old man with lung adenocarcinoma stage IV ALK+ diagnosed in 2024. Suprarenal metastases were found. He started antineoplastic treatment with lorlatinib as first line agent during hospitalization, with a dose of 100mg per day. Three months later, the patient experienced anxiety and impulse phobias of aggressive content which led to an intense psychological distress and behavioural repercussion (avoidance, overcompensation). He consulted because of these symptoms and the dose of lorlatinib was reduced to 75mg per day by his oncologist. By the time he was evaluated in Psychiatry Service, the symptoms had improved but remained present. Low doses of aripiprazole were prescribed as symptomatic treatment (2,5mg per day) with great results manifested one week later.

Most common adverse effects of tyrosin-kinasa inhibitors are fatigue, gastrointestinal symptoms, skin reactions or edema, among others. Although neuropsychiatric adverse effects are infrequent, they can occur and induce significative impairment and emotional distress. It’s important to recognize these other symptoms, especially on new drugs, and know how to approach them properly.

None Declared

Cognitive impairments are strongly associated with impaired everyday functioning in individuals with schizophrenia, and cognitive remediation (CR) has been identified as effective treatment. However, uncertainty remains regarding the most effective components of CR.

To identify (1) the most effective combination of core ingredients of CR (cognitive exercises, presence of a therapist, cognitive strategies, and generalization activities) and (2) the most effective type of CR to improve everyday functioning in individuals with schizophrenia (computer-assisted cognitive remediation, single domain computer-assisted cognitive remediation, social cognition interventions, paper and pencil interventions, integrative approaches, and combination approaches).

PubMed, PsycInfo, Medline, Embase were searched literature from inception until November 25, 2022. Reference lists of included studies and previous meta-analyses were searched for relevant studies. We included randomized controlled trials comparing CR with any control condition or a different type of CR, assessing everyday functioning pre- and post-intervention in individuals with schizophrenia. The studies were selected independently by two reviewers. We followed the PRISMA guidelines. Study data were extracted independently by two reviewers. Data were analyzed using Bayesian random-effects network models. Trial methodological quality was evaluated with the Clinical Trials Assessment Measure. Risk of bias was evaluated. Primary outcomes were changes in functioning and cognition from baseline to after CR and from baseline to followup (min. 3 months). Literature search was updated in September 2024.

86 studies and 6076 participants were included. For both outcomes, the most effective constellation of core elements of CR were cognitive exercises, CR provided by a therapist and the use of generalization procedures (functioning: g = 0.31, 95% CrI [0.14, 0.47]; cognition: g = -0.23, 95% CrI [0.03, 0.42]). Moreover, only combinations that included both cognitive exercises and a therapist were more effective than TAU. All four core elements were necessary to observe improved functioning at follow-up. For the specific types of CR, none was superior to any other CR type. All CR types were more effective in improving functioning compared to TAU (g = 0.19-0.45). Study quality did not influence the results. Results will be updated if necessary after inclusion of the updated literature search.

The findings indicate that the effectiveness of CR depends on the inclusion of four essential elements—cognitive exercises, therapist involvement, strategies, and generalization activities—rather than on the specific type of CR intervention. An update to the definition of CR is recommended.

None Declared

Recent advancements in large language models (LLMs) demonstrate their ability to perform verbal generalization and simulate agency, opening new possibilities for innovative applications in psychotherapy. One promising avenue is the integration of LLMs into Eric Berne’s Transactional Analysis, a psychotherapeutic approach that conceptualizes human personality through three distinct ego-states: Parent, Adult, and Child.

To investigate the potential of LLMs in Transactional Analysis.

LLM capabilities described in the literature were compared with demands derived from the theory.

By examining the interactions among ego-states in Transactional Analysis, individuals can become aware of their behavior patterns and modify ineffective ones, fostering healthier relationships and improving social adaptation. Incorporating LLMs into Transactional Analysis offers a novel tool for psychotherapeutic interventions. Therapists could utilize AI to help clients recognize emotional experiences and identify maladaptive interaction patterns. By simulating the Parent, Adult, and Child ego-states, an LLM could engage in dialogues that reflect these internal states, allowing the client to explore and better understand their emotional reactions and needs. This interaction would enable clients to actively engage with different parts of their personality, promoting self-awareness and providing valuable insights into the causes of relational difficulties. While the potential benefits are clear, further research is needed to assess the practical effectiveness of integrating LLMs into Transactional Analysis. Empirical studies should investigate the degree to which LLMs can accurately simulate ego-states and contribute to positive therapeutic outcomes. Additionally, ethical considerations must be addressed to ensure that the application of AI in psychotherapy is both responsible and beneficial for clients.

The proposed approach fosters a deeper understanding of internal conflicts and provides a structured, controlled environment where clients can work through problematic situations.

None Declared

Some individuals might be more prone to acquire assertive behaviors earlier in their lifespan than others. Nevertheless, assertiveness can be learnt, and studies suggest that developing them would be beneficial in various fields, including healthcare and medical studies.

This study was conducted to assess medical students’ level of assertiveness, and to characterize the factors that might influence it.

A cross-sectional study was conducted, targeting a representative sample of undergraduate medical students. In total, 91 medical students agreed to participate in an online questionnaire survey. They completed a sociodemographic questionnaire as well as the French validated versions of Rathus Assertiveness Scale (RAS), Depression, Anxiety and Stress Scale, Rosenberg Self-Esteem Scale, General Self-Efficacy.

The response rate was 31.1%. Results showed that 53.8% of participants were considered nonassertive. Assertiveness training was requested by fifty-six students (61.5%). Moderate to extremely severe levels of depression, anxiety and stress were reported by 61.5%, 69.2% and 43.9% of participants respectively. Medical students who practiced individual sport or played music showed significantly lower RAS scores, indicating a higher level of assertiveness (p= .022 and p = .003 respectively). Rosenberg self-esteem scores and general self-efficacy scores were strongly correlated with assertiveness. Depression, anxiety and stress scores were strongly and positively correlated with assertiveness scores. Hierarchical regression analysis revealed that playing music, Self-esteem and self-efficacy were independent predictive variables of assertiveness with beta values of -.219, -.247, and -.209, respectively, explaining 44% of the model.

Assertive communication can provide medical students with an opportunity to become more effective in dealing with those around them, fostering better relationships, and promoting mental well-being. Reinforcing music and individual sports activities may serve as valuable preventive and interventional strategies to improve assertiveness in medical students.

None Declared

Schizophrenia is a chronic illness that causes severe disability and dysfunction.The traditional approach focusing on symptom control does not always result in improvement in functioning. Functional recovery is considered to be the achievement of social and occupational functioning and independent living in addition to symptom remission.Factors like negative symptoms, depression, cognitive dysfunction, treatment compliance, internalised stigma, and education impact functional recovery. MetS may impact functional recovery by contributing to depression, reducing treatment compliance, and impairing cognitive functions, but studies on this are limited.

This study aimed to investigate the relationship between MetS and functional recovery in schizophrenia, along with related clinical features.

The study sample included 115 schizophrenia patients aged 18-65, who applied to Gazi University Psychiatry Outpatient Clinic, spoke Turkish, no exacerbation in the last year.Exclusion criteria were serious medical/neurological illness, alcohol/substance use disorder.MetS was diagnosed per American College of Cardiology criteria. Functional Remission of General Schzophrenia Scale (FROGS), Schizophrenia Cognition Rating Scale (SCoRS), Positive and Negative Syndrome Scale (PANSS), The Calgary Depression Scale for Schizophrenia (CDSS), Medication Adherence Rating Scale (MARS), Schedule for Assesing the Three Components of Insight (SAI), Internalized Stigma of Mental Illness Scale (ISMI) scales were applied to all participants. SPSS 22.0 was used, and p<0.05 was considered significant.

The mean age of participants was 48.61, 54.8% were male and 44% had a high school education. MetS was 55.7% of patients.Patients with MetS had significantly lower scores of FROGS, showed more cognitive impairment in problem solving, there were no significant differences between the groups in the other variables examined.The proportion of patients with MetS (79.7%) showing low level of functionality was higher than those without MetS.The total score of FROGS was positively correlated with years of education, scores of MARS and SAI, while it was negatively correlated with age and CDSS scores.Among the components of MetS, fasting glucose level and diastolic blood pressure were found to be significantly correlated with the scores of the FROGS.The negative predictors of functioning were found to be education level, MARS scores, MetS, SCoRS attention domain and PANSS negative scores.

Our results show that MetS associated with lower functionality in schizophrenia. Therefore, good metabolic control in patients with schizophrenia is important for cognitive skills and functionality as well as physical health.

None Declared

Financial capability, which encompasses both financial competence and financial performance, is a key requirement for an autonomous and independent life. However, individuals with psychiatric disorders often report difficulties with financial capability and financial stress.

The current study aims to disclose the impact of affective disorders (AD) on financial performance using prospective data from wave 8 and wave 9 of the Survey of Health, Retirement and Ageing in Europe (SHARE).

The SHARE project includes individuals born on or before 1971 or households with at least one member meeting this age criterion. During each wave, participants reported whether they received one of 17 diagnoses, including “affective or emotional disorders, including anxiety, nervous or psychiatric problems”. Furthermore, monthly household net income and whether participants experienced difficulties in managing money, challenges in making ends meet, and their debt situation were recorded. The differences between the AD and a control group (i.e., participants without affective or neurological conditions) on monthly household net income and the three financial performances were examined for both waves. Logistic regression analyses were performed to analyze whether an AD diagnosis predicted financial performances in wave 8 and wave 9.

2,645 individuals reported an AD diagnosis in wave 8, and 47,068 were classified as controls. In wave 9, 3,574 individuals indicated having an AD diagnosis and 60,902 were classified as controls. In both waves, individuals with AD received a lower monthly household net income and reported more difficulties across all three financial performances relative to controls. Furthermore, in both waves, AD individuals reported having more debts on cars and other vehicles, debt on credit/store cards, loans, debts to relatives or friends, overdue bills, and other types of debts than controls. In wave 8, the odds of experiencing difficulties in managing money, making ends meet, and having debts were 3.61, 1.45, and 1.73 times higher, respectively, in AD individuals than in controls. A diagnosis of AD increased the likelihood of future (i.e., during wave 9) financial difficulties: 2.67, 1.38 and 1.68 times for managing money, making ends meet, and having debt, respectively.

Individuals with AD are more prone to experiencing impairments with both current and future financial performance and might face financial difficulties. The present study emphasizes the importance of recognizing financial difficulties in individuals with AD and offering financial assistance when necessary, especially since financial difficulties might exacerbate affective symptoms.

None Declared

Up to 10% of women experience severe anxiety symptoms during pregnancy and the postpartum period, which are often underdiagnosed and undertreated, leading to negative outcomes for both mother and child.

This observational study aims to assess: 1) the prevalence of Generalized Anxiety Disorder (GAD) in the postpartum period, and 2) identify its predictors.

All women attending the Gynecology and Obstetrics Department at “L. Vanvitelli” University Hospital were invited to participate in the study. Women who provided consent were assessed within three days after delivery using a specifically designed form for sociodemographic and clinical data collection, the Labor and Delivery Questionnaire (LDQ) for obstetric and gynecological information, and the Italian versions of the following assessment tools: Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder 7-item scale (GAD-7). A GAD-7 score of ≥10 was used as the cutoff for moderate to severe Generalized Anxiety Disorder.

A sample of 110 women with a mean age of 30.74 (±5.67) years, predominantly Caucasian (91.8%), was recruited. Of these, 18.8% (n = 20) had GAD-7 scores indicating a diagnosis of Generalized Anxiety Disorder. Compared to women without GAD, those with GAD were significantly more likely to be unemployed or face difficulty finding work (p < 0.05), have a family history of anxiety disorders (p < 0.05), have other children (p < 0.05), experience conflicts with their parents (p < 0.001), and score higher on the EPDS (p < 0.001). Logistic regression analysis showed a higher likelihood of having GAD among younger women (OR: – 0.029; p < 0.05), those with a positive family history of anxiety disorders (OR: 0.63; p < 0.05), and those with higher EPDS scores (OR: 0.044; p < 0.001).

The study highlights that age, employment status, and a family history of anxiety disorders may be significant predictors of GAD in peripartum period. Further studies with larger samples are necessary to confirm these findings; however, collaboration between psychiatrists, gynecologists, and obstetricians is recommended to identify women at risk of developing GAD early on, facilitating timely and appropriate diagnosis and treatment, and reducing the risks to the mental health of both mother and child.

None Declared

Deliberate self-harm (DSH) is a strong predictor of future suicide attempts (SAs), highlighting the need to evaluate interventions that reduce recurrence risk.

This systematic review and meta-analysis aimed to evaluate pharmacological and non-pharmacological interventions for preventing repeated DSH in individuals recently engaged in DSH. We also examined how participants’ characteristics and trial inclusion criteria impacted interventions’ effectiveness.

Randomized controlled trials (RCTs) with participants engaged in DSH within one month before enrollment were included. Studies with participants showing only suicidal ideation or older DSH were excluded. We searched five databases (PubMed, Embase, PsycINFO, WHO ICTRP, and ClinicalTrials.gov) with no language restrictions through September 2023. Two reviewers independently selected studies and resolved discrepancies through discussion. Outcomes were assessed at three time points: T1 (0–6 months), T2 (6–12 months), and T3 (>12 months). The primary outcome was repeat DSH; secondary outcomes included suicidal ideation, suicide deaths, all-cause mortality, anxiety, depression, hopelessness, and quality of life. Interventions were categorized by type and delivery format (individual or group, remote or in-person).

The PRISMA flowchart is shown in Image 1. Sixty-one trials involving 125 comparisons and 21,147 participants were included in this review. Average age was 31.5 years, with most being female (66.58%), unmarried (60.82%), and white (65.49%). Participants’ history of self-harm was noted in 48 studies, with at least 56% having engaged in another act before inclusion. In 42 studies, suicidal intent was either not investigated or not required. The most common types of interventions were Treatment As Usual (TAU) (46 arms), Psychotherapy (36), and Active Contact and Follow-up (25). Interventions were primarily applied individually and in person (84), with Cognitive Behavioral Therapy (16) being the most frequent psychotherapy framework. Psychotherapies were associated with a reduced risk of new self-harm acts within the first six months (T1) compared to TAU (k = 12; N = 2110; OR = 0.69; 95% CI 0.48–0.99). Active contact and follow-up interventions outperformed TAU in the longer-term follow-up (T3) (k = 4; N = 3724; OR = 0.83; 95% CI 0.70–0.99).

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The superiority of psychotherapies at six months was not sustained at twelve months. However, active contact and follow-up interventions may offer benefits in reducing the risk of self-harm recurrence after one year.

None Declared

Neuroinflammation and the Kynurenine Pathway (KP) have gained attention in the last decades in the pathogenesis of cognitive impairment in schizophrenia. Pro-inflammatory cytokines and microglia activation induce oxidative stress, neurodegeneration, white matter (WM) disruption and increased synaptic pruning and, importantly, activate the KP, whose metabolites have neurotoxic/neuroprotective and neuromodulatory properties on cholinergic and glutamatergic neurotransmission, two pivotal systems in cognitive processes.

This study aims to investigate the relationship between levels of inflammatory markers and KP metabolites and cognition in schizophrenia with a focus on the differential impact of these biomarkers on the different phases of the illness.

Associations between levels of biomarkers and cognitive domains in the wholw sample of 120 patients with schizophrenia were firstly assessed. Then, patients were divided in two subsamples depending on the duration of illness, with the aim to evaluate the impact of inflammatory biomarkers and kynurenines on cognition depending on disease progression. Finally, we performed cluster analysis to investigate kynurenines as possible clustering variables with the final aim to attribute a different cognitive profile to each cluster.

In the whole sample we found negative correlations between multiple inflammatory markers including IL-1β, IL-6, TNF-α, and cognitive functions, particularly verbal memory. Negative associations between verbal memory and TNF-a, IFNg and IL-5 were found in early-phase patients compared to late-phase patients, who showed a less strong associations. Interestingly, kynurenines showed significant associations with cognition in multiple areas regardless of the duration of illness. Regarding clustering, Cluster 1 included patients with lower levels of Tryptophan, Quinolinic Acid, and Kynurenic Acid, as well as higher levels of 3-hydroxykynurenine, compared to Cluster 2 (Fig. 1). Interestingly the two clusters showed different cognitive profiles. Verbal memory, psychomotor speed and attention significantly differed between the two clusters, with Cluster 1 showing the most impaired cognition in all these domains (Fig. 2).

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These results stress the primary importance of inflammation and KP abnormalities in cognitive impairment. The effects of inflammation on cognition seems to decline over time, while metabolites of the kynurenine pathway continue to have an impact. Probably, pro-inflammatory cytokines impact cognition more in patients with a shorter duration of illness as the biological bases of cognitive functions are more preserved (cortical volumes, synapses, WM integrity), whilw the neuromodulation of KP metabolites combined with their neurotoxic/neuroprotective profile can explain the diferential effect.

None Declared