Psychiatric disorders,such as anxiety,depression,bipolar disorder and schizophrenia,remain major global health challenges. Although prevalence has not recently increased, mental health care struggles with early diagnosis, real-time monitoring and personalized treatment. Traditional methods, relying on self-reports and clinical assessments,often miss the dynamic nature of these conditions.AI and wearable technology offer a new approach, enabling continuous data collection and real-time analysis to improve early detection and optimize patient care

This study aims to assess the role of AI-driven wearables in diagnosing,monitoring and managing psychiatric disorders by:

Evaluating AI’s effectiveness in predicting psychiatric episodes using wearable sensor data

Exploring clinical applications to improve patient outcomes

Identifying challenges and ethical considerations in the broader use of this technology in mental healthcare

A systematic review of studies(2018-2023)on AI and wearable technology in psychiatry was conducted using PubMed, Scopus and Google Scholar.Studies were selected based on their focus on AI-driven wearables for predicting or managing psychiatric conditions.These devices typically captured physiological and behavioral data,such as heart rate variability,sleep patterns and movement.The accuracy of AI algorithms in predicting psychiatric episodes was compared to traditional methods,with statistical analysis used to assess outcomes

The review showed that AI-driven wearable devices significantly improved early detection and prediction of psychiatric episodes,with accuracy rates over 80% for depression, anxiety and bipolar disorder.Wearables,combined with AI algorithms, effectively monitored physiological data like heart rate and sleep patterns,providing real-time insights for personalized, timely interventions.For example,changes in sleep and activity levels,alongside heart rate variability,strongly predicted depressive episodes.In patients diagnosed with bipolar disorder,AI detected mood swings early by analyzing behavioral data from wearables,enabling stabilization.Wearables also helped monitor medication adherence and reduced relapse rates in patients diagnosed with schizophrenia by identifying early signs of psychotic episodes

AI-driven wearable technology has the potential to transform psychiatric care by enabling continuous monitoring and personalized interventions.These tools enhance early detection and prediction of psychiatric episodes,offering a more dynamic approach than traditional methods.However,challenges such as data privacy, ethical concerns and the lack of regulatory frameworks must be addressed before widespread clinical use.Further research is needed to refine AI algorithms,validate the long-term effectiveness of wearables and ensure patient safety through regulations and privacy protections

None Declared

Substance use and mental health problems commonly co-occur. Yet, people experiencing both problems commonly face barriers to getting the support they need and experience increased physical morbidity and premature mortality, compared to those with only one problem. In the UK, current guidance on treatment of co-occurring alcohol and mental health problems exist which set out standards for ways of working with this population, and how and where treatments should be offered.

Through a secondary qualitative analysis and a systematic review, we aimed to determine the extent to which the UK guidance for care for people with co-occurring problems is being implemented.

A secondary qualitative analysis was conducted of interview transcripts from people with co-occurring depression and hazardous/harmful alcohol (N = 39). In addition, a systematic review was conducted to identify studies published in the UK since 2017 which focueds on treatment for adults with co-occurring substance use and mental health problems. For both data sources, a deductive coding framework was developed based upon the UK guidance and a thematic analysis was applied.

The qualitative analysis identified four key themes from the service user perspective: Wrong doors and stigma; Responsibility and coordination of care; ‘Don’t discharge me’ and Impacts of gaps between services. The review identified three main themes: Challenges to care for co-occurring conditions; Integration of care; and System and structural level barriers. Both studies showed that making initial contact with services was challenging, as was continued engagement with treatment. Staff attitudes and knowledge were important, because the therapeutic alliance had a significant impact on treatment outcomes and recovery. Stigma, both intrinsic and extrinsic, was identified as a barrier to accessing, engaging with, and delivering support. Both studies found evidence of inconsistent treatment offerings and conflicting advice or support, especially around the most appropriate way to treat co-occurring conditions. Barriers and facilitators were evident across individual, organisational and systems levels. Findings indicate that people are often not receiving the care they need in the ways in which guidance recommends.

The results suggest that despite existence of current guidance in the UK, implementation is inconsistent. This work has identified specific areas for improvement around access to treatment and a need for better coordination and integration of care. It highlights the need to explore how guidance can be better embedded in current practice to improve experiences and outcomes for this population.

None Declared

Depression is a prevalent yet frequently underdiagnosed condition in patients with dementia, exacerbating cognitive decline and emotional health. The combination of depressive symptoms with dementia-related cognitive deficits complicates accurate diagnosis and management of depression in this group of patients. Improved diagnostic instruments specifically designed for dementia patients are essential for improving detection and treatment outcomes.

To evaluate the prevalence and diagnostic challenges of depression in dementia, focusing on symptom overlap. Additionally, it aims to assess the efficacy of diagnostic tools and management strategies to improve patient outcomes.

A systematic review of the literature was performed to evaluate the prevalence, symptomatology, and diagnostic difficulties of depression in dementia.

The results reveal a substantial intersection between the cognitive and emotional symptoms of dementia and depression, encompassing apathy, anhedonia, and mood disorders. The coexistence of these symptoms frequently results in the underrecognition of depression or its misattribution to the dementia process. Instruments such as the CSDD and NPI showed higher sensitivity in identifying depression among dementia patients. Pharmacological therapies, including psychotherapy and individualized behavioral interventions, demonstrated improvements in mood and cognitive function; nevertheless, therapeutic success fluctuated according to the stage of dementia.

Depression in dementia patients has distinct diagnostic and treatment issues owing to symptom overlap and cognitive deterioration. Enhanced diagnostic instruments, including the CSDD, NPI, and GDS, provide superior distinction of depression symptoms from dementia-related deficits. Early recognition and tailored treatment strategies, integrating pharmaceutical and behavioral interventions, may alleviate depression symptoms and enhance overall patient outcomes. Interdisciplinary collaboration is crucial for enhancing care.

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During the last decades, clinical practice for patients with first-episode psychosis has shifted to early intervention programmes that aim to accelerate access to treatment and also ensure adherence to antipsychotic (AP) medication. However, recent pragmatic, randomised controlled trials still report very high discontinuation rates of the initially prescribed AP treatment due to lack of efficacy, side effects, or other reasons. The CLinical Utility of early intervention including the 5-Step Precision Medicine (5SPM) Method in first-episode Psychosis (CLUMP) Project is a translational research initiative focused on improving adherence to antipsychotic medications and therapeutic outcomes in first-episode psychosis patients using pharmacogenetics. We present a preliminary descriptive analysis of this project based on a retrospective cohort.

• - To establish discontinuation rates of the first antipsychotic treatment administered to patients with a first-episode psychosis before the implementation of the CLUMP project.

• - To describe reasons for such discontinuations.

We conducted an observational study on a consecutive, retrospective cohort of 49 patients who experienced a first-episode psychosis in Salamanca, Spain, before the implementation of CLUMP, in order to subsequently determine the impact this project might have on AP treatment discontinuations. We reviewed their clinical records to collect variables such as sex, age, first prescribed antipsychotic medication, and any discontinuation within the first year post-treatment initiation, recording reasons for discontinuation or treatment changes, such as lack of efficacy, non-adherence, side effects, or others.

Of the 49 patients included in the analysis, 7 were excluded due to inaccessible information, leaving a final sample of 42 (26 males). Age ranged between 16 and 48 years, with a mean age of 25.9 (9.2). 38 patients (90.47%) discontinued treatment within one year, with similar rates in men (92.3%) and women (87.5%) (See Figure 1). 16 reported side effects as the main reason for discontinuation, 1 lack of efficacy, 9 lack of adherence, and 12 other reasons (Figure 2). Among the 16 who discontinued due to side effects (Figure 3), 3 experienced extrapyramidal symptoms, 3 drowsiness, 3 sexual dysfunction, 2 hyperprolactinemia/galactorrhea, 1 metabolic syndrome, 1 excessive salivation, and 3 did not specify the symptom.

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Most patients in our sample discontinued antipsychotic treatment within the first year post-treatment initiation, mainly due to side effects. These data indicate the need to restructure clinical care for patients with first-episode psychosis to ensure adherence to AP and reduce trial-error approaches to treatment choice from start. The CLUMP project proposes an individualised strategy, based on pharmacogenetics, to improve therapeutic adherence and outcomes in patients with FEP.

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While many evidence-based mental health prevention, promotion, and treatment interventions exist, they are poorly and inequitably scaled across populations. Too often, research produces interventions and implementation strategies that are difficult to scale due to misalignment with culture, policy, system, community, provider, and individual realities. This presentation will introduce the Lancet Psychiatry Commission on Transforming Mental Health Implementation Research, which makes five recommendations to transform the research enterprise to produce more actionable evidence and address the mental health implementation gap. These recommendations focus on strategies for integrating research and real-world implementation; centering health equity in mental health intervention and implementation research; using a complexity science lens to study strategies for scaling effective interventions; expanding research designs beyond the traditional randomized clinical trial; and using transdisciplinary approaches. The Commission also made cross-cutting recommendations related to elevating work on mental health systems and policy and the importance of strengthening mental health implementation research globally.

None Declared

Cannabidiol (CBD) is a non-psychoactive cannabinoid with therapeutic potential in various fields, such as its effect on mental health or antiepileptogenic, among others. For this reason, the interest in research on the potential effects of this substance is booming and the sale and consumption by the general population is increasing.

To describe the observed effects of CBD use during treatment with electroconvulsive therapy (ECT).

To describe in detail the clinical case and to correlate the changes observed in the seizures and the electroencephalogram (EEG) of the ECT sessions when the patient performed concomitant consumption of CBD, in addition to the changes at the clinical level that he experienced during this period.

The subject is a 47-year-old man who required admission for a psychotic decompensation of his schizoaffective disorder bipolar subtype. In recent years, he had no adherence to psychopharmacological treatment or follow-up, and reported self-medicating with CBD cigarettes in varying amounts (he reported 5 to 15 units/day). During admission, pharmacological treatment was instituted with poor response and an acute course of ECT was performed due to a history of good response in a previous episode 10 years ago and the patient’s preference. He remained abstinent from CBD during hospitalization and it was agreed to remain non-consuming at discharge. He presented progressive improvement in the clinical signs from the 4th session, with remission in the 7th session. Upon discharge, it was agreed to perform consolidation ECT on an outpatient basis, initially with weekly sessions and then every two weeks.

From the 2nd outpatient session, a worsening of motor and electroencephalographic seizures was observed in the ECT sessions. A possible relapse into CBD use, which the patient denied, was explored. After the 3rd outpatient session, the patient recognizes relapse into CBD consumption with occasional consumption. During the following 2 sessions, the deterioration in the quality of the EEG pattern progresses and it is decided to interrupt ECT treatment due to the absence of seizures in EEG recording, coinciding with an increase in the daily amount of CBD consumed.

There is little literature on the management of the effects of CBD in ECT treatment. The observations in this clinical case provide valuable information about the combination of CBD and ECT that can be useful to other professionals with similar cases.

None Declared

Over 55 million people currently have Alzheimer’s disease (AD), with estimates predicting a rise to 78 million by 2030. The burden of AD impacts not only the affected individuals but also their families and society due to the increasing care demands. Caring for people with AD is emotionally and physically taxing. The World Health Organization emphasizes the need for caregiver support.

This study aims to understand the caregiving experiences and needs of family caregivers for individuals with AD.

A qualitative descriptive design was used. Data were collected from 23 caregivers at a university hospital’s geropsychiatric clinic. Participants were family members caring for individuals with AD for at least four hours per day. Interviews were analyzed using content analysis.

Sample Characteristics: The mean age of participants was 57.82 and 57% were female. More than 85% lived with the care recipient, the average caregiving duration was 81.34 hours per week. The following themes were extracted from data collected during the interviews (Figure 1).

Stuck in Caregiving: Participants found caring for loved ones with AD to be an unexpected challenge. Many initially missed the onset of AD due to their loved ones’ previous abilities. Family conflicts over caregiving tasks, shaped by differing spiritual and cultural beliefs, were common. Caregivers faced difficulties, especially with stubborn behavior and personal care tasks.

A Life in Metamorphosis Most participants experienced profound changes in their personal lives, including social isolation and emotional turmoil. Half of the participants found meaning in caregiving, gaining new perspectives on life.

Caregivers identified specific needs, including psychosocial support, disease education, in-home care, and adult daycare services.

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The gradual onset of AD delays symptom recognition, making diagnosis hard for families to accept. As caregiving demands increase, conflicts between caregiving and personal responsibilities cause stress and neglect of personal life. Despite these challenges, many caregivers find personal growth. They seek temporary care options, home assessments, and improved access to education and counseling, highlighting areas for better caregiver support.

None Declared

The 3-dimensional (3D) marker-less motion capturing (MoCap) systems are an emerging technique in movement analysis. Recent studies have shown that such MoCap assessment have great potential for accurate and objective assessment of motor alterations in psychiatric patients. Gait as a fundamental gross motor function is the final motor outputs of a complex network integrating sensorimotor systems, cognitive and affective stimuli. Understanding gait alterations in catatonia patients can provide insights into their sensorimotor dysfunction and help in diagnosis and treatment in future.

The primary objective of this study is identifying gait alterations using a 3D optical marker-less MoCap system in catatonia patients (CAT) compared to non-catatonia controls (Non-CAT). We hypothesize that there will be significant reduction in the spatiotemporal parameters of gait, such as speed, stride width, stride length, step length, and cadence as well as increased gait instability in CAT group. Moreover, these alterations will be correlated with general psychomotor slowing.

In this cross-sectional study, we examined a total of 61 patients with and without catatonia diagnosis (CAT; n=22, Non-CAT; n=39) according to ICD-11. Participants were assessed with the Positive and Negative Syndrome Scale (PANSS), Northoff Catatonia Rating Scale (NCRS), the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF). We conducted clinical psychomotor examination with the Heidelberger Neurological Soft Sign Scale (NSS), Salpêtrière Retardation Rating Scale (SRRS) and Unified Parkinson Disease Rating Scale (UPDRS). Gait analysis were performed using a marker-less MoCap system with 8 cameras (Qualisys, Goeteborg, Sweden). Participants walked on a marked path (18 m) with a self-selected tempo during the experiment. The spatiotemporal parameters (STP) of gait were obtained automatically through Theia Software.

The two groups did not differ in age, sex, or BMI. The CAT group showed higher scores in PANNS, BPRS, NCRS and GAF (p< 0,05). We found a statistically significant difference in clinical psychomotor parameters in NSS, SAS and UPDRS between the two groups (p <0,05) and more specifically in gait subdomain of each scale. No differences were found in any of STP of gait or gait instability measurements after controlling for covariates (age, sex, BMI and medication).

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This study exhibit a significant difference between the results of clinical psychomotor assessments and objective gait analysis through marker-less MoCap. This discrepancy suggests a potential overestimation of gait alterations in clinical evaluations. The findings underscore the importance of integrating advanced 3D MoCap technologies into the psychiatric assessment to enhance our understanding of gait alterations in mental disorders.

None Declared

The presentation will summarize recent findings on the role of the two domains of negative symptoms (motivational impairment and expressive impairment) and social cognition as mediators of the impact of neurocognitive impairment on functional outcomes in people living with schizophrenia (PLWS).

One hundred and fifty subjects from 8 different European centers were recruited. Our data showed that the expressive impairment predicted global functioning and together with motivational impairment fully mediated the effects of neurocognition on the same outcome. Motivational impairment was a predictor of personal and social functioning and fully mediated neurocognitive impairment effects on the same outcome. Both motivational and neurocognitive impairments predicted socially useful activities, and the emotion recognition domain of social cognition partially mediated the impact of neurocognitive deficits on this outcome.

Our results indicate that pathways to functional outcomes are specific for different domains of real-life functioning and that negative symptoms and social cognition mediate the impact of neurocognitive impairment on different domains of functioning. Our results suggest that psychosocial interventions should target both negative symptoms and social cognition to enhance the functional impact of cognitive remediation.

A. Mucci Consultant of: Angelini, Gedeon Richter Bulgaria, Janssen Pharmaceuticals, Lundbeck, Otsuka Pharmaceutical, Pfizer, Pierre Fabre, Rovi Pharma and Boehringer Ingelheim.

The inconsistency in cancer incidence and mortality rates in terms of cancer site reported among patients with schizophrenia has been an interesting topic in epidemiology, and additional studies are necessary to gain a more comprehensive understanding.

Due to the inconsistency of the evidence about the cancer risk among patients with schizophrenia, the aim of this study was to analyse cancer mortality and morbidity in patients with schizophrenia treated in a single centre in Lithuania during the study period of 1992-2020.

A retrospective cohort study was conducted in Vilnius Republican Psychiatric Hospital, the biggest specialised psychiatric hospital in Lithuania, with approximately 5000 hospital admissions annually. The patients’ cohort was established by identifying all patients with the diagnosis of schizophrenia (ICD-10 code F20) in the hospital database from 1 January 1992 until 31 December 2017. The cancer cases and cancer deaths in the cohort were identified in the Lithuanian Cancer Register through linkage procedures. The analysis of risk was based on a comparison of observed and expected numbers of cancers and deaths. Expected number of cancer cases were calculated by multiplication of the exact person-years under observation in the cohort by sex, calendar year and a 5-year age-group-specific national incidence and mortality rate. All statistical analyses were carried out using STATA 15 statistical software.

During the follow-up, out of 8553 patients, 673 cases of cancer were diagnosed in both sexes. Statistically significantly lower risk for overall cancer incidence was observed in men (SIR 0.74, 95% CI 0.66-0.83), but not in women (SIR 1.07, 95% CI 0.97-1.18). We observed lower risk for pancreatic cancer (SIR 0.36, 95% CI 0.14-0.96), non-melanoma skin cancer (SIR 0.54, 95% CI 0.33-0.88) and prostate cancer (SIR 0.69, 95% CI 0.55-0.87) in men and higher risk for malignant neoplasm of liver (SIR 2.58, 95% CI 1.53-4.36) and skin melanoma (SIR 2.03, 95% CI 1.12-3.66) in men and for breast cancer (SIR 1.38, 95% CI 1.14-1.66) and corpus uteri cancer (SIR 1.56, 95% CI 1.18-2.07) in women (Table 1). Statistically significant lower overall cancer mortality risk was observed in men (SMR 0.82, 95% CI 0.70-0.96), while in the women’s group, risk of cancer deaths was significantly higher compared to the general population (SMR 1.28, 95% CI 1.11-1.48).

The current results of our study indicate lower risk of overall cancer incidence and mortality in male patients with schizophrenia, while female patients had a higher mortality risk, alongside variations in the risk of different cancer types. This information is important not only for patients, but for healthcare specialists to develop effective disease-specific preventive interventions and programmes.

None Declared

Social determinants of health (SDOH) have been linked to disparities in suicide rates across various demographics, including racial/ethnic groups, sex, age, and geography in the U.S. However, most studies have focused on individual or selected SDOH, rather than examining comprehensive, multi-dimensional SDOH factors. A more nuanced understanding of how clusters of SDOH contribute to suicide disparities across counties is needed to inform targeted prevention strategies.

To identify multi-dimensional SDOH county clusters and estimate their geographic and temporal associations with county-level suicide rates.

This study used national SDOH data from 3,109 U.S. counties over three time periods (2009, 2014, and 2019), matching them with county-level suicide rates from the National Vital Statistics System aggregated into three-year periods (2008-2010, 2013-2015, and 2018-2020). A total of 284 county-level SDOH variables, spanning six domains (social context, economic context, education, physical infrastructure, healthcare context, and natural environment), were analyzed using unsupervised machine learning algorithms to identify SDOH clusters. Associations between SDOH clusters and county-level suicide rates were estimated using negative binomial and LASSO regression.

Three distinct SDOH clusters were identified (Figure 1):

• • Cluster 1 (“REMOTE”) included rural counties with elderly, marginalized populations and substandard housing.

• • Cluster 2 (“COPE”) represented counties with complex family dynamics, overburdened health systems, poverty, and extreme heat challenges.

• • Cluster 3 (“DIVERSE”) encompassed densely populated areas with immigrants, racial/ethnic minorities, environmental challenges, and economic inequality.

Geographically, REMOTE was more common in North and Central U.S., COPE in the South and Central U.S., and DIVERSE along the coasts. Suicide rates were highest in REMOTE counties, especially among men. COPE counties had elevated suicide rates among Whites, while DIVERSE counties saw higher rates among women and Black/Hispanic populations. Most counties (70%) remained within the same cluster over time, with stable suicide rate associations.

This study identified three multi-dimensional SDOH clusters that were associated with varying suicide rates across U.S. counties. These clusters offer insight into the social and environmental conditions contributing to suicide risk. Future prevention strategies should focus on addressing the distinct challenges within each cluster, such as housing inadequacies, healthcare access, and economic inequality, to reduce overall suicide rates and related disparities.

None Declared

Mental health among young people, particularly students, has become an increasing concern in contemporary society, shaped by its complexity, fast-paced nature, and hyper-connectivity. High levels of stress have been observed in numerous studies of this population. Perceived stress goes beyond merely observing stressful events, encompassing the individual’s subjective evaluation of these situations. This perception involves awareness of one’s emotions and thoughts, as well as awareness of the surrounding environment.

The aim of this study was to explore the relationship between perceived stress and mindfulness levels among Tunisian students.

This was a cross-sectional study, conducted over a five-month period from August to December 2023. A questionnaire was distributed via email to 800 students, collecting sociodemographic data as well as two scales. The Perceived Stress Scale (PSS-10) was used to evaluate how participants perceive daily life situations as stressful: a higher PSS-10 score indicates greater perceived stress, categorized into three levels: low, moderate, and severe. The Five Factor Mindfulness Questionnaire-15 (FFMQ-15) assessed mindfulness dimensions: observing, describing, acting with awareness, non-judging, and non-reactivity. A higher FFMQ-15 score indicates greater mindfulness.

A total of 102 students agreed to participate in the study. Their ages ranged from 19 to 30, with more than half being under 20 years old. 75.5% of participants were female.

The average PSS-10 score was 23, with significantly higher scores observed among women (p < 10-3). Stress levels were mostly moderate (55.88%) or high (32.35%).

The mindfulness assessment revealed that the majority of participants had a moderate level of mindfulness (46 ± 8). Mindfulness scores were higher among students aged between 20 and 30 compared to those under 20 years old (p < 10-3).

A negative correlation was observed between perceived stress and mindfulness (p = 0.01; r = -0.508), particularly in three mindfulness dimensions: describing, non-judging, and acting with awareness.

Mindfulness appears to play a significant role in reducing perceived stress levels. Our findings suggest that mindfulness training should be integrated into programs aimed at improving stress management among students.

None Declared

Pregnancy-related hormonal fluctuations, such as changes in estrogen and progesterone, can exacerbate ADHD symptoms, complicating the diagnostic process. Overlap with symptoms of pregnancy-related conditions, such as fatigue and mood instability, further obscures ADHD identification.

Non-pharmacological interventions, including cognitive-behavioral therapy (CBT) and psychoeducation, are first-line recommendations. For patients requiring pharmacological treatment, stimulant and non-stimulant medications must be considered cautiously, weighing risks such as low birth weight or preterm labor against the potential impact of untreated ADHD on maternal functioning. Emerging data suggest that atomoxetine and certain stimulants may be relatively safe under close monitoring.

Untreated ADHD in pregnant women is associated with higher risks of prenatal stress, inadequate prenatal care, and postpartum depression, highlighting the need for tailored management strategies.

ADHD, pregnancy, diagnosis, treatment, pharmacological safety, maternal mental health.

None Declared

A history of psychiatric disorders significantly impacts patient evaluation and treatment in healthcare. Nearly 80% of excess mortality in individuals with mental illnesses is due to physical health issues. While suicide risk is widely recognized, most mortality from mental illnesses stems from physical conditions like cardiovascular diseases, respiratory issues, and cancer, leading to a life expectancy reduction of 15-20 years compared to the general population.

To exemplify through a case the possible impact of psychiatric history on healthcare provision.

We present the case of a 55-year-old woman with a history of severe functional neurological disorder resulting in mobility limitations, dyskinetic movements, and functional pain characterized as allodynia. She has been followed by neurology for the past year. She began mental health follow-up one year earlier due to reactive anxiety stemming from work-related issues. Her substance use history includes being a tobacco smoker for over 20 years (FTND score>50) and a former consumer of three liters of beer daily for two years, with periods of abstinence. The patient presented to the emergency department due to weight loss and low mood, worsening over the past few weeks, in the context of intense muscle pain and loss of strength. Blood tests and a brain CT scan were performed without abnormalities. She was initially admitted to Neurology for severe functional neurological disorder for symptom control, but was later transferred to Psychiatry due to suicidal threats. During her psychiatric admission, she experienced improvement in pain and subsequently in her mood. After discharge from psychiatry, the patient returned several times to the emergency department due to worsening neurological symptoms, being discharged with a diagnosis of functional disorder.

Two months after her discharge from psychiatry, the patient returned to the emergency department due to rib pain. After emergency assessment, she was referred to Neurology for worsening neurological symptoms. With suspicion of paraneoplastic polyneuropathy, an MRI of the brain and spine, EMG, lumbar puncture, and CT scans of the neck, chest, abdomen, and pelvis were performed during her neurology admission. She was diagnosed with small cell lung carcinoma stage IVA and asymmetric paraneoplastic sensory neuropathy. Following the diagnosis, she was referred to Oncology, receiving one cycle of chemotherapy. However, given the unfavorable progression, it was decided, in agreement with the patient, not to continue active oncological treatment, and she was transferred to a Palliative Care Center.

This case emphasizes the need to recognize how psychiatric history affects medical care. Stigma and the patient’s challenges in communicating symptoms can hinder the diagnosis and treatment of organic conditions, contributing to the excess mortality associated with mental health issues.

None Declared

Clozapine stands out among all other antipsychotics due to its superior efficacy in treatment resistant schizophrenia. Despite its proven superiority, it is not the first antipsyhotic choice on grounds of serious side effects. Clozapine remains underutilized, primarily due to its troubled safety profile.Lower prescription rates may be related with physicians’ hesitation because of side effects rather than patients’ unwillingness to use the drug.

To elaborate on the life-threatening side effects and discontinuation of clozapine, we retrospectively reviewed the medical records of all patients admitted to the inpatient psychiatry unit at the Hospital of Hacettepe University Faculty of Medicine, Ankara, Türkiye between January 2010 and April 2022.

Hospital records of inpatients with psychotic disorders, identified by ICD-10 codes (F20.X, F25.X, F.22, F28, F29), and patients with bipolar affective disorder, identified by ICD-10 code (F31.X) who discontinued clozapine during their hospitalization due to serious side effects were thoroughly investigated.

Among a total of 2298 patients hospitalized during the specified period, 178 patients with psychotic disorders and 21 patients with bipolar affective disorder were clozapine users. In this sample, 14 patients with psychotic and 3 patients with bipolar affective disorders had a serious side effect due to clozapine which led to discontinuation in 15 patients (7.53%). The median age of the cases was 32-years (min-max:18-62), the median duration of illness was 10-years (min-max:2-30), and the mean clozapine dose at onset of the serious side effect was 245±149.95 mg/day. The observed serious side effecs associated with clozapine included myocarditis (n=10, 58.8%), agranulocytosis (n=3, 17.6%), neutropenia (n= 1, %5.88), pancreatitis and myocarditis (n=1, 5.88%), refractory increase in level of C-reactive protein (n=1, 5.88%), refractory constipation, weight gain and worsening in obsessive-compulsive symptoms (n=1, 5.88%), and suspicion of neurotoxicity of clozapine in a patient with mutation in multi-drug resistance-1 gene (n=1, 5.88%). There was no report of sudden death, cardiac arrest or need for intensive care unit. The majority of serious side effects (88.2%) occurred within the first 6 months of clozapine initiation. Two patients (11.7%) were able to continue clozapine with clinical management. Among patients who discontinued clozapine, 3 (20%) were rechallenged with clozapine in which 2 attempts (66,6%) were successful.

An examination of 12 years of inpatient clozapine treatment at a University Hospital clinic revealed that even life-threatening side effects of clozapine can be managed successfully with close clinical care. Physicians’ concern about serious side effects should not lead to underutilization of clozapine in patients who could benefit from its trial.

D. Koçyiğit: None Declared, R. Aktaş: None Declared, S. Çoşkun: None Declared, E. Özçelik Eroğlu: None Declared, E. Mutlu: None Declared, A. E. Anıl Yağcıoğlu Grant / Research support from: Janssen, Boehringer Ingelheim, Consultant of: Janssen, Boehringer Ingelheim, Abdi Ibrahim Otsuka, Paid Instructor of: Abdi Ibrahim Otsuka, Speakers bureau of: Abdi İbrahim, Nobel, Janssen, Santa Farma.

Sexuality in the elderly has become an increasingly important topic in healthcare as the global population continues to age, raising new challenges and considerations related to the quality of life and well-being of older adults.

This work aims to explore the barriers faced by the elderly regarding sexuality and propose strategies for promoting healthy and fulfilling sexuality at this stage of life.

A narrative review was employed on the topic, aiming to broadly and exploratorily understand the main aspects related to sexuality in the elderly population.

Recent studies suggest that sexual activity can remain an important part of life for older individuals, positively influencing both mental and physical health. The main obstacles to healthy sexuality in old age can be broadly categorized into physiological, psychological, and sociocultural factors. Physiological changes include a natural decline in hormone levels, such as estrogen in women and testosterone in men, leading to reduced libido, vaginal dryness, and erectile dysfunction. Chronic illnesses like cardiovascular disease, diabetes, and arthritis, along with medications for these conditions, can further impact sexual function. Psychological factors, such as anxiety, depression, and reduced self-esteem due to aging-related body changes, also play a significant role in diminishing sexual desire and activity. Sociocultural factors include long-standing societal taboos around older adults and sexuality, which can lead to embarrassment, reluctance to discuss sexual health issues, and feelings of shame. Healthcare professionals can adopt several strategies to improve sexuality in aging such as open communication. Regular sexual health assessments should be integrated into routine care, including questions about sexual function, relationship satisfaction, and any challenges faced. Medical interventions, such as hormone replacement therapy or treatments for erectile dysfunction can address physiological barriers. Psychosocial support can improve communication, body image issues, and mental health factors like anxiety or depression that often accompany aging.

The approach to sexuality in the elderly should be multifaceted, integrating biopsychosocial perspectives, with an emphasis on promoting sexual education and providing appropriate treatments that address individual challenges. Healthcare professionals shouldadopt a welcoming and open attitude, encouraging dialogue on this topic to improve the quality of life of older adults.

None Declared

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that often persists into adulthood, significantly impacting daily functioning and quality of life. Studying sex differences in ADHD is crucial as females are frequently underdiagnosed or misdiagnosed, which can delay treatment and worsen outcomes. ADHD presents in three main subtypes: inattentive, hyperactive-impulsive, and combined. The combined subtype tends to cause more significant impairments, particularly in academic and social contexts. Males are more likely to be diagnosed with hyperactive-impulsive or combined types, while females often present with the inattentive subtype. A subtype-specific approach is essential, as it guides targeted interventions to address distinct behavioral and cognitive challenges, enhancing treatment efficacy and outcomes.

This study aims to analyze differences in ADHD severity, comorbidity with other conditions, and socio-functional impact by ADHD subtype and sex, as well as to evaluate interactions between these variables.

This population-based study included 900 adults diagnosed with ADHD from a specialized ADHD clinic. Participants were classified by ADHD subtype and sex. Diagnostic and severity assessments were conducted using validated tools, including the CAADID-I, DIVA-5, ADHD Rating Scale (ADHD-RS), Wender Utah Rating Scale (WURS), and Clinical Global Impression Severity Scale (CGI-S). Comorbid psychiatric conditions and psychosocial functioning were evaluated using the BDI-II, STAI, BIS-11, PSQI, FAST, and WHODAS scales. Statistical analyses included bivariate, multivariate, and General Linear Model (GLM) methods.

Females were diagnosed with ADHD later than males (p=0.001) and exhibited greater severity (ADHD-RS, p<0.001) and higher levels of depression and anxiety. No significant sex differences were observed in impulsivity or sleep quality. The combined ADHD subtype was associated with greater clinical severity and functional impairment. An interaction effect was found between sex and ADHD subtype only for WHODAS scores, with females in the combined subtype showing greater impairment.

ADHD presents differently across sexes and subtypes, with specific interactions observed in functional impairment. These findings emphasize the importance of considering sex and ADHD subtype independently to enhance diagnostic accuracy and inform targeted treatment strategies.

None Declared

Artificial Intelligence (AI) is revolutionizing the field of psychotherapy by introducing innovative, accessible, and efficient methods for mental health care. AI-based psychotherapy practices leverage machine learning algorithms, natural language processing (NLP), and predictive analytics to provide personalized therapeutic interventions, support mental health practitioners, and enhance patient outcomes. These systems, including virtual therapists and chatbot platforms, are designed to simulate human empathy, analyze user inputs, and deliver evidence-based therapeutic techniques such as cognitive-behavioral therapy (CBT).

Moreover, AI systems assist clinicians by offering diagnostic support, monitoring patient progress through behavioral data analysis, and optimizing treatment plans. The integration of AI into psychotherapy practices has shown promise in addressing barriers such as stigma, geographic limitations, and therapist shortages. However, ethical challenges related to data privacy, algorithmic bias, and the therapeutic efficacy of AI-driven interactions remain significant concerns. This abstract explores the potential, applications, and limitations of AI-based psychotherapy, emphasizing the need for rigorous research and ethical considerations to ensure its effective and responsible integration into mental health care.

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Parent-focused interventions are an important part of the treatment plan for children with Attention-deficit/hyperactivity disorder (ADHD). Minority families tend to be less involved in psychosocial treatments and are more likely to discontinue the intervention. The Haredi community in Israel is a cultural-religious minority of 1.2 million people

We aimed to assess the feasibility and potential efficacy of culturally adapted psychosocial programs for attention-deficit/hyperactivity disorder (ADHD) within the Haredi community in Israel.

This was an open-label non-randomized study conducted within the Haredi community in Israel between 2018 and 2021. The participants (N=265) were parents of children aged 8-12 years who had been diagnosed with ADHD or exhibited ADHD symptoms. Three culturally adapted programs were compared: 1. A program involving only the parents (N=46), 2. A program involving both children and parents (N=155) and 3. Only recorded video lectures with no interaction (N=38). Parents completed questionnaires to assess their self-efficacy using the Parenting Self-Efficacy tool (TOPSE) and their child’s ADHD symptom severity, using the Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS) both before and after the intervention.

The programs demonstrated high feasibility. Of 335 referrals, 265 parents were recruited. Participation rates differed significantly between the video lectures program (60%) and the two interactive programs (80%, p<0.001). A significant interaction was found between time and program type for both parental efficacy (F(2,213)=5.65, p=0.004) and for ADHD symptomatology (F(2, 213)=5.65, p=0.004). Post hoc analysis revealed that the video lectures program showed no benefit, whereas both interactive programs (parents-only and parent-child) exhibited improvement in parental self-efficacy and reduction in reported ADHD symptom severity.

Despite certain limitations, this study suggests that culturally adapted psychosocial programs for ADHD in the Haredi community are feasible and that including an interactive component is crucial for effectiveness.

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The potential of psychedelic substances to treat mental illness is of significant clinical and societal interest, leading to academic and industry-based research to test their effects. Partly, such research was conducted to fulfil requirements of government agencies such as the European Medicines Agency (EMA) and the Food and Drug Administration (FDA), that have started defining requirements and pathways to regulate psychedelic treatments. It is expected that such requirements will involve elements related to psychotherapeutic components of such treatments, which will require standardized reporting of such methods. Here, I will present the results of a systematic review summarising the quality of reporting on psychological interventions in original studies on psychedelic-assisted psychotherapy. We reviewed 45 studies assessing psilocybin, 3,4-methylenedioxymethamphetamine (MDMA), lysergic acid diethylamide (known as LSD), or ayahuasca, for the treatment of mental disorders. Our findings support that psychological interventions were done heterogeneously across studies, and completeness of information reported about these interventions was mostly low, according to an adaptation of the Template for Intervention Description and Replication checklist. In studies including MDMA, psychotherapy was more homogeneous and more procedural details were provided. We thus propose that improved reporting on psychological interventions of psychedelic treatments are necessary to support replicability, generalisability, and accurate interpretation of research. Furthermore, improved reporting practices are expected to enhance feasibility and safety of future clinical research and real-world implementation of treatments.

None Declared