Both childhood adversity (CA) and first-episode psychosis (FEP) have been linked to alterations in cortical thickness (CT). The interactive effects between different types of CAs and FEP on CT remain understudied.

One-hundred sixteen individuals with FEP (mean age = 23.8 ± 6.9 years, 34% females, 80.2% non-affective FEP) and 98 healthy controls (HCs) (mean age = 24.4 ± 6.2 years, 43% females) reported the presence/absence of CA <17 years using an adapted version of the Childhood Experience of Care and Abuse (CECA.Q) and the Retrospective Bullying Questionnaire (RBQ) and underwent magnetic resonance imaging (MRI) scans. Correlation analyses were used to assess associations between brain maps of CA and FEP effects. General linear models (GLMs) were performed to assess the interaction effects of CA and FEP on CT.

Eighty-three individuals with FEP and 83 HCs reported exposure to at least one CA. CT alterations in FEP were similar to those found in participants exposed to separation from parents, bullying, parental discord, household poverty, and sexual abuse (r = 0.50 to 0.25). Exposure to neglect (β = −0.24, 95% CI [−0.37 to −0.12], p = 0.016) and overall maltreatment (β = −0.13, 95% CI [−0.20 to −0.06], p = 0.043) were associated with cortical thinning in the right medial orbitofrontal region.

Cortical alterations in individuals with FEP are similar to those observed in the context of socio-environmental adversity. Neglect and maltreatment may contribute to CT reductions in FEP. Our findings provide new insights into the specific neurobiological effects of CA in early psychosis.

The expression of sexuality in the adult with mental disorders depends on the early incorporation of factors for promoting social inclusion. It is fundamental that sexual educators and advisors, in addition to working with the clients, also work with close family members. Intervention programs should establish objectives for developing a positive attitude towards sexuality in people with mental disorders and improving self-esteem (Katz G,Salud Publica Mex. 2008;50 Suppl 2:s239-54).

Achieving support for people with mental health problems and/or substance use disorder admitted to the Social Rehabilitation Process of a psychiatric hospital so that they develop their sexuality satisfactorily. The right to privacy must be taken into account.

Promoting a healthy and satisfactory development of sexuality in people with severe mental disorders. Raising awareness among healthcare teams, families and legal representatives regarding the need and suitability for support. Introducing the concept of sexuality as a dignifying perspective. Promoting sexual education that avoids disadvantages and situations of abuse in the target group. Coordinating the continuity of the project with non-health social services after discharge.

Possibility of receiving support in the development of sexuality through training, information and improvement in the management of emotions/feelings in people who express the need or willingness to receive it, will contribute to overcoming limitations or difficulties.

Detecting people who during 2021 wish to work on the objectives through the care team. Searching for community resources aimed at attending sexuality issues in people with mental health problems. Proposing the hospital a collaboration with a non-profit entity that develops a specialized program for attention to sexuality in disability. Coordination between Treatment team and Entity. Quantitative and qualitative assessment of one year of experience according to the parameters of the entity.

All patients included have a diagnosis of psychosis. Experience was very positive for the participants. Community intervention projects that lead to an education in healthy and respectful relationships in the field of sexuality and affectivity are necessary. This would allow to prevent behaviours and situations at risk of abuse as well as social and emotional instability.

None Declared

Hospital at home for psychiatric patients is a new emerging resource of delivering acute mental health care in the community. The main objective of this program is to provide intense care to patients with severe mental disorders at home as an alternative to acute admission.

Although home hospitalisation has begun to develop widely in recent years there is a notable lack of studies

The CAEM Psychiatric Home Hospitalization Unit (HAD-CAEM) has been operating since 2018 and takes place in Santa Coloma de Gramenet; and from March 2022 also in a part of Badalona. Both are sociodemographically depressed areas near Barcelona.

The aim of this study is to describe the characteristics of patients attended at the Psychiatric Home Hospitalization Unit of our hospital and to study differences according to area and place of referral.

Socio-demographic and clinical data were collected retrospectively at admission and discharge of all patients treated at HAD-CAEM between March 2022 to february 2023.

Statistical analysis was performed by using SPSS program.

85 patients were included in the study. 45.9% were women. The mean age was 45.5 years (SD 15.58 years). The main diagnoses of the sample were psychosis and schizophrenia (38.8%), Bipolar disorder (23.53%), Depressive disorder (21.18%), schizoaffective disorder (8.24%) and others (8,24%).

54 (63.53%) patients were from Santa Coloma area and 35 (41.18%) from Badalona area.

The total mean duration of admission was 40.22 days (SD 26.18 days), with a mean follow-up of 10.09 visits (SD 5.39 visits) and 2.41 teleassistence (SD 2.62).

The mean duration of admission for Santa Coloma patients was 43.98 days (SD 28.59), and for Badalona patients 33.68 days (SD 20.13). Trend without significance is observed (t= 1.77, p=0.08)

We found differences in the mean duration of admission according to referral location. Acute psychiatric unit 33.25 days (SD 18.06), Mental health Center 51.93 days (SD 33.45), Emergencies 34.28 days (SD 19.69) (F=5.1, p=0.008).

Sociodemografic and clinical característics obtained in our study are consistent with those reported in previous studies. The duration of admission of patients referred from the mental health center is longer than those referred from the acute psychiatric or emergency unit. Home hospitalization teams have been increasing in recent years, being an alternative to traditional hospitalization.

None Declared

Exercise and other lifestyles are key treatment strategies to improve diabetes outcome, prevent cardiovascular risk and may also result in further results in quality if life and emotional symptoms.

To evaluate the effectiveness of an exercise intervention program for people with diabetes or cardiovascular risk.

To evaluate the influence of previous metal health and quality of life status in the results.

61 people with a type 2 diabetes or cardiovascular risk factors were recruited from health primary health centers in Ponferrada (EL Bierzo), including patients from the mental health association. After informed consent they were included in a 20 week, twice a week supervised walking training program to improve exercise and other lifestyles. A poster used for advertisement of the adtivity (“the way/walk to change diabetes”) is displayed in image 1). Baseline and after 20 weeks BMI and Waist perimeter were assessed, quality of life was evaluated with EQ-5D-5L and WHO-5 scales and the weekly steps walked were recorded previously and after the intervention with the subject usual mobile device.

Differences in the variables were compared with Paired Ts and repeated ANCOVAs measures adjusted by gender, age and initial steps.

46 subjects (75.4%) completed more than 90% of the sessions and 3 more 70-90%. The 19.7% that did not complete had worse scores in SF-12 Role Physical (t 2.261, p=0.041) and Role Emotional (t:2.048, p=0.045) and Mental Component Summary (t:2,313; p=0,036) and WHO5 Total Score (t:2.101; p=0,040) at Baseline. Main reasons for dropout (Image 2) were health related problems (50%) and adherence to exercise and motivation problems (31.25%).

Those who completed the training improve number of weekly steps (baseline: 42022,92 +- 18836,35, final: 66448.06 +-28914,58; t:5.038; p<0.001), BMI (29.45 +-4.66 to 28.25 +-4.09 kg/m2; t:5.629; p<0.001), waist (from 107,34 + 9.98 to 102,88 +9,79 cm; t:6,840; p<0.001) and the EoQ-5D-EL VAS (form 72.88 to 82.42; t:6.122; p<0.001, image 3). The increase in the steps correlated directly with the improvement in the EoQ VAS (r:0.308; p=0.033).

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Image 2:

Image 3:

Exercise and lifestyle supervised intervention programs appear to be useful to improve physical health, wellbeing, emotional symptoms and quality of life in people with diabetes and cardiovascular risk.

Factors associated to higher dropout rates were previous limited quality of life scores and mental health worse status. These could be related with limited motivation and adherence to the program and may be of interest to develop specific strategies for these high-risk groups.

Studies focused on the long-term effect of the program are warranted.

None Declared

This study aimed to analyze stress, anxiety, depression, and self-efficacy levels among Spanish out-of-hospital emergency medical professionals from February 1, 2021, to April 30, 2021.

A nationwide survey was completed by 1666 Emergency Medical Services (EMS) workers. The Depression, Anxiety, and Stress Scale (DASS-21) and the General Self-Efficacy Scale (GSE) were used. Data analysis used chi-squared, análisis of variance (ANOVA), and logistic regressions.

The sample comprised 833 (50%) men, with an average age of 44.3 ± 9.9 y (range: 19-67 y). Occupational distribution included 453 (27.2%) physicians, 474 (28.4%) nurses, and 739 (44.4%) emergency medical technicians (EMTs). EMTs exhibited higher odds of severe or extremely severe depression compared with physicians (odds ratio [OR]: 1.569; 95% confidenceinterval [95% CI]: 1.213-2.030) and nurses (OR: 1.561; 95% CI: 1.211-2.012). EMTs also displayed higher probabilities of severe or extremely severe anxiety compared with nurses (OR: 1.944; 95% CI: 1.529-2.701). Furthermore, EMTs demonstrated elevated probabilities of severe or extremely severe stress compared with physicians (OR: 1.387; 95% CI: 1.088-1.770). However, no significant differences were found in self-efficacy, with a median value of 73 [20].

Out-of-hospital EMS workers experienced mental health challenges, showing varying levels of depression, stress, and anxiety across different occupational groups. EMTs were particularly affected.

Acute Confusional Syndrome (ACS) is the most common neuropsychiatric complication in COVID-19 infection. Its management is still a challenge because the data and recommendations based on the evidence are limited.

To describe the differential characteristics in the management of ACS in patients with COVID-19 pneumonia compared to ACS secondary to other causes.

We present a descriptive study that is has been carried out in 62 patients with ACS (26 of them diagnosed with COVID 19 pneumonia), who have required assessment by the liaison psychiatry service of Hospital del Mar between February and April, 2020. The sample was divided in 2 groups (with and without COVID 19 pneumonia). Chi square and Fisher’s tests were used to comparisons.

Dexmetomidine (26 vs 0) and olanzapine (13 vs 3) were significantly more frequently used in COVID-19 patients (p< 0 001). A greater number of different antipsychotic drugs were used in COVID 19 patients (2.40± 1 323 number of drugs), (p<0.0001). Further neuroimaging tests were requested in COVID 19 patients and they received less family support (4) compared to non COVID-19 (22), (p<0.005).

ACS associated with COVID-19 pneumonia in the patients in our sample is more difficult to manage than ACS associated with other pathologies, similar to which described in other series. It is associated with a longer duration of confusional symptoms and difficulties for control it.

No significant relationships.

Gender is a factor influencing characteristics of substance use disorders. The Covid-19 pandemic has had a great impact in all areas of society, meaning a context of exceptionality in this population. Usually the male population represents a greater number of patients in general samples, so the descriptive characteristics of a global sample may not be representative in the case of women.

- Identify if there are changes in the main substance of psychoactive substance use during the Covid-19 pandemic. - Identify possible divergences in characteristics of the general sample with respect to the sample made up of women.

It will be used data collected in the database of patients in follow-up with the addiction consultation service in two periods of 6 months, one prior to the pandemic situation due to Covid-19 and another corresponding to same period in 2020. A descriptive analysis is carried out by applying chi-square statistic, performing the analysis by subgroups according to gender.

84.8% of total sample are men. Results show that there are no statistically significant differences between periods in main substance of consumption. Despite this, differential trends can be observed in the sample that correspond to women with respect to the global sample and that of men.

Taking into account the low number of women that make up the sample, the fact that differential trends are observed could indicate possible differences, which in case of increasing the sample size could acquire statistical significance and that this it would be specific to women subgroup.

No significant relationships.

Coronavirus Disease 19 (COVID-19) was declared a pandemic by the World Health Organization (WHO) in March 2020. Since the outbreak, neuropsychiatric presentations such as delirium have been developing.

Our aim is to describe sociodemographic and clinical differences between inpatients cursing with Acute Confusional Syndrome (ACS) with and without COVID-19 pneumonia.

This is an observational-descriptive study. All patients attended by the liaison psychiatry service of Hospital del Mar, between February and April 2020, with ACS diagnosis were included. The sample was divided in 2 groups (with and without COVID-19 pneumonia). Sociodemographic and clinical variables including sex, age, previous somatic or psychiatric history, ACS risk factors, ACS subtype and pharmacological treatment were compared. Chi-square and U Mann Whitney tests were used.

The total sample was 62 patients. 43.5% were women with a mean age of 71,7 (SD 11,3). Covid pneumonia group included 26 patients. There was a higher percentage of Hypoxemia in Covid pneumonia patients (p<0,001). There were significant differences between Covid pneumonia group and ACS in relation to: a previous diagnosis of Ischemic Heart Disease (p=0,007), Heart Failure (p=0,029) and Nephropathy (p=0,022). Dexmedetomidine (p=0,001) was highly used for ACS treatment in Covid pneumonia patients.

In this sample, patients with ACS and Covid pneumonia had a bigger rate of hypoxemia and previous history of Ischemic Heart Disease, Heart Failure and Nephropathy compared to the rest of ACS patients. Dexmedetomidine was more commonly used for the treatment of ACS in Covid pneumonia group. More studies would be necessary to assess the significance.

No significant relationships.

The coronavirus disease 2019 (COVID-19) pandemic has had a profound worldwide impact on health. Acute Confusional Syndrome (ACS) is the most common neuropsychiatric complication in COVID-19 infection.

Describe the characteristics of the admited patients attended by the liaison psychiatry service for acute confusional syndrome during the COVID 19 pandemic. Sociodemographical and clinical variables were descrived.

We conducted an observational, descriptive study. All patients attended by the liaison psychiatry service of Hospital del Mar, between February and April 2020, with ACS diagnosis were included.

We included 62 patients with acute confusional syndrom; 35 were men (56.5%), and mean age was 71.71 years (standard deviation [SD]:11.345). The mean duration of admision stay was 41.19 days [SD: 38.039]. The mean number of consultations carried out was 6.5 [SD: 5.422]. 52.5% of our sample of our sample had confusional symptoms for 8 days. 50 patients presented complications during admission (80.6%), of which 43 patients developed infectious complications (69.4%). 59 patients had a history of chronic diseases (95.2%). 54 patiens (88.5%) had potencial risk factors associated with acute confusional syndrome including: isolation in 24 (39.3%), active infection in 46 (74.2%), hypoxemia in 25 (40.3%), previous cognitive impairment in 15 (24.6%)

Acute Confusional Syndrome mainly affects people with risk factors such as isolation, active infection and hypoxemia (which in turn are symptoms of Covid-19).

No significant relationships.

The compassionate use of intranasal esketamine is approved in Spain for treatment-resistant depression (TRD).

The objective of the study is to assess the clinical stability in the medium-term follow-up of patients with TRD after esketamine use.

Descriptive, retrospective and multicenter study carried out in Spain. Patients with TRD who had received esketamine treatment, and for whom there were clinical data of subsequent evolution, were included. The scores on the MADRS and Hamilton scales were changed into scores on the CGI scale according to the studies by Leucht et al. The Student’s t test was performed to assess differences in the CGI.

Eleven patients were included: 72.7% were women and the mean age was 56 (SD: 12.9). The maximum dose of esketamine used was 84mg in 63.7%. The onset of antidepressant action was observed from the 1st dose in 72.6% of the patients. The mean time in treatment was 6.6 months (SD: 2.3) and 90.9% reached remission criteria. After 7.4 months (SD: 3.0) from the end of the treatment, 90.9% remained in remission and without visits to the emergency room or hospitalization for psychiatric reasons. The mean baseline score on the CGI-SI was 5.7 points, at the end of the treatment was 1.2 points and after longitudinal follow-up it was 1. Statistically significant differences were observed (p<0.001) both at the end of the treatment and in the post-esketamine follow-up compared with baseline score.

In our sample, the use of esketamine in TRD shows clinical stability in the medium-term follow-up.

Daniel Hernández has participated in medical meetings and/or received payment for presentations from Otsuka, Lundbeck, Janssen, Angelini, Casen Recordati, and Ferrer.

Paediatric and adult psychiatric emergency department (ED) visits decreased during the initial COVID-19 pandemic outbreak. Long-term consequences of the pandemic will include increases in mental healthcare needs especially among especially vulnerable groups such as children and adolescents.

This study examined changes in the number of overall and diagnosis-specific mental health ED visits among patients aged <18 years following onset of the COVID-19 pandemic in Madrid, Spain.

We used electronic health records to extract the monthly numbers of total and diagnosis-specific mental health ED visits among patients aged <18 years, between October 2018 and April 2021, to La Paz University Hospital. We conducted interrupted time-series analyses and compared trends before and after the day of the first ED COVID-19 case (1st March 2020).

In March 2020, there was a marked initial decrease of -12.8 (95%CI -21.9, -7.9) less monthly mental health ED visits. After April 2020, there was a subsequent increasing trend of 3.4 (95%CI 2.6, 4.2) additional monthly mental health ED visits.

After onset of the COVID-19 pandemic, there was an increase in paediatric psychiatric ED visits, especially due to suicide-related reasons. These data reinforce the crucial role of the ED in the management of acute mental health problems among youth and highlight the need for renovated efforts to enhance access to care outside of and during acute crises during the pandemic and its aftermath.

No significant relationships.

In Spain, we are forced to familiarize ourselves with Arab-Muslim culture to properly treat our patients. The diagnosis becomes complicatedbecause western health professionals are not usually familiar with thisform of symptom presentation.

The objective of this work is to study the influence of Arab culture and Muslim religion on the psychopathological symptoms presented duringa psychotic episode.

We present two cases of psychosis in two brothers of Maghreb originwho were treated for the first psychotic episode in the acute psychiatricunit in a Spanish regional hospital. Then, we carried out a litle researchfrom the literatura.

The common psychopathological symptoms presented by two brothersof 26 and 27 years were: symptoms of thought, control and influence of the self. Delusional ideas of self-referential harm and persecution. Auditory and cenesthetic hallucinations. In the literature we find that patients with Islamic backgrounds whosuffer hallucinations can attribute these experiences to different beliefssuch as geniuses (jinn), black magic and the evil eye. One of the siblings was diagnosed with a psychotic episode withoutspecification, while the other brother got the schizophrenia label. Webelieve that this may be related to the fact that mental healthprofessionals generally tend to label fantastic stories as mind-blowingor delusional in nature.

1. Religious beliefs and fantastic tales of Muslim culture can be considered psychotic symptoms if healthcare professionals are notfamiliar with this culture. 2. Teamwork between mental health professionals, translators and religious counselors can improve care for Muslim patients.

Psychopathological symptoms and cognitive impairment are core features of patients with psychotic disorders. Executive dysfunctions are within the most commonly observed deficits and the Wisconsin Card Sorting Test (WCST) is the test most extensively used for their assessment. Yet, the structure of executive deficits remains unclear, as there may be different underlying processes.

The study’s aims were to explore and compare the network structure of the WCST measures in psychosis and their unaffected siblings.

Subjects were 298 patients with a DSM 5 diagnosis of psychotic disorder and 89 of their healthy siblings. The dimensionality and network structure of the 13 WCST measures were examined by means of the Exploratory Graph Analysis (EGA) and centrality parameters.

The WCST network structure comprised 4 dimensions: Perseveration (PER), Inefficient sorting (IS), Failure to maintain set (FMS) and Learning (LNG). Patient and sibling groups showed a similar network structure and in both cases the network structure was reliably estimated.

Perseveration measures reflect the inability to switch sorting rules when necessary. Scores for the IS dimension can occur when the subject ineffectively tries to test different sorting hypotheses, changing at random the response. FMS reflects the subject’s strategy when he/she is able to find out the sorting rule, but is unable to keep applying that rule long enough. LNG comprised conceptual ability and learning items. The lack of significant difference between network structures is in keeping with results from exploratory and confirmatory studies demonstrating an invariant cognitive factor structure between schizophrenia patients and their unaffected siblings.