Mental health-related stigma occurs not only within the public community but is also an issue among healthcare professionals. The relationship between national culture and provider stigma remains yet to be empirically attested.

We performed a cross-sectional multicentre study across 32 European countries to investigate the attitudes of psychiatrists towards patients with mental health problems. We aimed to examine the relationship of attitude with country-specific indicators.

We measured stigmatizing attitudes using the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) within an online survey among specialists and trainees in general adult, child and adolescent psychiatry. Its total score was correlated with the Human Development Index (HDI), the Democracy Index (DI), the Social Progress Index (SPI), the number of psychiatrists per 100,000 people, and the Hofstede dimensions. Latent class analysis was done to find subgroups of countries according to the stigmatizing attitudes of psychiatrists and the six Hofstede dimensions.

Altogether, n=4245 participants completed the survey. The total score of the OMS-HC significantly correlated with the long-term orientation (r=0.453, p=0.015) and indulgence dimensions (r=-0.629, p<0.0001) and with the HDI (r=-0.503, p=0.005), DI (r=-0.418, p=0.024), SPI (r=-0.348, p=0.040). The latent class analysis separated high- and low-stigma countries. High stigma was associated with high power distance and uncertainty scores.

Findings from this study not only expand knowledge of factors related to stigmatizing attitudes of healthcare professionals, but also enlighten the cultural aspects of the stigma that could contribute to the further development of anti-stigma programs.

D. Őri Grant / Research support from: Research grant form the Fulbright Association, P. Szocsics: None Declared, T. Molnár: None Declared, L. Bankovska Motlova: None Declared, O. Kazakova: None Declared, S. Mörkl: None Declared, M. Wallies: None Declared, M. Abdulhakim: None Declared, S. Boivin: None Declared, K. Bruna: None Declared, C. Cabaços: None Declared, E. A. Carbone: None Declared, E. Dashi: None Declared, G. Grech: None Declared, S. Greguras: None Declared, I. Ivanovic: None Declared, K. Guevara: None Declared, S. Kakar: None Declared, K. Kotsis: None Declared, I. Klinkby: None Declared, J. Maslak: None Declared, S. Matheiken: None Declared, A. Mirkovic: None Declared, N. Nechepurenko: None Declared, A. Panayi: None Declared, A. Pereira: None Declared, E. Pomarol-Clotet: None Declared, S. Raaj: None Declared, P. Rus Prelog: None Declared, J. Soler-Vidal: None Declared, R. Strumila: None Declared, F. Schuster: None Declared, H. Kisand: None Declared, A. Reim: None Declared, G. Ahmadova: None Declared, M. Vircik: None Declared, H. Yilmaz Kafali: None Declared, N. Grinko: None Declared, Z. Győrffy: None Declared, S. Rózsa: None Declared

The Screen for Disordered Eating/SDE was created as a primary care screening method for eating disorders, including binge eating disorder (Maguen et al. 2018). The SDE comprises five items (yes/no answers), extracted from other validated self-reported questionnaires assessing eating psychopathology. Its validity and reliability has proved in a Portuguese psychometric study, that only included woman (Pereira et al. 2022). It psychometric properties have yet to be evaluated in men.

We aim to assess the psychometric properties of the Portuguese version of SDE in males.

Participants were 227 male individuals with a mean age of 30.41 years (±13.96; range: 14-73). They answered an online survey including the Portuguese preliminary versions of the seven-item Eating Disorder Examination Questionnaire/EDE-Q7; the Body Image Concern Inventory/BICI and the Muscle Dysmorphia subscale of the Eating Disorder Assessment for Men/DM-EDAM.

Confirmatory Factor Analysis showed good fit for the unidimensional model (χ2/df=1.483; RMSEA=.0460; CFI=.980 TLI=.961, GFI=.988). Cronbach’s alpha was .621 which although inferior to .7 can be explained by the small number of items and the fact that each one assesses different dimensions. All items contributed to the internal consistency and presented high internal validity. Pearson’s correlations of SDE with BICI (.317) and EDE-Q7 (.361) were significant and moderate. The correlation with DM-EDAM was non-significant, probably due to its focus on muscle dysmorphia, which is not included in SDE’s items.

The Portuguese version of SDE demonstrated adequate validity (construct and convergent) and reliability.

None Declared

Primary care visits of persons with dementia often bring together triads composed of patients, family carers and general practitioners (GPs), as previously discussed (1). Communication dynamics potentially affect dementia outcomes, not least because primary care is a health setting where these triad encounters often occur naturally. Our aim is to present further data from Portuguese primary care consultations with persons with dementia, their carers and GPs.

We refer to the conclusion of our study ‘Dementia in Primary Care: the Patient, the Carer and the Doctor in the Medical Encounter - Bayer Investigation Grant | NOVAsaúde Ageing 2018’ (1). Fieldwork was interrupted during the COVID-19 pandemic and resumed in 2022. Sixteen consultations with persons with dementia, their carers and GPs (purposive sampling) were audio- recorded and transcribed verbatim. Interactions were thematically analysed using NVIVO® software. The analytical framework combined codes derived from the transcripts with codes from the literature.

Dementia-related content took up less than half of consultations’ time, despite their considerable length (as compared to the average in primary care). Most GPs assessments lacked breadth, although efforts towards positive attitudes were present. Themes specifically related to social health in dementia were not (or were poorly) covered. Frequently, carers facilitated GPs’ assessment of dementia consequences, but their own needs were neglected. Patients’ self-expression tended to be limited.

Our findings suggest that doctor-patient interactions in many GPs’ consultations seemingly compromise patient-centred approaches. There are challenges regarding how to assess the biopsychosocial consequences of dementia in a context of fragmented care (2,3). Given the scarcity of evidence from live-recorded primary care consultations about triadic dynamics, our findings are important to guide further explorations.

We identify a set of essential recent advances in climate change research with high policy relevance, across natural and social sciences: (1) looming inevitability and implications of overshooting the 1.5°C warming limit, (2) urgent need for a rapid and managed fossil fuel phase-out, (3) challenges for scaling carbon dioxide removal, (4) uncertainties regarding the future contribution of natural carbon sinks, (5) intertwinedness of the crises of biodiversity loss and climate change, (6) compound events, (7) mountain glacier loss, (8) human immobility in the face of climate risks, (9) adaptation justice, and (10) just transitions in food systems.

The Intergovernmental Panel on Climate Change Assessment Reports provides the scientific foundation for international climate negotiations and constitutes an unmatched resource for researchers. However, the assessment cycles take multiple years. As a contribution to cross- and interdisciplinary understanding of climate change across diverse research communities, we have streamlined an annual process to identify and synthesize significant research advances. We collected input from experts on various fields using an online questionnaire and prioritized a set of 10 key research insights with high policy relevance. This year, we focus on: (1) the looming overshoot of the 1.5°C warming limit, (2) the urgency of fossil fuel phase-out, (3) challenges to scale-up carbon dioxide removal, (4) uncertainties regarding future natural carbon sinks, (5) the need for joint governance of biodiversity loss and climate change, (6) advances in understanding compound events, (7) accelerated mountain glacier loss, (8) human immobility amidst climate risks, (9) adaptation justice, and (10) just transitions in food systems. We present a succinct account of these insights, reflect on their policy implications, and offer an integrated set of policy-relevant messages. This science synthesis and science communication effort is also the basis for a policy report contributing to elevate climate science every year in time for the United Nations Climate Change Conference.

We highlight recent and policy-relevant advances in climate change research – with input from more than 200 experts.

The Profile of Mood States is one of the most widely used instruments to assess mood states. It is a rapid and economic method of assessing transient affective states (McNair et al. 2003) and it has been translated and validated to several languages including Portuguese. In our country we have several versions, with different factorial structures and number of items. The scale presents a list of feelings and emotions (adjectives) that people commonly experience.

With university students, we have used a version composed of 36 items that evaluates three factors, with good validity and reliability: Depression, Anxiety/Hostility and Positive Affect (Amaral et al. 2013).

However, to be included in digital apps that in addition to ecological momentary assessment parameters require a weekly or even daily assessment of mood states, this version has little usability.

To develop a shorter version of the POMS-36 based on Exploratory Factor Analysis and to analyse its construct validity using Confirmatory Factor Analysis in a sample of Portuguese college students.

765 students (69.2% females; mean age=22.09±2.433; range: 17-26) fill in the POMS-36 and the Perceived Stress Scale (Amaral et al. 2014). The total sample was randomly divided in two sub-samples. Sample A (N=380) was used to EFA and sample B (N=385) was used to CFA.

Through EFA (with varimax rotation and extracting three factors), the four items with the highest loadings in their respective factor were selected. Then, the CFA, carried out with the AMOS, revealed that this three-factor model, with two pairs of correlated errors, indicated a good fit (X2/df= 4.6010; CFI =.9561; GFI =.9406; TLI=.9559; RMSEA=.0687, p[rmsea=0.04]. The internal consistency analysis resulted in α (Cronbach alphas) <.75 for the three factors. Pearson correlations of the three factors - Depression, Anxiety/Hostility, Amability/Vigour – with Perceived stress were all significantly (p<.01) and moderate, respectively: .533, .614 and -.461.

Although much shorter, the new POMS-12 has good validity (construct and divergent-convergent) and reliability, being more suitable in studies that require frequent and rapid self-monitoring of affective states, such as ISABELA (“IoT Student Advisor and Best Lifestyle Analyser”), an app targeting student mental health and well-being in which we have been working.

None Declared

Individuals with severe mental health problems are at greater risk of COVID-19 infection and increased risk of hospitalization and mortality. Vaccination against COVID-19 has demonstrated its importance in preventing and reducing these negative outcomes.

This study aims to assess the vaccination rate of people with mental illness in comparison with the general population.

We will conduct a retrospective evaluation of vaccine uptake in a sample of patients admitted to a psychiatric hospital between the 1st of July of 2021 and the 30th of June of 2022 in the Porto region. According to their vaccination plan, all patients were offered the possibility vaccination. Statistical analysis will be performed to analyse the data.

We expect to assess over 1500 patients. Regarding other studies on the same subject, although in different countries, we may predict that the vaccination rate in our sample will not, statistically, differ from the general population.

Some studies have shown higher resistance and hesitancy towards the COVID-19 vaccination in mental health patients, however others did not find differences between these patients and the general population. Therefore, this study will allow us to better understand the impact of mental illness in the vaccination rate in our population.

None Declared

Medical-related professions are at high suicide risk. Suicide is a major cause of premature death among physicians, but the prevalence of suicide-related behaviors is inconsistent across studies.

Presenting a review of the prevalence and risk factors of suicide among physicians.

Search on Pubmed® and Medscape® databases with the following keywords: “physicians” and “suicide”. We focused on data from systematic reviews and meta-analyzes. The articles were selected by the authors according to their relevance.

Female and US physicians were at higher risk of suicidal behavior. Suicide decreased over time, especially in Europe. Some specialties might be at higher risk such as anesthesiologists, psychiatrists, general practitioners and general surgeons. It is well established that anesthesiologists tend to have much higher rates of substance abuse than other physicians. Psychiatrists are also known to have more mental distress, mental illness and burnout compared with other physician groups and have concerning rates of depression and psychotropic. Physicians are less likely to seek mental health services out of career concerns, culture and/ or a predisposition toward self-reliance. Additionally, retrospective toxicology screening of suicide data finds that physicians are more likely than nonphysicians to have positive results for antipsychotics, benzodiazepines, and barbiturates but not antidepressants.

Physicians are an at-risk profession of suicide, with women particularly at risk. The rate of suicide in physicians decreased over time, especially in Europe. The high prevalence of physicians who committed suicide attempt as well as those with suicidal ideation should benefits for preventive strategies at the workplace. Physician suicides are multifactorial, and further research into these factors is critical. Appropriate preventive and treatment measures should be implemented to reduce the risk of suicide-related behaviors in this population.

None Declared

Since the literature investigating the stigmatising attitudes of psychiatrists is scarce, this is the first study which examines the phenomena across Europe. The Opening Minds Stigma Scale for Health Care Providers (OMS-HC) is a widely used questionnaire to measure stigma in healthcare providers towards people with mental illness, although it has not been validated in many European countries.

A cross-sectional, observational, multi-centre study was conducted in 32 European countries to investigate the attitudes towards patients among specialists and trainees in general adult and child psychiatry. In order to be able to compare stigma scores across cultures, we aimed to calculate measurement invariance.

An internet-based, anonymous survey was distributed in the participating countries, which was completed by n=4245 psychiatrists. The factor structure of the scale was investigated by using separate confirmatory factor analyses for each country. The cross-cultural validation was based on multigroup confirmatory factor analyses.

When country data were analysed separately, the three dimensions of the OMS-HC were confirmed, and the bifactor model showed the best model fit. However, in some countries, a few items were found to be weak. The attitudes towards patients seemed favourable since stigma scores were less than half of the reachable maximum. Results allowed comparison to be made between stigma scores in different countries and subgroups.

This international cooperation has led to the cross-cultural validation of the OMS-HC on a large sample of practicing psychiatrists. The results will be useful in the evaluation of future anti-stigma interventions and will contribute to the knowledge of stigma.

No significant relationships.