Sustained alcohol intake, when combined with incomplete treatment, can result in chronic structural changes in the Central Nervous System, including generalized cortical and cerebellar atrophy, amnesic syndromes like Korsakoff’s syndrome, and white matter disorders such as Central Pontine Myelinolysis and Marchiafava-Bignami syndrome. It is crucial to prevent these complications due to their potential for irreversible and debilitating consequences. For Wernicke-Korsakoff syndrome, early recognition and thiamine administration for prevention are paramount, as it arises from thiamine deficiency due to malnutrition caused by persistent alcohol use. In the case of Central Pontine Myelinolysis, which is caused by abrupt fluctuations in serum osmolality, controlled sodium correction is essential.

Through a clinical case and a review of published literature, this study aims to reflect on the importance of preventing neurological injuries associated with chronic alcohol consumption, specifically Wernicke-Korsakoff Syndrome and Central Pontine Myelinolysis.

A literature review was conducted by searching for articles on PubMed using the terms “Alcohol Use Disorder,” “Wernicke-Korsakoff syndrome,” and “Central pontine myelinolysis.” A clinical case is presented, featuring a 50-year-old patient with alcohol use disorder who developed Wernicke-Korsakoff syndrome and Central Pontine Myelinolysis. Considering this case, we reflect on the primary approaches that could have been beneficial in preventing these complications and propose a straightforward method for doing so.

A 50-year-old patient presented with poor general condition, characterized by low weight, significant loss of strength in the limbs and arms, and incoherent speech with anterograde amnesia and confabulation. This condition had progressed to a point where the patient could no longer walk, perform basic self-care tasks such as bathing, dressing, and eating independently, underscoring the severity of his condition. The diagnoses of Wernicke-Korsakoff syndrome and Central Pontine Myelinolysis were established based on clinical manifestations and the presence of hyperintense lesions observed in the central pons on T2/FLAIR axial MRI scans. This clinical case highlights the importance of proper and precocious prevention of complications in patients with alcohol use disorder. The foremost step in preventing these complications is to treat alcohol dependence effectively, even when faced with patient resistance. It’s vital to remain vigilant about potential complications and implement suitable prophylactic measures.

The devastating effects of complications arising from Alcohol Use Disorder, such as Wernicke-Korsakoff syndrome and Central Pontine Myelinolysis, underscore the importance of enhanced attention that clinicians should provide when approaching these patients at all clinical interactions.

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Commissioners play a central role in coordinating and planning CAMHS. However, there is little research on their experiences and approaches to understanding the needs of their populations. An improved understanding is likely to benefit the translation of research into practice, by ensuring research outputs meet the needs of key stakeholders and in optimising the sharing and use of data to improve services.

To better understand commissioners’ experiences of commissioning child and adolescent mental health services (CAMHS) and the challenges they face.

Between May to June 2023, we conducted twelve individual, semi-structured interviews with Integrated Care Board commissioners of CAMHS across England. We analysed data using framework analysis; a qualitative analysis method which involves systematically charting and organising data using a framework to generate themes.

We generated five core themes from the data: 1) ‘Reflections on role’ – how commissioners’ roles are informed by their background and ‘positioning’ within the system in which they work, 2) ‘Priorities and Tensions’ – the wider context in which commissioners work and how this may present challenges, 3) ‘Insights and evidence’– how commissioners develop an understanding of child mental health need and the different roles of quantitative and qualitative data, 4) ‘Children’s mental health in the limelight’ – commissioners’ perceptions of changes in child mental health in their populations, 5) ‘Responding to need’ – how commissioners are addressing the needs of their populations and the challenges they perceive.

CAMHS commissioners are negotiating a complex and changing political, social and economic environment with differing priorities and pressures. Commissioners draw heavily on insights from providers and their role is shifting towards managing relationships and bringing the system together. A key challenge is balancing investment in prevention/early intervention versus specialist services needed by children with more severe and complex problems.

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Involuntary admission rates differ between gender across various countries. In several European Union countries, men are more frequently involuntarily admitted, while an opposite trend, associating women with involuntary care, has been observed in countries like Switzerland, Brazil, and China.

Considering the contradictory evidence about gender and involuntary care in the literature, we aim to analyze the gender patterns of involuntary care in Centro Hospitalar Médio Tejo’s Psychiatric Acute Unit, exploring the gender differences in diagnosis among involuntary patients.

We stored and analyzed the data using Microsoft Excel and IBM SPSS Statistics. We studied psychiatry admissions at Centro Hospitalar Médio Tejo, Portugal over 2 years. The Acute Psychiatric Unit, located within a general hospital, has 24 beds, and offers acute mental healthcare services to adults aged 18 and above, serving a coverage area of approximately 251,000 residents. As part of our data collection process for all admissions to the Acute Psychiatry Unit, we recorded information such as gender, age, diagnosis at discharge, treatment type (voluntary or involuntary), and length of stay.

From January 1, 2021, to December 31, 2022, there were 686 psychiatry admissions at Centro Hospitalar Médio Tejo, of which 125 (18,2%) were involuntary. The admission rates were approximately 136.6 per 100,000 people annually, with 24.9 being involuntary admissions per 100,000 people annually. In our analysis of involuntary admissions, women had a lower rate of such admissions, making up 6.4%, while men had a higher rate at 11.8%. No other gender identity was mentioned. Schizophrenia-related disorders were the primary cause for involuntary admissions for both genders, with 67.9% for men and 50% for women. Mood disorders were the second most common reason for involuntary admission, accounting for around 40.9% of cases for women and a significantly lower 16% for men. Involuntarily hospitalized patients exhibited longer lengths of stay independently of the gender. Men hospitalized involuntarily tended to be younger, whereas for women, involuntary hospitalizations were associated with older ages.

In conclusion, our study reveals gender differences in psychiatric involuntary admissions, with more men being involuntarily admitted than women. Schizophrenia group disorders were the most common diagnoses among male and female involuntary patients. Furthermore, all hospitalized women exhibited a higher prevalence of mood disorders, a trend that was more pronounced among those admitted involuntarily. These gender trends match the overall patterns seen in the epidemiology of schizophrenia and mood disorders. Additionally, women with schizophrenia generally exhibit better social functioning than men, which may explain the lower needs of involuntary hospitalization.

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The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.

The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.

About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.

The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.

Mental health problems are common in children and young people (CYP) in England, yet evidence suggests high levels of unmet need in this group. Understanding of the determinants of mental health-related service contact is needed to identify gaps in service provision and areas for targeted intervention to improve access.

To determine the relationship between CYP characteristics and mental health-related support and service contact in England.

A secondary analysis of the 2017 NHS Digital Mental Health of Children and Young People (MHCYP-2017) cross-sectional survey dataset was performed. MHCYP-2017 was a national survey investigating the mental health of CYP using a stratified multistage random probability sampling approach, providing the official national statistics for England. Multi-informant data were collected through a combination of questionnaires and interviews. Expert clinical rating took place to formally identify the presence of mental disorders, according to established diagnostic criteria. This secondary analysis describes mental health-related support and service contact amongst 6681 participants aged 5-16 recruited to the MHCYP-2017 study. A range of socio-demographic and clinical characteristics were analysed as explanatory variables and their relationships with different types of support/service contact were examined through multivariable multinomial logistic regression. Analyses were stratified by age group: 5-10- and 11-16-year-olds.

Overall, around 25% of parents reported CYP mental health-related contact with one or more types of support/service in the past 12 months due to concerns regarding CYP “emotions, behaviour, concentration or difficulties in getting along with people”. Age stratified multivariable analyses revealed several statistically significant associations between participant socio-demographic/clinical characteristics and mental health-related support and service contact, independent of CYP mental health status and parental perception of difficulties. These associations were not necessarily consistent across mental health support categories, suggesting that several of the measured characteristics have differential relationships with different types of support and service contact. Whilst there were some differences between the 5-10 and 11-16 age groups, similar associations were seen for many of the explanatory variables. Socioeconomically disadvantaged and black and minority ethnic CYP were less likely to have had professional contact for mental health problems.

There may be higher levels of unmet need in socioeconomically disadvantaged and black and minority ethnic CYP, warranting further investigation and efforts to address inequalities. Further longitudinal studies are needed to elucidate causal associations and mechanisms underlying these observations.

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Steroids are a necessary treatment for hypoxic respiratory failure; however there are many side effects that should be taken into account. A 44- year-old-woman with asthma and no past psychiatric history was admitted due to COVID-19 pneumonia and Respiratory syncytial virus (RSV) infection, presenting hypoxic respiratory failure. After two days of intravenous methylprednisolone administration, the patient presented acute psychosis and agitation.

It has been previously described that steroid use can cause effects such as mania, anxiety, agitation, delirium and psychosis amongst other. However they are a necessary treatment in respiratory illnesses and are sometimes unavoidable.

The aim was to examine the appropriate medical response to steroid induced psychosis in patients with acute hypoxic failure.

A bibliographical review was done in PubMed database searching recent cases of steroid induced psychosis using the words (“Steroid”, “Psychosis” and “COVID-19”).

According to literature, it has been shown that partial or complete reduction of steroid use and/or use of psychotropic has been successfully used to treat steroid induced psychosis. Following the research it was decided to reduce intravenous methylprednisolone dose from 20mg/ 8h to 20mg/12h and start oral haloperidol 5mg/8h the first 24h and reducing the dose progressively as the patient recovered. After the first 24 hours the patient presented adequate response to steroids as well as partial response to antipsychotic treatment; presenting no further agitation, absence of hallucinations and partial persistence of the persecutory delusion. A couple of days later there was complete remission of the psychotic symptoms and the patient was on the way to recovery from COVID-19 and RSV.

There is evidence that suggests that medications such as steroids used to treat COVID-19 and other respiratory illnesses can lead to psychotic episodes. It is very important to pay attention to possible side effects when treating with steroids and evaluate the patient history as well as suggest having a follow up visit after the hospital discharge.

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The first definition of PAS, enunciated by Richard Gardner in 1985, refers to a disorder originating in the context of legal conflicts related to child custody. Its main characteristic would be a smear campaign by the child towards a parent, in the absence of plausible arguments. In this context, the child would experience an oppositional and dichotomous feeling towards his or her parents. In recent years, the presence of PAS has become increasingly important, both in the legal and health fields, largely due to the controversy and debate surrounding its approval and recognition, and there is currently no consensus on the matter.

The main objective of this work is to examine the current state of PAS in depth in the different fields in which it is emerging: the medical-scientific and legal spheres. The current controversies and debate, both scientific and legal, will be developed. Research will be carried out on the origin of the concept and its evolution, its symptomatic presentation, the neuropsychological consequences in minors, the role and legal value of expert reports, as well as the existing evaluation methods for the assessment of PAS.

An extensive literature review was carried out on the subject in question, extracting information mainly from scientific articles, but also from legislative documents, manuals and books.

There are currently no specific laws regulating PAS in European countries. According to Article 10.2 of the Spanish Constitution, norms related to fundamental rights shall be interpreted according to the Universal Declaration of Human Rights. As a direct consequence of the chronic psychological stresses experienced by children, adaptive disorders may appear, often characterised by symptoms of anxiety and depression. In addition, a multitude of neuropsychological consequences have been observed not only in the affected child, but also in the adult he or she will become.

Currently, there is a fervent debate about the validity and recognition of PAS as a diagnostic entity, spanning different disciplines, ranging from health to social and legal. In Europe, professionals in the scientific field have not reached an agreement regarding the approval of PAS. On the one hand, there are those for whom PAS is a verified phenomenon; on the other hand, there are those who flatly reject the existence of this phenomenon. The latter consider PAS an unscientific construct, referring to it as “court syndrome” or “patriarchal alienation syndrome”.

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CD is characterized by at least three features: its duration is prolonged, it does not resolve spontaneously and it is rarely completely cured. Approximately 10-15% of young people have CD. Adolescents with CD often have emotional and behavioral problems.

To assess risk factors, derived psychiatric pathologies and coping strategies for a CD diagnosis in adolescence.

An extensive literature review was carried out on the subject in question, extracting information mainly from scientific articles, manuals and books.

The main risk factors are those related with the CD in question, physical sequelae, the need for long-term hospital admissions or the use of drugs whose side effects include affective or behavioral symptoms; those related to the personality traits of the affected child or adolescent. In addition, as far as the family is concerned, the presence of a low level of education, lack of support or communication, as well as the presence of psychiatric disorders or serious medical conditions in parents. Among the most frequent psychiatric disorders associated with CD are affective and anxiety disorders, adaptive disorders, somatoform disorders, eating disorders and behavioral disorders. Whatever the CD is, it generates high levels of stress and uncertainty in the patient and family, which must be dealt together from a flexible perspective, allowing child or adolescent to adapt to the changes, reorganize and facing them with adaptive patterns of behavior. For this, it will be essential to have adequate social and family support with relational style based on communication, trust and acceptance.

In general, both adolescents with CD and their families have an adequate capacity to adapt to the repercussions and effects derived from the disease. Nevertheless, in case of possible emotional difficulties that may appear, a comprehensive and individualized approach to these adolescents and their families is necessary to provide them resources and coping strategies in different areas and contexts in which the disease debuts.The comprehensive therapeutic approach will consist of interventions at the individual and family level. Among the main objectives of these interventions are to achieve acceptance and adaptation to CD provinding adequate psychosocial support to enable them to cope with CD in the best possible way and to detect and address the emotional implications, even coexisting psychopathology.

None Declared

Verbal fluency tests are quick and easy to administer neuropsychological measures and are regularly used in neuropsychological assessment. Additionally, phonological fluency is a widely used paradigm that is sensitive to cognitive impairment. This paper offers normative data of phonological verbal fluency (letters P, M, R) for Spanish middle- and older-aged adults, considering sociodemographic factors, and different measures such as the total number of words, errors (perseveration and intrusions), and 15 sec-segmented scores.

A total of 1165 cognitively unimpaired participants aged between 50 and 89 years old, participated in the study. Data for P were obtained for all participants. Letters M and R were also administered to a subsample of participants (852) aged 60 to 89 years. In addition, errors and words produced every 15 seconds were collected in the subsample. To verify the effect of sociodemographic variables, linear regression was used. Adjustments were calculated for variables that explained at least 5% of the variance (R2 ≥ .05).

Means and standard deviations by age, scaled scores, and percentiles for all tests across different measures are shown. No determination coefficients equal to or greater than .05 were found for sex or age. The need to establish adjustments for the educational level was only found in some of the measures.

The current norms provide clinically useful data to evaluate Spanish-speaking natives from Spain aged from 50 to 89 years. Specific patterns of cognitive impairment can be analyzed using these normative data and may be important in neuropsychological assessment.

We have investigated the relationship between the Psychosomatic Classification method (Marty) and the Rorschach Test, with respect to the diagnosis of psychosomatic disorders, within the framework of the degree of mentalization measured by both.

A) To verify statistical coincidence with respect to the degree of mentalization (risk of generating psychosomatic disorders in a subject) between the Rorschach Test and the diagnostic technique Psychosomatic Classification, by P. Marty. B) To test the hypothesis: Patients diagnosed with infertility, whose degree of mentalization is good, will have a greater probability of achieving a successful pregnancy throught Assisted Reproduction Techniques.

Two evaluation tools were used: a) Psychosomatic Classification based on the criteria established by this diagnostic method; b) The Rorschach test (based on the evaluation of 29 indicators, selected according to their greater relevance in the generation of somatic symptoms).

A sample of 120 patients (women) diagnosed infertility at the Assisted Reproduction Unit (U.R.A.) at Hospital Universitario 12 de Octubre in Madrid was recruited. The method of ‘statistical correlation of coincidence’ between the results of the two diagnostic instruments used was used. Once both tests had been assessed by the “inter-judge” method and the quantitative values of the selected items had been weighted, the KAPPA statistical method was applied to establish the “correlation of coincidence” between the results of the two assessment instruments.

Considering that the KAPPA method takes values between “0" and ”1" and that between 0.6 and 0.8 the agreement or coincidence is considered good, and above 0.8 very good, the result applied to the hypothesis is 0’76 (’good’).

A) Using the Rorschach Test and P. Marty’s Psychosomatic Classification in a complementary manner, these two instruments together provide high reliability, with respect to the degree of mentalization (a subject’s risk of suffering psychosomatic disorders). B) The degree of mentalization has a significant impact on the success or failure in the application of Assisted Reproduction Techniques in infertile women.

None Declared

Relationships in various forms are an important source of meaning in people’s lives that can benefit their health, wellbeing and happiness. Relationship distress is associated with public health problems such as alcohol misuse, obesity, poor mental health, and child poverty, whilst safe, stable, and nurturing relationships are potential protective factors. Despite increased emphasis on relationship education (RE) in schools, little is known about the views of relationship professionals on relationship education specifically, and how this contrasts with the views of young people (YP).

This Wellcome Centre for the Cultures and Environments of Health funded Beacon project seeks to fill this gap by exploring their perspectives and inform the future development of relationship education.

We conducted focus groups with YP (n=4) and interviews with relationship professionals (n=10). The data was then thematically analysed.

Themes from YP focus groups included: ‘Good and bad relationships’; ‘Learning about relationships’; ‘the role of schools’ and ‘Beyond Relationship Education’. Themes from interviews with relationship professionals included: ‘essential qualities of healthy relationships’; ‘how YP learn to relate’ and ‘the role of RE in schools’.

YP and relationship professionals recognised the importance of building YP’s relational capability in schools with a healthy relationship with oneself at its foundation. Relationship professionals emphasised the need for a developmental approach, stressing the need for flexibility, adaptability, commitment and resilience to maintain relationships over the life course. YP often presented dichotomous views, such as relationships being either good or bad relationships, and perceived a link between relationships and mental health. Although not the focus of current curriculum guidance, managing relationship breakdowns and relationship transitions through the life course were viewed as important with an emphasis on building relational skills. This research suggests that schools need improved RE support, including specialist expertise and resources, and guidance on signposting YP to external sources of help. There is also potential for positive relationship behaviours being modelled and integrated throughout curriculums and reflected in a school’s ethos. Future research should explore co-development, evaluation and implementation of RE programmes with a range of stakeholders.

None Declared

In this research the Paris School (I.P.S.O.), by P. Marty, is chosen as the theoretical and clinical basis of Psychosomatics. We work with the degree of mentalization (good, bad and uncertain) -obtained through Marty’s Psychosomatic Classification-, as a previous diagnosis and prognosis of 120 infertile women undergoing treatment at the Assisted Reproduction Unit (ARU) at Hospital Universitario 12 de Octubre in Madrid.

a) To analyse the statistical coincidence between female infertility, stress and alexithymia syndrome. b) To verify the differences between psychosomatic disorders and other somatoform symptoms and syndromes (conversive and hypochondriac). c) To test the following hypothesis: subjects whose degree of mentalization is deficient, present high degree of alexithymia and stress.

120 infertile women undergoing treatment with Assisted Reproduction Techniques were examined by means of psychodiagnostic tests.

Diagnostic tools: P. Mary’s Psychosomatic Classification (P.C.) (semi-structured interview), as a means of diagnosing the degree of mentalization; T.A.S. (Toronto Alexithymia Scale); Battery of stress measurement questionnaires (H.A.D., PANAS. IRE, MCMQ).

The correlation of coincidence between the results of C.P. and the different Alexithymia and Stress questionnaires with the independent variable (success or failure of pregnancy in the selected subjects) has been studied, applying Spearman’s Correlation Coefficient.

With respect to what was obtained in the Psychosomatic Classification:

- T.A.S. questionnaire yields a coefficient of [-0.48]. Therefore, there is a negative correlation between the degree of mentalization and the presence of alexithymia; in other words, as the degree of mentalization increases, the degree of alexithymia decreases and vice versa;

- There is positive correlation [0.39] between the results of Mentalization (Psychosomatic Classification) and the degree of stress; therefore, the existence of stress does not prevent better mentalization.

The present research concludes: a) that people at risk for psychosomatic disorders have high scores on “alexithymia”; b) that patients at high risk for psychosomatic disorders do not necessarily suffer from “stress” situations; c) that there are many indicators in behavior and psychological functioning that differentiate psychosomatic disorders from conversive and hypochondriac disorders - both in their etiology and their development; d) there is a statistical correlation between female infertility and alexithymia; e) there is no statistical correlation between female infertility and stress.

None Declared

The influence of sexual hormones on mental disorders have been extensively reported. In fact, recent studies suggest that sex hormones may play a relevant role in the pathophysiology of psychosis, may be a precipitant when exogenously administered or even be used as a treatment agent of psychotic disorders.

To describe the case of a patient with a recent diagnosis of delusional disorder (DD) with an onset in the perimenopausal period.

Case report and narrative review focused on the impact of sexual hormones on depressive symptoms and alcohol use comorbidity during perimenopause in DD women by using PubMed database.

Case report: A 48-year-old woman diagnosed with DD. The clinical assessment of climacteric symptoms, as well as the gonadotropins (elevated levels of follicle-stimulating hormone -FSH- and luteinizing hormone -LH-) and estrogen levels monitoring (variations on 17-β-estradiol -E2-) enabled to link the endocrine changes with the onset and course of the psychiatric disorder. During the development of the disease, the patient also presented comorbid depressive symptoms and alcohol use disorder. Review: Estrogen depletion seems to increase the risk of psychosis, while scientific literature is not conclusive in establishing a definitive relationship between depressive symptoms and hormonal imbalance in DD. Alcohol use disorder is a common comorbidity in both perimenopausal women and patients with DD.

Multiaxial management of the case helped clinicians to achieve clinical stabilization. Sex differences as well as hormonal pattern disturbances should receive special attention due to the seminal implications in pharmacotherapy and clinical outcomes.

No significant relationships.