Mental and behavioral disorders resulting from alcohol use are a significant public health issue. As the nation’s most populous state, São Paulo encounters distinct challenges in this domain. According to the 2022 Census, the most recent national demographic survey, the state of São Paulo’s population is estimated at 44,411,238, representing approximately 21.9% of Brazil’s total population of 203,080,756. Understanding the epidemiological profile of these disorders is crucial to better assess their impact on the healthcare system and to guide effective resource allocation and management strategies.

The present study aims to analyze statistical data related to hospitalizations due to mental and behavioral disorders caused by alcohol use in the state of São Paulo in 2023.

A cross-sectional, descriptive, retrospective, and quantitative study was conducted, focusing on hospitalizations of individuals diagnosed with mental and behavioral disorders due to alcohol use in the state of São Paulo during 2023. Data were collected from the Department of Health Informatics of the Brazilian Unified Health System (DATASUS) within the “Hospital Information System of SUS” section, examining variables such as age range, gender, ethnicity, and length of hospital stay.

In 2023, São Paulo recorded 5,898 hospitalizations for alcohol-related mental and behavioral disorders, with total expenditures amounting to R$ 9,215,994.94. The average length of stay was 22.9 days, and the overall mortality rate was 0.64%, with 38 deaths. The highest number of hospitalizations occurred in the 35-39 years (12.1%), 40-44 years (14.7%), and 45-49 years (15.5%) age groups, which together accounted for 42.3% of all cases. Men represented 86.1% of hospitalizations, with an average length of stay of 23.4 days compared to 19.9 days for women. The ethnic distribution showed that 52.9% of hospitalizations were among White individuals, 8.3% were Black, 37.5% were Multiracial, and 0.7% were Asian. The longest average stays were among White individuals (25.1 days), followed by Black (22.2 days) and Multiracial (20.2 days). The overall mortality rate was 0.64%, with a slightly higher rate in men (0.65%) compared to women (0.61%). Black individuals had the highest mortality rate (1.23%), particularly among men (1.25%).

This study underscores the public health impact of alcohol-related mental and behavioral disorders in the state of São Paulo, particularly among middle-aged men. Ethnic disparities in hospitalization duration and mortality suggest the need for targeted healthcare strategies to meet diverse demographic needs. These findings highlight the importance of tailored interventions and strategic resource allocation to reduce the burden of alcohol-related disorders and enhance health equity.

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Substance Use Disorders (SUDs) are highly prevalent and substantially contribute to the global burden of disease, negatively impacting individuals’ health, well-being, and social functioning. While SUD treatments have demonstrated effectiveness in reducing substance use and related behaviors, there has been a growing emphasis on including subjective outcome measures, recognizing the importance of patients’ perspectives on their well-being. This shift has driven the development of Patient-Reported Outcome Measures (PROMs), which are progressively being integrated in healthcare to enhance patient-centered care, patient-provider communication and shared decision-making.

This study aims to develop a PROMs Digital Health Intervention (PROMs-DHI) with the potential to improve the quality and effectiveness of outpatient addiction treatment services.

PROMs-DHI includes the electronic adaptation of ICHOM’s standardized set for addictions using REDCap software and feedback created by Tableau on individual PROMs scores for patients and clinicians. PROMs-DHI will be assessed through mixed methods following a patient-centered design. Quantitative data will be collected using the System Usability Scale (Brooke, 1986), while qualitative data will be gathered through 5 focus groups with patients and 5 with healthcare professionals from collaborating addiction treatment centers. This strategy will yield valuable insights into the experiences and perspectives of both groups in utilizing the PROMs-DHI, offering a deeper understanding of their interactions and outcomes.

It is expected that patients will perceive a positive effect of the usage of the PROMs-DHI, gaining insights into their progress, reinforcing communication with clinicians, and enhancing self-management. Clinicians are expected to find the PROMs-DHI beneficial for managing patient care, profiting from the ability to monitor patient outcomes in real-time, receive notifications when values exceed critical thresholds, and access detailed reporting tools to inform their treatment decisions. This would enable them to provide more targeted and effective care, ultimately leading to improved patient outcomes.

Implementing the PROMs-DHI in addiction care could facilitate outcome comparisons, guide service improvement, and ultimately increase the effectiveness and quality of interventions, contributing to a stronger and more sustained recovery for patients undergoing treatment. Providing patients with regular feedback on their outcomes may also have a therapeutic effect in itself, promoting self-awareness, motivation and empowerment to manage their recovery. Furthermore, PROMs can support healthcare professionals in making well-informed treatment decisions that are tailored to each patient’s needs, thereby strengthening the impact and sustainability of addiction interventions.

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Borderline personality disorder (BPD) often results in recurrent acute hospitalisations, significantly burdening healthcare systems. Specialised intervention programs aim to stabilise patients and reduce hospital admissions. This study investigates the impact of a structured BPD Intervention Program at the Local Health Unit of São João on reducing the need for acute hospitalisations.

The objective of this study is to assess the effect of integration into the BPD Intervention Program on the frequency of acute hospitalizations. Furthermore, we aim to investigate the relationship between clinical and sociodemographic factors, as well as the need for inpatient care.

This is a retrospective longitudinal study with quantitative statistical analysis of data from 293 patients referred for suspected BPD at the São João Local Health Unit. The analysis included 163 patients who had their BPD diagnosis confirmed. We collected data from hospital records, focusing on the number of hospitalisations before and after program admission. We also analysed variables such as the program’s follow-up duration.

The mean age at the time of the first evaluation was 24.6 years, with symptoms typically starting at a mean age of 14.2 years. The majority of participants (94%) were female. The program’s integration led to a significant reduction in hospital admissions. Prior to the program, patients had an average of 1.01 hospitalisations per patient (median = 0). After integration, the average decreased to 0.66 hospitalisations per patient (median = 0). We are conducting further analyses to explore associations between additional factors and hospitalisation outcomes.

Integration into the BPD Intervention Program is associated with a decrease in acute hospitalizations. This clearly supports the idea that specific interventions can help stabilise BPD patients. The findings also highlight how personalised care can reduce strain on healthcare costs. Future research should evaluate the long-term benefits of the program, including its impact on the duration of hospital stays and the lasting effects of reduced hospitalisation rates after program completion.

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Bipolar disorder (BD) is a mental health disorder characterized by episodes of mania or hypomania alternating with depression, and it is known that seasonal changes can have an impact on the risk of relapse. Circadian rhythm - which works as an internal biological clock that regulates sleep-wake cycles, hormone production and mood stability -, plays a crucial role in the course of the disease, and it is likely that it influences relapse during seasonal changes, through mechanisms not entirely understood.

Review the relationship between seasonal changes and bipolar disorder relapse, focusing on circadian rhythm disruption, including possible pathophysiological pathways and treatment options.

Narrative review of articles published on Pubmed’s database using the following keywords and their combinations: bipolar disorder, circadian rhythms, seasonal and sleep disturbances, screening for relevance.

Several studies show us that manic episodes are associated with transition into spring and summer and depressive ones with transition into autumn and winter. Seasonal changes result in alterations in daylight exposure, which in turn, through the cardinal role of the suprachiasmatic nuclei in the hypothalamus, lead to disruptions in sleep-wake cycles, impacting melatonin and cortisol levels, which can contribute to mood instability. These hormones are also subjected to changes by other shifts in biological rhythms such as body temperature regulation, that come with seasonal transitions. On the other hand, light exposure also influences neurotransmission, particularly of serotonin and dopamine, with consequences on energy, mood and reward processing and arousal. There might also be a role for genetic polymorphisms like CLOCK, BMAL1 and PER, that influence sleep patterns and hormonal regulation, and therefore can predispose some people to mood disorders. Furthermore, there are important social factors related to seasonal changes, such as increases or decreases in social activities, that can impact mood. Therapeutic approaches that target circadian rhythm, such as light therapy and chronotherapy (including options like sleep deprivation and phase advance therapies), can be useful in decreasing relapse episodes. Additionally, simple psychoeducation on the matter, regarding maintenance of regular sleep schedules and social activities, might be helpful in preventing or, at the very least, decreasing relapses.

Seasonal changes play a relevant role in both manic and depressive relapses in BD through their role in circadian rhythm disruption, by way of a myriad of mechanisms. Future investigation should focus on these mechanisms and others that might possibly be involved, allowing us to reach more targeted treatment and even preventative measures to diminish relapse episodes in BD.

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Cognitive dysfunction has been reported in acute psychiatric patients for a long time and has profound implications for the management of severe mental disorders. The Screen for Cognitive Impairment in Psychiatry (SCIP) is a scale developed for screening cognitive deficits. This tool is simple and easy to administer.

To translate and to validate to Portuguese the SCIP.

The accepted back-translation method is employed for translating from English into Portuguese. One-hundred individuals in good health were characterized using demographic questionnaires and a neuropsychological battery. Subsequently, the new version of the scale was administered on two distinct occasions with a minimum one-week gap between them.

High internal consistencies as well as strong correlations with comparable neuropsychological tests were obtained.

The results obtained from the Portuguese version of SCIP are in line with those from the English version. Effectively, SCIP serves as a key instrument for the initial assessment of cognitive function. Its characteristics, particularly its conciseness and independence from a technological platform, allow it to be integrated into clinical practice. Our aim is to use this version and apply it to different pathologies, comparing patients with controls. This will allow us to study different patients and apply it to our population.

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The World Health Organization declared the coronavirus outbreak a pandemic on March 11th 2020. Since then, the containment measures were leading to increasing mental health problems in the general population and worsening of some pre‑existing psychiatric conditions. To our knowledge, there are few studies characterizing the impact of the COVID‑19 pandemic on psychiatric hospitalizations across the world.

We aimed to compare the number and characteristics of the hospitalizations in the mental health department of a Portuguese psychiatric hospital from March 2nd 2019 to October 31st 2019 with those that occurred in the same period in 2020.

We conducted a retrospective observational study including all patients admitted to hospital during these periods (n=805). Sociodemographic data, clinical characteristics and information about the context of hospitalization were collected. Statistical analysis was performed using t Student Test, Mann‑Whitney and Chi‑square.

In the pandemic period there was a marked reduction in the number of psychiatric hospitalizations. There was a statistically significant difference in the median length of stay and in the percentage of involuntary hospitalizations between the two periods. In 2019, the most frequent International Classification of Diseases (10th Revision) diagnostic categories were F30‑F39 (mood disorders) and in 2020 were F20‑F29 (schizophrenia, schizotypal and delusional disorders).

The reorganization of services and the decrease in admissions through the emergency department may explain these results.

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Several authors have demonstrated the relevance of the therapist sensitivity to the affective expression of his client (Merten & Schwab, 2005; 150-158), as well as to his own emotional experience (Haynal-Raymond et al., 2005;142-148) in order to build a more effective therapeutic relationship, and results. An important source of information to decode the emotional expression hints is the face, and its expression (Ekman & Friesen, 1975; Russel & Fernández-Dolls, 1997;275-294). Despite common sense saying that context is relevant to understand the meaning of the emotional facial expression, the literature review shows inconsistent results.

The main goal of this study was to evaluate the impact of clinical context over the perception of the emotional facial expression.

This study followed a within-subjects design, and its sample consisted of 60 clinical psychologists. 21 combinations of prototypical expression images with mixed emotional signals, and clinical information texts were presented to the participants. Then their judgement on the type of emotion displayed was requested. The presentation of the text-image pairs was randomized between three conditions: consistent, and non-consistent, and neutral.

The results suggest that emotions are more easily recognized in the presence of a concordant context than a non-concordant or neutral one, and that the greater the similarity between the facial expression of the image presented and the face prototypically associated with the context, the greater the influence of the context.

However, In the recognition of mixed emotional signs, there was greater recognition of signs of anger in the facial expression, as a non-dominant emotion, when in the presence of the neutral story than of the story that agreed with the dominant emotion (sadness). There was also greater recognition of sadness, as a non-dominant emotion, in the presence of a story in agreement with fear than in the presence of a neutral story. There was also a statistically significant increase in the attribution of anger to images in which it is not present and whose dominant emotion is fear, when associated with a context of aggression vs. a neutral context.

It was also found that there was a significant decrease in the attribution of fear to the sadness-anger image (25%-75%) in the presence of the aggression context compared to the neutral and panic contexts.There was also a statistically significant decrease in the attribution of sadness to an image of fear in the neutral context compared to the other contexts (panic and aggression).

In conclusion, our study have shown an impact of context over overvaluation or the undervaluation of the emotional facial expression as well as either with prototypical expressions or the mixed emotional signals when referring to sadness, fear, and anger. Thus, mental health clinicians should consider the influence of these contexts.

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Obsessive-compulsive disorder (OCD) is a chronic condition characterized by time-consuming and distressing obsessions and/or compulsions, often accompanied by avoidance behaviours. It is a highly prevalent and incident disorder that results in considerable disability and quality of life reduction.

Current pharmacological treatments are hindered by their delayed onset and the limited evidence on how to approach first and second line treatment-resistant patients.

Recent research showcased the involvement of glutamatergic pathways in the pathophysiology of OCD prompting research into the potential therapeutic use of ketamine, which binds to the N-methyl-D-aspartic acid receptor and acts as a non-competitive antagonist of glutamate.

The aim of this study is to conduct a literature review on the use of ketamine and its enantiomers as a treatment for OCD and report a clinical case involving an OCD patient who experienced significant improvement following ketamine use.

A search was performed on PubMed using a combination of keywords and Medical Subject Headings terms, including “Ketamine”, “Esketamine” and “Obsessive-Compulsive Disorder”. Only studies that involved patients with OCD aged ≥18 years who had received ketamine or its enantiomers as an intervention and that reported treatment response using a validated scale were included.

Nine studies were included, 4 case reports, 3 open-label trials and 2 randomized controlled trials, totalling 71 patients. Ketamine was administered intravenously in 7 studies and intranasally in the remaining 2. The results were heterogeneous, with some studies reporting no effect on obsessive-compulsive (OC) symptoms and others demonstrating significant and rapid improvement, albeit some only transitorily.

We present the case of a 42-year-old man who experienced OC symptoms since the age of 20 but was only formally diagnosed with OCD 3 years ago. During his first consultation, the patient described obsessive thoughts related to contamination and dirtiness, accompanied by handwashing rituals and avoidance behaviours (e.g., avoiding touching handles and switches). His Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score was 29. Escitalopram was initiated with a progressive dose titration, resulting in partial improvement (Y-BOCS 23). In a follow-up appointment, the patient disclosed that he had purchased and self-administered a single intravenous dose of 2g of ketamine 2 months earlier for recreational use. This led to an immediate and significant improvement of his OC symptoms. Subsequent re-evaluation 4 months later confirmed that he remained asymptomatic (Y-BOCS 2).

Ketamine may be a therapeutic alternative for OCD patients who are treatment resistant due to its rapid anti-obsessional effect. Further studies with improved designs and larger sample sizes are warranted to better assess the efficacy of ketamine in OCD treatment.

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Females outperform males on verbal memory tests across the lifespan. Females also exhibit greater Alzheimer’s disease (AD) pathology at preclinical stages and faster atrophy and memory decline during disease progression. Synaptic factors influence the accumulation of AD proteins and may underpin cognitive resilience against AD, though their role in sex-related cognitive and brain aging is unknown. We tested interactive effects of sex and genetic variation in SNAP-25, which encodes a presynaptic protein that is dysregulated in AD, on cognition and AD-related biomarkers in cognitively unimpaired older adults.

Participants included a discovery cohort of 311 cognitively unimpaired older adults (age mean [range]=70 [44-100]; 56% female; education mean=17.3 years; 24% APOE-e4+), and an independent, demographically-comparable replication cohort of 82 cognitively unimpaired older adults. All participants completed neurological examination, informant interview (CDR=0), neuropsychological testing, and blood draw. Participants were genotyped for the SNAP-25 rs105132 (T→C) single-nucleotide polymorphism via Sequenom (discovery cohort) or Omni 2.5M (replication cohort). In vitro models show the C-allele is associated with increased SNAP-25 expression compared to T/T genotype. A subset of the discovery cohort completed structural MRI (n=237) and florbetapir Aβ-PET (n=97). Regression analyses across cohorts examined the interaction of sex and SNAP-25 genotype (T/T homozygotes [53% prevalence] vs. C-carriers [47% prevalence]) on cognitive z-scores (verbal memory, visual memory, executive function, language), adjusting for age, education, APOE-e4, and APOE-e4 x sex. Discovery cohort models also examined sex-dependent effects of SNAP-25 on temporal lobe volumes and Aβ-PET positivity.

SNAP-25 T/T vs. C-carriers did not differ on demographics or APOE-e4 status across cohorts or within sexes. Sex interacted with SNAP-25 to predict verbal memory (p=.024) and language (p=.008) in the discovery cohort, with similar verbal memory differences observed in the replication cohort. In sex-stratified analyses, C-carriers exhibited better verbal memory than T/T carriers among females (d range: 0.41 to 0.64, p range: .008 to .046), but not males (d range: 0.03 to 0.12, p range: .499 to .924). In SNAP-25-stratified analyses, female verbal memory advantages were larger among C-carriers (d range: 0.74 to 0.89, p range: <.001 to .034) than T/T (d range: 0.13 to 0.36, p range: .022 to .682). Sex also interacted with SNAP-25 to predict Aβ-PET positivity (p=.046) such that female C-carriers exhibited the lowest prevalence of Aβ-PET positivity (13%) compared to other groups (23% to 35%). C-carriers exhibited larger temporal lobe volumes across sex, yet this effect only reached statistical significance among females (females: d=0.41, p=.018; males: d=0.26, p=.179). In post-hoc analyses, larger temporal lobe volumes were selectively associated with better verbal memory in female C-carriers (β=0.36, p=.026; other groups: |βs|<0.10, ps>.538).

Among clinically normal older adults, we demonstrate female-specific advantages of carrying the SNAP-25 rs105132 C-allele across cognitive, neural, and molecular markers of AD. The rs105132 C-allele putatively reflects higher endogenous levels of SNAP-25. Our findings suggest a female-specific pathway of cognitive and neural resistance, whereby higher genetically-driven expression of SNAP-25 may reduce likelihood of amyloid plaque formation and support verbal memory, possibly through fortification of temporal lobe structure.

Addiction Liaison Pychiatric Units are frequently requested by other medical services due to the high prevalence of medical pathologies in substance use disorders. We intend to know patient’s characteristics in order to improve the approach.

To describe patient characteristics of all medical request to the Addiction Liaison Pyshicatric Unit from January 2010 to December 2022.

Study data will be obtained from all patients that were referred to the Addiction Liaison Psychiatric Unit to assess addictive disorders and withdrawal symptoms related to drugs during 12 years in Hospital del Mar (Barcelona, Spain). Demographics and clinical data (substance use, medical comorbidity and dual diagnosis) were obtained.

The results will be presented as soon as all data is obtained. We will explore COVID-19 pandemic implications.

None Declared

Network analysis has been used to explore the interplay between psychopathology and functioning in psychosis, but no study has used dedicated statistical techniques to focus on the bridge symptoms connecting these domains.

The current study aims to estimate the network of depressive, negative, and positive symptoms, general psychopathology, and real-world functioning in people with first-episode schizophrenia or schizophreniform disorder, focusing on bridge nodes.

Baseline data from the OPTiMiSE trial were analysed. The sample included 446 participants (age 40.0±10.9 years, 70% males). The network was estimated with a Gaussian graphical model (GGM), using scores on individual items of the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), and the Personal and Social Performance (PSP) scale. Stability, strength centrality, expected influence (EI), predictability, and bridge centrality statistics were computed. The top 20% scoring nodes on bridge strength were selected as bridge nodes.

Nodes from different rating scales assessing similar psychopathological and functioning constructs tended to cluster together in the estimated network (Fig. 1). The most central nodes (EI) were Delusions, Emotional Withdrawal, Depression, and Depressed Mood. Bridge nodes included Depression, Conceptual Disorganisation, Active Social Avoidance, Delusions, Stereotyped Thinking, Poor Impulse Control, Guilty Feelings, Unusual Thought Content, and Hostility. Most of the bridge nodes belonged to the general psychopathology subscale of the PANSS. Depression (G6) was the bridge node with the highest value.

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The current study provides novel insights for understanding the complex phenotype of psychotic disorders and the mechanisms underlying the development and maintenance of comorbidity and functional impairment after psychosis onset.

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Stigma in mental health settings is described as a set of negative and unrealistic beliefs about those with mental illness. Authors suggest that stigma is consistently underdefined and overused, leading to resources toward preventing and managing this problem lacking intention and efficiency. Three interacting levels of stigma are defined: social, structural, and internalized or self-stigma. Internalized stigma refers to how people with mental illness see themselves as mentally unwell and, therefore, of lesser value.

We aim to discuss the impact of internalized stigma on psychiatric patients and ways of prevention and stigma resistance.

We performed a non-systematic literature review from the data base PubMed using the key words “internalized stigma” and “mental illness”.

Internalized stigma is one of the major factors leading to delayed contact with psychiatric care up to two years in outpatients. In psychiatric patients, higher internalized stigma was associated with weakened social support and integration, hopelessness and lower self-esteem and sense of coherence. Low self-esteem is the most significantly associated factor and mediates lower quality of life and higher treatment avoidance. The risk of self-esteem loss seems higher in patients with more insight, especially if they also have a loss of valued social identity. Although some studies suggest higher levels of internalized stigma in female, single and lower educated patients, adjusted statistical analyses do not validate these sociodemographic variations. It is however more prevalent in those with depression and who had been hospitalized because of their mental illness. The impact of internalized stigma is often compared to the levels of the illness burden itself, leading to higher levels of depression and greater psychiatric symptom severity. Additionally, more self-stigma seems to predict suicidal ideation, particularly in young adults.

The internalization of negative stereotypes undermines empowerment and negatively impacts the evolution and recovery of psychiatric patients. There’s strong evidence that general stigma constitutes a risk factor for poor biopsychosocial health outcomes. Programs addressing multiple stigma components seem to be most effective in improving suicide prevention. However, most self-stigma interventions involve groups, which can create barriers for people who are not comfortable disclosing a mental health condition to others. Anti-stigma programs are most effective when they involve people with lived experience of mental health conditions in all aspects of development. Interventions from a younger age should focus on prevention of general stigma by improving understanding of mental illness and reducing self and outwards discrimination. Working on professionals own stigmatizing behaviors is also key to improve the way we communicate and educate populations on how to internally process mental health problems.

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Delusion of pregnancy (DP) is a heterogeneous symptom that can emerge from different neuropsychiatric syndromes, including schizophrenia, bipolar disorders, but also major neurocognitive disorder (MND). According to the Diagnostic and Statistical Manuel of Mental Disorders-5 (DSM-5), DP is an unspecified type of delusional disorder present in the spectrum of schizophrenia and other psychotic disorders This type of delusion, which can affect both sexes, may have numerous determinants to its genesis and may last decades to resolve.

We aim to present a case and review of DP and its association with dementia/MND, hyperprolactinemia and galactorrhea.

Non-systematic literature review and case report, based on the search for titles and/or abstracts of articles that address both DP and dementia, and DP and hyperprolactinemia/galactorrhea, including articles published between 2010 and 2022 in English.

A 71-year-old female patient was admitted to the Psychiatric unit due to a change in usual behavior in the past 6 months: insomnia, anterograde amnesia, delusions of ruin and persecutory and, for the past month, the belief of being pregnant with twins, supported by the galactorrhea she presented after starting Risperidone prescribed by her Family Doctor weeks prior. Shortly after admission, the patient also revealed hearing her fetuses’ voices. DP vanished briefly after admission due to the combination between the change of Risperidone to Aripiprazole (a prolactin-sparing antipsychotic) and psychotherapy to help deconstruct the patient’s cognitive misinterpretations. She was furthermore diagnosed with Alzheimer’s disease and Memantine was started.

This patient, according to Bera et al. (Bera et.al. Indian J Psychol Med 2015;37:131-7) is part of the 28.6% of patients more than 50 years of age who present DP, 6.0% that report having twins and 8.3% that report hearing voices of their fetuses. No data was found correlating DP and MND directly. Hyperprolactinemia and its consequent galactorrhea represent one of the many explanations behind DP, especially in suggestible demented patients that easily misinterpret somatic sensations, in which delusional thoughts are frequent and contribute to the morbidity.

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Substance Use Disorders are frequently associated to other medical problems. The temporal evolution of the main drug requests is related to drug and drug users’ facts. COVID-19 pandemic is worthy of investigation.

To analyze temporal trends in the characteristics of all medical requests to the Addiction Liaison Psychiatric Unit from January 2010 to December 2022.

Study data will be obtained from all patients that were referred to the Addiction Liaision Psychiatric Unit during 12 years in Hospital del Mar (Barcelona). Demographics and clinical data (substance use, medical diagnosis, dual diagnosis) will be obtained and analyzed by semesters.

The results will be presented as soon as all data is obtained. We will explore COVID-19 pandemic implications.

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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.

The use of internet among children and adolescent has risen in the last decade. In addition, suicide is the second cause of death among adolescents. Previous research have indicated the relation between Problematic Internet Use (PIU) and different mental health problems. Nonetheless there is a lack of studies analyzing the relation between suicide behaviour and PIU

The main objective of the present work was to analyze the relation between Problematic Internet Use and suicide behaviour and depression in adolescents

A total of 1036 adolescents (450 males) were randomly selected. Mean age was 15,21 (SD = 1,23). The Adolescent Behavioural Suicide Scale SENTIA, The Reynolds Adolescent Depression Scale Short Form (RADS-SF), and The Compulsive Internet Use Scale (CIUS) were used. A Manova was performed with two groups (risk and non-risk to PIU) as independent variables and suicide and depression scores as dependent variables

The results revealed a statiscally signifficant association between PIU and both depression and suicide behaviour (λ = 0.245, F(2,81,000) = 15.549, P ≤ 0.001, η² = 0.116). In particular, adolescents at a higher risk for PIU obtained higher scores on suicide behaviours and depression.

Results found in the present study reveal that adolescents have moderate prevalence rates for PIU. Also adolescents at risk for PIU with a total of more than 3 hour sof internet use everyday were at a higher risk for suicide. Prevention strategies should be devote to intervene in internet use as it maybe a variable affecting suicide behaviour.

No significant relationships.

Kleptomania is characterized by recurrent failure to resist the impulse to steal items of little value despite the ego-dystonic impulse and awareness of the wrongfulness of the act. Its prevalence is considered to be 0.6–0.8% in the general population and it is mostly comorbid with other psychiatric disorders. Kleptomania is a disabling disorder since patients suffer from emotional distress and impaired functioning.

Although there is no cure, treatment may help prevent Kleptomania worsening and its negative consequences. We propose a review of the therapeutic approach to this disease.

Non-systematic literature review.

No effective treatment is available for Kleptomania. Better efficacy can be achieved by combining psychotherapy with pharmacotherapy. Different treatment interventions can be selected based on clinical similarities to other disorders, co-occurring conditions or behavioral core features. Patients with significant mood symptoms may benefit from mood stabilizers or antidepressants. For patients with shoplift cravings and/or family history of substance use disorders, Naltrexone may reduce symptoms. Stimulants may be useful for Kleptomania bassociated with Attention Deficit Hyperactivity Disorder impulsivity. Benzodiazepines are effective in tension relief when used as adjuvants, at the beginning of treatment. Electroconvulsive therapy should be reserved for patients with treatment-resistant symptoms and comorbid depression. Cognitive-behavioral therapy has replaced Psychoanalytic and Psychodynamic psychotherapies.

Treatment helps decrease disruption to the person’s life, preventing the intense shame, legal, social, family, and occupational repercussions of Kleptomania. Although pharmaceutical and psychosocial interventions are available, we still lack specific treatments for Kleptomania.

No significant relationships.

There is emerging evidence of heterogeneity within treatment-resistance schizophrenia (TRS), with some people not responding to antipsychotic treatment from illness onset and a smaller group becoming treatment-resistant after an initial response period. It has been suggested that these groups have different aetiologies. Few studies have investigated socio-demographic and clinical differences between early and late onset of TRS.

This study aims to investigate socio-demographic and clinical correlates of late-onset of TRS.

Using data from the electronic health records of the South London and Maudsley, we identified a cohort of people with TRS. Regression analyses were conducted to identify correlates of the length of treatment to TRS. Analysed predictors include gender, age, ethnicity, positive symptoms severity, problems with activities of daily living, psychiatric comorbidities, involuntary hospitalisation and treatment with long-acting injectable antipsychotics.

We observed a continuum of the length of treatment until TRS presentation. Having severe hallucinations and delusions at treatment start was associated shorter duration of treatment until the presentation of TRS.

Our findings do not support a clear cut categorisation between early and late TRS, based on length of treatment until treatment resistance onset. More severe positive symptoms predict earlier onset of treatment resistance.

DFdF, GKS, EF and IR have received research funding from Janssen and H. Lundbeck A/S. RDH and HS have received research funding from Roche, Pfizer, Janssen and Lundbeck. SES is employed on a grant held by Cardiff University from Takeda Pharmaceutical Comp

Ethnic disparities in treatment with clozapine, the antipsychotic recommended for treatment-resistant schizophrenia (TRS), have been reported. However, these investigations frequently suffer from potential residual confounding. For example, few studies have restricted the analyses to TRS samples and none has controlled for benign ethnic neutropenia.

This study investigated if service-users’ ethnicity influenced clozapine prescription in a cohort of people with TRS.

Information from the clinical records of South London and Maudsley NHS Trust was used to identify a cohort of service-users with TRS between 2007 and 2017. In this cohort, we used logistic regression to investigate any association between ethnicity and clozapine prescription while adjusting for potential confounding variables, including sociodemographic factors, psychiatric multimorbidity, substance use, benign ethnic neutropenia, and inpatient and outpatient care received.

We identified 2239 cases that met the criteria for TRS. Results show that after adjusting for confounding variables, people with Black African ethnicity had half the odds of being treated with clozapine and people with Black Caribbean or Other Black background had about two-thirds the odds of being treated with clozapine compared White British service-users. No disparities were observed regarding other ethnic groups, namely Other White background, South Asian, Other Asian, or any other ethnicity.

There was evidence of inequities in care among Black ethnic groups with TRS. Interventions targeting barriers in access to healthcare are recommended.

During the conduction of the study, DFdF, GKS, and RH received funds from the NIHR Maudsley Biomedical Research Centre. For other activities outside the submitted work, DFdF received research funding from the UK Department of Health and Social Care, Janss

Studies have shown ethnic inequalities in health, with a higher incidence of illnesses among people of some minoritised ethnic groups. Furthermore, it has been observed that people with severe mental illnesses have a higher risk for multimorbidity. However, no study has investigated ethnic disparities in comorbidity in people with a schizophrenia spectrum disorder.

This study investigates potential ethnic disparities in physical health comorbidity in a cohort of people with psychosis.

Using a cross-sectional design, we identified service-users of the South London and Maudsley NHS Trust who were diagnosed with a schizophrenia spectrum disorder between 2007 and 2020. We assessed the prevalence of asthma, bronchitis, diabetes, hypertension, low blood pressure, overweight or obesity, and rheumatoid arthritis. Latent class analyses were used to investigate distinct profiles of comorbidity. Multinomial regression was then used to investigate ethnic disparities in these profiles. The regression model was adjusted for gender, age, neighbourhood deprivation, smoking and duration of care.

On a sample of 23,418 service-users with psychosis, we identified two classes of comorbidity: low comorbidity and multiple comorbidities. Compared to the White British ethnicity, a higher risk for multiple comorbidities was observed for people with any Black background, Indian, Pakistani, Asian British, and mixed-race ethnicities. Furthermore, Black African women had a significantly higher risk for multiple comorbidities than their male counterparts.

Ethnic disparities are observed in multiple comorbidities among people with psychosis. Further research is needed to understand the impact of these disparities, especially in relation to mortality.

No significant relationships.