Frequent emergency department users are high-risk and high-resource-utilizing patients. In psychiatry, reasons for frequent use of psychiatric emergency departments (PED) are complex, numerous and unpredictable.

This study aimed to identify profiles of high PED users (4+ visits/year) based on their patterns of PED use and clinical characteristics and to evaluate demographic factors associated with these patients.

This was a retrospective cohort study of all patients presenting to Unidade Local de Saúde Viseu Dão-Lafões PED, from January 2022 to December 2024.

In 2022, 34 patients were identified as high PED users, accounting for a total of 194 episodes. 58.8% were female, and 50% of them live in the city where the hospital is located. Regarding diagnosis, 47.1% had comorbidity with Personality Disorders (PD), 23.5% had comorbidity with Disorders of Intellectual Development (DID), and 23.5% had comorbidity with Psychiatric Disorders with psychotic symptoms. Of the 194 episodes, 22 resulted in hospitalization.

In 2023, 23 patients were high PED users, accounting for a total of 142 episodes. 52.2% were female and 60.9% of them lived in the city where the hospital is located. Regarding diagnosis, 39.1% of users had comorbidity with PD, 26.1% had comorbidity with DID, and 26.1% had comorbidity with Psychiatric Disorders with Psychotic Symptoms. Of the 142 episodes, 20 resulted in hospitalization.

In 2024, 30 patients were identified high PED users, accounting for a total of 194 episodes. 43.3% were female and 56.7% lived in the city where the hospital is located. Regarding diagnosis, 30% of users had comorbidity with PD, 23.3% had comorbidity with DID, and 33.3% had comorbidity with Psychiatric Disorders with Psychotic Symptoms. Of these 194, 20 resulted in hospitalization.

With this work, it was possible to verify that in 2022 and 2023, female users resorted more to the PED, as high users, a context that was reversed in 2024. Also in 2024, there was a greater preponderance of users with psychiatric disorders with psychotic symptoms, relative to PD and DID, for example, compared to 2022 and 2023.

Nevertheless, the fact that in that year, the 194 emergency episodes involving high PED users resulted in only 20 hospitalizations suggests that most of these episodes did not actually correspond to genuine psychiatric emergencies. Finally, easy access to the hospital, such as proximity to it, may increase the number of emergency episodes.

Therefore, it will be important to discuss strategies to be implemented to reduce the number of non-emergency visits to the PED.

None Declared

Romantic attachment is a fundamental human drive supported by neural systems involved in reward, motivation, and social bonding. When disrupted by loss or rejection, these same circuits contribute to what is often described as ”love sickness”—a state characterized by emotional distress, obsessive thinking, and physiological arousal. Neuroimaging research indicates that romantic suffering engages brain regions implicated in both physical pain and affective disorders, including the ventrolateral prefrontal cortex (vlPFC), anterior cingulate cortex (ACC), and anterior insula (AI). Beyond neurobiology, romantic loss has been linked to psychopathological symptoms such as depression, anxiety, and exacerbating borderline personality symptoms.

The objective of this review is to examine the neurobiological correlates of romantic suffering, explore gender differences in neural and psychological responses to romantic rejection or loss and discuss the psychopathological implications of romantic distress, particularly its links to depression, anxiety, and emotional dysregulation.

A non-systematic review of the literature, using combinations of keywords such as “romantic rejection”, “love sickness”, “neurobiology”, “gender differences”, “social pain” and “psychopathology” in database PubMed/MEDLINE.

Romantic rejection and loss activate brain regions involved in emotion regulation and pain (vlPFC, AI, ACC), overlapping with patterns seen in depression and addiction. Women tend to show stronger limbic and stress responses, while men engage more prefrontal and reward circuits, reflecting different coping styles. People with insecure attachment or high rejection sensitivity experience more intense emotional and physiological distress. Clinically, romantic loss is linked to depression, anxiety, rumination, and sometimes borderline personality features.

Romantic suffering involves brain and psychological processes linked to emotional disorders. Gender influences these neural and behavioral responses, shaping vulnerability and coping. Recognizing these patterns can inform gender-sensitive prevention and treatment. Future research should use longitudinal and experimental methods to clarify how romantic distress leads to psychopathology.

None Declared

Social support plays a central role in the recovery of individuals with substance use disorders (SUDs). It not only enhances treatment adherence but also helps sustain connections, reinforce motivation, and foster a sense of belonging. Yet, the ways in which gender norms influence the reception and provision of support within therapeutic communities (TCs) in Brazil remain under-explored.

To understand how individuals with SUDs perceive and experience social support during treatment in TCs, considering gender influences and the role of family and community ties in their care trajectories.

This is a qualitative exploratory study. A focus group was conducted with six participants (three men, including one trans man, and three women, including one trans woman) in a TC in an inland region of São Paulo state, Brazil. Discussions were audio-recorded, transcribed, and subjected to thematic content analysis.

Three primary themes emerged: (1) Emotional and instrumental support: Affectionate encouragement, attentive listening, and everyday presence were valued as fundamental, while lack of understanding by family members weakened support; (2) Family and institutional networks: When family ties were fragile, bonds forged in the TC and in social assistance networks assumed a central role in maintaining treatment motivation; (3) Gender norms: Men reported difficulties expressing vulnerability and seeking help, whereas women emphasized the importance of affective ties and acceptance from family and peers. These differences affected how support was accessed and incorporated into recovery pathways.

In TCs, social support emerges at the intersection of affective, institutional, and gendered dimensions. Recognizing the influence of gender norms is essential to foster equitable access to emotional support. We argue that policies and practices should strengthen family and institutional networks while creating environments that validate vulnerability and emotional expression among men, women, and trans people in treatment.

None Declared

Social support is a recognized protective factor in the recovery of individuals with substance use disorders (SUDs), contributing to relapse reduction and treatment retention. Sociodemographic conditions can either enhance or restrict access to emotional, instrumental, and community support networks, especially in vulnerable settings such as therapeutic communities (TCs) in Brazil.

To analyze the sociodemographic profiles and perceived social support of individuals undergoing treatment for SUDs, and to discuss how these conditions influence access to different forms of social support over the recovery process.

This is a cross-sectional, descriptive study with 307 participants who use psychoactive substances, admitted in two TCs in the Southeast region of Brazil. The following instruments were applied: sociodemographic questionnaire; the Family/Social Status domain (domain 6) of the Addiction Severity Index (ASI); the Spirituality Self-Rating Scale (SSRS); and the MOS Social Support Survey (MOS-SSS).

The sample was predominantly male (83.4%), non-white (52.8%), single (65.9%), and with children (67.6%, of whom 45.1% had minors). Religious affiliation was high (83.7%); Catholic (41.2%) and Evangelical (38.6%) predominated; 60.9% reported regular religious practice. Although 80.5% had worked in the last year, 44.0% received government benefits. Social vulnerability was significant: 37.0% had a history of homelessness, and 44.4% had no monthly income. Regarding social support, most participants reported receiving some support, especially emotional and religious, even amid limitations in instrumental support and family networks. Participants with weakened family ties tended to rely more on institutional support provided by TCs and public social assistance. Those who maintained frequent contact with family and had prior employment history reported greater perceived instrumental and motivational support, while religious ties emerged as an important source of affective and spiritual support during treatment. This set of conditions indicates fragility in family support, associated with unstable partnerships and economic hardship, but also reveals protective elements such as religious involvement and past work experience, which may facilitate access to emotional and instrumental support.

The sociodemographic profile highlights vulnerabilities and protective resources that directly influence access to social support during recovery. We advocate that care strategies in TCs incorporate income generation and housing interventions, linked to strengthening family, religious, and peer ties, as a means to expand support networks and promote more protective treatment environments.

None Declared

The rising global prevalence of pediatric mental health problems requires the identification of preventable factors underlying their development. This study assessed whether maternal adverse childhood experiences (ACEs) and pregnancy stress were intergenerationally associated with offspring mental health.

This study used data from 34 sites in the nationwide Environmental Influences on Child Health Outcomes Cohort. Eligible parent–child dyads (child age: 1.5–18 years) provided data on at least one measure of maternal stress and at least one measure of child mental health. Study aims were evaluated using regression analyses, including interaction tests to determine potential effect modifiers.

Participants were organized into three subsamples with data on (1) maternal ACEs (N = 2,906), (2) perceived prenatal stress (N = 4,441), and (3) both stress exposures (N = 834). After adjusting for confounders, maternal ACEs and prenatal stress were significantly associated with child mental health problems (B = 2.53 [95% confidence interval [CI]: 2.09, 2.96], p < 0.0001 and B = 2.36 [95% CI: 2.03, 2.68], p < 0.0001, respectively). Among participants with data on both stress exposures, maternal ACEs (B = 1.72, 95% CI: [0.96, 2.48], p < 0.0001) and prenatal stress (B = 2.05, 95% CI: [1.29, 2.80], p < 0.0001) were independently associated with child mental health problems. Neither maternal ACEs nor child sex modified the association between prenatal stress and child mental health problems.

Maternal exposure to ACEs and pregnancy stress were associated with the development of child mental health problems. These findings highlight the need for policies and interventions that mitigate exposure to adversity and protect pregnant individuals and their children from the intergenerational transmission of mental health problems.

Forensic psychiatry transcends legal and cultural boundaries across Europe, but specialization and training remain inconsistent. With freedom of movement in most European countries, psychiatrists accredited in one country can practice in others if they meet language requirements. Therefore, harmonizing psychiatric education and practice is crucial and aligns with the European Federation of Psychiatry Trainees (EFPT)’s goals.

This study aims to map the current state of forensic psychiatry education across Europe, focusing on its recognition as a specialty on its own or subspecialty, training structure, and financial implications. It also assesses whether general adult psychiatry (GAP) and child and adolescent psychiatry (CAP) trainees receive adequate forensic psychiatry education, identifying gaps and variations across countries.

Data was collected via an online survey distributed to European National Trainee Association (NTA) representatives in the EFPT through Google Forms in August 2024. Responses from non-European countries and incomplete entries were excluded. The final dataset was analyzed using SPSS 24.

A total of 29 participants, including 24 GAP trainees (82.8%), 2 CAP trainees (6.9%), and 3 specialists (10.3%), from 20 European countries responded to the survey. Forensic psychiatry was recognized either as a specialty or subspecialty in 13 counctries (65%) with 20 (69%) of participants confirming its recognition. 38% reported forensic training lasts less than 1 year or lacks a formal program. Financial support varied as well, with some countries offering full subsidies, while others required trainees to cover costs. Forensic psychiatry was included in the training of 66.7% of GAP trainee and 50% of CAP trainees, though the depth of exposure differed. Notable gaps were found particularly in risk assessment, expert witness training, and competency evaluations.

This study reveals significant variation in the recognition, structure, and delivery of forensic psychiatry training across Europe. While some countries offer well-defined programs, discrepancies in accessibility and comprehensiveness persist. These findings highlight the need for standardized curricula to ensure consistent training. Enhancing forensic psychiatry education is crucial for preparing future psychiatrists and ensuring high-quality psychiatric contributions in legal contexts and harmonization of forensic training across Europe.

None Declared

Treatment-resistant schizophrenia patients have the worst clinical outcomes and poor quality of life, despite the administration of clozapine. Currently, the definition of resistance is based on treatment response, but evidence differentiating resistance remains unclear. The dysconnectivity theory suggests that disrupted brain interactions contribute to schizophrenia pathology. Advances in functional and structural neuroimaging allow exploration of connectivity patterns that may characterize treatment-resistant schizophrenia.

This study aimed to describe functional and structural connectivity patterns in schizophrenia patients on clozapine.

Patients taking clozapine (CLZ) or other antipsychotic (nCLZ) were recruited from the Hospital of the Medical School of Ribeirão Preto. Healthy controls (HC) were recruited from the Hospital database. Seventy-seven participants were selected: CLZ = 35, nCLZ = 27, and HC = 27. Functional connectivity (FC) was assessed via resting-state functional magnetic resonance imaging (rs-fMRI) and ROI-to-ROI analysis using the CONN toolbox. Structural connectivity was analyzed with diffusion tensor imaging and tractography using TRACULA toolbox. ANOVA and Tukey test were used for three-group comparisons, and the t-tests for two-group comparisons. Functional analysis was performed with a significance threshold of p < 0.05 and false discovery rate (FDR) set to p < 0.01.

Reduced frontotemporal FC and increased FC in the frontal-occipital were common in CLZ and nCLZ compared to HC. An increased FC between sensorimotor and the cerebellum was notable in CLZ compared to HC. Structural findings included increased axial diffusivity (AD) and mean diffusivity (MD) in 8 of 10 tracts in CLZ compared to HC. The corticospinal tract and inferior longitudinal fasciculus exhibited increased AD and MD in CLZ compared to nCLZ. The cingulum angular bundle showed significantly altered diffusion measures in nCLZ: increased AD, MD, and radial diffusivity (RD), and reduced fractional anisotropy (FA).

This study described a widespread functional and structural dysconnectivity in CLZ, characterized by reduced frontotemporal FC and increased frontal-occipital and sensorimotor–cerebellum FC. Altered AD and MD measures in the corticospinal tract and inferior longitudinal fasciculus were observed in the CLZ. Alterations in AD, MD, RD, and FA measures in the cingulum angular bundle, particularly noted in nCLZ, may be associated with antipsychotic administration. Further studies are necessary to establish whether these dysconnectivity patterns consistently characterize these patient groups.

None Declared

Research into early interventions following a first episode of psychosis (FEP) has enabled a focused approach on prognostic-modifying factors. Among these, poor medication adherence contributes to relapse, as well as cognitive and functional deterioration. Several studies report discontinuation rates of oral antipsychotics (OAPs) after FEP at 70%, regardless of the prescribed OAP. The early introduction of long-acting injectable antipsychotics (LAIAs) could present an alternative.

This study aims to review the efficacy of LAIAs in the early stages of psychosis and compare the most relevant international guidelines on this topic.

Methodology: A non-systematic literature review using the keywords “long-acting injectable” and “first episode psychosis,” limited to articles published in English and Portuguese in the last 10 years from the PubMed®/MEDLINE® database, and clinical practice guidelines on psychosis, schizophrenia, and FEP from NICE, APA, and RANZCP.

Despite frequent selection biases (such as reserving LAIAs for patients with worse prognostic factors), significant benefits of LAIAs over OAPs in preventing hospitalization and relapse during the early phases of psychosis are consistently reported. LAIAs reduce non-adherence due to forgetfulness or reduced insight, while their different pharmacokinetics minimize withdrawal symptoms, drug interactions, and fluctuations in plasma concentration, enhancing tolerability. No second-generation LAIA was found to be clearly superior in terms of efficacy. Various guidelines recommend offering this treatment option early, favoring an informed and collaborative decision-making process. However, despite documented benefits in robust studies, they do not consider LAIAs as a first-line treatment.

Discussion/Conclusions: Significant variations in the proportion of patients on LAIAs across countries suggest that factors other than efficacy may influence its use. Greater understanding of these factors could help identify potential barriers to optimal implementation. New evidence may prompt a review of the guidelines.

None Declared

Depressive disorder is a common mental disorder, with an estimated 3.8% of the population experiencing it. Despite the advent of new antidepressant medication, many patients presenting with Major Depressive Disorder (MDD) do not recover after multiple trials. Although the prevalence of treatment-resistant depression (TRD) is not clear due to the lack of a standard definition, its prevalence ranges from approximately 30 to 70 percent.

Considering the high prevalence of treatment-resistant depression, this work aims to evaluate the effectiveness of alternative treatments, namely Noninvasive Neuromodulation Therapies in the treatment of MDD.

Non-systematic literature review, using Pubmed as database, with the keywords “depression treatment”, “neuromodulation” and “noninvasive neuromodulation”.

We can divide non-invasive neuromodulation into convulsive therapies (CV) and therapies that do not involve inducing a seizure. Additionally, we can also divide them into clinically available therapies and others only available in investigational settings.

Regarding clinically available CV, we have Electroconvulsive Therapy (ECT), the oldest neurostimulation procedure. Being heavily studied, ECT is superior to pharmacotherapy for MDD based upon meta-analyses of randomized trials and is generally considered the most efficacious treatment for depression, albeit recurrence following remission is common.

Other CV, but still in investigational stages, are Magnetic seizure therapy (MST) and Focal electrically administered seizure therapy (FEAST) both showing positive results in prospective studies and MST in a small head-to-head randomized trials with ECT, that showed a similar efficacy between these two therapies.

Other clinically available, but not convulsive therapies, are Repetitive Transcranial Magnetic Stimulation (rTMS) and Cranial Electrical Stimulation (CES). Meta-analyses of randomized trials indicate that rTMS is beneficial for treating TRD, being also approved by the FDA. In its turn, multiple reviews indicate that no high-quality studies have demonstrated that CES is efficacious for MDD or TRD.

Additional non-convulsive therapies, available in investigational settings, include Transcranial Direct Current Stimulation, Transcranial Low Voltage Pulsed Electromagnetic Fields, Trigeminal Nerve Stimulation, Low Field Magnetic Stimulation and Transcutaneous Vagus Nerve Stimulation, with all of them showing positive effects in the treatment of MDD or TRD, except for Low field magnetic stimulation.

With this review, we were able to verify that clinically available non-invasive neurodomulation therapies, such as ECT and rTMS, present robust results in the treatment of MDD and TRD, however, resistance to these therapies also exists.

Considering the positive results of multiple novelty therapies, these could be the solution to this scourge.

None Declared

Treatment for bipolar disorder (BD) predominantly focuses on psychopharmacology, including lithium, antipsychotics, and anticonvulsants. Electroconvulsive therapy (ECT) is highly effective for managing manic or depressive episodes, yet studies on the effects of anticonvulsant therapy as a modifying factor of clinical outcome during ECT are scarce.

To evaluate how concurrent anticonvulsant use affects seizure parameters and clinical outcomes of ECT in BD patients.

A comprehensive search of multiple databases (MEDLINE, Embase, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov) was conducted on October 2, 2024, without language or publication date restrictions. Eligible studies included clinical trials and retrospective analyses comparing BD patients undergoing ECT with and without anticonvulsant use. Random-effects models were applied for a sufficient number of studies, while fixed-effects models were used for fewer studies. Subgroup and sensitivity analyses were conducted.

Six studies met the criteria, involving 359 participants (mean age: 29.7 years; 31.2% female). Five studies focused on the effect of concomitant treatment with valproate during a manic episode, and only one study included subjects in treatment with other anticonvulsants during different mood episodes of BD. Anticonvulsant users required significantly higher minimal electrical dosages to achieve adequate seizures (SMD = 0.71, 95% CI [0.46 to 0.95], p < 0.0001), as indicated by higher seizure thresholds and stimulus doses. Additionally, anticonvulsant use was associated with a significantly shorter seizure duration (SMD = -0.75, 95% CI [-1.10 to -0.41], p < 0.0001). However, no significant differences in symptomatic improvement were found between those using and not using anticonvulsants (SMD = 0.03, 95% CI [-0.19 to 0.25], p = 0.78).

Concurrent anticonvulsant use in BD patients undergoing ECT is associated with higher seizure thresholds and shorter seizure durations, but this does not affect clinical outcomes regarding disease severity. Based on these findings, discontinuation of anticonvulsants during ECT may not be necessary. This review was limited by the small number of studies, small sample sizes, and considerable heterogeneity. Additionally, the majority of the studies analyzed only included patients in the manic state of the illness. Further research is needed to explore whether variations in seizure parameters are linked to individual clinical outcomes in BD patients, the impact of different anticonvulsants on these parameters and the outcome for depressive and mixed episodes of bipolar disorder.

I. Borja De Oliveira: None Declared, E. Tolotti Leite: None Declared, I. Santos Raposo Andrade: None Declared, M. Geremias: None Declared, A. Stephany: None Declared, A. de Vasconcelos: None Declared, D. Xavier: None Declared, F. Wagner: None Declared, G. A. M. Alves: None Declared, M. O. Pozzolo Pedro: None Declared, D. Soler Lopes: None Declared, A. Balduino de Souza: None Declared, M. Carbajal Tamez: None Declared, J. Quevedo Shareolder of: Instituto de Neurociencias Dr. Joao Quevedo, Grant / Research support from: LivaNova; and receives copyrights from Artmed Editora, Artmed Panamericana, and Elsevier/Academic Press, Consultant of: EMS, Libbs, and Eurofarma, Speakers bureau of: Myriad Neuroscience and AbbVie.

Psychoactive substance use among pregnant women has reached alarmingly high rates and is considered a public health problem. Pregnancy is a period in which women become more sensitive and concerned about their well-being, in view of how that will affect their baby. Therefore, pregnancy becomes a favorable period for therapeutic intervention, especially with regard to drug use. Despite this, there is still a small number of studies that address the issue of female drug users in Brazil, especially due to stigma and prejudice.

Our main aim was to characterize the clinical and psychiatric profile of pregnant crack users in Brazil, with a focus on comorbidities, the severity of crack use, and the use of other substances.

This was a cross-sectional study of 24 pregnant crack users admitted to a referral hospital for psychiatric disorders in pregnant women, in Porto Alegre, Brazil, over three years. Most women tend to remain hospitalized for a long time, often months, until giving birth. This scenario directly influenced the sample size of this study. The following instruments were applied: a clinical-obstetric questionnaire; the condensed version of the Addiction Severity Index; a diagnostic interview for psychoactive substance use based on DSM-5; the Mini International Neuropsychiatric Interview for DSM-IV; and the Semi-Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II).

Most patients had severe crack dependence and used other substances, such as tobacco, cannabis, and alcohol. The median duration of crack use was three years, ranging between three and 12 years. Most women subsisted from illegal or informal activities; a fifth had previously been arrested and often had relationship problems. Twenty percent had HIV (n = 5), and 37.5% (n = 9) had syphilis. Borderline personality disorder was the most prevalent mental condition (62.5%), followed by suicidal tendencies (45.8%), hypomanic episodes due to substance use (37.5%), and past major depressive episodes (33.3%).

This is one of the few studies exploring and characterizing social, economic and health aspects of pregnant crack users in Brazil. An alarmingly high prevalence of consumption of other drugs, psychiatric disorders, and difficult-to-treat personality disorders was observed in our study. Investigating the psychiatric profile of women who use substances is essential to minimize the impacts on the mother and child, optimize therapeutic approaches to comorbidities, and enable more effective relapse prevention.

None Declared

Epidemiological evidence shows a concerning rise in youth mental health difficulties over the past three decades. Most evidence, however, comes from countries in Europe or North America, with far less known about changes in other global regions. This study aimed to compare adolescent mental health across two population-based cohorts in the UK, and two population-based cohorts in Pelotas, Brazil.

Four population-based cohorts with identical mental health measures were compared. In Brazil, these included the 1993 Pelotas Birth Cohort and the 2004 Pelotas Birth Cohort. In the UK, cohorts included the Avon Longitudinal Study of Parents and Children, and the Millennium Cohort Study. Mental health was measured in all cohorts using identical, parent-rated scores from the Strengths and Difficulties Questionnaire (SDQ). This was assessed in both countries over approximately the same time periods, when adolescents were aged 11 (2004 vs 2015 in Brazil, and 2003 vs 2012 in the UK), with follow-up analyses focused on outcomes in later adolescence.

Mental health problems were higher in the UK for adolescents born in the early 2000s compared to those born in the early 1990s. In Pelotas, the opposite was found, whereby problems were lower for adolescents born in the early 2000s compared to those born in the early 1990s. Despite these promising reductions in mental health problems in Pelotas over time, SDQ scores remained higher in Pelotas compared to the UK.

Our study represents the first to compare two population-based cohorts in the UK, and two population-based cohorts in Pelotas, Brazil, to understand how mental health problems have changed over time across the two settings. Our findings provide the most up-to-date insight into population-level rates of youth mental health problems in Pelotas, and shed novel insight into how these have changed over the last two decades in comparison to the UK. In doing so, our study provides a tentative first step towards understanding youth mental health over time at a more global scale, and presents a valuable opportunity to examine putative contributors to differences across time.

Cannabis use and familial vulnerability to psychosis have been associated with social cognition deficits. This study examined the potential relationship between cannabis use and cognitive biases underlying social cognition and functioning in patients with first episode psychosis (FEP), their siblings, and controls.

We analyzed a sample of 543 participants with FEP, 203 siblings, and 1168 controls from the EU-GEI study using a correlational design. We used logistic regression analyses to examine the influence of clinical group, lifetime cannabis use frequency, and potency of cannabis use on cognitive biases, accounting for demographic and cognitive variables.

FEP patients showed increased odds of facial recognition processing (FRP) deficits (OR = 1.642, CI 1.123–2.402) relative to controls but not of speech illusions (SI) or jumping to conclusions (JTC) bias, with no statistically significant differences relative to siblings. Daily and occasional lifetime cannabis use were associated with decreased odds of SI (OR = 0.605, CI 0.368–0.997 and OR = 0.646, CI 0.457–0.913 respectively) and JTC bias (OR = 0.625, CI 0.422–0.925 and OR = 0.602, CI 0.460–0.787 respectively) compared with lifetime abstinence, but not with FRP deficits, in the whole sample. Within the cannabis user group, low-potency cannabis use was associated with increased odds of SI (OR = 1.829, CI 1.297–2.578, FRP deficits (OR = 1.393, CI 1.031–1.882, and JTC (OR = 1.661, CI 1.271–2.171) relative to high-potency cannabis use, with comparable effects in the three clinical groups.

Our findings suggest increased odds of cognitive biases in FEP patients who have never used cannabis and in low-potency users. Future studies should elucidate this association and its potential implications.

High rates of intimate partner violence (IPV) and mental disorders are present in Mozambique where there is a significant treatment gap. We aimed to report Mozambican community stakeholder perspectives of implementing couple-based interpersonal psychotherapy (IPT-C) in preparation for a pilot trial in Nampula City.

We conducted 11 focus group discussions (6–8 people per group) and seven in-depth interviews with key informants in mental health or gender-based violence (n = 85) using purposive sampling. We used grounded theory methods to conduct an inductive coding and then deductively applied the consolidated framework for implementation research (CFIR).

For the outer setting, local attitudes that stigmatize mental health conditions and norm IPV as well as an inefficient legal system were barriers. Stakeholders expressed high acceptability of IPT-C, although a lack of resources was a structural challenge for the inner setting. Adaptation of the approach to screen for and address potential mediators of IPV was important for adopting a multisectoral response to implementation and planning. Delivering IPT-C in the community and in collaboration with community stakeholders was preferable.

Stakeholders recommended multilevel involvement and inclusion of community-based programming. Task shifting and use of technology can help address these resource demands.

The Positive and Negative Syndrome Scale (PANSS) has been used as a universal instrument for clinical assessment of psychopathology in schizophrenia. Different studies have analyzed the factorial structure of this scale and have suggested a five-factor model: positive, negative, excited, depressive, and cognitive/disorganized factors. Two of the most used models are the Marder´s solution and the Wallwork´s one.

The aim of this work was to study the correlations of the two cognitive factors (Marder and Wallwork) with a cognitive assessment performed with a standard cognitive battery, in a sample of patients with first psychotic episode of schizophrenia.

Seventy four patients with first psychotic episode of schizophrenia (26.9, SD:7.8 years old; 70.3% male) were included. The cognitive assessment was performed with the MATRICS Consensus Cognitive Battery (MCCB). The MCCB present seven cognitive domains: Speed of processing, Working memory, Attention/Vigilance, Verbal Learning, Visual Learning, Reasoning and Problem Solving, and Social cognition). Pearson correlations were performed between MCCB scores and Marder´s PANSS cognitive factor (P2, N5, G5, G10, G11, G13, G15) and Wallwork´s one (P2, N5, G11).

Correlation between MCCB scores and cognitive factors of Marder and Wallwork can be seen in the table.

Both PANSS cognition factors show a moderate correlations with Speed of processing, Working memory, Attention/Vigilance and Verbal Learning assessed by MCCB. More discrete correlations were found with Visual Learning, Reasoning and Problem Solving, and with Social cognition (in fact, non-significant correlation with Wallwork´s cognitive factor was found).

Acknowledgements. This study has been funded by Instituto de Salud Carlos III (ISCIII) through the project PI19/00766 and co-funded by the European Union.

None Declared

tardive dysphoria is a relatively new term used to describe the phenomenon of clinical worsening of depression after long-term antidepressant use. Most of the theories proposed to explain this talk about antidepressants tachyphylaxis that implies the loss of efficacy with its prolonged use, or even a pro-depressant effect of antidepressants when used for long periods of time.

to explore the concept of tardive dysphoria, potential causes and clinical implications, by making a literature review on the topic. Moreover we pretend to understand the challenges in its diagnosis and treatment.

bibliographical search in PubMed database, using the key-words “long-term antidepressant”, “tardive dysphoria” and “antidepressant tachyphylaxis”, limited to works published in the last twenty years.

from our search resulted 53 articles, 26 were chosen for further analysis.

the concept of tardive dysphoria is controversial, namely doubt persists if it constitutes a clinical entity by itself caused by long-term antidepressant use or if it simply relates to cases of treatment-resistant depression. We conclude that it is necessary further investigation in this area given the significant implications on clinical practice specifically in the psychopharmacological treatment with antidepressants, which is very common in psychiatric and general practices, with antidepressants being used to treat many mental health conditions.

None Declared