The econsulta is the telematic coordination system between hospital care and primary care. In this way, it allows an agile and fluid coordination, improving the coordination and the care process of the patient.

With the data collected and analyzed, a descriptive study of the functioning of the econsulta as a coordination tool between Mental Health and Primary Care is carried out.

The data collected corresponds to health area 6 of the Community of Madrid, which consists of 18 primary health centers for a Mental Health Center. The econsultations carried out between January 2022 and August 2024 are analyzed.

The data collected are broken down into patient diagnoses, coded according to the ICD-10 classification system, and the attitude to be taken in each of them.

A total of 1489 econsults performed in the period between January 2022 and August 2024 were obtained. The majority diagnoses are:

• - Organic mental disorders, including symptomatic.

• - Mental and behavioral disorders due to the use of multiple drugs or other psychotropic substances.

• - Schizophrenia, schizotypal disorder and delusional disorders.

• - Mood (affective) disorders.

• - Mood disorders

• - Neurotic disorders, secondary to stressful situations and somatoform disorders.

• - Eating behavior disorders.

• - Personality and behavioral disorders in adults.

• - Mental retardation.

• - ADHD

Thanks to the econsult, 692 patients have been resolved, without requiring referral to Mental Health, through direct indications and recommendations on treatments prescribed in Primary Care. Likewise, 61 of them avoided referral only to obtain a visa for the usual treatment. On the other hand, 378 patients required direct referral to Mental Health and 54 to the CAID. In addition, 229 of the patients who were already under follow-up were consulted about their treatment.

After analyzing the data, Primary Care made adequate use of the system, given that only 40 of the consultations were not appropriate.

After analyzing the data, the econsultation is a fast and effective coordination system that increases the efficiency of the patient care system.

None Declared

Autism spectrum disorder is a complex pathology that can occur very frequently with other disorders. It is known to co-occur with ADHD (attention deficit hyperactivity disorder), anxiety disorders or depression. Comorbidity with obsessive-compulsive disorder (OCD) can be difficult to detect since rigid and obsessive thinking, which in many cases is similar to the obsessions and compulsions of the OCD patient, is part of the core symptomatology of autism spectrum disorder.

To present two cases of patients atteded in the Adolescent Hospitalization Unit with Autism Spectrum Disorder comorbid with OCD

Two clinical cases are presented, with review of literature.

First case

This is a 16-year-old male, diagnosed with autism spectrum disorder at age 4. He begins with intense preoccupation for hygiene, developing cleaning rituals. He begins to develop the idea that his cells are released from his body and that they are sensitive to external stimuli in the same way that he is. He claims that in order for them to be eliminated and “not to suffer” he has to wash them and make flapping movements and avoid their accumulation.

He begins to treat with sertraline up to 200 mg with partial response, adding fluvoxamine 100 mg with important improvement of the symptomatology.

Second case

17-year-old male admitted to the inpatient unit for isolation and cleaning rituals and fear of contamination. The patient had no past psychiatric history. He had been out of school for 4 months. The patient began to develop a fear of pathogen contamination. He maintained cleaning and checking rituals. He ate only packaged food and spent hours, and slept, in the same corner of the bed.

Medication with sertraline up to 150 mg was started with progressive improvement. During the admission a history of evolutionary development was taken, observing a difficulty in the mentalization of other people’s emotions. Very adult and literal speech with difficulty in abstract thinking. He revealed presence of restricted interests throughout his history such as rare languages. Finally, the diagnosis of Autism Spectrum Disorder and comorbid obsessive compulsive disorder was made.

The comorbidity between autism spectrum disorder and OCD occurs between 37%. This comorbidity can make it difficult to perform psychotherapeutic interventions. This work shows on the one hand an already diagnosed autistic patient who develops an OCD, and on the other hand, how the initial diagnosis is an OCD on which an autism spectrum disorder is detected. This highlights the importance of knowing the comorbidity in order to detect both diagnoses.

None Declared

Several studies have reported that high fruit and vegetable consumption is associated with increased life expectancy. In migrant populations, lifestyle habits are modified in the process of acculturation.

Our aim was to review the diversity/functional compounds of food groups in Latin American, African, Asian and European cultures. In a second step, we aimed to review the dietary patterns for migrant women with schizophrenia.

A two-stage systematic review was conducted using the PubMed and ClinicalTrials.gov databases (2004-2024). The first part included studies reporting information on food and nutrients in adult populations from the nationalities with the highest prevalence of women with schizophrenia attending the Mútua Terrassa Functional Unit for Women with Schizophrenia (Dominican Republic, Venezuela, Ecuador, Morocco, Senegal, Romania and Pakistan). In a second part papers focused on food consumption among migrant women with schizophrenia.

A total of 87 studies were included from a total of 21,306 records screened. First part: (1) Latin America (n=32). Outcomes:food choice trajectories for dietary acculturation, barriers and facilitators for fruit and vegetable consumption (antioxidant effects of polyphenols), fruit/tubers/legumes traditionally consumed. (2) Africa (n=25). Regular consumption of oils, changes in medications during the holy month of Ramadan, anti-inflammatory effects of species. (3) Europe (n=17). Antioxidant properties of phenolics in mushrooms, and polyphenols in berries. (4) Asia (n=13). Women more vegetables, fruit and fish. Second part: Dietary intake of vitamin C, niacin, and folate reduced in schizophrenia. Few studies in women with schizophrenia.

Nutritional intervention programmes for migrant women with schizophrenia should pay attention to biocultural heritage and traditional antioxidant/anti-inflammatory foods.

None Declared

Depressive symptoms that do not respond to 2 lines of antidepressant treatment in adequate doses for 6-8 weeks are known as resistant depression. As therapeutic alternatives we currently have, among other options, intranasal esketamine and electroconvulsive therapy (ECT).

To present two cases of resistant depression in combined treatment with esketamine and ECT as an effective tratment

2 cases report

The first one is a 60-year-old male with a diagnosis of recurrent depression who was admitted after an autolytic attempt by drug overdose. Our second patient is a 59-year-old male with a diagnosis of bipolar disorder, current major depressive episode with psychotic symptoms. He had a history of previous depressive episodes, requiring treatment with ECT on 2 occasions due to resistance to psychopharmacological treatment.

Both patients had major depressive symptoms resistant to conventional pharmacological treatment, with a predominance of sadness, apathy, anhedonia, hopelessness, psychomotor inhibition and self-induced suicidal ideation. One of them also presented psychotic symptoms congruent with mood.

The first patient received treatment with intranasal esketamine with partial response, so a combination with ECT was started once the 8 biweekly sessions of the induction phase were completed. The second patient was initially ambivalent to a new cycle of ECT. For this reason, treatment with esketamine was proposed and after 6 biweekly sessions he agreed to overlap treatment with ECT. In both patients there was a clear improvement in clinical symptoms and adequate tolerability, allowing discharge home.

There are few data in the literature on combined treatment with intranasal esketamine and ECT. Our experience in the 2 cases described points to an adequate response and tolerability. Specific studies would be necessary in this regard.

None Declared

Anorexia nervosa (AN) and autism spectrum disorder (ASD) share symptoms that complicate diagnosis and treatment, including rigidity in thinking and behavior. This inflexibility often manifests as strict food routines in anorexia. Both conditions involve excessive preoccupation with control and perfection, leading to restrictive behaviors and heightened anxiety.

To show the clinical presentation of Anorexia Nervosa and austism spectrum disorder through the presentation of two cases.

Cases presentation and literature review

Case 1

A 15-year-old girl is receiving psychiatric follow-up for restrictive eating habits. She developed normally and has used sophisticated language since childhood. However, during her infancy, she did not engage in symbolic play. Academically, she performs exceptionally well. She describes herself as having a very rigid personality and struggles with understanding irony and certain social behaviors. She has few friends, viewing friendships as a waste of time. Her interests lie deeply in literature and science, and she tends to wear childish clothing.

She expresses feelings of jealousy towards her younger sister and mentioned that she reduced her food intake to prevent growing taller and to achieve “thinner ankles.” As she begins psychotherapy, she shares that she finds it challenging to grasp what the psychologist means due to her tendency for literal thinking.

Case 2

The patient is a 14-year-old male from Peru, who arrived in Spain 8 months ago. Developmental milestones within the normal range. Little symbolic play and difficulty with non-verbal language. Highly ritualised behaviours and tendency to obsessions, requiring psychological intervention due to compulsion to clean in the COVID-19 pandemic. The patient was admitted to the inpatient unit for weight loss of 6 kilograms in one month, with food restriction and excessive increase in physical exercise. Selective mutism is associated with months of selective mutism, as ‘he does not speak to people who do not speak with a Peruvian accent’. Parents speak of a rigid and literal idea of ‘having to be thin in order to make friends and strong in order not to be weak’.

Both cases reflect how the rigidity and literal thinking of autistic disorder can lead to extreme behaviours such as ‘don’t eat so as not to grow up’ in the first case, or ‘don’t eat to make friends’ in the second case, lived with no flexibility

There is a recognized connection between ASD and AN, with studies indicating a prevalence of 20-25%. Inflexible thinking associated with ASD can negatively impact the prognosis of AN, as ASD may contribute to the chronicity of the eating disorder. Additionally, psychotherapy can present challenges, and research suggests that behavioral techniques, particularly Applied Behavior Analysis (ABA), tend to yield better outcomes for individuals with AN.

None Declared

Loneliness and social isolation are frequently associated with mental health problems. In Spain, the term ‘unwanted loneliness’ has gained particular importance in recent years, referring to an involuntary insufficiency in social relationships. According to recent studies, this affects an estimated 13.4% of the Spanish population (Jiménez Rodríguez. Rev Esp Salud Publica 2024; 98).

To conduct a review of the studies that address loneliness and social isolation

We searched in PubMed using the following terms: ‘((unwanted loneliness[Title/Abstract]) OR (loneliness[Title/Abstract]) OR (social isolation[Title/Abstract])) AND (mental health[Title/Abstract])’, limiting the search to the last 30 years.

We found 5,472 articles on the subject, of which 4,373 were published in recent years, confirming the growing interest in this issue. The countries with the most publications on this topic were England (1,733 results), the United States (1,561 results), and Switzerland (894 results). Although we did not focus on this aspect, it is worth noting that the most frequently used keyword was ‘COVID-19,’ appearing a total of 1,229 times, which may partially explain the increase in publications over the last year.

Upon reviewing the content of the articles, we observed that many focus on demographic factors. For example, living with a romantic or sexual partner has been consistently identified as a protective factor against loneliness (Currin et al. Curr Psychol 2022; Online publication), and we also found significant associations between loneliness and being single, separated, or divorced (Ibáñez-Del Valle et al. Int J Environ Res Public Health 2022; 19:16622).

The association of this issue with social inequalities has also been highlighted (Martín Roncero et al. Gac Sanit 2021; 35:432-437). We observed a potential gender bias, with findings indicating a higher risk in women for the perception of loneliness and the evaluation of social relationships (Pavlidis et al. Aging Ment Health 2023; 27:1313-1321). Other studies have found that higher population density reduces social isolation in areas with a high proportion of people of the same race or ethnicity but increases it in areas with fewer people of the same ethnicity (You et al. Inquiry 2024; 61:469580241273127). Sexual orientation-related factors also appear to be significant: internalized homonegativity has been associated with loneliness, where it is noted that accepting and integrating a gay or lesbian identity seems particularly important for younger, non-gay-identified individuals (Berg et al. J Gay Lesbian Ment Health 2015; 19:285-302).

Unwanted loneliness is a complex and highly significant phenomenon, with a demonstrated association with poorer overall and mental health (Martín Roncero et al. Gac Sanit 2021; 35:432-437). This issue should be studied not only from the lens of mental health but also from a sociological perspective.

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The management of situations of behavioral dyscontrol is essential in hospitalization units. Strategies such as verbal or pharmacological restraint are the first steps to assist in the emotional regulation of a patient with a potentially escalating state of restlessness. In cases where this fails or is not possible, and there is a risk to the patient or others, physical restraints are a strategy for managing the agitated state. The Adolescent Short Stay Unit at Puerta de Hierro Hospital consists of 11 beds. The age of admission is 12 to 17 years.

To present data on the number of physical restraints placed in the Adolescent Brief Hospitalization Unit and the average time of placement from 2020 to 2023. The results from 2024 will be presented in the poster of this abstract.

Physical restraint data were reviewed through patient records and the physical restraint registry that is part of the unit’s protocol.

During 2020, physical restraints were placed on 8.7% of the patients admitted that year (21 of 240). In that year, a total of 110 physical restraints were placed for a total of 707.73 hours and an average of 7.06 hours. During the year 2021, 13.3% required physical restraint (30 of 2236). In that year 89 physical restraints were placed for a total of 470.25 hours and an average of 5.35 hours. In 2022, 6.4% of the patients admitted required physical restraint (15 of 236), 11 of whom were women. In that year a total of 100 physical restraints were placed with a total of 457 hours and an average of 4.57. It should be noted that that year, of the 100 restraints, 52 were on the same patient, with 19 restraints on the second patient requiring the most restraints. In 2023, 8.2% of patients required mechanical restraint (19 of 229), 14 of whom were women. A total of 169 restraints were placed for a total of 402 hours and an average time of 2.37 hours. This year, 2023, of the 169 restraints, 106 are on the same patient. From January to August 2024 restraints were applied to 10 patient. A total of 58 restraints were placed, with one patient requiring up to 30 restraints.

It should be noted that the patients who require the most physical restraints are patients with a diagnosis of autism spectrum disorder or patients with intellectual disabilities.

A decrease in the average restraint time has been observed(7.06 to 2.37), which we believe is due to greater training on the part of the nursing team. Patients with Autism Spectrum Disorder and patients with Intellectual Disability are those who have received more physical restraint, suggesting that their management requires a structure and intervention different from those offered by the short hospitalization units.

None Declared

The ecological hypothesis for schizophrenia supports the relationship between the urban environment and the clinical expression of severe psychosis. Housing conditions have been poorly studied.

Our aim was to investigate the impact of housing conditions on schizophrenia, particularly in women.

A systematic literature search was conducted in PubMed, Scopus and ClinicalTrials.gov from inception to July 2024 according to the PRISMA guidelines. Search terms: (housing conditions) OR (poor housing) AND health AND schizophrenia.

The search yielded 301 articles, from which 16 were included. Only three studies reported results specifically to women.

1) Building (n=4). Poor housing conditions associated with better self-esteem (n=1), but increased incidence of schizophrenia in African-Caribbeans (n=1). Despite difficulties in accessing adequate housing (n=1), schizophrenia patients showed high resilience (n=1).

2) Housing environment (n=4). Living in deprived neighbourhoods associated with higher negative symptoms (n=1) and poor community adjustment (n=2). Importance of the house’s proximity to places for recreation (n=1).

3) Living in group/independent housing (n=3). Women living in institutions need more physical care than men (n=2). Living in shared accommodation reduces social loneliness and quality of life (QoL) (n=1).

4) Private homes/ boarding houses (n=3). Boarding houses are the least preferred type of community accommodation compared to private homes (n=3).

5) Social support/QoL (n=2). Lower QoL is associated with non-institutional housing (n=1). Housing type may influence cognitive function (n=1).

Inadequate housing is negatively associated with mental health outcomes in schizophrenia. Few studies have investigated light, ventilation and internet access with health and QoL. Future studies should investigate housing conditions, especially in women.

None Declared

Following the COVID pandemic, there has been an increase in mental health consultations in recent years, often referred to as a ‘fourth wave’. However, what has been observed in mental health centres is that these consultations are not so much about serious mental disorders, but rather occasional disorders due to social and work-related factors.

The aim of this study is to analyse the data collected from referrals to psychology in a mental health centre.

Referrals to psychology from primary care at the Majadahonda Mental Health Centre were analysed for the period from October 2022 to April 2024 in a specific weekly consultation for the psychology waiting list.

The data collected are the diagnoses of these patients, whether or not they attend the assessment consultation and whether or not they are discharged after the first consultation.

A total of 115 patients were seen between October 2022 and April 2024. These patients were all notified of the appointment one week in advance.

Of the total number of patients who attended, 29 consulted for depressive-anxiety-adaptive disorder, 22 were referred for work-related reasons (burn out), 12 for marital problems, 7 for parenting problems, 12 had no clinical reason for referral to Mental Health and 25 did not attend the consultation.

Those who were discharged at the first consultation were 33.

Given the scarce resources and long waiting lists, it is important at all levels of patient care not only to adjust expectations with regard to specialised care, but also to promote an appropriate setting. In this way it will be possible to run an efficient mental health care system.

None Declared

The impact of migration on cardiovascular risk factors have been reported to be gender-specific. Obesity and cardiovascular disease are increased in those who migrate to Western countries.

Our aim is to investigate changes in the dietary habits of women after migration, especially in schizophrenia women.

A systematic review was performed in PubMed, Scopus and PsycINFO databases from inception to October 2024 according to the PRISMA statement. Search terms: (diet OR food OR “dietary acculturation”) AND migration AND women. Studies were included if they were focused on dietary changes after migration in women. In a second step, we conducted electronic searches to find additional papers on schizophrenia.

A total of 2046 records were screened, of which 36 studies were included.

(1) Socio-clinical scenarios of migration: a)Latin-American (n=5), b)African (n=7), c)Asian (n=17), Europe (n=2). Results: Weight gain after migration to developed countries, reduced dietary diversity and limited access to culturally appropriate foods are common (poor traditional-food trajectories). Early stages of migration are critical. Model of dietary transition during pregnancy (3 stages) and risk of gestational diabetes.

(2) Transnational migration (rural-urban, n=5). Indian women had higher intakes of both fruit and vegetables and fat. Migration from rural-to-urban and urban-to-urban areas was associated with obesity risk. Exception: rural migrants to Mongolia’s capital maintaining traditional lifestyles. Few studies focus on women with schizophrenia.

The dietary habits of migrant women may have implications for future chronic disease risk, particularly for those with schizophrenia. Early culturally sensitive weight-loss interventions for migrant women are recommended.

Migration; Diet; Dietary acculturation; Schizophrenia; Women.

None Declared

Bipolar disorder is a serious mental disorder that requires follow-up and pharmacological treatment for the patient to function properly. It is known that stressful events can generate decompensation in these patients. Pregnancy and postpartum are moments of high vulnerability for women with bipolar disorder, being essential their immediate follow-up and treatment in case of decompensation. In these cases it is essential to ensure an adequate bond with the baby.

To present a case of a patient with a diagnosis of bipolar disorder, who in both pregnancies has a manic episode after delivery.

Case presentation and literature review.

The patient is a 37-year-old woman who comes to the emergency department for manic symptoms. Her psychiatric history includes a diagnosis of bipolar disorder in 2022 after an admission for a manic episode two months after the birth of her first child. She is currently under active follow-up by psychiatry and a perinatal group intervention program. She lives with her husband and two-year-old son.

During pregnancy she received lithium without decompensation. When she came to the emergency room, she was on lithium 400 mg every 8 hours and olanzapine 10 mg prescribed 4 weeks ago by her psychiatrist, who had noticed the decompensation, which she stopped a week ago on her own.

In the examination, he shows an accelerated speech with verbose and uninhibited contact. She says that 5 days ago she began to present the idea that she was a threat to her children, with increasing anguish. She began with a decrease in the hours of sleep and suddenly refers that the idea of having to travel to Bali appeared, since “it is her favorite place in the world”. Without considering the price and without informing her husband, she left her home and arrived in Bali, where she incurred high expenses. When she arrived there, she reported meeting a friend who helped her to return to her country and informed her family.

Pregnancy and postpartum are moments of high vulnerability and emotional intensity for any woman. It is known that for patients with mental disorders, this vital moment may involve a risk of decompensation of their mental disorder, compromising their health, and may have negative repercussions on the bonding with their baby and the style of attachment they build with it. It is essential to train professionals in pharmacological treatments allowed during pregnancy, postpartum and lactation, as well as to facilitate close follow-up programs for these patients in order to reduce the risk of decompensation as much as possible.

None Declared

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

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

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

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

Suicide is the most frequent psychiatric emergency. About 1% of all deaths are due to suicide so around 700,000 people commit suicide each year. Suicide attempt is more frequent in women (3:1) while completed suicide is more frequent in men (4:1). Most suicides occur in the 35-64 age range. The severity of a suicide attempt is assessed in terms of method, potential lethality, rescuability and impulsivity. A previous suicide attempt is the main risk factor for suicide behavior. The majority (more than 90%) of suicide behavior are related to an underlying psychopathology, mainly depression and substance abuse, especially alcohol. However, there are also numerous cases of impulsive attempts in the context of life stressors.

To analyze sociodemographic and clinical characteristics of adult patients with suicidal behavior attended in the emergency department during a one-year period. To study the stability of the data obtained in the following annual period

A retrospective review of the population over 18 years attended in the emergency department during 2022 because of suicidal behavior, was carried out. Data collection for the year 2023 is in progress in order to be able to carry out a comparative study between both annual periods.

562 patients over 18 years were attended in the emergency department of our hospital due to suicide behavior during 2022. 383 of these patients were women (68.1%) and 179 men (31.9%). with an average age of 38.6 and 42.2 years respectively. The age range between 18 and 25 years accounted for 28.5% of the total cases. The most frequent suicidal behavior was medication overdose with a total of 307 (54.6%), being more frequent in women than in men (2.6:1). The second most frequent reason for attention was suicidal ideation without suicide attempt, with a total of 212 patients (37.7%). 371 patients were discharged home from the emergency department (66%) and 191 required a longer observation in hospital environment. We are awaiting to complete data collection for 2023 to establish a comparison with those described above.

According to our study, suicidal behavior in adult population is more frequent in women than in men. The most frequent age range in both genders was between 18 and 25 years old. The method most frequently used was medication overdose and suicidal ideation without a suicide attempt was the second most frequent reason of attention. Our patients mostly presented diagnoses of personality disorder, depression and substance use disorder.

None Declared

Dementia can present with psychiatric symptoms even before the cognitive impairment, which makes difficult to establish an adequate diagnosis. There have described symptoms of this type in vascular dementia, frontotemporal dementia, Alzheimer disease and Lewy bodies dementia. Frontotemporal dementia has a prevalence of 9-20% and it`s the third in frequency among degenerative dementia. It appears before the age of 65 years old and is more common in men. Two variants have been described, linguistic and behavioral. The behavioral one has usually an initial psychiatric presentation, with behavioral disorders, disinhibition and personality changes. Therefore it`s important to make an adequate differential diagnosis with late onset bipolar disorder.

To review about frontotemporal dementia and its differential diagnosis with late onset bipolar disorder.

We carry out a literature review about frontotemporal dementia and its differential diagnosis with late onset bipolar disorder, accompanied by a clinical description of one patient with behavioral disturbance and language disorder.

A 59-year-old female was admitted to the short-term hospitalization unit from the emergency department due to behavior disorder. She had no relevant personal or familiar psychiatric history up to two years before when she received diagnosis of bipolar disorder. She presented behavioral disorganization, psychomotor restlessness, verbal aggressiveness, verbiage, insomnia and decreased intake. Psychopathological examination became difficult due to her language disorder since she presented an incoherent speech with paraphasias and loss of the common thread. Neurological study guided diagnosis to frontotemporal dementia even though they left the psychopharmacological treatment to our discretion. Olanzapine 5 mg twice a day was initiated, and behavioral improvement was observed. However, the patient maintained a significant functional impairment.

Psychiatric presentation is frequent in dementia, even before cognitive failures which makes essential an exhaustive differential diagnosis. It`s important to consider the diagnosis of frontotemporal dementia in those patients who debut with behavioral disturbance in the 50s. Psychopharmacological treatment is only symptomatic so functional recovery should not be expected.

None Declared

There are numerous organic causes that can be related to affective symptoms such as neurological, metabolic, infectious and pharmacological. Neurological conditions associated to affective symptoms include vascular lesions, tumors, infections, seizures and dementia. Within cognitive impairment conditions, depressive symptoms are more frequent in vascular dementia and Alzheimer disease, and behavioral or manic symptoms in frontotemporal dementia although we cannot rule out less common associations.

To review about organic mania due to dementia

We carry out a literature review about organic mania accompanied by a clinical description of one patient with manic symptoms and cognitive impairment.

A 80-year-old male was admitted to the short-term hospitalization unit from the emergency department due to maniform symptoms. He had believed for weeks that he was millionaire and capable to cure all the diseases in the world, reason for which he had given away many of his belongings and had tried to register the patent for his invent. He also had future plans to invest all the money he earned from the patent in the construction of roads in Latin America. He had not previous history of mental illness. Neurological study concluded a diagnosis of Alzheimer disease. It was treated as a manic episode with a mood stabilizer and antipsychotic, with partial resolution of the condition.

It is common to find depressive symptoms in cognitive disorders. Although manic symptoms are much more frequent in frontotemporal dementia or other organic disorders, we can also find them in patients with Alzheimer disease. Since there is no specific curative treatment for this disease, concomitant psychopharmacological treatment is recommended if manic symptoms appear.

None Declared

An increase in suicidal behavior among the adolescent population is reflected in the literature and in clinical practice. According to a study of suicidal behavior and mental health by the Spanish ANAR Foundation, the number of cases with suicidal behavior has experienced an accentuated growth in the period 2012-2022 (1,921.3%), highlighting the increase produced in the post-COVID-19 period, between 2020 and 2022 (128%)

To analyze the reasons for admission to the short hospitalization unit. To describe the sociodemographic characteristics of hospitalized adolescents.

Descriptive observational study of the sample of adolescents admitted to the inpatient psychiatric unit of the Hospital Universitario Puerta de Hierro between January 1, 2023 and June 30, 2023. It is carried out through the information obtained in the clinical history of the patients.

During this period of time 113 adolescents were admitted, 80.2% were female. The mean age was 15.16 years. The main reason for admission was autolytic ideation, occurring in 33.3% of the patients. The second most frequent reason for admission was suicide attempt (29.7%) and behavioral disturbance (17.1%) was the third most frequent. Of the methods used in suicide attempts, drug overeating stands out among the methods used in suicide attempts. (75.8%), followed by attempted hanging (12.1%) or cutting (12.1%).

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The results corroborate what is reported in the scientific literature, where self-harm and self-injury attempts have increased and are the most frequent reasons for admission. This shows that suicide is a public health problem of the first order, where prevention and early intervention programs are necessary.

None Declared

Artificial intelligence (AI) and virtual reality (VR) are useful tools that can improve precision medicine and can prove useful in the clinical care of patients with psychosis.

Our aim was to determine whether AI and VR have been applied to the prediction of clinical response in women with schizophrenia.

A systematic review was carried out in PubMed and Scopus from inception to September 2023 by using the PRISMA guidelines. Search terms: (“artificial intelligence” OR “intelligent support” OR “machine intelligence” OR “machine learning” OR “virtual reality” OR “intelligent agent” OR “neural networks” OR “virtual reality” OR “digital twins”) AND (“schizophrenia” OR “psychosis”) AND (“women” OR gender”). Inclusion criteria: 1)English, French, German or Spanish language, 2) reporting treatment response in schizophrenia (as long as information in women was included), and 3) including AI and VR techniques.

From a total of 320 abstracts initially screened (PubMed:182, Scopus:138), we selected 6 studies that met criteria.

• - Prediction of treatment response. (1) Clinical information, genetic risk score and proxy methylation score have been shown to improve prediction models. (2) Graph-theory-based measures have been combined with machine learning.

• - Therapeutic drug monitoring. (1) A machine learning model has been useful in predicting quetiapine blood concentrations.

• - Pharmacovigilance. (1) Machine learning has connected prolactin levels and response in olanzapine-treated patients. (Zhu et al., 2022).

• - Treatment-resistant schizophrenia (TRS). (1) Women with TRS have been found to receive clozapine less frequently than men (adjusted for sociodemographic, biological and clinical factors). (2) Statistical learning approach: Women have been found to respond better to clozapine than men.

AI, including machine learning, show promising results in the prediction of treatment response in women with schizophrenia. As of yet, digital twins have not been investigated to test specific interventions or to personalize treatment in women with schizophrenia.

None Declared

A 56-year-old patient diagnosed with bipolar affective disorder type II, who remains stable, with no manifest episodes, thanks to aripiprazole 60mg daily.

The aim is to carry out a brief review of the use of the drug as the only stabiliser in bipolar affective disorder.

A 56-year-old patient, who has been suffering from episodes of hypomania since the age of 40, with episodes of depression. After poor tolerance to the use of the usual stabilisers, and the impossibility of using antidepressants due to hypomanic swings, it was decided to start treatment with aripiprazole orally, up to a maximum of 60mg daily. Despite the fact that the patient, with this treatment, had no side effects and remained more stable psychopathologically, the patient did not comply adequately with the correct dosage, due to his rotating work shifts. This fact explained that although he acknowledged an improvement, he continued with episodes of depressive symptoms lasting several days followed by episodes of hypomanic characteristics.

For this reason, it was decided to change treatment to aripiprazole long-acting injectable, in order to ensure linear blood levels of the drug. Initially, it was decided to prescribe 400mg every 28 days. However, after the first administration, 20 days later, the patient began to show dysphoric mood, with marked emotional lability, living in an egodystonic manner. For this reason, the dose was increased to 600mg on a monthly basis. Since then, after a year and a half with the same treatment, the patient has been stable and in line. There has been no further decompensation of the underlying psychopathology and no side effects.

Aripiprazole in TAB is superior to placebo in type I patients, mainly affecting manic and mixed episodes, but not so much in depressive episodes. It has also been observed that it not only acts in the acute phases, but also has a stabilising function, preventing manic episodes.

One study showed that up to 65% of patients on oral aripiprazole in whom it was replaced by AOM remained clinically stable. In the same study, approximately 50% of those who completed 52 weeks of follow-up were able to maintain clinical stability.

None Declared

Neighborhood socioeconomic status seems to be related to functioning in patients with first episode of psychosis

(FEP).

The present study aimed to assess if neighborhood vulnerability and risk of social exclusion could predict functional outcomes in people with FEP after controlling for other key variables identified in previous literature.

A total of 137 patients with FEP (DSM-IV-TR criteria) and 90 controls comprised the study sample from February 2013 to May 2019. Functioning was assessed with the WHO Disability Assessment Schedule. Neighborhood vulnerability was measured using a multidimensional socioeconomic deprivation index; data for the index were collected by the Madrid City Council and based on the participant’s home address. Multilevel mixed-effects regression analyses were conducted to estimate the effects of neighborhood vulnerability on functioning.

Our results show that FEP patients could be more vulnerable to the effects of neighborhood-level characteristics than healthy controls (B = 1,570.173; z = 3.91; Pc .001). In addition, our findings suggest that higher neighborhood vulnerability is related to greater functional disability in people with FEP, after controlling for other relevant confounders (B = 1,230.332; 2=2.59; P=.010). based on the participant’s home address. Multilevel mixed-effects regression analyses were conducted to estimate the effects of neighborhood vulnerability on functioning.

Our results show that FEP patients could be more vulnerable to the effects of neighborhood-level characteristics than healthy controls (B = 1,570.173; z = 3.91; Pc 001). In addition, our findings suggest that higher neighborhood vulnerability is related to greater functional disability in people with FEP, after controlling for other relevant confounders (B = 1,280.332; z=2.59; P= 010).

These results highlight the importance of incorporating contextual factors into assessment of patients with FEP, since psychosocial difficulties observed In these patients could be partially related to the quality of neighborhood social-related resources.

None Declared

We present the case of an elderly patient with a severe depressive episode who, in order to maintain psychopathological stabilisation, receives ECT on an outpatient basis.

The objective is to briefly review the use of ECT as a maintenance treatment for severe depression in the elderly.

Patient aged 76 years, multipathological, with a history of hypertension, DM and LBP. Femoral head fracture, myelodysplastic syndrome, severe osteoporosis with vertebral crushing, requiring rescue treatment with tramadol, and renal failure.

She came for consultation, reporting depressive symptoms of months’ duration, together with delusions of ruin and nihilism. Despite antidepressant and stabilising treatment with duloxetine at daily doses of 120mg, extended-release quetiapine 600mg, lorazepam 2.5mg and mirtazapine 45mg, the patient began to show negative behaviour towards accepting food, clinophilic behaviour and abandonment, which led to her being admitted to the short-term hospitalisation unit.

Due to the severity of the depressive symptomatology, it was decided to start ECT, administering a total of 12 sessions, which were effective, and outpatient follow-up was resumed. However, after a week, the patient again began to show marked apathy and abulia, as well as complete anorexia lasting more than 24 hours, which led to a new admission. It was then that it was decided to maintain the ECT treatment, on an outpatient basis, as maintenance treatment, together with pharmacological treatment.

ECT is indicated in severe depression, with or without psychotic symptoms, with malnutrition and organic pathology. According to studies, it has a beneficial response of more than 60%. However, the rate of receiving depressive symptomatology in a severe episode is high, despite ECT, so studies and clinical practice recommend maintenance ECT. It is usual to start with weekly sessions, and progressively space them out to maintain the minimum that guarantees stability.

None Declared