Diabetes distress, whereby people with diabetes experience distressing psychological symptoms associated with living with their condition, is an emerging problem in India. Diabetes distress leads to self-care deficits, suboptimal glycaemic control (which can lead to increasing risks of complications) and impaired quality of life.

To determine the burden of diabetes distress and its associated factors in an Indian tertiary care centre in Trichy, Tamil Nadu, India, covering a population of 1.25 million.

This prospective observational study involved a structured questionnaire covering demographic and clinical details, which was given to patients. The Diabetes Distress Scale 17 (DDS-17) was used to assess diabetes distress levels. The DDS-17 also measures four subdomains: emotional burden, physician-related distress, regimen-related distress and diabetes-related interpersonal distress. Patients were divided into two groups based on their DDS-17 score: no diabetes distress (DDS-17 score <2) versus diabetes distress (DDS-17 score ≥2) and compared. Correlation analysis, chi-squared tests and t-tests were used, with P < 0.05 considered statistically significant.

Of 1019 respondents (mean age 56 years; 59.6% male, 40.4% female), diabetes distress was reported in 24.4% (n = 249). Factors significantly associated with higher DDS-17 scores were younger age (<45 years) (P < 0.0001), long-standing diabetes (>10 years) (P < 0.0001), and smoking and alcohol (P < 0.05). Significant protective factors for diabetes distress included working, daily exercise, no comorbidities and medical insurance cover (P < 0.05). Significant positive correlation between DDS-17 score and all four subdomains was observed (P < 0.0001).

Our findings highlight the need for routine psychological screening and holistic management strategies in diabetes care, to improve patient outcomes and quality of life.

As liaison psychiatrists, it is very important to mantein a good relationship with other medical specialties in order to obtain the best result for our patients. Most of the times, the somatic process affects direct or indirectly to mental healt and vice versa, so our cooperation is extremely important for the patient’s welbeing.

With this study we try to find special considerations and necesities of every specialty that count on us in our hospital. We have design this batebase with the aim of discovering which are the main problems that suffer the admitted patients, which doubts face our colleagues when evaluate mental health patients, etc. Thus, our team could help other physicians properly or so we could stablish a proper liaison in order to make things easier.

A database has been created with all the patients evaluated by our liaison psychiatry team during half a year. We have taken into account sex, age, referral specialist, mental health diagnosis (after our evaluation), previous mental health follow-up, if they are on psycopharmacology treatment, if they requiere psycopharmacology treatment and if they requiere follow-up once discharged.

22,9% were kid/adolescent patients. 25,8% were elderly people (>70 yo). 47% were men (of which, 6% were trans men), 53% were women. 22,9% suffered from adjustment disorder, 14,1% had no acute mental health problem, 11,76% presented substance abuse. Main petitions were made from Internal Medicine (30%)

With this information we can explore other specialists’ and admitted patients’ needs and concerns and focus our effort in solving them.

No significant relationships.

Several studies describe that the coexistence of a substance use disorder with another psychiatric condition or “dual disorder” (DD) is associated with a worse evolution at all levels, including a greater burden of medical illnesses and greater mortality.

To describe the presence of DD and related factors in patients admitted to a General Hospital that required assessment by a psychiatry service.

A descriptive study that includes patients admitted to the Hospital del Mar in Barcelona for all medical-surgical reasons and attended by the specific addiction psychiatry consultation service between January 2016 and October 2021. Sociodemographic and clinical data are collected including the history of consumption and the diagnosis of dual disorder. Chi-square test was used for comparison between groups.

The sample was 1796 patients (Women: 345. Mean age: 50.3 years; SD: 12.6). 43.7% of the sample presented DD, with axis 1 disorders being the most frequent. There was an association of DD to factors as: being woman (54 vs 41.2% p <0.001), HIV positive serologies (54 vs 42.7% p <0.001), being homeless (49 vs 31.7% p <0.001) and cocaine consumption compared to other substances (53.4 vs 39.8% p <0.001).

In our sample, almost half of patients had DD. The representation of women was significantly lower, however they presented a higher proportion of DD. In this study we describe an association of DD with other biopsychosocial problems, and further studies are necessary to determine in which sense they are related and optimize patient care.

No significant relationships.

In Camden and Islington (North Central London) we have restructured our emergency mental health services significantly. Prior to January 2020 all emergency mental health presentations, including those detained in public by the police (S136) were supported through our three emergency departments and their respective liaison mental health teams. In January 2020 a new ‘Health Based Place of Safety’ (for those detained by police) was opened to avoid people spending time in emergency departments unnecessarily. When the COVID-19 pandemic first took hold in the UK in March 2020 a second unit, a ‘Mental Health Crisis Assessment Service’ (MHCAS) was set up again away from the acute sites, encouraging people in MH crisis to attend a designated MH ED away from the acute sites. This study aims to review the system and patient outcomes since the development of the pathway.

Relieving pressures on ED by reduction in patient numbers that could be better supported elsewhere and free up resource for alternative assessments and patient needs.

A retrospective cohort study to review the outcomes of the new system in relation to emergency mental health crisis presentations. Comparison to be made with ED data for 2 years prior to new system.

Pending final results but initial data suggests 25% reduction in ED presentation for MH cause with new system. Reduction in psychiatric inpatient admissions of between 3-5%.

Creative system wide initiatives to provide alternatives to emergency departments for people in emergency mental health crisis can lead to significantly improved patient outcomes and experience.

No significant relationships.

Self‑harm is an ‘act of self‑poisoning or self‑injury carried out by a person, irrespective of their motivation’. A history of self-harm is linked with suicide risk. A study in Pakistan found self-harm to be more common in young people with unemployment and interpersonal difficulties as common triggers. Expanding liaison psychiatry services leads to an earlier assessment of patients with self-harm.

To study the demographic and clinical variables of patients along with methods and precipitating factors of self-harm.

A retrospective chart review of patients presenting with self-harm seen as a part of liaison psychiatry from October 2018 to June 2021.

A total of 168 cases were seen of which 10 were excluded due to incomplete data. Of 158 cases gender split was roughly in the middle, with 49.4% males (n=78) and 50.6% females (n=80). The mean age of patients was 27.59 with a range of 12-70, 40.5% belonged to the age group of 20-29 (n=64) (Figure 1).

77.8% (n=123) had a past psychiatric history. The most common being depressive disorder 31.6% (n=50) and borderline personality disorder 30.4% (n=48). 35.4% of patients reportedly had previous attempts of self-harm. The most common methods being the use of sharp objects, rat-pill poisoning, and corrosive intake (Figure 2).

Conflicts with family and relationship difficulties were reported to be the most common precipitating factors.

Self-harm is a challenging and frequent presentation. Patients may present with diverse characteristics and varying needs. Hence physicians must be prepared for timely liaison and prompt management.

No significant relationships.

Healthcare services are increasingly confronted with challenges related to old age mental disorders. The survey aimed to provide an overview of existing psychogeriatric services in Albania, Bulgaria, Greece, and North Macedonia.

After identification of psychogeriatric units across the four countries, their head physicians were asked to provide data on their clinical, teaching, and research activity, as well as staff composition. Moreover, the attitudes of head physicians to current needs and future service development were explored.

A total of 15 psychogeriatric units were identified (3 in Bulgaria, 8 in Greece, and 4 in North Macedonia). Results show wide variation regarding the location, team size and composition, service availability, numbers of patients attending, and inpatient treatment length. Most head physicians underscored the urgent need for breakthroughs in the graduate and postgraduate education in psychogeriatrics of medical and nonmedical professionals, as well as in the interconnection of their units with community primary healthcare services and long-term care facilities for seniors via telemedicine. They would welcome the development of national standards for psychogeriatric units, potentially embodying clear pointers for action. A number of head physicians advocated the development of nationwide old age mental health registries.

Regional disparities in resources and services for seniors’ mental health services were unveiled. These data may enrich the dialogue on optimizing psychogeriatric services through planning future cross-border collaborations mainly based on telemedicine services, especially in the era of the novel coronavirus pandemic, and training/education in psychogeriatrics of mental health professionals.

A review of the literature demonstrates that relatively little is known about acute psychiatric presentations in children (0–12 years), compared with adolescents or young adults (12 years+). This study aims to review psychiatric presentations of children to a CAMHS Liaison Service at Children’s Hospital Ireland (CHI) at Tallaght University Hospital over a 10-year period.

A retrospective study was undertaken of case notes of all children aged 12 years and under who were referred to the CAMHS Liaison Service between January 2009 and December 2018 (n = 318). Data were anonymised and inputted into SPSSv25 for analysis. The relationships between presentations and methods of self-harm over time were measured using Pearson’s correlation. Associations between categorical variables were analysed using chi-squared tests.

There was a significant increase in presentations of under-12s over the 10-year period (r(8)=0.66, p = 0.02). There was also a significant increase in children presenting with a disturbance of conduct and/or emotions over time (r(8) = 0.79, p < 0.001). There was a significant association between female gender and ingestion (X2 = 12.73, df = 1, p < 0.05) and between male gender and ligature as a method of self-harm (X2 = 5.54, df = 1, p < 0.05). Over half (53%) of children presented with suicidal thoughts and 22% presented with suicidal behaviours. The reported use of ligature as a method of self-harm emerged only from 2012 among cases studied.

Children aged 12 years and under are presenting in increasing numbers with acute mental health difficulties, including suicidal thoughts and behaviours. There is a worrying trend in methods of self-harm, particularly in high lethality behaviours such as attempted strangulation.

There are concerns about the quality of care that people with dementia receive in the general hospital. Staff report a lack of confidence and inadequate training in dementia care.

A train-the-trainer model was implemented across eight acute hospital trusts in London via a large academic health and science network. Impact was evaluated using mixed methods. Data were collected at (a) individual level: “Sense of Competence in Dementia Care” (SCID), (b) ward level: Person Interaction and Environment (PIE) observations, (c) organization level: use of specific tools, i.e. “This Is Me,” (d) systems level: numbers and types of staff trained per trust. Results were analyzed with descriptive statistics and paired t-test with thematic framework analysis for PIE observations.

The number of staff trained per trust ranged from 67 to 650 (total 2,020). A total of 1,688 (85%) baseline questionnaires and 456 (27%) three month follow-up questionnaires were completed. Mean SCID score was 43.2 at baseline and 50.7 at follow-up (paired t-test, p < 0.001). All sub-scales showed a small increase in competence, the largest being for “building relationships.” Organizational level data suggested increased use of carer's passport, “This Is Me” documentation, dementia information leaflets, delirium screening scales, and pathways. PIE observations demonstrated improved staff–patient interactions but little change in hospital environments.

There was a significant improvement in staffs’ sense of competence in dementia care and the quality of interactions with patients. More hospitals adopted person-centered tools and pathways. Work is required to investigate if these changes improve hospital outcomes for people with dementia.