“Sex work” refers to the provision of sexual services in exchange for monetary or material compensation. The exact number of sex workers in Germany, where prostitution is legal, remains uncertain, but estimates suggest it could be as high as 700,000. The majority of the group is female and has a migration background. Sex work covers different areas. These include work in brothels and strip clubs, street prostitution, hostess services and work in the porn industry. Previous research into sex work has mainly focused on sexually transmitted diseases. While results from Switzerland indicate elevated prevalences of depression, anxiety disorders, and substance use among sex workers, to date, there has been no research specifically addressing mental illnesses among sex workers in Germany.

The research project aims to fill this gap by determining the 1-year prevalence as well as risk and resilience factors for mental illness among sex workers in Berlin. The research findings aim to enhance psychosocial care services for sex workers and foster meaningful contributions to the broader social discourse.

The socio-demographic composition of the sex worker population is constantly shifting, making it difficult to obtain a truly representative random sample. Quota sampling offers the closest alternative, with interviewees being approached at various workplaces. Additionally, we ensure a diverse age range is included in the study. A total of 500 participants will be surveyed using structured interviews. The interview consists of a sex work questionnaire, standardized research instruments, and a mental health screening. The sex work questionnaire gathers data on work type and intensity, socio-demographic characteristics, and individual access to counseling and support services. Standardized instruments include assessments for personality (TIPI), coping behaviors (Brief COPE), health-related quality of life (SF-12), stigmatization experiences (PASS 24), and childhood trauma (CTQ). The mental health screening will be conducted using the Mini-DIPS.

The submitted poster will offer a detailed overview of the study design and methodologies. In addition, preliminary results will be shared, shedding light on the mental health status and access to healthcare services among sex workers.

This pioneering study seeks to address a significant gap in current research. The final findings will form the foundation for more in-depth analysis and guide future recommendations to improve support services for this population.

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Conceptually, the internet has transformed the Earth into a vast information network village, significantly enhancing human experience through unprecedented availability and exchange of information. However, the potential adverse effects of internet addiction on human health have emerged as a major global concern.

This study aimed to estimate the prevalence of internet addiction among students.

A cross-sectional, descriptive, and analytical study was conducted between October 2022 and January 2023 among students from various faculties in Sfax. Data were collected through a self-administered electronic questionnaire accessible online, created using the Google Forms application. The questionnaire explored sociodemographic and relational data. Internet addiction was assessed using the Internet Addiction Scale (IAS).

The average age of the students was 25,62 ± 3,29 years, with a sex ratio of 1/5. Among the participants, 96% resided in urban areas, and 81,9% lived with their families. Nearly half of the students were from the Sfax Faculty of Medicine, and 64,4% were in the third cycle of their studies. The study found a mean total score of 74,27 +/- 21,25 on the IAS, indicating an estimated prevalence of internet addiction at 24,2%. Factors correlated with internet addiction included excessive internet use by family members (p=0,004) and poor adaptation to the faculty (p=0,03).

Internet addiction was prevalent in our student population. Exploring the characteristics associated with this addiction would undoubtedly assist in identifying the risks our students might face.

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Familial dynamics profoundly impact the behavioural development of adolescents. This study investigates the impact of family-related behaviours, such as hyperactivity, aggression, and callous-unemotional features, on social responsiveness and the propensity for behavioural disorders, offering essential insights for targeted interventions.

The study aimed to: (1) examine the influence of hyperactivity, aggression, callous-unemotional traits(CU), and thrill-seeking behaviour on social responsiveness and behavioural disorders; (2) assess the predictive efficacy of various behavioural traits through structural equation modelling (SEM) and logistic regression; and (3) recommend practical interventions derived from these findings.

Data were obtained from adolescents 12 to 17 years participating in the enhanced Nathan Kline Institute Rockland Sample (NKI-RS), a continuous, institutionally focused initiative designed to establish a large-scale lifespan sample. Behavioural evaluations comprised the Behaviour Assessment System for Children (BASC), Social Responsiveness Scale (SRS), and Inventory of Callous-Unemotional Traits (ICU-P). Structural Equation Modelling (SEM) was utilised to investigate the intricate associations between behavioural characteristics and social responsiveness (Figure 1), whereas logistic regression was applied to forecast the probability of behavioural disorders (Figure 2).

Structural Equation Modelling analysis indicated that CU traits were the most significant predictor of diminished social responsiveness (β = 0.738, p < 0.001), succeeded by hyperactivity (β = 0.384, p = 0.069) and agression (β = 0.183, p = 0.038). Engagement in fun-seeking behaviour demonstrated a protective effect (β = -0.638, p = 0.001). Logistic analysis indicated that elevated ICU-P scores heightened the probability of behavioural problems (OR = 2.09, p < 0.001), whereas fun-seeking behaviour diminished this probability (OR = 0.52, p < 0.001), yielding an AUC of 0.83 (Figure 3).

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CU qualities represent the most significant risk factor for behavioural disorders, whereas a propensity for fun-seeking behaviour offers a protective effect. Practical implementation should focus on two main areas: (1) early screening for CU traits and hyperactivity in family settings to identify at-risk adolescents, and (2) promoting adaptive fun-seeking activities that enhance social responsiveness and reduce behavioral risks. Family-oriented therapies that include good social activities and behavioural management can markedly diminish the risks associated with behavioural disorders.

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Sex work and transactional sex (SWTS), along with Chemsex, are linked to high-risk sexual behaviors and poorer health outcomes. Chemsex is the use of methamphetamine, GHB/GBL and mephedrone in a sexual context especially among men who have sex with men (MSM). Transactional sex (TS) is the exchange of sexual services for other services or things in a non professional way. Sexwork (SW) means having sex with people in exchange for money in a professional way.

The aim of our study was to determine the prevalence rates of sex work and transactional sex (SWTS) among chemsex users and to answer the question of whether the combination of the two leads to an increased risk profile of those affected in terms of sexual health.

To achieve this, we conducted an online survey across three European German-speaking countries, targeting MSM. The survey gathered data on participants’ substance use patterns, sexual behaviors, and health outcomes, with a particular focus on their engagement in SWTS. SWTS was defined as the exchange of sexual favors for money, drugs, or other material goods, which has been shown to be associated with higher risk behaviors, including unprotected sex and multiple sexual partners.

A total of 399 sexually active MSM were included, categorized into three sub-groups: 129 engaging in Chemsex (MSM-CX), 128 in sexualized substance use with non-Chemsex substances (MSM-SSU), and 142 not engaging in sexualized substance use (MSM-NSU). MSM-CX reported significantly higher rates of SWTS compared to both MSM-SSU (p=.032) and MSM-NSU (p<.001), indicating that Chemsex use is strongly linked to transactional sex. Both Chemsex and SWTS were associated with higher HIV (p<.001, p=.042) and STI (p<.001, p=.023) prevalence, but no cumulative effect was found. Among MSM-CX engaging in SWTS, participants were younger (p=.006), had more sexual partners (p=.029), and reported higher substance use, including methamphetamine, mephedrone, and GHB/GBL. These factors may contribute to the increased vulnerability to HIV and STIs.

The results highlight the need for targeted prevention and intervention measures addressing the risks of Chemsex and SWTS among MSM. Public health campaigns should consider the socio-behavioral traits of Chemsex users, such as their younger age, higher number of sexual partners, and frequent substance use. These efforts should also reduce stigma, encourage help-seeking, and promote safer sex practices. Prevention should focus on regular HIV/STI testing and accessible harm reduction strategies. In conclusion, this study underscores the importance of tailored, evidence-based interventions to improve health outcomes for MSM-CX engaging in Chemsex and SWTS.

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Autoimmune psychosis has gained increased recognition as a distinct entity and is known to mimic variants of primary psychosis, typically presenting with an acute onset of polymorphic psychotic symptoms. We describe a case of probable autoimmune psychosis in a young patient who experienced a severe first psychotic episode.

Reflection over the diagnostic challenges of autoimmune psychosis.

Clinical case report.

A 19-year-old male patient with no relevant medical history was admitted to the psychiatric ward due to a first psychotic episode with a peracute onset. The episode peaked with severe confusion, disorientation, and disorganized behavior, leading to his referral to the emergency room. This episode was characterised by delusional ideation with mystical, self-referential, and persecutory themes, complex auditory-verbal hallucinations, and marked negative and cognitive symptoms (including affective blunting, social withdrawal, apathy, alogia, impaired attention, decreased social cognition, and reduced speed of cognitive processing). The analytical study, substance screening, and brain CT upon admission were normal, leading to the assumption of a primary psychotic disorder. Antipsychotic therapy was initiated with progressive titration (risperidone, cariprazine, and clozapine), yet there was no significant improvement. Given the severe presentation and treatment resistance, a neurological examination was requested, which revealed no focal signs. A comprehensive laboratory workup showed positive ANAs, anti-recoverin antibodies, and hypocomplementaemia (C3 and C4). No significant abnormalities were observed in the brain MRI. CSF analysis revealed slight protein elevation (55 mg/dL) without pleocytosis, oligoclonal bands, or antibodies. EEG indicated mild to moderate encephalopathy with FIRDA bursts and focal paroxysmal activity in the left temporo-parieto-occipital region. Brain PET-FDG showed no significant abnormalities. Serum and CSF neurofilament levels were normal. Full-body CT and PET-FDG scans were also unremarkable. Given the findings, autoimmune psychosis was assumed. Treatment with IV immunoglobulin (30 g) and methylprednisolone (1 g for 5 days) was administered. The case was discussed in a multidisciplinary meeting, and a regimen of daily prednisolone (10 mg) was chosen. At follow-up, the patient showed slight improvement, with mitigation of the positive symptoms.

Psychosis that does not respond to antipsychotic treatment and presents with atypical signs should raise suspicion of secondary immune-mediated schizophreniform psychosis. However, the challenge lies in identifying these patients, selecting appropriate diagnostic tests, and establishing criteria for implementing treatment.

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Tunisia is considered one of the countries where women occupy an important place in the working society. Given the fundamental role played by women in the family, they would have to balance their family responsibilities with professional duties, especially after returning from maternity leave. In many cases, the return to work can be particularly difficult which could affect their physical and mental health and even the relationship with their child.

Assessing the effects of returning to work on the perceotion of stress after maternity leave among Tunisian women.

A cross-sectional study was conducted over a two-month period, from February to April 2024, in the department B of gynaecology and obstetrics in Charles Nicoles hospital (Tunis). Women who were in labor before delivery, who had fully responded to the questionnaire before and after returning to work and willing to take part in the study were included. A questionnaire including socio-demographic, pregnancy and delivery and labor characteristics was filled in by the participants. The effects of returning to work on the perception of stress after maternity leave were assessed using the Perceived Stress Scale (PSS-10). Women were assessed one month and three months after the delivery corresponding to one month after the return to work (maternity leave in Tunisia lasts two months).

A total of 62 women were included. The mean age was 32.45 ± 6.41. Pregnancy was planned in 56.4 % of cases, well supervised in 83.8 % of cases, and complicated by gestational diabetes in 24.1 % of participants. Most deliveries were at full term (92 %) and vaginal (66.1 %). Complications were post-partum hemorrhage (11.2 %), eclampsia (3.2 %) and puerperal infections (3.2 %). Most women worked in the public sector (69.3 %) with a salary between 500 and 1000 Tunisian dinars (42%). The mean PSS-10 before returning to work was 12.36 ± 4.79 and 19.41 ± 4.31 after. After returning to work, the PSS-10 was significantly higher among women with more than two children, whose deliveries were with complications and working in the private sector.

Several factors have been found to involved in the increase of stress after post-maternity leave return. Focus on the psychological aspect and on supporting young mothers throughout the perinatal period seem highly needed.

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Bioethics is a discipline based on ethical principles aimed at guiding healthcare practice. Four fundamental principles are defined: autonomy, non-maleficence, beneficence, and justice. The first of these is autonomy, which expresses the ability of each individual to make decisions regarding their own health.

This case presents a 47-year-old male patient diagnosed with schizophrenia, legally incapacitated and under guardianship by a Foundation. He has no awareness of his illness, is on pharmacological treatment in a controlled environment, and does not cooperate for testing or procedures. He has been involuntarily admitted to the Psychiatry Unit since 2022, awaiting transfer to a residential facility.

In recent months, the patient has exhibited dysphagia and constitutional syndrome. A tumor suspicious for malignant oropharyngeal neoplasm is identified. He is informed in simple terms, in the presence of his legal guardians, that he has a tumor with malignant characteristics, which will grow over time, eventually blocking his airway and leading to death. Testing is necessary to reach a diagnosis and propose treatment.

The patient repeatedly and firmly expresses his desire not to undergo any tests or treatment. In coordination with the Psychiatry and Otorhinolaryngology services, and in consultation with the Bioethics Committee, it is decided to respect the patient’s autonomy and his decision to refuse tests or invasive procedures. At all times, comfort measures and pain management are provided.

Autonomy is the ability to have control over one’s own life. Every person has the right to make decisions about their health. Mental impairments can alter a person’s autonomy, as they hinder the conscious process of decision-making.

The dignity of the person plays a key role in the protection of life, physical and psychological integrity, and the freedom of individuals with mental disorders.

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First-episode schizophrenia (FES) is a critical period where early intervention can influence long-term outcomes. Tracking functional changes and finding their correlates are essential for understanding the disease process.

This study aims to evaluate the progression of functional outcomes over a five-year follow-up in FES patients and to examine the clinical correlates of functioning in the fifth year.

This cohort study included 197 FES patients admitted to the Istanbul Faculty of Medicine Department of Psychiatry Psychotic Disorders Research Program. Global Assessment of Functioning (GAF), Brief Psychiatric Rating Scale(BPRS), and Scale for the Assessment of Negative Symptoms(SANS) scores were recorded, and a comprehensive neuropsychological battery was applied at baseline. FES patients were evaluated regularly with the same clinical scales and GAF scores. The baseline clinical and cognitive parameters and clinical parameters at 1st, 2nd and 5th years were compared with GAF scores over the years. A repeated measures ANOVA was conducted to examine the effect of time on GAF scores over a 5-year follow-up, as well as the effects of gender and education. SPSSv29 was used to conduct all statistical analyses, and significance levels were set at p<0.05.

Seventy-seven FES patients had a follow-up duration of at least five years. Of these, 36.4% (n=28) were female, and the mean age was 22.18±6.09 years. The mean follow-up duration was 133.09±56.94 months. The mean GAF scores were 51.44±12.71 at baseline, 60.00±9.48 at the end of the first year, 62.14±9.04 at the end of the second year, and 62.89±8.34 at the end of the fifth year. There was a significant effect of time on GAF scores, F(2.56, 182.8) = 26.43, p < 0.001, partial η² = 0.29, with scores improving significantly from baseline to year 1 (p<0.001), and further improving by year 5 (p=0.034). There was also a significant effect of time*gender interaction on GAF scores, F(2.56,40.9) = 6.17, p=0.001, although there is no direct effect of gender (p=0.740). No direct effect of education or time*education interaction was found (p values >0.05). Additionally, baseline RAVLT-5 (r=0.725; p0.001), Stroop Time difference (r=-0.718; p0.001), WCST correct answers (r=0.644; r=0.003), category completed (r=0.630; p=0.004), and SANS scores (r=-0.427; p=0.42) significantly correlated with GAF in the 5th year. Among the CTQ subscores, physical abuse was significantly correlated with GAF in the 5th year (r=-0.415; p=0.009).

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GAF scores improved significantly over the 5-year follow-up in FES patients, with notable improvements occurring in the first year. Baseline cognitive performance, negative symptoms, and childhood trauma were found to be significant correlates of functioning, highlighting potential targets for early intervention.

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The consumption of alcohol, cannabis, cocaine, or heroin causes alterations in the central nervous system, affecting mood, perception, and behaviour. Despite the harmful effects of these substances, they remain widely used. Younger individuals tend to consume cannabis and cocaine, while older adults more commonly use alcohol and prescription medications. Ageing brings changes in consumption patterns and has both physical and mental health consequences

This study aims to analyze how age influences the clinical characteristics of patients with Substance Use Disorder (SUD), comparing differences between older and younger users.

A total of 297 SUD patients participated in this study. They were divided into two groups: those aged 55 and older (G1) n= 88, and those younger than 55 (G2) n= 209. The SF-36 questionnaire was used to assess quality of life, the BIS-11 for impulsivity, the ASRS v1.1 for ADHD, the STAI-R for anxiety, and the AQ for autistic traits. All participants provided informed consent, and the study adhered to ethical guidelines.

G1 showed better social functioning (SF-36) but a significant physical decline compared to G2. G1 also demonstrated lower levels of impulsivity (BIS-11), aggression, anxiety (STAI-R), and ADHD symptoms (ASRS), though higher autistic traits (AQ) were observed in G1.

Ageing reduces impulsivity, aggression, anxiety, and ADHD symptoms in individuals with SUD, but worsens physical health and may increase social isolation and autistic traits. These findings underscore the need to adapt SUD treatments according to age, addressing both physical and psychosocial challenges specific to each group.

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Previous research suggests that individuals with lower socioeconomic status are frequently exposed to more health risks and emotionally stressful conditions compared to those with higher status. There is a clear link between income and poor quality of life, with disadvantaged older adults lacking key resources. This study explores the relationship between the economic profile of older individuals and their psychosomatic health within the Greek population. It continues a previous investigation on the impact of socioeconomic status on health, offering a deeper understanding of long-term effects.

This study investigates how socioeconomic status affects the physical and mental health of older adults in Greece, focusing on income levels’ influence on health quality and disparities in health outcomes.

This cross-sectional study was conducted among 516 Greek participants (214 men, 302 women, average age 73.47 ± 7.72). The participants’ average monthly income was €796.72 ± 621.82 (p=0.002). Psychosomatic health was evaluated using the Other As Shamer Scale (OAS), Experience of Shame Scale (ESS), and Cardiac Anxiety Questionnaire (CAQ). A one-way MANOVA analyzed the impact of income on health quality, focusing on both physical and mental health using the 36-Item Short Form Health Survey (SF-36).

Our findings revealed that individuals with a monthly income above €1,500 reported significantly higher quality of life scores. In contrast, those with lower economic profiles exhibited increased levels of shame (measured by OAS and ESS), anxiety about their heart health (measured by CAQ), and a tendency to somatize stress. The analysis indicated that for every additional €100 of monthly income, physical health quality increased by 4.4 points on the SF-36 Physical Health Scale, and mental health quality improved by 2.9 points on the SF-36 Mental Health Scale. These results underscore the statistically significant impact of monthly income on overall physical and mental health scores.

The study highlights a strong link between lower economic status and poorer physical and mental health among older Greek adults. Addressing these effects requires political and societal efforts, with mental health policies that focus on economically vulnerable populations to mitigate the health impacts of low income and improve overall well-being.

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With increasing urbanization, more people are exposed to mental health risk factors stemming from the urban, social or physical environment. However, research on the connection between urban living and mental health remains unclear.

This study aims to explore environmental and social risk factors for mental health issues using network analysis.

The study was conducted among a nationally representative sample of 2,701 habitants of Poland (51% of women). The measurements used were PHQ-9, UCLA, Neighbourhood Cohesion (Neighbourhood Belonging and Social Cohesion), REAT 2.0 (Quality of architecture conditions in neighbourhood area), distance and frequency use of blue, green, and urban public areas, Self-Rated Health, Physical Activity, urbanicity, size of place of residence per person and sociodemographic survey (age, education, income). We used a sparse Gaussian graphical model (GGM) with a graphical lasso with an EBICglasso estimator.

We showed that urbanicity and physical environment were linked to mental health issues via neighbourhood cohesion and loneliness in the estimated network. Depression and anxiety were the nodes with the highest centrality strength and expected influence. Blue and green areas usage also had high centrality strength. Urbanicity played an important role as a bridge between the network nodes and had a high strength score. Physical health with blue and green areas frequency use had the highest closeness centrality score.

We revealed the connections among mental health, loneliness, social cohesion, and various environmental factors, particularly urbaicity. This will enhance our understanding of mental health risks and protective factors.

This study is a part of the “Urbanization and Health”( NdS-II/SN/0391/2024/012) project financed by state budget funds granted by the Minister of Education and Science within the framework of the Science for Society II Program in Poland.

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Antidepressants are a valuable treatment option for patients with PTSD and MDD. Sleep is an important dimension of both: PTSD and MDD. Insomnia is a common residual symptom in patients with PTSD and MDD comorbidity who are generally good responders to SSRI monotherapy.

To explore wheather trazodone evening augmentation could be beneficial for persistent insomnia in patients with comorbid PTSD and MDD that are generally good responders to one of followed SSRIs: escitalopram or sertraline.

Thirty outpatients (N=30) with comorbid war-related PTSD and MDD who are generally good responders to escitalopram (20 mg daily, N=15) or sertraline (100 mg daily, N=15) except persistent insomnia, were augmented with 100 mg trazodone. Trazodone was prescribed one-two hours before the sleep. Each patient met ICD-11 as well as DSM-V criteria for both: PTSD and MDD. No patient had psychiatric premorbidity, excluded by MINI. There was no significant somatic comorbidity that could influence the persistance of insomnia. Four sleep-related parameters were evaluated at two time points: at zero-point and 12-weeks after trazodone augmentation. This parameters/efficacy measures included: the improvement on the recurrent distressing dream item of the Clinician Administered PTSD Scale (CAPS-RDDI), reduction of the amount of time needed to fall asleep, prolongation of sleep duration, and reduction in the average number of arousals per night during the last seven days before assessment.

All sleep-related parameters improved significantly at the end of a 12-weeks follow-up: sleep duration prolongation (p<0.001), sleep latency decrease (p<0.001), median number of arousals per night decrease (p<0.001), and CAPS-RDDI median decrease (p<0.001).

Trazodone augmentation could be a beneficial treatment strategy for persistent sleep problems in patients with comorbid PTSD and MDD who are generally good responders to escitalopram or sertraline monotherapy.

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The perception of marriage involving individuals with schizophrenia remains critical in understanding the broader societal attitudes towards mental illness. Stigma and misconceptions often shape public views. Few studies have been conducted on this subject and the perceptions regarding this topic have not been thoroughly investigated.

This study aimed to explore perceptions of the general public regarding marriage in individuals with schizophrenia and to assess the relationships between these perceptions and affirming attitudes.

A cross sectional study was conducted via an online survey. It included a detailed description of clinical symptoms and outcomes of schizophrenia. Thirteen open-ended questions, adopted from the study of Kumar et al., 2019, and assessing various aspects of marriage in individuals with schizophrenia were asked.

A battery for measurement of affirming attitudes about mental illness was used, comprising the Empowerment scale(ES) to assess people’s beliefs about the social worth of people with mental illness, the Recovery scale (RS) to evaluate people’s beliefs about potential of recovery from serious mental illness and the self-discrimination scale (SDS) to assess people’s expectations about a person with mental illness successfully pursuing his life goals.

A total of 304 participants took part in the study, most of whom were between 20 and 30 years old, 80,9 were women. Additionally, 23.35% mentioned living with someone diagnosed with a psychiatric disorder. Results revealed that the majority of participants held reservations about marriage for individuals with schizophrenia. Over 50% believed that marriage neither cures nor improves symptoms, and more than 60% were reluctant to marry someone with schizophrenia or agreed to a marriage match involving a schizophrenic person. However, 53% agreed that individuals with schizophrenia have the right to make their own decisions about marriage, though concerns remain regarding their ability to manage family responsibilities. Regarding perceptions of schizophrenia, individuals who believed that marriage is not a cure for the illness and those who stated they would never consider marrying someone with schizophrenia exhibited significantly higher RS scores (p=.009 and p<10^-3, respectively). Participants who disagreed with the fact that individuals with schizophrenia have the right to marry showed significantly higher RS (p=.023), ES (p=.03), and SDS (p=.033) scores.

This study highlights the ongoing challenge of stigma towards individuals with schizophrenia, particularly about their perceived suitability for marriage. While there are encouraging signs of changing attitudes, broader efforts are needed to foster a more inclusive and supportive societal perspective on mental health and marriage.

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In Western countries, men die by suicide three to four times more often than women, a disparity driven by masculine norms that emphasize stoicism and self-reliance. These cultural expectations often discourage men from seeking help, leading them to face their struggles in isolation. Reluctance to seek support significantly reduces access to the social connections that are vital for suicide prevention. Remote services, such as France’s national suicide prevention helpline 3114, offer a discreet and accessible way for men to bypass these barriers and receive the support they need.

The national coordination center of the 3114-helpline set out to enhance men’s engagement with its services by developing a strategy that accounts for the impact of masculine norms on their willingness to seek and accept help. To ensure the strategy is relevant and effectively addresses the specific needs of men, it aimed to incorporate insights from those who had been directly affected by suicide.

A Cyclical Evaluation Process was employed to design and assess this digital public health intervention, comprising three key phases: (1) conducting interviews with men who had contacted the 3114 helpline; (2) developing narratives based on their testimonies; and (3) distributing these narratives through social media and the 3114 website. The stories were specifically crafted to boost readers’ self-efficacy and encourage help-seeking behaviours. This approach triangulates data to evaluate the narratives’ impact on men’s attitudes and behaviours concerning suicide prevention.

Phase 1 involved interviews with five men aged 35 to 51, revealing that hegemonic masculine norms, such as stoicism, significantly impede help-seeking behaviors. In Phase 2, a multidisciplinary team transformed the participants’ testimonies into compelling narratives, which were published between April and May 2024. Phase 3 saw these narratives garner 2,264 website visits and 49,782 social media impressions, indicating strong public engagement. The anonymity provided by telephone helplines facilitated emotional expression, helping to redefine traditional notions of masculinity. The stories played a significant role in raising awareness, normalizing help-seeking among men, and actively dismantling harmful gender stereotypes.

Incorporating the narratives of individuals who have experienced suicidal episodes offers a deeper, more nuanced understanding of this complex issue. When shared through empathetic and respectful approaches, testimonies significantly enhance prevention strategies. Co-constructing knowledge with those directly affected leads to interventions that are more relevant, tailored, and responsive to their actual needs. This approach underscores the ethical imperative of amplifying the voices of vulnerable individuals to develop more equitable and inclusive solutions.

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Dual diagnosis, the co-occurrence of substance use disorders (SUD) and mental health conditions, presents unique challenges influenced by gender-related factors. This narrative review explores the role of gender in the epidemiology, treatment access, environmental factors such as intimate partner violence, clinical features, and outcomes of dual diagnosis, highlighting structural and social determinants that exacerbate disparities. Women and gender minorities with dual diagnosis face heightened stigma, higher rates of trauma, and significant barriers to healthcare, often resulting in delayed treatment and poorer prognoses. Additionally, traditional gender roles and caregiving responsibilities influence coping mechanisms and treatment adherence. Despite increasing awareness, research on gender-responsive interventions remains limited. This review underscores the need for gender-sensitive approaches in dual diagnosis treatment, advocating for integrated, trauma-informed care that addresses the specific needs of diverse gender identities.

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Suicidality is one of the leading causes of death in young adults. Most of the suicidal patients suffer from background depression. Developments in the last few years in brain simulation technology as dTMS enables a more intensive care in accelerated protocols that have already been approved in the treatment of the depression field. However, most major studies in the field excluded the participation of patient with active suicidality.

This study focuses on efficacy of dTMS in patients with active suicidality.

This double-blind randomized study offers an accelerated protocol dTMS treatment in the span of 10 treatment days, while the patient is maintained in full hospitalization and secure conditions. The study examined the efficacy of the dTMS accelerated protocol (which includes 3 treatments a day for the course of 10 treatment days) on suicidality indicators. This treatment was given in addition (add-on) to standard ward treatments in three arms (1:1:1) sham, active H1 coil and active H7 coil.

38 patients were enrolled in the study. 30 patients successfully completed 10 treatment days. 8 patients did not complete treatment due to withdraw of informed consent before starting treatment (N = 4), panic attack (N = 2), discharge from the ward (N = 1) and suicide attempt (N = 1). Patients received active treatment (both H1 and H7) showed superior response (defined as >50% improvement in depression scale) compared to placebo arm (PA) (p = 0.03). Additionally, clinically close to significance improvement in suicidality intensity scales was found after 5 and 10 days of treatment in active treatment compared to placebo (p = 0.09). However, no significant difference was found regarding suicidality type scores. No major differences in depression and suicidality were found comparing H1 and H7 coils. The main side effects were headaches and dizziness, motoric tremor during the treatments, vomiting and general exhaustion. One patient (placebo group) completed suicide a month following the end of the study.

Active suicidality is a major challenge in treating severe mental disorders, and death by suicide is still a leading cause of death among patients. However, most clinical studies in mental health still exclude patients with active suicidality, hence treatment options are limited. In this study, we found deep TMS accelerated protocol (both H1 and H7 coils) to be both safe and effective in decreasing suicidality intensity and depression symptoms among inpatients with severe mental disorders accompanied by suicidality. Further studies are needed to differentiate H1 and H7 coils effectiveness in different depression sub-types and common psychiatric comorbidities.

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Depressive disorders and anxiety disorders are typical comorbidities in autism spectrum disorder (ASD), with a reported prevalence of 20% and 9%, respectively (Lai, 2019). Autistic subjects are more at risk for suicidal thoughts and behaviors compared to typically developing peers; moreover, depressive symptoms are often resistant to both pharmacological and psychotherapeutic treatments. In 2019 intranasal esketamine was approved in Italy for treatment-resistent depression (TRD). We observed two young outpatients affected by autism (diagnosis made by “Lab-Aut”, a specialized mental health service in Pavia) treated with esketamine in our ambulatory for TRD. Clinical information and personal details were summarized in Image 1.

To evaluate the clinical response to intranasal esketamine in subjects with major depression in ASD and to compare the outcome with neurotypical patients.

Autism diagnosis wase made according to ADOS-2 and ADI-R scores, confirmed by a clinical judgment of senior psychiatrist. Our follow-up protocol during esketamine treatment consists in the following scales: MADRS, C-SSRS, DES-II, Psychace Scale, Reading the Mind in the Eyes Test, HAM-A, HAM-D, BDI, PANSS. Psychometric evaluation was performed at T0 (before esketamine), T1 (one week of pharmacotherapy), T2 (one month), T3 (2 months) T4 (3 months) and T5 (6 months). We collected results from neurotypical patients (n=12) and autistic patients (n=2) between 2022 and 2024.

Both in autistic patients and in neurotypical ones we noticed a premature decrease in depressive symptoms and a reduction of suicidal thoughts. This improvement was testified by a reduction from T0 to T1 in MADRS total score and in C-SSRS sub-score focused on intensity of suicidal ideation. The reduction was maintained during the observation period (Image 2). Due to the small sample size of autistic patients, we couldn’t reach the statistical significance threshold for this population. Considering the entire sample (n=14) we obtained significant results (T0-T1: MADRS decrease p=0,00006, C-SSRS decrease p=0,00009. T0-T5 MADRS and C-SSRS variations p<0,00001). Comparing our sub-samples, it’s possible to notice a similar trend in follow-up between autistic and neurotypical patients. (Image 3).

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Our preliminary data coming from clinical experience suggest the efficacy of intranasal esketamine in depressive episodes occurring in autistic patients. A larger sample size of autistic patients will be necessary to set a comparative study and to give significance to these results. Esketamine could represent an important therapeutic option in depressed patients with ASD comorbidity.

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Perampanel is a selective antagonist of the AMPA receptor for glutamate, primarily approved for the treatment of certain types of epilepsy. With the evolving understanding of psychiatric disorders’ neurobiology, it’s hypothesized that targeting the glutamatergic system could offer substantial therapeutic benefits (Perversi F, Costa C, Labate A, Lattanzi S, Liguori C, Maschio M, et al. The broad-spectrum activity of perampanel: state of the art and future perspective of AMPA antagonism beyond epilepsy. Front Neurol [Internet]. 2023 [cited 2024 Sep 2] ;14:1182304).

The purpose of this study is to evaluate the effectiveness of perampanel in managing psychiatric symptoms such as sleep disturbances, depression, anxiety, and irritability.

A comprehensive review of scientific studies was carried out, centering on clinical trials and observational research that explored the application of perampanel in individuals exhibiting psychiatric symptoms. The review included articles published between 2013 and 2024, utilizing databases like PubMed, Scopus, and PsycINFO for sourcing. The inclusion criteria covered studies that assessed the impact of perampanel on psychiatric conditions, detailing both the clinical results and any side effects.

Findings indicate that perampanel may have beneficial effects in reducing symptoms of insomnia (Abenza-Abildúa MJ, Suárez-Gisbert E, Thuissard-Vasallo IJ, Andreu-Vazquez C. Perampanel in chronic insomnia. Clin Neurol Neurosurg. 2020 May 1;192), depression and anxiety (Scorrano G, Lattanzi S, Salpietro V, Giannini C, Chiarelli F, Matricardi S. The Cognitive and Behavioural Effects of Perampanel in Children with Neurodevelopmental Disorders: A Systematic Review. J Clin Med [Internet]. 2024 Jan 10 [cited 2024 Sep 3];13(2)) in certain patient groups. However, significant adverse effects were also reported, including behavioural changes and increased aggression in some cases, necessitating careful monitoring during treatment.

Numerous antiepileptic medications have been effectively utilized in treating psychiatric conditions. Perampanel, in particular, has demonstrated effectiveness in managing nocturnal seizures, preserving sleep architecture, and treating restless legs syndrome. A study conducted in Spain revealed that combining perampanel with either an antidepressant or an anxiolytic significantly enhances sleep quality after three months in patients without epilepsy (Abenza-Abildúa MJ, Suárez-Gisbert E, Thuissard-Vasallo IJ, Andreu-Vazquez C. Perampanel in chronic insomnia. Clin Neurol Neurosurg. 2020 May 1;192).

While there are no large-scale clinical trials specifically targeting mood disorders, some ongoing research is exploring the broader psychiatric effects of Perampanel, including its impact on anxiety disorders.

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Children and adolescents frequently encounter a range of adverse childhood experiences (ACEs), which encompass various forms of adversity such as abuse, neglect, and household dysfunction. These experiences can have profound and lasting effects on an individual’s health and well-being. Alarmingly, nearly three out of four children—approximately 300 million aged 2 to 4 years—are subjected to physical punishment and/or psychological violence by parents and caregivers. Moreover, statistics indicate that one in five women and one in thirteen men were sexually abused during their childhood (ages 0-17). Despite the widespread prevalence of these experiences, trauma in children often goes unrecognized. The nature of trauma can make it challenging for both the child and caregivers to identify and articulate trauma-related symptoms. Children may struggle to understand or express their experiences, and caregivers might misinterpret or overlook these signs, leading to underreporting and a lack of timely intervention.

Experiencing adverse events during childhood or adolescence is particularly concerning because it can significantly disrupt normal developmental trajectories, affecting physical, emotional, and cognitive growth. During these formative years, the brain is highly plastic and sensitive to environmental influences, making it especially vulnerable to the effects of trauma and stress. Such exposure can result in long-term consequences, including a heightened risk of developing mental health disorders, behavioral issues, and challenges in academic and social settings.

In this context, early identification of children and adolescents who have faced adverse experiences is crucial. By providing appropriate support and resources early on, it is possible to foster resilience and promote more positive growth despite the challenges posed by early adversity.

Using tools like the Child PTSD Symptom Scale (CPSS), a widely recognized self-report instrument designed to assess the severity of post-traumatic stress disorder (PTSD) symptoms in children and adolescents aged 8 to 18, can be especially effective for identifying and evaluating the impact of trauma exposure in young individuals and facilitating early intervention.

Research published by the National Institute of Mental Health (NIMH) indicates that early identification through screening can lead to timely interventions, significantly reducing the psychological harm associated with trauma exposure.

Research strongly supports the effectiveness of screening for trauma symptoms in children and adolescents, emphasizing its critical role in early detection, timely intervention, and the prevention of long-term negative outcomes. This proactive approach not only addresses the immediate psychological impact of trauma but also contributes to improved long-term well-being and quality of life for those affected.

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