Auditory verbal hallucinations (AVH) are prevalent in schizophrenia and are often distressing. However, relatively little is known about their linguistic structure, although a number of authors have commented that they tend take the form of short, syntactically simple sentences (Tovar et al Schizophr Res 2019; 206 111-117; Corona-Hernández et al Schizophr Res 2022; 241 210-217). It has been suggested that these features may be related to the high frequency with which AVH feature insults and commands (which are normally short and simple).

We aimed to quantify sentence length and complexity of AVH in schizophrenia patients, and to examine how far length reductions were attributable to presence of insults and commands. We also examined the same variables in real speech from patients with schizophrenia and healthy controls.

We transcribed verbatim AVH from 11 patients with very frequent AVH following a previously used protocol (Fuentes-Claramonte et al Sci Rep 2021; 23 18890). Mean sentence length and mean dependency distance (a measure of syntactic complexity) were calculated using the udpipe package in R. Insults and commands were also coded. For comparison, (real) speech samples were collected and transcribed from patients with schizophrenia (N=14) and healthy controls (N=15). All groups were matched for age, sex and estimated premorbid IQ.

We found that AVH sentences were on average significantly shorter (t(37)= -6.51, p < 0.001; see Fig. 1A) and syntactically simpler (t(37)= -4.37, p < 0.001; see Fig. 1B) than in the (real) speech of healthy controls. AVH sentences were also shorter (Fig. 1A) and simpler (Fig. 1B) than the speech of schizophrenia patients, although the latter comparison only approached significance (t(37)= -4.09, p < 0.001 and t(37)= -2.31, p = .08, respectively). After insults and commands were removed from the analysis, AVH sentences were still shorter (t(37)= -6.09, p < 0.001) and simpler (t(37)= -3.89, p < 0.001) than those in the speech of controls, and shorter (t(37)= -3.68, p < 0.01) than those in the speech of patients, but not simpler (t(37)= -1.86, p = 0.213).

Image 1:

From our data AVH mainly (though not exclusively) take the form of short and simple sentences. These features are not explained by presence of insults and commands.

None Declared

This report describes a case of delirium tremens in a 35-year-old male patient with myasthenia gravis and epilepsy. He first came to our clinic on 18th of August 2024. His complaints were of bad mood, nervousness and loss of will and appetite, he started to drink alcohol. He was advised to quit drinking and was prescribed quetiapine.

On 20th of August he was hospitalised in our clinic as he presented with the withdrawal state. That, along with his initial blood tests, indicated a high probability of developing delirium tremens and presented us with the problem of treating this patient given his pre-existing condition.

The patient was started on saline with vitamins and glucose infusions. Low doses of quetiapine (25-50 mg) were given.

Current literature regarding MG and medications, puts diazepam in risk level 4, which means it rarely worsens MG, but symptoms must be monitored. Considering the high doses of diazepam usually required in states of delirium tremens and also not being able to predict how the strain of the delirious state will affect a patient with MG, we were cautious in administrating benzodiazepines.

A neurologist was consulted and they evaluated there was no need to transfer the patient or to adjust his medication. His chronic therapy was pyridostigmine 3x60 mg and valproic acid 2x600 mg. Blood tests showed a rise in CK level from11463 U/L to 12793 U/L in just a few hours. Myoglobin was at 630 ng/mL. Potassium levels were initially 2.9 mmol/L and were corrected to the value of 3.8 in the control test. An internal medicine specialist was called for but did not come that day. The patient was more agitated, began hallucinating, profusely sweating and trembling trough out the night. He was physically restrained.

The following day, blood test showed a further increase of CK (15578 U/L). His general state was progressively worsening, and we resorted to administering low doses of diazepam and haloperidol along quetiapine.

On Aug 22nd, test results were: urea 6.9 mmol/L, creatinin 112 umol/L, K 4.0 mmol/L, Na 149 mmol/L, Cl 111 mmol/L, CRP 91.3 mg/L, AST 381 U/L, ALT 211 U/L, LDH 653 U/L, CK 17747 U/L, CKMB 134 U/L, Mg 0.72 mmol/L, amonia 58.28 umol/L. The patient was transferred to an IC unit where he was treated for two days and during which time he was respiratory stable but in need of constant electrolyte and pH correction. His CK levels were as high as 43400 U/L and myoglobin 5542.8 ng/mL.

On August 24th the patient was returned to our clinic to continue his treatment. He was hospitalised for 20 more days and released home in good health.

in emergency psychiatry there are sometimes cases which exceed our competences and practical possibilities to treat, but because they’re psychiatric in origin, those patient are admitted in psychiatric hospitals. There is need for therapeutic guidelines for patients who develop delirium tremens and are burdened with comorbidities.

None Declared

Since the risk of relapse is particularly high after completion of acute treatment of depression until remission, the guidelines recommend maintenance therapy or continuation over several months and subsequent relapse prevention. In contrast, average waiting time for further outpatient treatment after a part-time inpatient stay is 19.9 weeks in Germany. Digital health technologies can help to support patients at the vulnerable interface when changing health care sectors from part-time inpatient treatment to further outpatient treatment and contribute to a successful change of health care sectors.

Flowzone is a digital communication platform in which therapists and patients can stay in contact after completion of part-time inpatient treatment. Individualized therapy content can be shared with patients in weekly plans and communication can be maintained via the chat function. The aim of the current study is to investigate whether Flowzone enables continuity despite long waiting times when health care sectors changes from part-time inpatient to outpatient care.

In a longitudinal intervention study depressive symptoms (BDI-II) and quality of life (WHOqoL-Bref) will be assed at the end of part-time inpatient treatment (t1) and 8 weeks after end of treatment (t2). Participants diagnosed with depression will be recruited in a day clinic with treatment focus of men of a psychiatric psychotherapeutic specialist hospital in Lower Saxony (Germany). Participants of control group (CG, n = 11) will take part in the local 8 week aftercare groups of the psychiatric hospital. Participants of intervention group (IG, n = 21) will take part in the digital aftercare with Flowzone. Furthermore subjective benefit, of IG will be measured. In addition, the subjective benefit and user experiences of IG will be measured.

Mean BDI scores of IG are t1 = 14 vs. t2 = 15 and of CG t1 = 9. Mean values of IG for WHOqoL-Bref domains are general quality of life t1= 77/ t2 = 73; physical health t1= 71/ t2 = 68; psychological health t1 = 59/ t2 = 55; social relationships t1 = 65/ t2 = 57; environment t1 = 77/ t2= 71. Further inferential statistical analysis and group comparisons will be reported when date are available.

Results might suggest that depressive symptoms and quality of life could be stabilized with the use of Flowzone 8 weeks after part-time inpatient treatment. Further data collection will allow statistical comparisons to CG. Inclusion of the CG with standard follow-up in an outpatient setting is needed. Flowzone could help to bridge the gap in treatment when patients switch health care sectors and experience a gap between part-time inpatient care and further outpatient care.

None Declared

The nature-based therapeutic perspective includes: green therapy, blue therapy, animal-assisted therapy, and natural landscape therapy. Until now researchers haven’t clearly recognized underlying mechanisms of nature-related mental health well-being.

The study aimed to clarify the relationships between experienced nature connectedness (NC) and social connectedness (SC) before and after blue nature based intervention and mental health (WHO-5, PHQ-4)

Study group included 54 adults (Mean = 30.6; SD 13,2). Participants completed semi-structured questionnaires before and after blue interventions (one week high sea sailing under supervision of two psychologists). The questionaire measured following variables: nature connectedness, social connectedness, well-being, and mental health.

Results showed a significant increase in social and nature connectedness as well as in mental well-being after the blue interventions. Full results will be shown on the e-poster.

The mental health and wellbeing benefits of contact with nature are becoming increasingly recognized in psychology and medicine. The findings support hypothesis that nature connectedness and social connectedness increased after nature based interventions, and therefore they seem to be important factors conected with mental health.

None Declared

Severe psychiatric disorders, including schizophrenia (SCZ), bipolar disorder (BIP) and anorexia nervosa (AN), are frequently comorbid with lung function decline and asthma. Despite considerable heritability, the genetic relationships between severe psychiatric and respiratory comorbidities are inconclusive.

We aimed to thoroughly investigate the shared genetic architecture between three severe psychiatric disorders (SCZ, BIP and AN) and lung function (forced expiratory volume/forced vital capacity ratio) or doctor-diagnosed asthma based on available genome-wide association studies.

We performed linkage disequilibrium score regression analyses (LDSC) and MiXeR to quantify the genetic overlap. A conditional/conjunctional false discovery rate (cond/conjFDR) approach was employed to detect shared genomic loci. Functional annotations, gene mapping and gene-based enrichment analyses were adopted to explore shared biological mechanisms. Web-based cell-type-specific enrichment analysis (WebCSEA) was employed to identify the cell types enriched for shared genes across tissues. Transcriptome analyses were conducted via S-PrediXcan to prioritize biologically plausible shared genes in relevant tissues.

Despite weak or null genetic correlations identified by LDSC, MiXeR analyses demonstrated extensive moderate polygenic overlap (~400 to 800 shared variants) across all pairs of psychiatric and respiratory phenotypes. The cond/conjFDR approach detected a total of 378 unique loci jointly associated with severe psychiatric disorders and lung function or asthma, harboring a mix of concordant and antagonistic variants. Gene-based enrichment analyses applied to the 4,105 genes mapped to shared loci highlighted cell types including type II pneumocytes and macrophages in lung and monocytes in blood as well as biological processes involving the interferon (IFN) JAK-STAT pathway and natural killer cell activation, suggesting common immune mechanisms. Furthermore, when stratified by respiratory outcome, genes shared with asthma were enriched for immunity-related pathways, whereas genes shared with lung were enriched for non-immune mechanisms, indicating divergent shared etiology. A total of 22 shared genes identified by conjFDR approach were prioritized as biologically plausible in transcriptome analyses.

This study reveals the complicated shared genetic etiology between severe psychiatric disorders and lung function or asthma and implicates overlapping immune and non-immune mechanisms. Our findings suggest that individuals with severe psychiatric disorders should be screened for lung function decline and asthma in clinical settings.

None Declared

Obsessive-compulsive disorder (OCD) is characterized by recurrent intrusive distressing thoughts, images, or urges (obsessions), and/or by behavioral acts (compulsions) that the individual feels driven to perform. In patients with severe functional impairment, a combination of selective serotonin reuptake inhibitors (SSRIs) or chlomipramine and cognitive behavioural therapy is recommended. Evidence for use of repetitive transcranial magnetic stimulation (rTMS) as an adjunct in severe, medication-resistant cases of OCD is accumulating.

We present a case of severe OCD in a patient who responded poorly to SSRIs, and who was trialed on rTMS, with marked improvement.

Details of the case were described. Information was gathered based on medical records.

Patient T was a 34-year-old Chinese male, with a drug allergy to clomipramine, who was diagnosed with severe OCD in 2017, when he presented to the Institute of Mental Health for excessive anxiety with checking behaviour. He was maintained on fluoxetine 60mg OM and aripiprazole 10mg OM, from 2017 to 2020. He completed a course of rehabilitation during admission, as well as empowerment and job training programs in the outpatient setting. He still had residual symptoms of excessive checking and would take a long time to complete activities of daily living such as eating or showering. He then defaulted medications and follow up from 2020 onwards. In 2024, he was brought in by his father to the emergency services for an infected foot wound due to poor self-care, as well as loss of weight from only eating one meal a day, due to his excessive checking behaviour. He would take 5 hours to finish a meal and 4 hours a day showering. He had also stopped speaking to anyone for 3 years. In the ward, he was switched to paroxetine 40mg OM as he had urinary incontinence on fluoxetine and weight gain on aripiprazole. However, improvement with paroxetine was minimal and the patient was still taking 2 hours each for showering and meals. The decision was made to give him a trial of rTMS. Drug treatment remained unchanged during the rTMS trial. Prior to rTMS, his Yale-Brown Obsessive-Compulsive Scale (YBCOS) was 30 (severe OCD).

After 30 sessions of rTMS, his obsessions and compulsions were significantly reduced, with a YBCOS of 17. He was able to finish his meals and shower for less than 30 minutes each. He was also more participative in ward activities with other patients, such as playing ping pong. He also showed interest in self-care by asking questions about his infected foot wound and prevention strategies.

In this case, there was a need for early treatment to address the risk of self-neglect posed by the patient’s obsessive checking behaviour. rTMS is a safe and efficient treatment for patients suffering from refractory OCD. Further research is needed to optimize rTMS protocols and evaluate the long-term efficacy of rTMS for OCD.

None Declared

The turn of the century was an important era for the field of psychiatry. Influential physicians such as Sigmund Freud (1856-1939) or Eugen Bleuler (1857-1939) made headlines and new theories on the pathogenesis of psychological disorders emerged with the psychoanalytic approach – the whole field seemed in a state of transition. But did this modern image correspond to how two of psychiatry’s most famous conditions – psychoses and delusions – where framed in the mass media of film? Surprisingly, there are no systematic works on these question, neither by medical nor film historians. This lecture tries to close this gap and, for the first time in international research, provides a systematic overview of the representation of the theme in silent cinema. With the aim of sketching a representative image, 36 works portraying psychoses and / or delusions were identified and, among other things, historically classified, analyzed and evaluated for medical correctness. In summary, it is shown that the early film depicts the condition in a highly ambivalent way, from dangerous and untreatable Insanity to curable illness, thereby reflecting one of the most significant transitions in the history of the understanding delusional symptoms. The presented therapy methods – e. g. psychoanalysis, hypnotherapy, electrotherapy, water therapy and even music therapy –, thus rarely utilized, appear highly modern, while the depiction of the patients seems more influenced by the shadows of the past. Accompanied by scenes from representative works such as The Other (1913), Wolf Blood (1925), Shadows (1923) or the German classic The Cabinet of Dr. Caligari (1920), the presentation aims to illustrate all these characteristics of the early ‘psychosis und delusion film’ and explores the important role of cinema as a source of medical history.

None Declared

Suicide is a global public health issue. According to the World Health Organization (WHO), more than 700,000 people die by suicide worldwide each year. In 2019, it was the fourth leading cause of death among those aged 15 to 29 globally. In Spain, suicide has been the leading cause of external death in recent years, which has motivated in some regions the implementation of preventive strategies, such as Codi Risc de Suïcidi (Suicide Risk Code).

This study examines the epidemiology of suicidal behavior in the Catalan population between 2010 and 2019, exploring geographical disparities and the influence of different sociodemographic and clinical variables on the incidence of suicidal ideation and suicide attempt.

All residents in Catalonia who attended the public health system from 2010 to 2019 were included in the study. Data were obtained from the Program d’analítica de dades per a la recerca i la innovació en salut (PADRIS) of the Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS). Data on geographical, sociodemographic, and clinical variables were collected for subsequent statistical analysis. Statistical significance was set at p<0.05.

A total of 1,421,510 individuals were included. Overall, 6921 cases of suicidal ideation (0.5%) and 1143 suicide attempts (0.1%) were registered, which an accumulated incidence of 487/100,000 inhabitants for the first outcome and 804/1,000,000 inhabitants for the second. From the whole sample, 83,592 individuals (5.9%) had a severe mental illness (SMI), whereas the proportion of patients with a SMI in the group of suicide attempters was 9.6%. The majority of individuals who attempted suicide were women (64.1%). The highest proportion of individuals with suicidal thoughts or attempts was found in the age range from 15 to 19 years. The presence of a somatic illness, low socioeconomic status, tobacco use and the presence of a severe mental illness were significantly associated with suicidal ideation and attempt. Those patients with suicidal behavior had a higher number of emergency visits during the 10-year period, and also a higher probability of being prescribed antidepressants, antipsychotics, benzodiazepines or lithium. Geographical disparities in the incidence of suicidal behavior were found, with specific regions showing higher rates. In a logistic regression analysis, all associations remained significant.

This study highlights the association between sociodemographic and clinical factors, which should have been assessed in clinical practice, with suicidal behavior. Geographical disparities may be attributed to various factors, including access to mental health services and socioeconomic factors. This study underscores the importance of identifying specific profiles at a higher risk for committing suicide, and also to implement policies and prevention programs in order to address this public health issue comprehensively.

None Declared

Lumateperone, an atypical antipsychotic drug, has a dual mechanism of action by combination of activity at central serotonin (5-HT2A) and dopamine (D2) receptors.

This subgroup analysis of an Indian Phase 3 study was conducted to evaluate the efficacy and safety of Lumateperone 42mg compared to Quetiapine 300mg in treatment of Bipolar II depression when stratified based on age (18-45, >45-65).

The phase-III, randomized, multi-centric, assessor-blind, parallel-group, active-controlled, comparative, non-inferiority study included Indian patients with Bipolar II depression with moderate severity having a Montgomery-Asberg depression rating scale (MADRS) score ≥20 and Clinical global impression–bipolar version–severity (CGI-BP-S) score ≥4. The study was conducted after receiving regulatory and ethics committee approvals. The patients were randomized (1:1) to either receive Lumateperone 42mg [Test] or Quetiapine 300mg [Comparator] for 6 weeks. The patients were stratified based on age: Subgroup 1 [S1]: 18-45 years and Subgroup 2 [S2]: >45-65 years. For efficacy outcomes MADRS score, CGI-BP-S (total score, depression subscore and overall bipolar illness subscore), and Quality of life enjoyment and satisfaction-short form questionnaire (Q-LES-Q-SF) score were evaluated and for safety outcomes treatment emergent adverse events (TEAEs) were assessed. [Clinical trial registration: CTRI/2023/10/058583]

This subgroup analysis included 462 patients, out of which 320 in S1[Test=159; Comparator=161] and 142 in S2[Test=72; Comparator=70]. The baseline demographic characteristics were comparable in between treatment arms across subgroups. The primary endpoint of reduction in MADRS score from baseline to Day 42 in Test arm was non-inferior to Comparator arm in both subgroups [Figure 1] as the upper 95% CI was below the pre-defined margin of 3.0. The reduction of CGI-BP-S (total score, depression subscore and overall bipolar illness subscore) from Day 14 to Day 42 were comparable in both Test and Comparator arms in both subgroups. The improvement in Q-LES-Q-SF score from baseline to Day 42 were comparable in both Test and Comparator arms in both subgroups. The incidence of TEAEs were comparable in both treatment arms [S1: Test=31.4% and Comparator=36.6%; S2: Test=41.7% and Comparator=32.9%] and no serious adverse events were reported.

Image 1:

This subgroup analysis demonstrated that Lumateperone 42mg is non-inferior to Quetiapine 300mg in treatment of Bipolar II depression as assessed via MADRS score from baseline to Day 42, irrespective of age of the patients and both treatments were found to be well tolerated. Hence, Lumateperone can be considered as valuable treatment option in management of Bipolar II depression.

A. Dharmadhikari: None Declared, P. Chaurasia: None Declared, Y. Patel: None Declared, D. Choudhary: None Declared, P. Dasud: None Declared, M. Bhirud: None Declared, P. Meena: None Declared, F. Shah: None Declared, G. Ganesan: None Declared, B. P. Rathour: None Declared, K. Mistry: None Declared, M. Dutta: None Declared, A. Ramaraju: None Declared, S. Mangalwedhe: None Declared, S. G. Goyal: None Declared, G. Kulkarni: None Declared, A. Mukhopadhyay: None Declared, P. Chaudhary: None Declared, G. T. Harsha: None Declared, M. Parikh: None Declared, S. Dey: None Declared, S. Sarkhel: None Declared, N. Jyothi: None Declared, A. Kumar: None Declared, N. Sooch: None Declared, A. Shetty Employee of: Sun Pharma, S. Saha Employee of: Sun Pharma, P. Devkare Employee of: Sun Pharma, A. Shetty Employee of: Sun Pharma, D. Patil Employee of: Sun Pharma, P. Ghadge Employee of: Sun Pharma, A. Mane Employee of: Sun Pharma, S. Mehta Employee of: Sun Pharma

Several years ago, the first studies were conducted in which the effects of psychedelics in low doses were tested in healthy participants. These studies focused mainly on the acute effects of LSD. Questions that remained unanswered were whether low doses have lasting effects, as well as whether they can reduce symptoms of ADHD. To answer these questions, we conducted two studies, administering LSD (15 mcg) repeatedly over 2 weeks to healthy participants and administering LSD (20 mcg) repeatedly over 6 weeks to participants with ADHD. The latter study was a multicenter trial conducted by Universitatsspital (Basel) and Maastricht University. Based on the findings of both studies, we have now planned a follow-up study in 100 individuals with ADHD who also have problems with emotion regulation and/or sleep, to get closer to an “average” ADHD population. This study, which will start later this year, aims to find markers of treatment response. Lastly, plans for a study investigating high-ventilation breathwork as a novel intervention for individuals with social anxiety symptoms will be presented. High-ventilation breathwork has the potential to induce altered states of consciousness similar to those elicited by psychedelics. This research aims to explore its therapeutic potential as a non-pharmacological alternative to psychedelics in psychiatric treatment.

K. Kuypers Grant / Research support from: Part of the work that is presented is funded by Mindmed Inc (LSD, ADHD), the Beckley Foundation (LSD, healthy volunteers), and grants from the Dutch research organisation (LSD, ADHD, biomarkers) and the Tiny Blue Dot Foundation (Breathwork, Social Anxiety).

Developmental language delay in children is characterized by the qualitative and quantitative underdevelopment of vocabulary and insufficient expressive language skills. These delays frequently co-occur with mental health issues including the emotional and behavioral sphere difficulties and it may result in adaptation difficulties in school. A multifactorial etiology has been identified for developmental language delay, highlighting the necessity for early prediction and intervention tools. The early prediction of speech and language delays in children under one year of age can help to prevent complications of the existing impairments in future.

To develop an algorithm of developmental language delay prediction in toddlers, based on anamnesis data.

The training dataset had been collected from anamnesis of 232 children aged 18 till 36 months. Signs of developmental language delay had been presented in 50% children; typical language development had been presented in the other half of the sample. The neural network architecture had been developed using the Python 3.0 programming language and the Keras library. The compiled neural network had been trained on data which represented anamnesis of children under 1 year old. 70% of the collected data array were used for neural network training, 30% were used for validation.

The algorithm architecture consisted of direct propagation neural network of 5 Dense layers. A one-dimensional tensor of 58 values had been fed to the input of the network. At the output, the value of the probability of developmental language delay had been obtained. During 1000 of training iterations the accuracy of 95% had been achieved. Sensitivity and specificity of the model reached 95% and 100%, respectively.

For the first time in the world, a neural network model of predicting the developmental language delay in early age children had been developed. This model considers data of intrauterine period of development, as well as the life of a child up to 1 year. It may help to prevent severe mental disorders which are comorbid to speech disorders.

None Declared

Shared psychotic disorder (Folie à Deux) is a phenomenon in which one person adopts the delusions of another with whom they have a close relationship. This case is particularly interesting because the delusions primarily developed through telephone conversations between two sisters and were notably exacerbated when they reunited in person. The telephone-based relationship between the sisters raises questions about the psychological influence from a distance in the development of shared psychosis.

To describe a clinical case of Folie à Deux in which delusion transmission occurred predominantly through telephone communication, highlighting the role of physical contact in the exacerbation of psychotic symptoms.

We present the case of a 59-year-old woman hospitalized for shared psychosis. Her sister, with whom she maintained a close relationship through frequent phone calls, had previously developed persecutory delusions related to a complicated divorce. Over the course of five years, the patient began to share the same delusions of persecution and surveillance that her sister transmitted over the phone. However, following a visit from her sister to Madrid in July 2024, the patient’s psychotic symptoms intensified, leading to psychiatric hospitalization in the brief hospitalization unit (UHB), where antipsychotic and antidepressant treatment was initiated.

The patient was admitted with persecutory delusions centered on alleged surveillance related to her sister’s divorce, delusions that her sister initially developed and which they shared after years of phone conversations. During hospitalization, antipsychotic treatment was effective, leading to remission of the active psychotic symptoms. The patient demonstrated insight into her delusions, linking them to her sister’s influence. As contact with her sister decreased and treatment was introduced, the psychotic symptoms subsided. Since discharge, the patient has remained stable, though a medication adjustment was required due to reported side effects.

This case of Folie à Deux highlights how a telephone relationship can be sufficient to transmit and maintain shared psychotic delusions. While physical contact exacerbated the symptoms, emotional exchange from a distance can also be a potent medium for perpetuating delusions. This case suggests that proximity, whether physical or emotional, directly influences the severity of shared psychosis.

None Declared

Generalized anxiety disorder (GAD) is among the most common psychiatric disorders and has significant impairment on patients’ daily life. Effective and well-tolerated pharmacotherapies are needed. The FDA has noted that the inclusion of psychotherapy within trials complicates assessment of psychedelic drug efficacy, although to date many psychedelic trials have included co-occurring psychotherapy.1 Co-occurring psychotherapy confounds the evaluation of efficacy and may complicate commercial labeling. A phase 2b study of the dose response to single treatment MM120 (lysergide D-tartrate) suggests a safe, rapid, and durable dose-dependent response in participants with moderate-to-severe GAD2 and design elements are examined herein.

To examine the methodological use of Dosing Session Monitors (DSM) within MM120 treatment without co-occurring of psychotherapy.

This phase 2b (NCT05407064) multicenter, randomized, double-blind, placebo-controlled study enrolled adults aged 18 to 74 years diagnosed with moderate to severe GAD.2 Two DSMs, meeting FDA recommended qualifications,1 were assigned to a participant throughout the study duration. Prior to dosing, participants engaged in baseline study education with their DSMs. During dosing, DSMs provided assistance and comfort as needed and monitored the participant for safety. Starting at 8 hours post-dose, a pre-specified checklist to end the session was administered, although all participants were required to stay onsite a minimum of 12 hours. The follow up period for the trial was 12 weeks, and DSMs only followed up with participants at Day 2, Week 1, and Week 2 post-dose. DSM follow up focused on participant safety and did not include focus on producing post-synaptic change.

In total, 198 participants were enrolled in the study. The phase 2b study demonstrated a statistically significant safe, dose-response relationship at the week 4, 8, and 12 primary and secondary endpoints.1 Utilizing the prespecified checklist, 45% of participants receiving MM120 100μg met criteria for end of session at 8 hours post dose, with 87.5% achieving criteria at 10 hours.

The results demonstrate that a single treatment with MM120 produces a safe and durable clinical response without co-occurring psychotherapy. These findings indicate that MM120 treatment sessions may be safely shortened from a minimum of 12 hours to 8 hours for some participants, and psychotherapy does not appear to be essential for its safety and efficacy.

1. FDA—Center for Drug Evaluation and Research. Psychedelic drugs: considerations for clinical investigations (FDA-2023-D-1987).

2. Karlin, D et al. Rapid and Durable Response to a Single Dose of MM120 (Lysergide) in Generalized Anxiety Disorder: A Dose-Optimization Study. Poster P03-026. Presented at: APA Annual Meeting; May 4-8, 2024; New York City, NY. 2024.

S. Karas Employee of: Mind Medicine, Inc., R. Barrow Employee of: Mind Medicine, Inc., C. Conant Employee of: Mind Medicine, Inc., J. Freedman Employee of: Mind Medicine, Inc., P. Jacobsen Employee of: Mind Medicine, Inc., J. Jemison Employee of: Mind Medicine, Inc., D. Karlin Employee of: Mind Medicine, Inc., T. Solomon Employee of: Mind Medicine, Inc.

Conflicts concerning land ownership and inheritance disputes among older adults are prevalent and often lead to extreme and criminal behaviors. Even seemingly insignificant differences, such as disputes over a few square meters of land or a single tree, can escalate into violence or homicide.

This study aims to examine these phenomena through the lens of the fragmentation of the “good object,” as well as the accompanying sense of urgency experienced by older adults. This fragmentation refers to the loss of emotional and psychological foundations that provide a sense of security and identity. The study explores how these seemingly minor disputes, when they threaten the “good objects” of older adults, combined with their intense urgency to resolve these issues before it is too late, can turn into serious identity crises, potentially leading to extreme behaviors.

Through the analysis of case studies and a psychoanalytic approach, the psychosocial factors influencing older adults’ decisions regarding the management of their property and their emotional connections to these assets are examined.

The findings reveal several key factors contributing to these conflicts, including: a) Emotional attachment to property stemming from years of hard work, b) Inheritance tensions and a sense of injustice, c) Financial insecurity, which makes property the most valuable asset for survival, d) Psychological pressure and isolation, which may lead to unpredictable behaviors, e) Lack of emotional control and traditional perceptions of honor and dignity, f) A sense of loss of control as they age and the need to defend what they deem important.

The psychoanalytic interpretation of these phenomena reveals that the fragmentation of the good object, which may be land or other property, is closely tied to the identity and mental well-being of older adults. These individuals experience an intense sense of urgency, as delays in resolving their legal issues can mean the loss of their identity. This urgent need to protect their “good objects” often leads to reactions, frequently violent, stemming from despair and the perception that their social fabric is abandoning them. For older adults, legal and property disputes are not merely material concerns but represent their last struggle to maintain their identity. It is essential to recognize the importance of these issues and provide them with the value they deserve.

None Declared

The concept of dealing with stress refers to different forms of behavior that an individual uses in response to stressful situations, with the aim of reducing the effects of those stressful events or situations. Ways of coping are important as a prerequisite for positive growth and development and can be a significant factor in the etiology of psychological and somatic problems. Coping strategies include all those behaviors that are used to overcome difficulties in stressful situations. They refer to emotional, cognitive and behavioral responses to stressful situations that vary with time and characteristics of a specific stressful situation. In adolescence, the child encounters various forms of life situations and stresses, without yet having developed a wide range of coping strategies on which to rely. Children’s growth and development and the influence of sociodemographic factors represent certain risks that can directly or indirectly affect stress coping strategies.

The aim is to determine ways of coping with stress in early adolescents and their connection with sociodemographic risk factors.

We analyzed a group of 240 early adolescents (11-15 years) from Tuzla Canton, Bosnia and Herzegovina, in the general population. The sample was chosen because the early adolescent period is vulnerable in children’s growing up and psychological development. The Kidcope coping scale for children and adolescents was used to assess the way of coping. The data were processed using the method of descriptive statistics. Pearson’s correlation test was used to assess the association between sociodemographic risk factors and coping methods.

On the coping scale, early adolescents showed a statistically significantly higher level of self-blame and blaming others. On the questionnaire of psychosomatic symptoms (PS), the obtained results show that living in a rural area leads to frequent blaming of others as a way of coping (p<0.05), as well as a significantly higher level of prayer (p<0.05). Higher economic status and higher monthly income are significantly positively associated with resignation (p<0.01). Higher educational status of the mother and better living conditions are also positively related to resignation as a way of coping with stress (p<0.05). Disturbed family relationships are associated with a higher frequency of distraction (p<0.05).

Early adolescents show significant levels of various stress coping strategies. There is a significant correlation between sociodemographic risk factors (place of residence, economic status of the family, disturbed family relations) and psychosomatic symptoms in early adolescents.

None Declared

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

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

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

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

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

None Declared

The use of anxiolytics is a complex phenomenon, increasingly affecting the student population. Inappropriate use of this type of treatment can lead to abuse and even dependence.

To study the prevalence of dependence on anxiolytics, particularly benzodiazepines BZD in this population and to identify its associated factors.

This was a cross-sectional descriptive study carried out among students from Gabes institute of nursing sciences, for a period of two months(March to May 2024).

Data were collected using an online anonymous questionnaire from Google form that we distributed via Messenger social network.

We used the Benzodiazepine Attachment Cognitive Scale (BACS) to study BZD dependence.

A score ≥ 6 enables to differentiate between dependent and non-dependent patients.

We collected data from 135 students. Our sample included only 33 students.

The mean age of our population was 21.30 ±1.51 years and the sex ratio (M/F) was 0.65.

Consumption of psychoactive substances (PAS) was reported by 21 students (63.63%): tobacco by 21.2%, coffee by 12.2% and alcohol by 12.2%.

All students reported having taken benzodiazepines BZD.

In our study, 13 students (39.4%)reported having used BZDs 1 or 2 times in their lives (for experimental purposes). Daily use of BZDs was not reported.

The mean score of the ECAB scale was 6.93, with extremes of[3-10].

According to our results, dependence on BZD was clearly predominant, found in 28 students (84.8%). No correlation was found between the socio-demographic characteristics and the presence of anxiolytic dependence.

BZD dependence (assessed by the ECAB scale) was correlated with coffee consumption (p=0.03), unlike for other substances (tobacco, alcohol, cannabis).

The study highlighted the high level of dependence on anxiolytics, particularly BZD and identified individuals who were at higher risk. Specific interventions were necessary to deal with the problem of addiction.

None Declared