Patients of depression and psychotic disorders are often troubled by unsatisfactory interpersonal relationships. While an inability to maintain a stable sense of self restricts one’s understanding another’s emotional state, whether disrupted self-versus-other referential processing is a transdiagnostic predictor of increased emotion misreading across diagnostic groups has not been explicated.

We tested whether weakened differential learning between self and other may account for impoversihed emotion recognition accross mood and psychotic disorders.

Inpatients admitted for major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SCZ; ns = 59, 32, and 43) and 40 healthy controls were recruited. Aside from ratings of depressive and schizophrenic symptoms by psychiatrists, participants were assessed on self- versus other- referential learning, emotion recognition, emotion sharing.

Regression analysis indicates lower effectiveness of self-other tagging to be a predictor independent from symptom severity for increased emotion misrecognition across MDD, BD and SCZ (F(8, 160) = 8.52, p < 0.001). Clinical groups showed lower accuracy for other-referential recall and emotion recognition, but comparable emotion sharing and self-prioritization to healthy controls.

Image:

Heightened emotion misrecognition in MDD, CD, and SCZ patients can be traced back to the weakened ability in coordinating self- and other-representations according to task-demands. Future examinations on whether interventions on brain regions pertaining to self-versus-other learning might enhance emotion recognition in different patient groups would be clinically relevant.

None Declared

Electroconvulsive therapy (ECT) is an effective treatment for major depressive disorder (MDD). Only few studies have measured CSF in patients undergoing ECT; thus far, no prognostic candidate biomarkers for treatment response have been found (Kranaster et al. Neuropsychobiology. 2019;77(1):13-22). Neurofilament light chain (NfL) is a protein found in the axons of neurons. If elevated in blood or cerebrospinal fluid (CSF), it is an indicator of neuroaxonal damage. A recent study including 15 patients with MDD who underwent ECT found no significant change in serum NfL concentrations after completion of treatment (Besse et al. Eur Arch Psychiatry Clin Neurosci 2024; 274(5):1187-95). The astrocyte marker glial fibrillary acidic protein (GFAP) is elevated in MDD and neuroinflammatory diseases. Serum GFAP levels in 40 MDD patients decreased after ECT compared to baseline (Xu et al. Psychiatry Clin Neurosci. 2023; 77(12):653-64). No studies measuring CSF levels of both markers have been performed.

In this prospective study we aimed to measure changes in CSF of NfL and GFAP in patients undergoing an ECT series.

In a sample of 9 MDD patients undergoing bilateral ECT, CSF was analyzed before and after the 8th ECT session. Patients took antidepressant medication in a steady state over the course of ECT. A mixed-effects linear regression analysis was done using the log-transformed NfL and GFAP levels as outcome variables. The timepoint (pre-ECT, post-ECT) were entered as fixed effects, patient ID was included as a random effect to account for individual variability. We corrected for multiple testing and defined alpha = 0.05/2 = 0.025. Statistical analyses were performed using R version R-4.3.2.

The mean age ± SD was 34 ± 11 years, 6 out of 9 patients (67%) were women. Mean elevations of NfL by 19,9 pg/ml (95% CI: -120.3 to 160.0) and GFAP by 445.8 pg/ml (95% CI: -1279.6 to 2171.4), there was no significant change in NfL (p = 0.213) or GFAP (p = 0.362) levels after ECT. Figure 1 shows concentrations of both NfL and GFAP pre and post ECT.

Image:

This study found no significant changes of NfL or GFAP levels in CSF after an ECT series, suggesting no evidence of neuroaxonal damage or brain damage through astrocyte activation related to ECT. However, the small sample size may have obscured potential effects. Future research with larger sample sizes is therefore essential.

S. Riessland Grant / Research support from: This study was sponsored by the Austrian Science Fund (project number KLI 1098, principal investigator P. Baldinger-Melich) and the 2021 NARSAD Young Investigator grant (grant number 29950, principal investigator P. Baldinger-Melich). S. Rießland is partially funded by the Austrian Science fund and the NARSAD Young Investigator Grant., M. Ponleitner: None Declared, V. Millischer: None Declared, S. Macher: None Declared, R. Lanzenberger: None Declared, P. Rommer: None Declared, R. Frey: None Declared, D. Rujescu: None Declared, P. Baldinger-Melich Grant / Research support from: This study was sponsored by the Austrian Science Fund (project number KLI 1098, principal investigator P. Baldinger-Melich) and the 2021 NARSAD Young Investigator grant (grant number 29950, principal investigator P. Baldinger-Melich). The other authors have no conflict of interest related to this study to declare.

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) typically describe the sudden onset of neuropsychiatric symptoms, such as Obsessive-Compulsive Disorder (OCD), following streptococcal infections. However, cases that present with comorbid motor abnormalities, such as myoclonic jerks, are rare and pose diagnostic challenges. We report the case of a child who developed severe OCD accompanied by myoclonic movements after a streptococcal pharyngitis infection, representing a rare neuropsychiatric syndrome with an atypical clinical course.

To present a rare case of post-streptococcal OCD in a child with comorbid motor myoclonus, highlighting the unusual presentation and the multidisciplinary therapeutic approach.

An 11-year-old male presented to the emergency department with sudden-onset severe compulsive behaviors, including repetitive prayers and ritualistic actions. These symptoms were accompanied by involuntary, rapid, jerky movements in both upper and lower limbs, consistent with myoclonus. Two weeks prior, the patient had been treated for streptococcal pharyngitis. A comprehensive evaluation was performed, including throat culture, elevated antistreptolysin O (ASO) titers, and electroencephalogram (EEG) to rule out seizures. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used for assessing OCD severity.

The patient was managed with a multidisciplinary approach involving pediatricians, neurologists, and psychiatrists. A combination of antibiotics, selective serotonin reuptake inhibitors (SSRIs), and clonazepam for myoclonus was prescribed, alongside Cognitive-Behavioral Therapy (CBT).

ASO titers were elevated, indicating recent streptococcal infection, and the EEG showed no epileptiform activity. The initial Y-BOCS score was 32, reflecting severe OCD. After four weeks of antibiotic therapy, CBT, and pharmacological treatment, the Y-BOCS score decreased to 18. Myoclonic movements also reduced by 70% with clonazepam. Symptomatic improvement continued over the next three months, with residual mild OCD symptoms and no recurrence of myoclonus.

This case illustrates a rare and complex presentation of PANDAS, where post-streptococcal OCD is accompanied by myoclonic movements. The integration of antibiotics, SSRIs, clonazepam, and CBT significantly improved both OCD and motor symptoms. This highlights the importance of recognizing and treating atypical neuropsychiatric manifestations following streptococcal infections in pediatric populations.

None Declared

NAVIGATE, is a comprehensive manual based intervention developed in the US for young people experiencing a first episode psychosis (FEP). The intervention is based on four main service components: Individual Resilience Training (IRT), supported employment and education (SEE), family psychoeducation (FEP) and medication management.

To describe the process of implementing NAVIGATE in Israel with an emphasis on cultural adaptation, fidelity, patterns of use and their relation to outcomes.

Between 2017-2021 demographic and diagnostic, service utilization data and ratings of functioning and symptoms were collected from clinical registries of 142 NAVIGATE participants.

Most participants were males (70%), aged 23.5 (SD 5.5, Range 16-43). On average, participated in the program over a year. IRT was the most utilized intervention (M=23, SD 11.51). Overall, three clusters of program usage were found. Number of sessions and their frequency were highly correlated. Number of family psychoeducation meetings showed the highest correlation with improvement overtime in functioning and symptoms severity. Program Fidelity rates ranged from 2.8 to 3.3 (range 0-4).

The NAVIGATE program in Israel demonstrated significant clinical and functional outcomes across all service use patterns. NAVIGATE was formally offered for two years and included four components, in reality, service users attended less than what was offered. It is possible that when an effective comprehensive team-based intervention is offered flexibly to meet the often rapid changes needs of young people with FEP, the actual use is less than one might expect, which has important implications for policy and practice.

None Declared

Globally, the number of international migrants has been rising, with Europe seeing a significantly higher increase compared to other regions. Migration has been frequently identified in the literature as a risk factor for various mental health issues (Schouler-Ocak et al. Indian J Psychiatry 2020; 62 242-6). Despite this, migrant populations often encounter significant challenges in accessing mental health care services, primarily due to language and communication barriers and cultural differences (Forray et al. BMC Public Health 2024; 24 1593). To improve mental health treatment for migrant populations, it is essential to not only provide cultural competence training for healthcare professionals and ensure access to professional interpreters but also to establish and maintain multicultural treatment teams (Machleidt W. Der Nervenarzt 2022; 73 1208-12). Addressing these needs, we have been operating a multicultural treatment team at our day clinic in Hamburg for the past year, providing care to Turkish-speaking migrants and native-born patients together.

To describe our efforts in developing a cross-cultural center and facilitating effective communication between migrant patients and native-born patients.

A descriptive overview of our efforts to establish a day clinic model adapted to the cultural and linguistic needs of the migrant (Turkish) population in Germany with a brief review of the relevant literature.

At our day hospital, we provide care for patients with psychiatric disorders who do not require inpatient treatment but for whom outpatient care is insufficient. Our multicultural treatment team is composed of healthcare professionals whose native languages are German and/or Turkish.In our day hospital, patients with a migration background receive psychotherapy and medical consultations in their native language, ensuring they can access the treatment they need without language barriers. Additionally, we aim to improve cultural understanding through collaborative activities. This approach facilitates the development of cross-cultural communication among patients and healthcare professionals from different backgrounds, while also contributing to equal opportunities in psychiatric treatment. The program addresses linguistic, cultural, and religious communication difficulties, aiming to build and sustain meaningful relationships.

The migrant population in Europe continues to grow each day, and mental health care services must adapt to this heterogeneous population and their diverse treatment needs. We advocate for the establishment of treatment centers where migrant populations and native-born patients are considered together, as such centers can play a role in bridging the intercultural communication gap.

None Declared

In Ireland, 1 in 5 young adults (aged 18-25) experience moderate to severe levels of depression and anxiety. To meet the growing need for mental health supports, Jigsaw – The National Centre for Youth Mental Health – provides accessible, early intervention services throughout Ireland. Building on its reputation for championing youth voices and inspired by examples set by other international integrated youth mental health services, one such strategy Jigsaw is exploring is youth peer support.Peer support offers social, emotional, and practical assistance from young people with personal experience of mental health challenges. Evidence suggests that peer support can positively impact young people by promoting a recovery-based approach to mental health. However, despite the recognized benefits, peer support is underutilized in Irish youth mental health services, and there is limited guidance available for its development.

This research adopts a collaborative approach to intervention development, aiming to create an evidence-informed framework to guide the introduction of peer support in Jigsaw services.

This PhD project adheres to the Medical Research Council’s Guidance for Developing and Evaluating Complex Interventions. The first stage of this project comprised a published scoping review of peer support in integrated youth mental health services and educational settings. The second stage of the project aimed to understand the benefits and challenges of peer support using semi-structured interviews with mental health professionals. The final stage of the project will take a participatory approach to intervention design, utilizing co-design workshops with stakeholders to identify potential intervention functions.

The scoping review identified common types of peer support programs (peer-delivered one-to-one support, self-help groups, and internet support groups) and target problems addressed (depression, anxiety, and psychological distress). Interviews with fifteen professionals revealed insights into the benefits of peer support for young people, such as increased connection and empowerment, and for services, such as reduced power imbalances and increased accessibility. Challenges for implementation were also identified, including boundary management, funding, and resource allocation. The ongoing final stage focuses on developing a program theory underpinning a potential peer support intervention in Jigsaw. Key stakeholders, including Jigsaw’s senior management and youth advisory panel (YAP), will be consulted to identify intervention components.

Recommendations regarding key components of peer support, as well as barriers and facilitators to its implementation, will be shared to support other organizations in enhancing their understanding and application of peer support for youth mental health.

None Declared

As traumatic brain injury (TBI) is a significant concern among military veterans, ongoing neuroimaging is a beneficial tool for monitoring functional brain changes and evaluating the progression of symptoms.

Highlighting the importance of follow-up neuroimaging assessments in guiding treatment adjustments and understanding the evolving relationship between TBI, post-traumatic stress disorder (PTSD), and neurocognitive dysfunction.

A 27-year-old male veteran injured by an IED experienced trauma to the right side of his body, resulting in 80% vision loss in the right eye and 20% in the left. He reported memory gaps and sleep disturbances. After inpatient and outpatient rehabilitation, he was prescribed Olanzapine (5 mg/day), Quetiapine (150 mg/day), and Venlafaxine (75 mg/day). On his second admission for increased sleep disturbances and anxiety, Quetiapine was increased to 200 mg/day. One year later, the patient developed new cognitive impairments and reported memory deficits and anterograde amnesia, concurrently PET scans revealed hypometabolism in the frontal lobe.

Neuropsychological Evaluation: The Raven Standard Progressive Matrices Test indicated potential issues in reasoning and problem-solving, while the Verbal Fluency Test suggested difficulties with cognitive flexibility and memory, and the Trail Making Test revealed problems with attention and sequencing. Imaging Findings: The initial CT scan demonstrated displaced linear fractures in the right temporal bone and two brain contusions shortly after the incident. On his visit nine months later, SPECT imaging showed relative hypoperfusion in the right posterior parietal cortex and bilateral temporal lobes. An EEG revealed slow wave anomalies in the right temporooccipital area and sharp spasms in the left temporal region. One year later, a follow-up PET scan revealed diffuse hypometabolism in the left frontal lobe, parietal lobes, and cerebellum.

Image:

Image 2:

Image 3:

This case emphasizes the role of follow-up neuroimaging in managing complex cases of combat-related TBI and PTSD. The progression from structural damage to later functional changes like hypometabolism in the frontal and parietal lobes illustrates how neuroimaging helps track the long-term impact of brain injuries and provides a comprehensive understanding of the evolving neurocognitive challenges. Continued neuroimaging is crucial for monitoring neurodegenerative processes and guiding adjustments in treatment (Koerte et al., 2015b). This approach supports a more targeted treatment plan, improving the veteran’s long-term prognosis (Wilde et al., 2015). Future studies should prioritize large, multi-site longitudinal research to track long-term neurotrauma effects through imaging, providing insights into neurodegeneration, recovery, and neuroplasticity.

None Declared

Despite extensive investigation, the neurophysiological underpinnings of ASD remain poorly understood; a predominant hypothesis relates to the activity of the brain’s mu-rhythm (defined as the frequency band ranging between 8–14 Hz topographically centered over the sensorimotor cortex) and the so-called “Mirror Neuron System” (MNS), considered as an execution-imagination-observation matching system. In particular, mirror neurons (MN) are bimodal neurons located in the ventral premotor cortex, discharging both when a goal-directed action is performed and when it is observed. Previous studies investigating mu-wave suppression in individuals with ASD were limited by having consistently employed video clips filmed with a fixed camera position, hence not including the potential movement of the observer towards the other person (a condition perceived as more ecological and close to reality).

Aim of this study was to investigate differences in mu-wave modulation in individuals with Autism Spectrum Disorder (ASD) without intellectual disabilities with respect to a group of neurotypical controls (NT).

Thirty individuals with ASD and thirty NT underwent an EEG recording while watching short videos depicting goal-oriented action filmed from a fixed position, zooming in on the scene, and approaching the scene by means of a steadycam. Afterwards, participants underwent a rating task to evaluate their subjective viewing experience.

Steadycam videos elicited enhanced event-related desynchronization (ERD), suggestive of an enhanced neural activity, in the NT group, and a reduced ERD in the ASD group, with respect to the other filming conditions. ASD participants also showed difficulties in returning to baseline mu-power levels after watching videos filmed from a fixed position. NT reported to feel more comfortable watching videos with movement, whereas participants with ASD did not exhibit differences between conditions.

The ecological nature of video recording (i.e., visual stimuli filmed with a steadycam) seems to have an opposite effect on the ASD an NT population, as it enhances mu-wave suppression in NT, and reduces it in individuals with ASD, bringing them to a level of desynchronization closer to the one of NT. Understanding these differences might help developing tailored interventions to support perceptual, cognitive, and social processes of people with ASD.

None Declared

Psychiatrist working with ADHD-patients since 2007.

I have diagnosed and treated more than a 1000 patients with ADHD. I have always, when it has been possible, given one medication at a time to be able to evaluate how it works, and what gives side effects.

When stimulants suddenly don’t work anymore, I have searched for physical and psychological problems that could explain it. By solving these problems, the stimulants work again.

By working this way, we have noticed that patients have a high compliance, and there are a lot less cases of relapse with ADHD symptoms.

None Declared

In this talk, Dr. Arnardottir will summarize the main findings of the SLEEP REVOLUTION, an EU Horizon 2020 Research and Innovation Programme no. 965417. The project is an inter-disciplinary and international research and development project with 39 partner institutions and companies in Europe and Australia. SLEEP REVOLUTION aims to introduce an approach based on machine learning to assess sleep apnea severity and treatment needs as well as the use of digital health technology to measure sleep and health (app, cognitive testing, consumer sleep technology and clinically validated sleep technology for home use). Through these technological solutions , the project brings together researchers, patients and healthcare professionals to provide beyond the current state-of-the-art diagnosis and optimal treatment for sleep disorders. The approach of this project can be used as a model for other disease assessment and follow-up.

E. Arnardóttir Consultant of: Medical Advisory Board for Philips (Feb 2022-Feb 2024) and Lille (Sept 2024), Speakers bureau of: Nox Medical, ResMed, Jazz Pharmaceuticals, Linde Healthcare, Apnimed, Wink Sleep, Vistor (NovoNordisk)

Depression is one of the most disabling diseases worldwide, but despite numerous attempts to investigate novel drugs, no significant step forward has been taken so far. Traditional antidepressants, including selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors, have been shown to have a slow onset of action and require assessing these drugs for up to eight weeks to determine their effectiveness. As a result, there is an urgent medical need for new, rapid, and effective treatments like Esketamine Nasal Spray for the large number of patients suffering from the disease.

In our study, treated with esketamine nasal spray in an inpatient setting, we were able to show better functioning and severe depression, and, at the same time, a reduction in suicidal thoughts was documented. Our 107 analyzed patients demonstrated that this drug is safe and suitable for short-term use.

One hundred and seven (107) participants with major depressive episodes (MDE) were examined at Sulwan Psychiatric Hospital. The study, spanning 12 weeks, comprised two treatment protocols. After they had been educated concerning the two groups, the subjects decided their preferred treatment protocols. During the four-week induction phase, 56 mg - 84 mg of drug treatment twice a week was administered to the subjects. Then, based on whether they showed clinical response during the induction phase, the subjects entered the eight-week maintenance phase with 28 mg-56 mg twice monthly.

In total, after 14 administrations, all depressive scores decreased significantly, indicating an improvement in depressive symptoms. Esketamine had a fast onset of action, so that already half of the patients felt better after the 2nd administration and 75% showed an effect after the 4th administration; not only the reduction of the mean but also that of the median illustrated a quick relief.

Our main results confirm the unique contribution of this study. In summary, the intranasal administration of esketamine is effective in patients with treatment-resistant depression (TRD) due to major depressive disorder (MDD) and bipolar disorder (BD).

None Declared

Despite differences in the onset and symptomatology, Autism Spectrum Disorder (ASD) and Schizophrenia (SCH) are neurodevelopmental conditions with evolving conceptual links in modern psychiatry. This stems from increasing evidence suggesting overlap in social cognition, attachment and the conceptualization as disorders of the self. A transdiagnostic approach, in which network analysis can play an important role, offers valuable insights into the complex interrelationships between symptoms and key constructs in the psychopathology of them. It may reveal underlying similarities and differences, contributing to more targeted interventions.

Our study aims to investigate the symptom structures of ASD, SCH, and neurotypical individuals (NTP) using network analysis. By comparing them, our explorative goal was to identify key constructs and their connections, providing potential intervention targets. We hypothesize that both ASD and SCH networks will significantly differ from the NTP network, and that mentalization and disorganized schizotypy would be the most central nodes in the networks of ASD and SCH.

In a cross-sectional study, 1694 participants were involved in the analysis (NNTP=1477, NASD=155, NSCH=62). Participants completed self-report questionnaires. Based on theoretical and methodological considerations we included psychological inflexibility, mentalization, insecure attachment, perceived social support, minimal and narrative self, negative and disorganized schizotypy, autistic traits, anxiety in the analysis. Gaussian Graphical Models were used to estimate relationships between constructs, with LASSO regularization, focusing on network centrality and predictability measures. Network Comparison Test was applied to unveil local and global differences.

A comparative representation with node scaling for predictability values are shown in image 1 and image 2. Minimal self was the most predictable node in each case. Central nodes in the ASD network were psychological inflexibility and minimal self, in the SCH network narrative self and insecure attachment, in the NTP network psychological inflexibility and minimal self. Significant differences in global strength were observed between ASD and NTP networks. Details of a relevant pattern are shown on image 3.

Image 1:

Image 2:

Image 3:

Our study highlights distinct symptom networks in ASD and SCH, with distinct centralities emerging. Results suggest interventions targeting psychological inflexibility and self-concept may be effective for ASD, while in SCH, narrative self experience and attachment insecurity may be beneficial. Results show that focusing on isolated constructs may overlook the importance of other constructs. By focusing to the strongest edges and relevant patterns, clinicians may benefit from interventions that simultaneously target the dimensions of the relationships, also considering the most central nodes in the network.

None Declared

Cancer prehabilitation has emerged as a pivotal strategy for the augmentation of patients’ comprehensive well-being, encompassing physical, psychological, and functional aspects while improving their quality of life. The profound impact of breast cancer on patients and their family caregivers emphasizes the critical need for interventions addressing their holistic well-being.

In this portion of the study, researchers intend to develop two psychological-based prehabilitation modules within a larger investigation targeting to address the quality of life as well as relationship quality among breast cancer patients and their family caregivers. The deliberate involvement of the family caregiver proposed here is based on the belief that the well-being of an individual is interconnected with his/her community.

Guided by the Allostatic Model and Systems Theory, these modules are tailored to mitigate the negative effects associated with breast cancer with a systemic perspective in mind. Leveraging on Sidek’s Module Development Model, the first module (PreCARE) targets breast cancer patients, while the second (PreCARE Plus) extends its focus to patients and their family caregivers. The content validity of these modules is rigorously assessed through consultation with six experts across mental health, oncology, rehabilitation, and radiology disciplines. The study aims to look at the aspects of content validity of the developed modules through the content validity index (CVI).

The CVI for both PreCARE and PreCARE Plus modules were high (above 0.83) with values of 0.92 and 0.93 respectively. The findings also yielded high S-CVI for both modules with values of 0.98 (PreCARE) and 0.96 (PreCARE Plus).

These crafted psychological-based prehabilitation modules proposed to revolutionize oncological care in Malaysia by empowering healthcare professionals in the oncology setting to enhance the psychological and physical well-being of breast cancer patients and their family caregivers. Their potential impact underscores the importance of integrating systemic-inspired interventions into comprehensive cancer care paradigms.

None Declared

The efficacy of yoga as an adjunctive treatment for schizophrenia spectrum disorders (SSD) has garnered interest, however, meta-analytic findings exhibit heterogeneity. While yoga may positively influence various symptom domains, further investigation is needed due to the limited number, quality, and generalizability of studies. Yoga-based Group Intervention (YoGI) was specifically developed together with persons with SSD through a participatory approach and its mechanisms and processes were explored within qualitative studies.

This pre-registered randomized controlled trial (RCT) assessed the acceptability and feasibility as well as preliminary outcomes of YoGI compared to a commprehensive treatment as usual (TAU) in an inpatient setting.

Fifty inpatients with SSD received either treatment as usual (TAU, n = 25) or YoGI+TAU (n = 25) for four weeks. Preliminary analyses examined rater-blinded positive and negative symptoms, self-rated depressive and anxiety symptoms, body mindfulness, mindfulness, psychological flexibility, subjective cognition, social functioning, quality of life, and medication regime at baseline and post-intervention.

Outcomes showed a 95% protocol adherence, feasibility and retention rates of 91% and 94%, respectively, and a dropout rate of 6%. ANCOVA revealed significant between-group post-intervention improvements for YoGI+TAU in positive symptoms, depression, cognitive fusion, and a mindfulness subscale. Medium-to-large pre-to-post intervention effects were found for body-mindfulness, positive, negative, and general symptomatology, depression, anxiety, stress, cognitive fusion, attention, and quality of life in YoGI+TAU, while within-group changes were consistently smaller in TAU. No severe adverse events were reported.

This trial contributes to the growing evidence supporting the feasibility and acceptability of yoga for persons with SSD in an inpatient setting. Furthermore, preliminary evidence suggests that YoGI may provide additional benefits beyond TAU alone, across various self- and rater-based outcomes. These outcomes include improvements in body mindfulness, mindfulness, and psychiatric symptomatology, including positive and negative symptoms, subjective cognition, depression, anxiety, stress, social functioning, and quality of life. Additional fully powered RCTs are warranted to further elucidate the efficacy and potential mechanisms of action of YoGI for SSD, which should also assess the cost-efficiency of YoGI and explore longitudinal changes associated with the intervention. Such comprehensive research endeavours will not only enhance our understanding of the therapeutic potential of YoGI but also inform clinical practice and intervention strategies for persons with SSD.

None Declared

Increased levels of anxiety in patients with opioid dependence is a common problem that requires a comprehensive approach to treatment. They can manifest as GAD, panic attacks, social anxiety, and other forms of anxiety. The level of personal distress in patients on methadone therapy can be significant, as these patients often face a complex of psychological and social problems related to addiction and treatment.

The causes of anxiety disorders can be: 1) biological factors - changes in the neurochemistry of the brain associated with the use of opioids, which can affect the regulation of emotions and cause anxiety; 2) psychological factors – trauma in the anamnesis, stressful situations or negative experiences can contribute to the development of anxiety disorders; 3) social factors – relationship problems, social isolation and economic hardship can increase anxiety.

Factors affecting the level of personal anxiety include both medical and social aspects - a) changes in life; b) concomitant mental disorders; c) attitude toward therapy; d) social support.

In the course of the study, 150 patients aged 26 to 64 years with a diagnosis of opioid dependence, who receive methadone hydrochloride as OAMT, were examined. The Psychopathological Symptom Severity Questionnaire (SCL-90-R, Derogatis, Lipman, Covi) and the Hamilton Anxiety Rating Scale (HAM-A/HARS) were used to assess the level of personal anxiety and existing anxiety disorders.

According to the levels of interpersonal anxiety (very low, low, medium, high), the indicators were distributed as follows: in the control group - 10 (20.4%), 32 (65.3%), 7 (14.3%), 0 (0 .0%); in the main group - 28 (27.7%), 59 (58.4%), 13 (12.9%), 1 (1.0%), respectively (p=0.685).

The degree of clinical anxiety according to the Hamilton scale (mild, moderate, severe, strong) in the main group was distributed as follows: 60 (59.41%), 23 (22.77%), 15 (14.85%) and 3 (2.97%); in the control group - 31 (63.27%), 10 (20.41%), 6 (12.24%), 2 (4.08%), respectively (p=0.930).

The level of anxiety according to the SCL-90 scale (very low, low, medium, elevated, high) was determined in 19 (38.78%), 22 (44.90%), 6 (12.24%), 2 (4.08%) and 0 (0.00 %) of persons, respectively, in the control group; 39 (38.61%), 46 (45.54%), 15 (14.85%), 1 (0.99%) and 0 (0.00%) - in the primary (p=0.628).

The results of the study showed that receiving substitution maintenance therapy did not significantly increase the level of personal anxiety and the risk of anxiety disorders in patients on methadone therapy, the vast majority of patients showed very low, low and mild levels of manifestations. However, the level of personal anxiety may vary, but it is important to provide a comprehensive approach to treatment, including psychological support and social integration, to improve patients’ quality of life and reduce anxiety.

None Declared

Repeated reports of association of low-grade inflammation in bipolar disorder led to exploration of the causes and consequences of this inflammatory background, now thought to be due to interaction between environmental factors such as infections, stress, pollution, unhealthy life style with immune-genetic background.

Association with functional gene variants of Toll-Like Receptor genes (TLR, NOD), possibly explain diminished response to infections observed in bipolar disorder (rev in Oliveira et al, 2017) association while mitochondrial genes (Angrand et al, BBI, 2021), HLA-E and HLA-G (Boukouaci et al, 2021) contribute to maintenance of inflammation. Association with particular HLA haplotypes very likely explains pro inflammation and auto-immune induction observed particulary in bipolar patients with suicidal behavior and/or with rapid cycling (Tamouza et al, 2020). While HLA haplotypes, in particular when they are associated to anti-inflammatory effect have also been found to be associated with good lithium response (Leclerc et al, 2021).

Systemic inflammation and persistent infections activate different pathways paving the way to biomarker-guided personalized medicine. For example the identification of “autoimmune psychosis” defined by presence of anti-neuronal antibodies in psychosis and in bipolar disorder (Jezequel et al, 2017). Systemic inflammation induced by microbial infection and/or psychosocial factors can also be at the origin of the activation of human endogenous retrovirus (HERV-W) in patients with bipolar disorder (Tamouza et al, 2021). One last example can be found in the immune-metabolic abnormalities that pave the way to metabolic syndrome associated with psychiatric disorders. Various mitochondrial dysfunctions have recently been reported including deregulated bioenergetics and mitochondrial DNA alterations in bipolar disorder, underlying depressive and manic episodes and their association with metabolic syndrome.

Findings accumulated so far favour the consideration of cellular and molecular targets for the treatment of specific subgroups of bipolar disorders. This is the case for clinical trials of the efficacy of anti-inflammatory treatment in patients with blood auto-antibodies against brain receptors. Or for low dose IL-2 therapy in bipolar depression based on the hypothesis that IL-2 is a differentiation factor for T cells and low dose IL-2 combats premature T cell aging and induce the production of new naïve T cells from the thymus particularly T regulator cells (Leboyer et al, 2025). Another example comes from drugs that boost mitochondrial function in bipolar depression (Khandra et al, 2023).

None Declared

The early stages after the onset of a first episode of psychosis (FEP) are crucial for the long-term outcome of the disease. Good outcome can be expected in <50% of patients, but three-quarters of all patients who experience a remission from a first episode of psychosis will have a recurrence of psychotic symptoms within a year of treatment discontinuation. Relapse prevention is key to preventing disease progression and further deterioration. Considerable number of patients experiencing a first episode of psychosis, will eventually transition to a diagnosis of Schizophrenia, so maintenance treatment should be the preferred option even in stable patients after a first episode of psychosis to remain in recovery. There is scarce information about differential effectiveness of antipsycotics in the long term. In such an atmosphere, the idea of polypharmacy with antipsychotics arises and may gain more supporters. Despite its obsolence, and unclear therapeutic benefits, as well as significant health risks, polypharmacy with antipsychotics is relatively common. This practice, due to unwanted effects, can lead to the arbitrary discontinuation of medication, and the consequent relapse of psychosis.

To determine the association of transition to schiyophrenia after the first episode of psychosis with a monotherapeutic or polypharmacy approach to the use of antipsychotics.

A retrospective analysis of all hospitalized patients (87 patients, 65.5% were women), diagnosed with first episode of psychosis during a five-year period was conducted. The rate of relapse, and conversion to schizophrenia was analyzed in relation to the therapeutic approach (monotherapy vs polypharmacy with antipsychotics), within one year after the end of hospitalization due to the first episode of psychosis.

35.6% (31) of the subjects were treated with monotherapy. 25% (8) of them relapsed within a one-year period. 64.4% (56) of patients were treated with polypharmacy. 55.2% (48) of patients were treated with two antipsychotics, and 9.2% (8) with three. 75% (24) of subjects treated with polypharmacy had a relapse of psychosis within a year after discharge. There is a statistically significant difference between the groups of patients (p˂ 0.05).

A significantly higher rate of relapse, and conversion to schizophrenia within a year after the end of hospitalization due to the first psychotic episode exists in subjects who were treated with two or more antipsychotics compared to subjects treated with monotherapy. The practice of polypharmacy with antipsychotics should remain reserved for individual, specially selected patients.

None Declared

The mental health burden of post-traumatic stress disorder (PTSD) is significant for all those affected, with a higher incidence among veterans due to military trauma and the particular strains of military duty. It results in detrimental effects on life quality and functional impairment in various domains, including sexual dysfunction (SD).

One of the most prevalent yet underreported sexual dysfunction in Tunisian veterans is erectile dysfunction (ED).

The aim of the current study was to assess the prevalence of ED and its severity among Tunisian veterans with PTSD versus those without it.

A cross-sectional descriptive and analytical survey was conducted between September and November 2024 on Tunisian veterans seeking consult, using a data file and 2 self-report questionnaires :

The PTSD Checklist for DSM-5 (PCL-5) to assess current PTSD symptoms with a cut-off score of 33 or higher to detect PTSD cases.

The IIEF-5 (International Index of Erectile Function 5) to evaluate ED with six categories: [1-4]: uninterpretable, [5-7]: severe, [8-11]: moderate, [12-16]: mild to moderate, [17-21]: mild and [22-25]: no ED.

To analyze the obtained data, IBM SPSS was used.

Fourty veterans were enrolled in this study with an average age of 38.5 [24-61] years. The majority (67.5%) were married, followed by 25% single individuals, 5% divorced and 2.5% in a relationship. Most of the participants (77.5%) were smokers and 25% reported alcohol consumption, with 20% of them being regular drinkers and 80% consuming alcohol occasionally. None reported using cannabis or other illicit drugs. Regarding medical history, 32.5% had health issues with the most common being varicocele, diabetes, arterial hypertension and myocardial infarction.

Among the veterans, 50% had PTSD. Ninety-five percent had received psychiatric follow-up, and 78.9% were on antidepressants. In the control group with no PTSD (50%), 85% had a psychiatric follow-up, with 76.5% taking antidepressants.

In patients with PTSD, 75% reported ED, while 15% had no SD and 10% had an uninterpretable score. ED was mild to moderate in 46.7%, mild in 33.3% and moderate in 20%. No severe cases of ED were observed in this group.

In contrast, in patients with no PTSD, ED was only reported in 60% of cases and was even severe in 33.3% of patients.

No significant correlation was found between ED and PTSD (p= 0.3).

The prevalence of ED in the overall sample was 67.5% with only 11.1% of them using sexual enhancers.

This study suggests that while PTSD may exacerbate ED in some individuals, other factors such as comorbid psychiatric or medical condition and the use of a variety of medications may play a more significant role in the underlying cause. Given its significant impact on quality of life, early screening and treatment are essential.

Additionally, further research is needed to understand the underlying causes of ED and to develop more targeted interventions.

None Declared

HIV (Human Immunodeficiency Virus) is a virus that damages the immune system, weakening the body’s ability to defend against infections and certain types of cancer. If left untreated, HIV can progress to an advanced stage known as AIDS (Acquired Immunodeficiency Syndrome). HIV can be transmitted through blood, sexual contact, from mother to child during childbirth, or through breastfeeding. Today, with antiretroviral treatments, it is possible for individuals living with HIV to lead healthy and long lives. In addition to health issues, HIV-positive individuals face mental stress and societal stigmatization. Their personality traits play a significant role in determining the level of mental stress they experience and their ability to cope with stigma. We have developed a survey for HIV-positive individuals addressing these aspects.

This study, aimed to observe how HIV-positive individuals cope with societal stigmatization and the mental stress they experience based on their personality types, as well as the connection between these factors.

The study’s survey was prepared using the open-source platform ‘Google Forms’ and will be administered in person. The tests used in this study are widely accessible and have been validated for reliability and validity in Turkey. Specifically, we utilized the Enneagram, the HIV Stigma Scale developed by Berger and colleagues, and the Hospital Anxiety and Depression Scale developed by Zigmond and Snaith. The study has no commercial purpose. The analysis was conducted on a total of 63 respondents, consisting of 45 men and 18 women.

In the study, data were collected from 63 individuals, 71.4% of whom were male (n=45) and 28.6% female (n=18). The average age of participants was 39.69 years (range 20-77). It was observed that individuals with primary education were the most stigmatized, while those with middle school education experienced the least stigmatization. The most common personality type among both men and women was Type 2 (the helper). According to the data, participants had an average stigma score of 94.9.

The study did not find a significant relationship between age and stigmatization, nor between gender and stigmatization. Personality types that perceived the highest levels of stigmatization were Type 2 and Type 8, with average scores of 108. Conversely, the personality type that perceived the lowest levels of stigmatization was Type 5, with an average score of 74. These findings highlight that certain personality types may be more susceptible to experiencing or perceiving stigmatization, while others may experience it less. Further research could explore the underlying factors influencing these perceptions and their implications for support and intervention strategies.

None Declared

Cannabis use is highly prevalent among individuals at risk for psychosis, yet its role remains paradoxical—offering both temporary relief and potential harm. In this session, we present preliminary results from a study examining cannabis perception, use patterns, and motivations in cannabis users with and without psychosis. Findings reveal that cannabis users with psychosis consume over three times more THC but do not perceive significantly greater risks. They also exhibit a higher risk of cannabis addiction, which may influence their risk assessment and experience of cannabis effects. Both groups reported similar reasons for use and quitting, though individuals with psychosis were more likely to cite cost as a reason for quitting. These insights suggest that financial concerns could be a target for intervention. Understanding why individuals vulnerable to psychosis turn to substances is crucial for refining treatment strategies, as addressing these underlying motivations may enhance therapeutic outcomes.

None Declared