Synchronization refers to the coordinated physiological, biological, and behavioral changes during interpersonal interactions.

The project aims to assess correlations between pre-term physiological synchrony and post-birth behavioral synchrony between mothers, fathers, and their anxiety, depression levels, and attachment styles. Since the development of early synchronization remains unclear, the project investigates its initiation between mother and fetus, with a focus on including fathers in early attachment and synchrony research. It is hypothesized that synchrony plays a key role in predicting a child’s attachment style.

BIOPAC Student Lab MP36 measures ECG data from parents, while cardiotocography records the fetus’s heartbeat. Women in their 24-36th weeks of their first pregnancy without any chronic illnesses and their partners are being included in the study. Surveys for the participants cover sociodemographic scales, Beck Anxiety (BAI) and Depression Inventories (BDI) and The Relationship Scales Questionnaire. The recordings last fifteen minutes, with the first and last five minutes taking place in a non-stimulatory environment. During the middle five minutes, the fetus’s heartbeat is projected for the parents. ECG data are analyzed in Matlab for synchrony. At 3 months, parent-infant interactions will be videotaped and analyzed via Ruth Feldman’s Coding Interactive Manual for behavioral synchrony. Triads who show higher levels of physiological synchrony during pregnancy will be expected to show corresponding levels of behavioral synchrony at three months old.

The ECG and survey data of 16 participants have been collected. BAI results have shown the mean anxiety results of the mothers and the fathers to be 14.6 (mild anxiety), 4.9 (minimal anxiety), respectively, whereas BDI yielded mean depression results of 7.3, 6.3, both minimal depression for mothers and fathers. Out of 8 mothers, 4 showed secure and 4 showed dismissive attachment. 2 of the mothers with dismissive attachment showed moderate and severe levels of anxiety as expected whereas the other 2 mothers showed mild anxiety. The mothers with dismissive attachment showed higher anxiety levels and are expected to show lower physiological synchrony levels with their partners and babies. Among fathers, the most prevalent attachment style was secure, observed in 3 (37.5%), with the second being Dismissive attachment identified in 3 fathers (37.5%). One father exhibited a preoccupied/dismissive style, (12.5%)while one father showed a mixed secure/dismissive pattern(12.5%).

The ECG data of the 16 participants are currently being evaluated for physiological synchrony between the triad and recruitments are still ongoing. After the infants are 3 months old, behavioral and physiological synchrony within the triads will be evaluated and analyzed for further relationships.

None Declared

Systemic Lupus Erythematosus (SLE) is an autoimmune disorder characterized by systemic inflammation and high prevalence of neuropsychiatric symptoms. Among these, suicidal ideation represents a significant concern, with reported higher rates than in the general population. The etiology of suicidal ideation in SLE is multifaceted, encompassing both disease-specific factors and psychosocial variables. Recent research has highlighted the intricate interplay between SLE and psychiatric symptoms, suggesting a bidirectional relationship mediated by inflammatory processes, neurological involvement, and psychosocial stressors. However, the specific contributions of these factors remain unclear.

This study aims to elucidate the primary predictors of suicidal ideation in a cohort of SLE patients.

A cross-sectional study was conducted with a cohort of SLE patients from the Autoimmune Diseases Unit at Cruces University Hospital (Biscay, Spain). Each patient underwent a thorough clinical evaluation by a psychiatrist, and relevant clinical and sociodemographic data were collected. Suicidal ideation was assessed using the Plutchik scale, while predictor variables included autoimmune factors such as cumulative corticosteroid dose, disease activity, and accumulated organ damage. Psychiatric symptoms were assessed using various psychometric scales. A multiple linear regression model was employed to examine the associations between these variables and suicidal ideation.

A total of 92 SLE patients in active follow-up were included, with a female predominance (91%). Most patients were in an inactive disease state, receiving low-dose prednisone and antimalarial therapy according to our clinical protocol; the majority were in remission, as reflected by a mean SLEDAI-2K score of 1.59(±2.44). Despite a median disease duration of over 10 years, cumulative organ damage was low (mean SDI score 0.33 ± 0.84). In a multiple linear regression analysis, the model showed a strong fit (R=0.732, R²=0.535, p<.001), explaining approximately 53.5% of the variability in suicidal ideation. Suicidal ideation was significantly associated with cumulative corticosteroid dose (β=0.172, p=0.011), total anxiety score (β=0.248, p<.001), and frequency of traumatic experiences (β=0.118, p<.001). Collinearity statistics (VIF 1.03–1.07) indicated no significant multicollinearity issues.

Suicidal ideation in our SLE cohort was associated with corticosteroid use, anxiety, and traumatic experiences, highlighting the importance of addressing these factors in suicide risk management. The relationship between corticosteroid dose and suicidal ideation may be linked to the neuropsychiatric effects of these drugs, while anxiety and traumatic experiences contribute to the emotional burden of the patient. Notably, disease activity was not linked to suicidal ideation in this cohort.

None Declared

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by persistent patterns of inattention, hyperactivity, and impulsivity. Cognitive Behavioral Therapy (CBT) is a well-established intervention for ADHD, helping individuals manage symptoms by targeting dysfunctional thought patterns and behaviors. In recent years, the accessibility of digital CBT apps has expanded, providing a potential alternative to traditional therapy. This systematic review aims to assess the efficacy of digital CBT apps for symptom management in individuals with ADHD.

This review seeks to (1) evaluate the effectiveness of digital CBT apps in reducing ADHD-related symptoms such as inattention and impulsivity, (2) assess the adherence and usability of these apps, and (3) identify gaps in the literature to guide future research on digital interventions for ADHD.

A systematic search was conducted using PubMed and Google Scholar to identify peer-reviewed studies published within the last 5 years (2019–2024). The search terms used included “ADHD,” “digital CBT,” “mobile apps,” and “cognitive behavioral therapy.” Inclusion criteria were studies that focused on the use of digital CBT interventions specifically for ADHD symptom management in both children and adults. Studies that assessed the effectiveness of these interventions using standardized symptom rating scales were prioritized. Articles that involved non-CBT digital interventions, case reports, or review articles were excluded.

Six studies met the inclusion criteria. The results showed promising outcomes for ADHD symptom reduction, particularly in reducing inattention and impulsivity. Lenhard et al. (2018) demonstrated significant improvement in ADHD symptoms in children using digital CBT programs. Nigg et al. (2020) found similar improvements in adults. Sibley et al. (2021) observed enhanced executive functioning with high adherence to app-based interventions. In Torous et al. (2020), digital CBT apps improved patient engagement and accessibility to care. Hirvikoski et al. (2017) reported moderate effectiveness in symptom control but emphasized the need for continued monitoring of user adherence. Russell et al. (2021) highlighted the potential for personalization in digital therapies, although further research is needed to optimize these interventions.

The review suggests that digital CBT apps offer a promising approach for ADHD symptom management, particularly in increasing accessibility and adherence to therapy. While these interventions show moderate to significant effectiveness in reducing core symptoms like inattention and impulsivity, further research is needed to address personalization and long-term efficacy. This highlights the growing potential for digital mental health interventions to complement traditional ADHD treatments.

None Declared

Stepping Stones Rehabilitation Centre(SSRC) is a one-year old psychiatric rehabilitation centre in the Institute of Mental Health Singapore.

SSRC was initially created as a 100-bed inpatient ward to address a treatment gap and fast-track the psychiatric rehabilitation of patients admitted for acute psychiatric conditions. SSRC serves as the ‘stepping stone’ for acutely unwell inpatients as they transcend the hospital back to the community. To do so, SSRC actively engages our upstream partners (teams managing acutely unwell patients) as well as downstream partners (social service agencies) to continually assess the treatment gap between acute and community psychiatric care and evolve our programme and processes to close this gap and smoothen the transition.

The overall objective is to provide patients with the relevant levels of rehabilitation by training and equiping them with the necessary skills to intergrate back to society at the level for which they have set their goals on.The levels of rehabiliatation range from intermediate rehabilitation following acute illness to regain their functional status to perform their daily activities to tertiary rehabilitation which provides higher intensity rehabilitation programmes to help patients return to their daily function and to work and life as much as possible. This is achieved via a multi-disciplinary team comprising of patient, psychiatrists, doctors, nurses, occupational therapists (OT), medical social workers (MSW), psychologists, peer support specialists (PSS) and case managers(CM) to derive a bespoke rehabilitation programme for each patient over their course of stay in the ward.

Patient are referred to the SSRC from the acute inpatient wards of IMH or from the outpatient setting. Upon acceptance to the ward, patients are reviewed and a timetable is created based on the goals the patient would like to achieve. Patients are reviewed at weekly MDT (multi-disciplinary team) meetings at frequencies which commensurate to their rate and intensity of rehabilitation. Measures obtained to assess the progress of each patient and the programme are:

1. 1. CGI-I (Clinical Global Impression - improvement) scale

2. 2. GAF (Global Assessment of Functioning)

3. 3. RAS-DS (Recovery Assessment Scale - Domains and Stages)

4. 4. SLOF (Specific Level of Functioning)

5. 5. Acceptance rates to stepdown care

6. 6. 30-day readmission rates

At the latest tabulation of data, there has been 117 patients successfully discharged from SSRC. The other data are currently being tabulated and analysed and updated results will be shared at the meeting.

SSRC is one of few psychiatric rehabiliatation entities that reside in an acute psychiatric hospital. It was assessed that patients who present with acute decompensation in their mental state could benefit from intense fast-tracked rehabilitation measures before stepping down to community provided services.

None Declared

Benzodiazepines and zolpidem are commonly prescribed as long-term treatments for anxiety and insomnia, although recommendations generally do not support their extended use. These medications are often prescribed for longer durations than necessary, at inappropriate doses, and with potential drug-drug interactions. In this context, rational prescribing strategies are essential. One potential strategy is the integration of a clinical pharmacist into the inpatient team for daily interdisciplinary ward rounds. However, this approach remains under-researched in the context of inpatients with mental disorders.

This study aimed to evaluate the impact of a clinical pharmacist on medication-related problems (DRPs) focused on benzodiazepine and zolpidem use during daily ward rounds within an interdisciplinary team in a Slovenian psychiatric hospital.

A retrospective observational pre-post study was conducted at Ormož Psychiatric Hospital in Slovenia, including patients treated between 2019 and 2020. During this study, clinical pharmacists provided recommendations focused on benzodiazepines and zolpidem. The primary outcomes assessed were the difference in the total number of DRPs observed at the time of hospital discharge compared to admission. The secondary outcomes evaluated adherence to existing treatment guidelines.

The study involved 20 participants with a mean age of 57.2 years (SD = 17.1). A total of 23 recommendations related to DRPs associated with benzodiazepine and zolpidem use were performed (1.15 per patient). Of these, 19 DRPs (82.6%) were identified as potential issues, while 4 DRPs (17.4%) were already expressed. Most DRPs concerning benzodiazepines and zolpidem were classified as unnecessary treatment, with 18 recommendations (78.3%). The remaining five recommendations (21.7%) addressed treatment effectiveness. The most common recommendation was the discontinuation of benzodiazepine and zolpidem therapy, suggested in 12 cases (56.5%), followed by adjustments to the treatment regimen, predominantly dose reductions, in 9 cases (39.1%). In only one case (4.3%) was the recommendation to initiate benzodiazepine treatment. Initially, the acceptance rate of recommendations was 100.0% (N = 23) at the time of discharge, but this decreased to 82.6% (N = 19) three months after discharge. Adherence to treatment guidelines improved (p < 0.05).

The results indicate that this approach led to fewer DRPs, improved adherence to treatment guidelines, and a high acceptance rate. This is the first retrospective pre-post study in the European Union to include this collaboration in daily rounds at psychiatric hospitals, focusing on these medications. However, the study has notable limitations (non-randomized design and small sample size), which should be addressed in future research.

M. Stuhec Grant / Research support from: Matej acknowledges the financial support from the Slovenian Research and Innovation Agency (research core funding No. J3-50127)., A. Gazdag: None Declared, Z. Cuk: None Declared, R. Oravecz: None Declared, B. Batinić: None Declared

Reflective functioning, the cognitive ability to interpret both one’s own and others’ behaviors in terms of underlying mental states such as emotions, desires, intentions, and beliefs, is essential for effective social interaction, emotional regulation, and self-awareness and is compromised more in Personality disorders. In the context of depression, reflective functioning can be particularly compromised, leading to difficulties in processing emotional experiences and managing social interactions. (Williams, 2010; Luyten, 2013)

This study aims to understand the impact of esketamine on RF.

Tool test: Montgomery-Åsberg Depression Rating Scale (MADRS) and the Reflective Functioning Questionnaire (RFQ-8), to monitor changes in depressive symptoms and mentalization ability across six stages of treatment with Spravato: before treatment (T0), after 1 week (T1), 1 month (T2), 2 months (T3), 3 months (T4), and 6 months (T5) of Spravato treatment.

The analysis revealed significant positive correlations between mentalization scores and the severity of depressive symptoms (MADRS):

• - T1 Mentalization and T1 MADRS: The Pearson correlation coefficient of 0.349 indicates a moderate positive relationship, suggesting that poorer mentalization at Time 1 (T1) is associated with more severe depressive symptoms at the same time point.

• - T0 Mentalization and T3 MADRS: The Pearson correlation coefficient of 0.392 shows a moderate positive association between mentalization at Time 0 (T0) and depressive symptoms at Time 3 (T3), indicating that poorer mentalization at T0 is related to more severe depressive symptoms later.

• - T2 Mentalization and T3 MADRS: A Pearson correlation coefficient of 0.384 indicates a moderate positive relationship between mentalization at Time 2 (T2) and depressive symptoms at Time 3 (T3), suggesting that lower mentalization at T2 correlates with higher depressive symptoms at T3.

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The study assessed the effects of esketamine on depressive symptoms and reflective functioning (RF) in patients with treatment-resistant depression (TRD) and a 58% comorbidity rate of personality disorders. These findings underscore the potential impact of mentalization on the severity and trajectory of depressive symptoms. The observed correlations indicate that patients with mentalization scores above 3.5 generally report higher levels of depressive symptoms. These results highlight the significant role of mentalization in influencing the severity and progression of depressive symptoms.

None Declared

Common psychiatric disorders in oncological patients include depression, anxiety, delirium, sexual dysfunctions, adjustment and sleep disorders, affecting 30%–40% of those diagnosed. The incidence is even higher in advanced cancer stages. Despite the profound impact on quality of life, these issues are often underdiagnosed and undertreated. While effective management includes both pharmacological and nonpharmacological interventions, psychologists are rarely involved in palliative care, as doctors tend to focus primarily on physical symptoms overlooking the emotional and existential suffering these patients endure.

The aim of this study was to determine the frequency of clinical psychologist involvement in the care of palliative cancer patients.

We performed a single centre cross-sectional study of patients with metastatic or locally advanced, inoperable cancer who were hospitalized at the University Clinical Centre Maribor every first Wednesday of October between 2017 and 2023. Patient records were retrieved from the hospital’s electronic medical database. Data extraction included demographic information, clinical details, and whether a clinical psychologist was consulted by the treating physician. We also aimed to identify the reasons for consultation when applicable.

Out of the 600 patients, 342 (57.0%) were male, and 258 (43.0%) were female. Their ages ranged from 30 to 95 years, with a mean age of 67.9 ± 11.1 years and a median age of 68 years. Only 1.3% (8 patients) had a clinical psychologist involved in their care through a doctor-initiated consultation while most (592 patients or 98.7%) did not. Anxiety-related concerns were the most common reasons for consulting a psychologist, with 4 patients addressing these issues: 1 patient expressed a fear of dying, another feared the pain, a third had concerns about potential side effects of therapy, especially infertility, and the fourth presented general anxiety. Additionally, 1 patient expressed suicidal ideations. Unfortunately, the reason for consulting was not available for 3 patients.

Our study shows the underutilization of clinical psychologists in the care of palliative cancer patients, with only a small part receiving psychological support despite the known prevalence of psychiatric disorders in this population. Given the comorbidity of depression, anxiety and other psychiatric disorders among these patients, integrating mental health professionals into palliative care teams is crucial for enhancing their overall quality of life and emotional well-being.

None Declared

The widespread use of mobile devices, particularly among young people, extends beyond entertainment to education and professional purposes. However, excessive smartphone use has led to health issues such as headaches, poor concentration, sleep problems, and anxiety. A condition called nomophobia, or the fear of being without a mobile phone, has emerged, though it’s not officially recognized as a psychiatric disorder. In adults, 20% experience mild nomophobia, 50% moderate, and 20% severe symptoms, which can be measured using the Nomophobia Questionnaire (NMP-Q). Smartphone overuse is also linked to psychopathological issues like insomnia and anxiety.

The aim of this study is to evaluate the impact of nomophobia in insomnia and anxiety.

Non-systematic review of the literature regarding nomophobia and anxiety and insomnia. The research was carried out through the PubMed® database, using the terms “nomophobia”, “nomophobia and anxiety” and “nomophobia and insomnia”.

The included studies highlight that nomophobia is associated with higher anxiety levels in most individuals as well as a substantial correlation between nomophobia symptoms and insomnia.

Nomophobia is increasing due to technological advancements and widespread access. Overuse of mobile phones is linked to psychopathologic symptoms, like anxiety and insomnia. Raising awareness and helping young adults manage their phone use is essential for promoting health and well-being as digital technologies become an integral part of daily life.

None Declared

There is an increasing emphasis on incorporating sex differences into mental health research [Galbally et al. CNS Drugs 2024; 38(7):559-570; Ercis et al. J Affect Disord. 2024; 352:171-192]. Reports on evaluating sex-related differences in risperidone efficacy are limited [Galbally et al. CNS Drugs 2024; 38(7):559-570]. Recently, Risperidone ISM (Risp-ISM), a monthly long-acting injectable (LAI) formulation has been authorised in Europe, USA and some other countries.

To assess potential sex-related differences in the short-term efficacy of Risp-ISM LAI in adults with schizophrenia [Correll et al. NPJ Schizophr. 2020; 6(1):37].

Post-hoc analysis of a double-blind (DB), randomised, placebo-controlled, 12-week study conducted in participants with acutely exacerbated schizophrenia (NCT03160521). Data from the Clinical Global Impressions-Severity (CGI-S) rating scale were analysed by sex to reveal potential differences in efficacy versus placebo. The data were analysed within three separate study groups: 75 mg Risp-ISM, 100 mg Risp-ISM and placebo using a mixed effect with repeated measures model (MMRM). Herein, CGI-S scores changes from baseline (the key secondary efficacy endpoint) are shown.

In the double-blind phase, 437 eligible participants were randomly assigned 1:1:1 to receive Risp-ISM 75 mg, 100 mg or placebo every 28 days. 144 (33%) were female and 293 (67%) male. Analysis showed no sex-related differences on CGI-S scores. Decreases from baseline (Figures 1 and 2) were significantly greater versus placebo at Day 8 (after first injection) and beyond in both male and female subgroups at the 100 mg Risp-ISM dose; likewise, at Day 15 and beyond for the 75 mg Risp-ISM dose.

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There were no statistically significant differences in efficacy, measured as CGI-S score change from baseline, for male or female participants versus placebo with Risp-ISM 75 mg or 100 mg. Risp-ISM, using monthly intramuscular doses of 75 mg or 100 mg provided significant reduction in severity of the disease as early as 8 days after the first dose in acutely exacerbated patients with schizophrenia regardless of their sex.

C. Sherifi Employee of: ROVI Biotech Ltd., J. Martínez González Employee of: Laboratorios Farmaceuticos ROVI S.A., L. Anta Carabias Employee of: Laboratorios Farmaceuticos ROVI S.A., M. Almendros Gimenez Employee of: Laboratorios Farmaceuticos ROVI S.A., C. Salazar García Employee of: Laboratorios Farmaceuticos ROVI S.A., C. Correll Shareolder of: Cardio Diagnostics, Kuleon Biosciences, LB Pharma, Mindpax, and Quantic., Grant / Research support from: Janssen and Takeda., Consultant of: AbbVie, Acadia, Alkermes, Allergan, Angelini, Aristo, Biogen, Boehringer-Ingelheim, Cardio Diagnostics, Cerevel, CNX Therapeutics, Compass Pathways, Darnitsa, Denovo, Gedeon Richter, Hikma, Holmusk, IntraCellular Therapies, Jamjoom Pharma, Janssen/J&J, Karuna, LB Pharma, Lundbeck, MedAvante-ProPhase, MedInCell, Merck, Mindpax, Mitsubishi Tanabe Pharma, Mylan, Neurocrine, Neurelis, Newron, Noven, Novo Nordisk, Otsuka, Pharmabrain, PPD Biotech, Recordati, Relmada, Reviva, Rovi, Sage, Seqirus, SK Life Science, Sumitomo Pharma America, Sunovion, Sun Pharma, Supernus, Takeda, Teva, Tolmar, Vertex, and Viatris.

Alcohol use disorder (AUD) is associated with increased dopaminergic activity, and evidence suggests that α1b-adrenergic and 5HT2A serotonergic receptors play critical roles in modulating dopamine-mediated behavioral responses. Preclinical studies indicated that simultaneous blockade of these receptors with prazosin (α1b blocker) and cyproheptadine (5HT2A blocker) can reduce alcohol preference. This phase 2 clinical study aimed to evaluate the efficacy and safety of this combination in reducing alcohol consumption among patients with severe AUD.

The primary objective of the study was to assess the efficacy and safety of a combination of prazosin extended-release (ER) and cyproheptadine in reducing total alcohol consumption (TAC) in patients with severe AUD.

This was a phase 2, double-blind, parallel-group, placebo-controlled, randomized clinical trial conducted across 32 addiction treatment centers in France. A total of 154 participants (108 men and 46 women) with severe AUD were randomly assigned to one of three treatment groups for 3 months: 1) low-dose group (LDG) with 8 mg cyproheptadine and 5 mg prazosin ER daily, 2) high-dose group (HDG) with 12 mg cyproheptadine and 10 mg prazosin ER daily, or 3) placebo group (PG). The primary outcome was the change in TAC from baseline to Month 3. Secondary outcomes included changes in heavy drinking days, abstinence days, Obsessive Compulsive Drinking Scale (OCDS), and Beck Depression Inventory (BDI) scores. Safety was assessed through adverse events (AEs), sedation, and orthostatic hypotension (OH).

A significant main treatment effect in TAC change was observed in the intent-to-treat (ITT) population (p=0.039). Compared to the placebo group, the HDG showed a greater reduction in TAC from baseline to Month 3 (-23.6 g/day, p=0.016, Cohen’s d=-0.44), while the LDG also showed a reduction (-18.4 g/day, p=0.048). In the very high-risk drinking level subgroup (>100g/day of pure alcohol for men and >60g/day for women), the HDG showed a reduction of -29.8 g/day compared to the PG (p=0.031, d=-0.51). A significant dose-response relationship (p=0.027) was observed. Both low and high doses were well-tolerated, with AEs predominantly mild or moderate. No serious adverse events were reported in the HDG, and OH incidence was comparable across groups.

The combination of prazosin and cyproheptadine showed efficacy in reducing alcohol consumption in individuals with severe AUD, with a larger effect observed in the high-dose group. Both doses were well-tolerated, with a safety profile comparable to placebo. These findings suggest that the prazosin-cyproheptadine combination may be a promising treatment option for severe AUD and warrant further investigation in phase 3 trials.

J. Guiraud Shareolder of: Vergio, Employee of: Vergio

Social media is now known as a vital aspect of the younger generation’s existence, significantly impacting their emotional and psychological growth. In contrast to prior generations, Generation Z has been raised in an environment of continuous digital connectivity, which poses distinct issues with body image, emotional health, and sleep quality. Platforms such as Instagram, TikTok, and Snapchat have been increasingly associated with mental health conditions, including eating disorders, anxiety, depression, and insomnia. Considering the ubiquity of these platforms, it is imperative for psychiatrists, public health practitioners, and educators to comprehend the mental health ramifications associated with social media participation.

This study attempts to examine the relationship between social media exposure and mental health disorders in Generation Z, specifically emphasizing eating disorders, anxiety, depression, and sleep disturbances.

Relevant studies and existing research on social media usage patterns and their effects on mental health in Gen Z were reviewed. Attention was given to how different platforms contribute to the development of body dissatisfaction, social comparison, and sleep difficulties. The analysis included an exploration of platform-specific features and user behavior, focusing on Instagram’s image-centric nature, TikTok’s short-form, high-stimulation content, and Snapchat’s emphasis on transient communication.

The analysis indicated that Instagram, being predominantly a visual medium, exacerbates body dissatisfaction and increases the likelihood of eating disorders by consistently advocating unattainable beauty ideals and trends such as “thinspiration” and “fitspiration.” TikTok, although promoting mental health awareness, may also induce anxiety and attention deficits because to its intensely stimulating, rapid content. Snapchat’s design, that encourages continuous monitoring of temporary content, seems to exacerbate anxiety stemming from the fear of missing out (FOMO). Cyberbullying has surfaced as a substantial factor exacerbating mental health conditions across all platforms, particularly with anxiety and desperation, along with severe instances associated with suicidal ideation.

Social media has a complex influence on the mental health of Generation Z, with each platform uniquely affecting conditions such as eating disorders, anxiety, depression, and insomnia. Instagram’s emphasis on aesthetics, TikTok’s rapid content consumption, and Snapchat’s addictive interaction present unique mental health issues. These findings underscore the necessity for medical professionals to integrate social media practices into their evaluations and therapies for Generation Z, while public health professionals and educators are encouraged to work together to promote better online habits.

None Declared

The literature review on anxiety/depression rates during Covid-19 is inconsistent due to significant methodological challenges in quantifying the impact of the pandemic on the mental health of the population.

To identify and understand the prevalence of anxiety/depression as a result of the COVID-19 situation aiming to synthesize impact of COVID-19 in mental health of population in Kosovo.

It’s a classic literature review which involves a thorough examination of existing research in internet, including raw data of the individual empirical results from several repeated cross-sectional surveys. We examined data of eight published researches and nine cross-sectional surveys conducted during the period 2020 to end of 2021.

In the review of eight published studies (seven from 2020 and one from 2021) of cross-sectional type, online, with sample sizes from 155 to 904 (four with student population, two with healthcare workers and two with general population) the prevalence of anxiety was from 13% to 73% (average 47.07%; measured with HADS, DASS-21 and GAD-7) while the prevalence of depression was from 13.9% to 71.60% (average 34.42%; measured with HADS, DASS-21 and PHQ-9). The methodological quality of included studies was low. Analysis of raw data of our nine cross-sectional surveys conducted during the period 2020 to end of 2021 show pooled prevalence for anxiety (measured with GAD-7, ≥10) for 2706 participants (five samples) to be 34.59 % (95% CI, 33.11%-36.07%) and for depression (measured with PHQ-9, ≥10) for 3703 participants (seven samples) to be 40.84% (95% CI, 39.43%-42.25%). Mostly, younger age, females and low SES emerged as factors associated with higher levels of anxiety/depression.

Our anxiety/depression prevalence rates, mostly is above average in comparison to other countries in Europe. Despite awareness for methodological flaws of studies, measurement invariances and some evidence of variation in the estimated prevalence rates of depression and anxiety disorder across countries; high prevalence of mental health problems during the pandemic indicates need for mental health prevention, promotion and intervention programs to mitigate the consequences of the COVID-19 pandemic on the population.

None Declared

Functional gastrointestinal disorders (FGIDs) represent a significant global health burden, affecting approximately 15-20% of the population. These disorders can significantly impair quality of life, particularly in individuals facing high levels of psychological stress, such as medical students.

To study the association between psychiatric factors, specifically anxiety and depressive disorders, and the prevalence of FGIDs among medical students in Tunisia.

A cross-sectional study was conducted among second-year medical students at the Faculty of Medicine, Sousse, from March 2023 to February 2024. Data were collected using a self-administered questionnaire designed to assess gastrointestinal symptoms such as abdominal pain, bloating, diarrhea, constipation, and heartburn. Psychiatric conditions were assed using validated screening tools.

The study included 206 students, with a strong female predominance (80.1%). Among them, 46.1% (n=95) reported experiencing between 1 and 4 digestive disorders, primarily abdominal pain and bloating (66%). Psychiatrically, univariate analysis revealed a significant association between FGIDs and several psychological factors: female gender (p<0.01), a tendency towards anger in daily life (p<0.01), anticipatory anxiety (p<0.01), and the presence of panic attacks (p<0.01).

Functional gastrointestinal disorders (FGIDs) are prevalent among medical students and are often linked to anxiety and depressive disorders. Preventive measures focused on stress management and mental health could significantly improve the quality of life of these students and prevent digestive complications.

None Declared

The management of coexisting schizophrenia and rheumatoid arthritis (RA) is complex due to the lack of clear guidelines. While immunosuppressants are the cornerstone of RA therapy and clozapine is the gold standard for treatment-resistant schizophrenia, their shared adverse effects make combined treatment challenging, requiring alternative therapeutic options.

present the therapeutic complexity of managing treatment-resistant schizophrenia alongside RA.

We report a case of drug-induced toxidermia in a patient being treated for RA with some therapeutic particularities.

Mr. W, a 66-year-old man, has been under treatment since 2007 for schizophrenia. Somatically, he has rheumatoid arthritis (RA) that has been progressing since 2016, for which he is treated with Methotrexate.

The diagnosis of treatment-resistant schizophrenia was made. Given this resistance, the introduction of Clozapine was proposed. However, the issue of an interaction between Methotrexate and Clozapine, contraindicated according to pharmacologists’ report, required therapeutic reevaluation.

Clinical and biological evaluation showed remission of RA with an EVA score of 0, NAD of 0, NAG of 0, a DAS28 score of 1.13, and an VS of 5 mm. The choice then fell on Sulfasalazine to replace Methotrexate, with a progressive introduction of the drug, starting at 500 mg and increasing by 500 mg every 7 days up to a dose of 2000 mg/day, accompanied by weekly control tests.

Twelve days after the introduction of Sulfasalazine, at a dose of 1000 mg/day, the patient presented with a diffuse rash associated with erythroderma, facial and eyelid edema, an infiltrated, pruritic maculo-erythematous rash, confluent in places but sparing the palms and soles. Given the characteristics of the dermatological lesions and their timing, drug-induced toxidermia caused by Sulfasalazine was strongly suspected. Consequently, Sulfasalazine was discontinued, as well as the antipsychotic, and the patient was treated with topical skin treatments and two boluses of intravenous corticosteroids.

The initial biological workup was normal. However, seven days after stopping Salazopyrin, the patient became febrile with a temperature of 40°C, accompanied by erythematous pharyngitis, an elevated CRP of 45, monocytosis, and the presence of activated lymphocytes on the blood smear. Pharmacovigilance opinion: a DRESS syndrome was suspected, with a Regi score of 2. Two weeks later, the clinical course was favorable, with the complete disappearance of dermatological lesions and normalization of biological parameters.

Managing treatment-resistant schizophrenia alongside rheumatoid arthritis poses a therapeutic challenge due to drug interactions. The case of Sulfasalazine-induced toxidermia highlights this complexity. Close monitoring and tailored treatment alternatives are crucial to minimize risks while ensuring efficacy.

None Declared

Tourette Syndrome (TS) is a neurodevelopmental disorder involving multiple motor and vocal tics, typically beginning in childhood with symptoms peaking around age 10-12. Though the exact cause remains unknown, genetic and environmental factors are believed to contribute to its development. Children with TS often face significant social, emotional, and academic challenges, further complicated by comorbidities which can lower their quality of life and place stress on family dynamics.Using data from the 2021 National Survey of Children’s Health(NSCH), this study provides updated insights into the prevalence and comorbidities of TS.

Assess TS prevalence in children aged 3-17 using 2021 data

Identify common TS comorbidities and evaluate TS’s demographic distribution

This cross-sectional study utilized 2021 NSCH data collected via parent-proxy responses in English and Spanish through mail and web-based surveys in the United States. Statistical analyses, including t-tests, Chi-Square tests, and multivariate regression, were performed to explore associations between TS, socio-demographic factors, and comorbidities. Results were reported using adjusted odds ratios and confidence intervals, with analyses conducted in Stata 18.0.

This study included 79,236 participants, of which 208 (0.26%) had TS.The TS group had a mean age of 12.7 years, with most cases found in adolescents aged 11-17.Males made up 74% of TS cases. While TS was slightly more common in White participants (72%), no significant racial differences were found. Higher-income households had lower odds of TS.Comorbidities were more common in individuals with TS:

Neurodevelopmental and Behavioral Disorders: ADHD (49% in TS vs. 10.2% in non-TS), Autism (21% vs. 3.2%), Learning disabilities (28% vs. 7.5%), Developmental delay (23% vs. 6%), Behavioral problems (36%)

Psychiatric Disorders: Anxiety (60% in TS vs. 11.3%), Depression (25% vs. 5%), Seizures (6%), Headaches (14.4%).

Immune Conditions: Asthma (15.5% in TS vs. 8%), Allergies (37%).

Physical Health: Hearing problems (3.8%), Vision problems (4.3%). Fig. 1

Children with TS born prematurely or with low birth weight had higher rates of comorbidities. Asthma was more common in the TS with a history of prematurity (37.1%) and TS with a history of low birth weight(30.7%) compared to the overall TS population (15.5%). Autism was also more prevalent in these groups, suggesting increased risks of comorbidities due to premature birth and low birth weight. Fig.2

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The study highlights significant socio-demographic disparities and the increased burden of comorbid conditions in children with TS. These findings emphasize the need for early diagnosis and comprehensive management strategies to address the complex challenges of TS, particularly the high prevalence of neurodevelopmental, psychiatric, and physical health comorbidities.

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Global epidemiological research suggests that approximately 1% of the global population is affected by schizophrenia, with 2 to 3% experiencing obsessive-compulsive disorder (OCD). Additionally, a noteworthy proportion of individuals with schizophrenia also exhibit comorbid OCD. This overlap often complicates differential diagnosis, especially as many schizophrenia patients display obsessive and/or compulsive symptoms akin to those seen in OCD.

This literature review is designed to examine how frequently schizophrenia and OCD co-occur and to summarize the treatments reported in various studies.

A comprehensive literature review was carried out focusing on the co-occurrence and treatment of schizophrenia and OCD. This review involved an extensive search of scientific publications, selecting articles pertinent to the subject from databases such as Scopus and PubMed using keywords like “schizophrenia and OCD” and “schizophrenia and OCD treatment,” yielding over 1500 articles from 1988 to 2024. Additional sources included Google Scholar and various grey literature sources. After applying specific exclusion criteria, 44 recent articles were selected that addressed the frequency of co-occurrence and the treatment modalities used for schizophrenia and OCD. These articles were categorized by country, frequency of co-occurrence, and treatment methods.

The review revealed that roughly 14.5% of individuals with schizophrenia also suffer from OCD. Among treatments, Clozapine was commonly associated with the worsening of OCD symptoms, while Haloperidol showed better tolerability. Other antipsychotic medications like Olanzapine, Risperidone, and Quetiapine were noted to either aggravate existing OCD symptoms or initiate the onset in some cases. In contrast, some antipsychotics, such as Amisulpride and Aripiprazole, helped reduce symptom severity. Non-pharmacological treatments, particularly Cognitive Behavioral Therapy (CBT), have proven effective in reducing symptom severity with favorable outcomes noted in numerous cases. The integration of pharmacological and psychotherapeutic strategies is generally recommended to maximize therapeutic outcomes, underscoring the potential of combined modalities in treating OCD.

Our literature review investigated the prevalence of comorbidity between schizophrenia and obsessive-compulsive disorder (OCD), as well as the pharmacological and non-pharmacological treatments utilized. The significant overlap between these disorders highlights the complexity of managing patients with these co-occurring conditions, underscoring the need for systematic screenings and integrated treatment approaches.

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Although cognitive impairment is a core symptom of schizophrenia related to poor outcome in different functional domains, it still remains a major therapeutic challenge. To date, cognition is still poorly assessed in both research and clinical settings and no comprehensive treatment guidelines for assessment and treatment of cognitive impairment in schizophrenia are implemented.

The aim of the European Psychiatric Association (EPA) guidance paper was to provide a comprehensive meta-review of the current available evidence for the assessment of cognitive functions in schizophrenia both in research settings and in real-world clinical practice and for treatment of cognitive impairment, structured into three sections: pharmacological treatment, psychosocial interventions, and somatic treatments.

Based on the reviewed evidence, the EPA guidance recommends a comprehensive and systematic assessment of neurocognitive and social cognitive domains in schizophrenia, in all phases of the disorder, as well as in subjects at risk to develop psychosis. It is recommended not only the use of observer reports, but also of self-reports and interview-based cognitive assessment tools. As for treatment, the EPA guidance recommends an appropriate pharmacological management as a fundamental starting point in the treatment of cognitive symptoms in schizophrenia. Among psychosocial interventions, cognitive remediation and physical exercise, and some variables have been confirmed as core elements for cognitive remediation effectiveness.

The dissemination of the EPA guidance papers may promote the development of shared guidelines concerning the assessment and treatment of cognitive functions in schizophrenia, with the purpose to improve the quality of care and to achieve clinical recovery in this population.

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Depressive disorders are the most prevalent chronic mental disorders globally, affecting approximately 322 million people, or 4.4% of the world’s population, with a significant portion residing in the Americas, including Mexico. Adolescence represents a critical period for the onset of depression, where preventive interventions should focus on enhancing cognitive abilities, which are malleable and can mitigate the impact of early negative experiences, particularly in marginalized areas and indigenous communities.

To identify the prevalence of depressive symptoms and characteristics associated with the presence or absence of depressive symptoms in a population of adolescents and young adults residing in rural and indigenous communities in San Luis Potosi state, Mexico.

A cross-sectional study was conducted. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), while anxiety symptoms were measured using the Generalized Anxiety Disorder-7 (GAD-7) scale. Descriptive statistics, a comparative analysis and a principal components analysis were performed with the sociodemographic data and the evaluations of each item of the PHQ9 and GAD7.

1,057 participants aged between 15 and 25 years (16.63 ± 1.53 years) were included in the study. The sample comprised 60.51% females 39.48% males, and 7 participants reported speaking an indigenous language. 28.67% of participants had responses compatible with anxiety, while 34.98% had depression, of which 46.1% qualified as having major depressive disorder. Regarding GAD7, participants with higher severity scores presented a higher average response on item 3 about feeling excessively worried about different things, while those with depression did not respond predominantly to questions regarding mood, but rather to item 3 referring to having difficulty falling or staying asleep and item 4 about feeling tired or having low energy. 4.67% of participants reported suicidal ideation almost every day. When the GAD7 and PHQ9 items were subjected to a principal component analysis, it was observed that PC1=51.67%. The factors self-reported as most closely linked to depressive and anxious symptoms included the age of the caregiver, sex and age of the participant, as well as whether they spoke an indigenous language.

Difficulty falling and staying asleep, as well as perceived lack of energy or fatigue, are the main ways in which this population recognizes signs of depression, rather than feelings of sadness or anhedonia. Given the high prevalence of depressive symptoms and the identified risk profiles, there is an urgent need for targeted mental health services and interventions in these vulnerable populations.

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Dispositional mindfulness (DM), also known as Trait mindfulness, refers to the inherent ability to focus on and sustain attention on present-moment experiences with an open and nonjudgmental attitude. Recent research has increasingly highlighted the positive impact of DM on mental health.

To evaluate the association between DM and sexual dysfunction (SD) among female medical residents.

A cross-sectional online survey, designed using Google Forms, was distributed on social media platforms. We included married and sexually active medical residents. Female Sexual Function Index (FSFI) was used to evaluate female sexual dysfunction. We used the Mindfulness Attention Awareness Scale (M.A.A.S.) to measure the frequency of open and receptive attention and awareness of ongoing events and experiences and the Spielberger State-Trait Anxiety Inventory (STAI-Y-T) to assess anxiety traits.

Sixty-five medical residents with an average age of 29.43 ± 1.95 years completed the online questionnaire. The average age at first sexual intercourse was 25.15 ± 2.34 years and the average frequency of sexual intercourse was 6.61 ± 4.18 times per month.

The mean scores for the M.A.A.S and STAI-Y-T were 26.25 ±5.61 and 45.85 ±9.36 respectively.

The anxiety assessment using the STAI-Y-T scale showed that 30 residents (46.4%) had moderate anxiety, and 8 (12.3%) had high to very high anxiety levels.

The mean total FSFI score was 26.25 ± 5.61 and SD was noted in 49.2% of the cases.

A positive correlation was found between the level of MAAS and the total FSFI score (p=0.003; r=0.35),”Desire” dimension (p=0.02; r=0.28), “Lubrication” domain (p=0.004; r=0.35), and the “Satisfaction” (p=0.006; r=0.33)

Anxiety levels were negatively correlated with the total FSFI score (p<10-3; r=-0.42), the “Desire” dimension (p=0.008; r=-0.32), “Arousal” dimension (p=0.003; r=-0.36), “Lubrication” domain (p=0.002; r=-0.37) and “Satisfaction” domain (p=0.002; r=-0.38).

The results of this study revealed relatively high prevalence rates of SD among medical residents and highlighted several vulnerability factors. Therefore, several measures should be implemented to prevent and determine the factors correlated with SD.

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The World Health Organization (WHO) estimates that in Western societies the incidence of psychiatric disorders is up to seven times higher in the prison population. Drug dependence is also a major destabilizing factor in this population. Our study is the first one in Greece with a focus group of incarcerated males which have comorbidity of emotional psychosis and Substance Use Disorder.

Hypothesis testing: “Aripiprazole LAI antipsychotic treatment is associated with improved quality of life and functionality in incarcerated patients with comorbidity of Bipolar disease - I (BD-I) and Substance Use Disorder (SUD)”.

30 patients with BD I were prisoners at the Penitentiary of Neapolis of Lasithi of Crete (Greece). Median age was 36 years (all men). 76.67 % had comorbidity of bipolar disorder type I (BD-I) and alcohol use disorders. 80% had comorbidity of BD-I and cocaine use disorders. 93.3% had comorbidity of BD – I and Cannabis Use Disorder. All were medicated in prison by aripiprazole LAI 400mg/month. For the evaluation of our hypotheses the instruments WHOQOL-BREF questionnaire and the CGI-S scale were used. The quality of life and the functionality were compared in each patient, before the initiation of the LAI medication and during the active treatment period. The minimum of follow-up period was 6 months. Five cases of patients, who remained compliant with LAIs treatment after release from prison for a period of at least 6 months maintained a very good quality of life without ever getting into trouble with the law again.

In all 30 patients (imprisoned) of our sample, the CGI-S score with depot aripiprazole therapy administrated at least for 6 months decreased statistically significantly from 5.72 ±0.88 to 2.94±1.33 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001). Additional, the quality-of-life scale score of these patients increased statistically significantly from 0.7 ±0.53 to 3.6±0.67 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001) with depot aripiprazole therapy administrated at least for 6 months too.

Aripiprazole LAI significantly improves the quality of life and functionality of patients with dual diagnosis of emotional psychosis and SUD in prison. Our study highlights that ensuring medication compliance, during the incarceration and after the release from prison, delays the time to reincarceration for this specific population or diminishes importantly the probability of the reincarceration.

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