Recently, there have been wide-ranging debates about gender affirming treatment for young people with gender incongruence. The ethical principle of self-determination of young people must be reconciled with a careful assessment and weighing up of the risks and benefits of medical treatment steps. The focus is on psychosocial support for young people struggling with gender incongruence in adolescence. The evidence for the effectiveness of medical interventions in adolescence is still limited. Nevertheless, there is a great need among affected adolescents. In a literature review and based on international debates, guidelines and treatment recommendations, a cautious and balanced approach to the question of the right support for adolescents with gender dysphoria is recommended.

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Flight crew members are subjected to various stressors that can disrupt their sleep-wake cycle, leading to a higher prevalence of sleep disorders.

to assess the prevalence of sleep disturbances among flight crew members of a private airline company in Tunisia.

A cross-sectional study was conducted involving flight crew members employed by a private airline in Tunisia who underwent periodic medical examinations at the Occupational Medicine and Pathology Department in a University Hospital in Sousse. Data collection included socio-demographic information, lifestyle habits, and professional details, gathered through a structured questionnaire. The Sleep Condition Indicator (SCI) was used to screen for insomnia disorder.

The study included 160 participants, predominantly female (60%). Sixty-five percent of the population was over 40 years old. A significant majority (58.8%) were smokers, while 41.3% consumed alcohol. Coffee consumption was high, with 84.4% of participants reporting regular consumption. Regarding professional data, 71.3% of participants were flight attendants, with a median length of service of 15 years. The majority of participants (65%) had flown medium-haul flights (less than 5 hours) in the preceding month. Insomnia was reported in 23.1% of participants.

Our findings highlight the importance of screening for sleep disorders through periodic medical examinations which can significantly contribute to improving sleep quality, enhancing alertness, and ultimately enhancing aviation safety.

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A growing body of evidence suggests that physical activity can be an effective treatment for depression. In consideration of individual conditions, Sports and Exercise Therapy may be used as standalone or complementary treatment during partial or full-time inpatient treatment. However, current data indicate that only a minority of patients make use of it during the course of their treatment. The beneficial health effects of exercise on mental health can only be realized if the exercise is actually undertaken. Therefore, further research is required on the motivational psychological aspects of participation in Sports and Exercise Therapy. It can be assumed that it is crucial to consider the individual patient preferences when initiating and sustaining physical activity. Moreover, there are notable differences between men and women in terms of their motivation for engaging in exercise.

The present study examines gender-based differences in the motivation underlying the participation in Sports and Exercise Therapy during the course of inpatient treatment for depression, whether on a partial or full-time basis.

In a psychotherapeutic and psychosomatic hospital, motives for Sports and Exercise Therapy of female and male (age 35-64) patients with a primary diagnosis of depression were recorded using the Bernese Motive and Goal Inventory in Leisure and Health Sports. The motives analysed include contact, body/appearance, competition/performance, distraction/catharsis, health, fitness and aesthetics. The survey was conducted within seven days of admission to either partial or full-time inpatient treatment setting.

The total number of patients included in the analysis was 140, comprising 65.0% male (mean-age=48.0, 21.0% full-time treatment) and 35.0% female (mean-age=50.7, 43.0% full-time treatment). The most important motives for both men and women are health (M male=4.29, M female=4.37), fitness (M male=4.20, M female=4.20) and distraction/catharsis (M male=3.72, M female=3.80) due to the highest mean scores. Compared to women (M=1,60, SD=0.77) men (M=2.19, SD=1.93) reported significantly higher mean score for the competition/performance motive (U-test, z=3.987, p<.001). No further significant gender differences were identified.

Significant gender differences were found only for the motive competition/ performance, despite this motive rated lowest on average. The absence of further gender differences may be due to the fact that gender differences may be of less importance for Sports and Exercise Therapy in the treatment context. On average health, fitness, and distraction/ catharsis were rated highest by both genders. This is consistent with typical symptoms during depression, which involve distraction from negative thoughts as well as recovering physical fitness to cope with everyday life. All authors of this study declare that they have no conflicts of interest.

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Migraine is strongly associated with depressive and anxiety disorders, as migraine patients have over a twofold higher risk of major depressive disorder and nearly a threefold higher risk of anxiety disorders compared to non-migraine individuals.

This study investigates the 13-year trajectories in individuals with a depression or anxiety disorder with and without comorbid migraine. Additionally, the time to recovery of the depressive or anxiety disorder was compared.

The NESDA cohort consists of participants with an affective disorder at baseline, according to the Composite International Diagnostic Interview (CIDI). Depressive symptoms were measured using the Inventory of Depressive Symptomatology (IDS) and anxiety symptoms with the Beck Anxiety Inventory (BAI). The participants were divided at baseline into three subgroups: migraine, non-migrainous headache and non-headache. The individual symptom trajectories were evaluated over 13 years with linear mixed models. Additionally, the time to recovery of the affective disorders with or without migraine were compared with a Cox-proportional hazard analysis.

In total 1,448 participants had either a depressive or anxiety disorder or a combination of both at baseline, 327(23%) had additional comorbid migraine, 518(36%) non-migrainous headache. Participants with comorbid migraine consistently reported higher severity of depressive and anxiety symptoms than non-headache participants over the 13-year follow-up, with an estimated higher IDS sum score of 0.22 (p<0.001) and a higher BAI sum score of 0.28 (p<0.001) (see Figure 1 and 2). The time to recovery of an affective disorder was similar for migraine and non-headache individuals (HR: 1.13 (p=0.17)).

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In this cohort, individuals with comorbid migraine showed consistently higher severity of depressive and anxiety symptoms than non-headache individuals over 13 years. Recovery time from an affective disorder was similar for migraine and non-headache individuals.

N. Van Veelen: None Declared, N. Pelzer Grant / Research support from: Independent support from the European Community, Dutch Heart Foundation, Dutch Research Council, Dutch Brain Foundation, Dioraphte, and the Clayco foundation, Consultant of: Consultancy support from Abbvie/Allergan, Lilly, Lundbeck, Novartis, Pfizer, Teva, B. Penninx: None Declared, G. Terwindt Grant / Research support from: Independent support from the European Community, Dutch Heart Foundation, Dutch Research Council, Dutch Brain Foundation, Dioraphte, and the Clayco foundation, Consultant of: Consultancy support from Abbvie/Allergan, Lilly, Lundbeck, Novartis, Pfizer, Teva, E. Giltay: None Declared

Neurostimulation procedures have also been in use for some time to treat neurological and neuropsychiatric disorders. In the field of non-invasive brain stimulation, a number of methods have been the subject of investigation, including transcranial magnetic stimulation (TMS), transcranial electrical stimulation (tES), and transcranial pulse stimulation (TPS). Although TMS and tES have been the subject of more extensive investigation, particularly in the context of Alzheimer’s disease (AD) and depression, there remains a pressing need for research into TPS. Some studies have demonstrated favorable outcomes when these methods were used. Nevertheless, these methodes have yet to be incorporated into clinical practice, largely due to the inability to conclusively assess and confirm their effectiveness, which is influenced by a number of factors.

TPS as a method of neurostimulation will be presented. Results of a recent study using TPS in patients with mild to moderate Alzheimer’s disease will also be presented. The aim of the study is to investigate whether cognitive performance is significantly increased and depressive symptom severity is significantly reduced. Furthermore, a research proposal for the use of TPS in patients diagnosed with a depressive disorder will be presented.

The cognitive performance (MoCA) and depressive symptoms (GDS) of patients with early- or late-onset, mild or moderate AD will be assessed at baseline (t1), three months (t2) and six months (t3) following treatment with TPS. In the context of this longitudinal study, which is designed with a single center, the participants will be recruited in an outpatient setting within a specialized psychiatric-psychotherapeutic clinic in Lower Saxony, Germany.

Repeated measures ANOVA; Mean scores MoCA t1 = 13,9 vs. t2 = 14,1 vs. t3 = 14,5 (F(2, 66) = .749, n.s.). Mean scores GDS t1 = 9,5 vs. t2 = 7,6 vs. t3 = 6,8 (F(2, 32 = 4.410, p ˂ .05). n = 34. Preliminary data for the study of TPS in AD, study is being continued. Research proposal for the use of TPS in patients diagnosed with a depressive disorder will also be presented.

As in other studies, remarkable effects were shown with the use of TPS in patients with a mild to moderate AD. The results may indicate that the cognitive performance can be stabilized and the depressive symptom severity can be reduced. It is important to note that the results are based on a relatively small sample size and lack control conditions, which may limit the generalizability of the findings. Further research is required to evaluate the effectiveness of treatment of TPS in AD and to assess the potential suitability of neurostimulation as an add-on therapy, complementing previous drug and non-drug approaches. Further research is also required in the use of TPS in depression given the dearth of scientifically reliable findings on this topic.

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The professional activity of doctors is often associated with conflict situations, so it is important for them to obtain conflict-free communication skills during their education. These skills can be formed during a new academic course in curriculum. In this paper, we describe the prerequisites of the course “Conflict-free communication skills” on the sample of teaching pediatrics students at the Sechenov University.

To clarify the possibility and expediency integration of a new course into the curriculum of medical students.

The primary method employed is bibliographic analysis.

The main purpose of a new course is the formation of universal, general professional and professional competencies in verbal and nonverbal communication for medical students. It is necessary for medical students to acquire the basic principles of communication psychology and the formation of conflict-free communication skills. In the process of organizing education for future medical staff, it is important to start from the basic concept of communication, not from the basic concept of conflicts. From our point of view, the concepts of effective communication and conflict-free communication are interrelated. To make this course more practical, classes should be held in the format of business games, case studies, and social-psychological training.

We have identified the following sections of the discipline:

The phenomenon of communication;

Business communication and its types;

Psychological boundaries and their violations;

Empathy in the work of a doctor;

Teamwork and collaboration.

The integration of a new course into the curriculum of medical students will allow us to develop conflict-free communication skills and teamwork, thereby simplifying business communication in the medical field.

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Sex differences in psychiatric disorders are well-documented, yet clinical diagnoses remain primarily symptom-based, overlooking underlying neurobiological distinctions. Despite evidence of sex-specific symptomatology leading to similar diagnostic labels, treatment paradigms often follow a one-size-fits-all approach, contributing to misdiagnosis, suboptimal treatment, and delayed functional recovery. Women, in particular, are disproportionately affected, as psychiatric research has historically prioritized male cohorts to control for hormonal fluctuations and reproductive events (e.g., menarche, pregnancy, menopause), resulting in a gap in sex-specific interventions.

With the advancement of precision psychiatry, integrating sex-informed, multimodal approaches into clinical decision-making is imperative. Machine learning (ML) provides a promising avenue for improving diagnostic accuracy and individualized risk prediction, moving beyond conventional categorical diagnoses.

Here I will highlight findings from two studies leveraging ML to analyze sex-related neuroanatomical patterns:

• Neuroanatomical Sex Differences in Early-Phase Psychiatric Disorders – Investigating grey matter volume alterations in individuals at clinical high risk for psychosis (CHR), recent-onset psychosis (ROP), and recent-onset depression (ROD) using a Support Vector Machine (SVM) model.

• Sex Differences and Neuroanatomical Classification in Transgender Individuals – Exploring whether ML classifiers trained on cisgender populations accurately reflect neurobiological patterns in transgender individuals, considering sex assigned at birth, gender identity, and hormone therapy.

This research does not seek to exclude individuals with Differences in Sex Development (DSD) but rather aims to establish biological sex as a critical, yet underutilized, variable in psychiatric research. Recognizing sex-specific neurobiological mechanisms is a necessary step toward developing targeted risk calculators (e.g., for postpartum depression, suicide risk) and advancing personalized mental health interventions. By refining ML-based models and integrating sex-informed frameworks, this work contributes to the broader goal of precision psychiatry—tailoring psychiatric care to the diverse biological and psychological realities of individuals.

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Stress is a physiological and psychological response that contributes to the development and worsening of psychiatric disorders such as depression and anxiety. Objective stress measurement is crucial in psychiatric settings, as stress affects the onset and progression of these conditions. Reliable data can improve diagnosis, treatment, and management. Speech analysis offers a non-invasive way to assess stress, as stress-induced physiological changes can influence features like pitch, jitter, and speaking rate.

This study aims to explore whether automatic speech analysis can serve as an objective stress measure by examining the relationship between speech features and cortisol levels during an acute stressor.

Participants were recruited at the Department of Psychiatry, University of Frankfurt, Germany. Cortisol levels were measured in saliva before (T0) and 20 minutes after (T1) a stress-inducing or control task. Participants immersed their hand in cold or warm water while being observed via video, then completed a speech task by reading 16 standardized sentences before and after the task. Various speech features, including frequency, energy, and spectral characteristics, were analyzed in relation to cortisol levels. Correlations and mixed-effects models were calculated.

A total of 52 participants (n=28 stress, n=24 control) read 1040 sentences across T0 and T1. Cortisol levels increased in both sexes in the stress condition compared to the control (Figure 1). Vocal tremor showed a strong positive correlation with cortisol at T0 and a strong negative at T1 regardless of condition. The harmonic-to-noise ratio had no correlation at T0 but displayed a negative one at T1. Pitch range showed no initial correlation but was strongly negative post-stress. Mixed-effects models revealed significant interactions between time point and group for features like number of pauses and loudness standard deviation (p=.036 and p<.001, respectively). Loudness rate was significantly associated with time point (p<.001). In the linear mixed-effects model, an interaction effect was observed between time point and group for the harmonics-to-noise ratio, with a significant decrease in the stress condition (p<.001).

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This study supports speech analysis as a potential objective stress measure. Findings suggest that features like vocal tremor and pitch range are sensitive to acute stress, indicating that speech analysis could provide a non-invasive, real-time tool for assessing stress in psychiatric settings, offering an alternative to traditional self-report methods.

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Postictal Psychosis (PIP) is a severe psychiatric complication of epilepsy, defined by a brief psychotic episode, with a mean duration about 10 days, occurring after a cluster of seizures, or a focal seizure evolving to bilateral tonic-clonic seizure, and sometimes after a single seizure. Around 2 % of patients are affected by this disorder, mostly in long-lasting, drug-resistant temporal lobe epilepsy, but its prevalence is probably underestimated. (Kanemoto et al. Cambridge, 2011; p.67-79). PIP can lead to severe behavioral disturbances, such as agitation, violence and suicide (Tarrada et al. Epilepsy Behav, 2022). Multiple hypotheses exist about the pathophysiology of Postictal Psychosis (de Toffol et al. Encephale, 2016; p443-447). As the clinical manifestations of PIP are roughly stereotyped regardless of the epileptogenic zone, we assumed the existence of a common neurological pathway.

We aimed to determine if a specific brain network sustained the psychotic episode, regardless of the localization of the epileptogenic zone.

We conducted a systematic review following the PRISMA guidelines (Cheval et al. Seizures, 2024; p 44-55). We included studies that provided EEG, and metabolic imaging performed during the presence of psychotic symptoms. Studies were not included, when the diagnosis of PIP was doubtful, or when the results EEG and/or imaging were not detailed enough.

We included a total of 24 studies providing electrophysiological results(n=22) and metabolic imaging performed during the PIP(n=5). Temporal and frontal lobes seemed frequently involved, without clear evidence for lateralization. The EEG patterns were heterogenous, varying from unchanged to diffuse slowing. Metabolic pattern showed an increased perfusion within temporal and frontal lobes during PIP. These results correspond to the patterns described during postictal state, but they persisted throughout PIP, within regions larger than the epileptogenic zone and resolved with the recovery (Cheval et al. Seizures, 2024; p 44-55).

PIP symptoms are associated with an excessive persistence of postictal changes within extended frontotemporal networks. A hypothesis could be that PIP results from an abnormally prolonged and diffuse post-ictal dysregulation. Nonetheless this results is relatively imprecise and further studies should elucidate the subjective experience of the epileptic seizure, and the neuropsychological profile of patients with PIP episodes. Finally, these results could be also compared to the results of invasive EEG in patients with schizophrenia obtained in a previous controversial study, that showed the presence of epileptic activities in depth regions of the brain (Heath et al. Epilepsy Behav, 2005; p633-645), a pattern distinct from PIP, that would suggest epileptic psychoses have a pathophysiology different from primary psychoses.

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Attachment styles, developed through early life interactions, influence how individuals perceive relationships and manage stress. Medical students often exhibit insecure attachment styles, which are linked to increased psychological distress.

The primary aim of this study is to explore the extent to which resilience influences the connection between attachment styles and general psychological well-being among medical students.

This cross-sectional study was conducted at New Giza University in Cairo, Egypt, and involved 437 medical students. Participants completed self-report surveys measuring attachment styles, resilience, and psychological distress. The survey instruments included the Relationship Questionnaire (RQ) for attachment styles, the General Health Questionnaire (GHQ-12) for psychological distress (where a lower GHQ-12 score indicates less psychological distress), and the Connor–Davidson Resilience Scale (CD-RISC-10) for resilience. Participants were grouped into four attachment styles: secure (SA), fearful avoidant (FA), anxious preoccupied (AP), and dismissive avoidant (DA).

The sample’s mean age was 20.32 years (SD = 2.09). Females comprised 69.6% of the cohort, and single students made up 80.1% of the whole cohort. The distribution of attachment styles across females and males differed significantly (p < 0.0001, χ² = 25.7), with DA being more prevalent in males compared to females (28.6% and 13.2%, respectively). GHQ-12 median scores were similar between genders (p = 0.23), while CD-RISC-10 scores differed (p = 0.002), with males having a higher median (28).

Median scores of GHQ-12 and CD-RISC-10 differed significantly across groups of attachment styles (p < 0.0001 and p = 0.0002, respectively). AP and FA had the highest GHQ-12 medians (15), while AP had the lowest CD-RISC-10 median (25).

A negative correlation between CD-RISC-10 and GHQ-12 scores was significant in the whole cohort (p < 0.0001, r = -0.3227), with FA showing the strongest correlation (p < 0.0001, r = -0.3292, CI: -0.4714 to -0.1704) and other groups showing similar reuslts (figures 1, 2 and 3).

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The findings underscore the critical role of resilience in buffering against the psychological impacts of insecure attachment among medical students. Approaches targeting resilience enhancement could serve as a valuable intervention target to mitigate psychological distress and improve well-being in this high-risk attachment styles. Future research is recommended to develop and test resilience-focused interventions tailored to medical students with insecure attachment styles, which may help reduce burnout and promote mental health in medical training environments.

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Firefighters face routine occupational risks and high-stress environments. Accordingly, 96.4% are exposed to a potentially traumatizing event throughout their career (Nazari et al. Work 2020; 67(1):215-222). This is accompanied by high rates of trauma-related mental illnesses (TRMI) such as PTSD. First-line treatments of TRMI remain limited. A novel treatment that has emerged, Ketamine-Assisted Therapy (KAT) has shown meaningful improvements in PTSD treatment (Ragnhildstveit et al.Ther Adv Psychopharmacol 2023; 6:13).

The primary objective was to synthesize prevalent themes among participants, shedding light on their journeys to accessing KAT as well as highlighting internal motivations and societal barriers that exist.

In this study, there are six working firefighters, diagnosed with TRMI. They have enrolled in but not begun the 12-week Roots to Thrive (RTT) KAT program. Interviews were conducted individually and transcribed for further analysis. Data from the interview responses was analyzed by two independent reviewers and coded to create main themes of focus. The inconsistencies were managed by the third senior reviewer.

The major themes prevalent among participants include social stigma, self-advocacy/education, logistical barriers and feeling stuck with previous treatments.Throughout the interviews, participants indicated that the use of ketamine and their mental illness diagnosis were stigmatized. Some kept their treatment a secret from family members while others reported telling very few colleagues about their PTSD. In response to traumatic events at work, one participant explained that the prevalent attitude was “Suck it up. Move on.” The lack of administrative support prompted several participants to teach themselves about psychedelics and mental health in order learn about treatment possibilities. Logistical barriers included barriers to physically commuting, paying for and having time away for the KAT sessions. They pointed out that aside from the price of the treatment itself, paying for cabs and ferries adds to the costs. Each of the participants detailed their journey with trauma and mental illness before KAT. A common sentiment expressed was that they couldn’t cope anymore with symptoms like night terrors and extreme anxiety. Participants discussed a gradual build-up and burnout, as one explained, “You continually are always going to other trauma calls, so it kind of builds up layer, layer, layer after layer.” A reoccuring theme in their experiences was trying different treatment modalities (EMT, EMDR and CBT) with little permanent success.

Greater funding, awareness and administrative support is needed for firefighters diagnosed with PTSD to successfully receive and undergo treatment.

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The Ross procedure offers several advantages for adolescents requiring aortic valve replacement, but progressive pulmonary autograft dilation is a well-described risk. To provide novel insight into the pre-Ross histology in an adolescent with bicuspid aortic valve (BAV)-associated aortopathy, we describe the extracellular architecture of the pulmonary artery (PA) compared to the native ascending aorta.

A 15-year-old with BAV, symptomatic moderate aortic insufficiency and aortic stenosis, and ascending aortic dilation underwent Ross. Intraoperative specimens included the main PA and ascending aorta. Tissue specimens were fixed, stained using 1) haematoxylin and eosin, 2) Verhoeff’s van Gieson, and 3) trichrome, and compared using light microscopy.

Elastin van Gieson stain revealed that the aortic media in the dilated ascending aorta contained a greater concentration of dense elastin weaves and a regular distribution of collagen compared to the PA. In contrast to the dense and organised compaction of elastic fibres in the media of the aortic specimen, the PA, though grossly normal, demonstrated extensive disruption and fragmentation. Trichrome staining revealed minimal fibrosis in both specimens.

Notable pre-Ross histological differences include marked disruption of elastin in the PA compared to the aorta. Age-based differences in Ross outcomes suggest that adolescents may experience proportionally more significant autograft dilation over time, so future studies should include prospective collection and histological analysis of specimens across the age spectrum, both pre- and post-Ross, to allow comparison to age-matched controls.

Prolonged symptoms of SARS COV2 infection known as Long COVID, are defined as symptoms persisting for more than four weeks after the initial diagnosis of COVID-19. Psychiatric symptoms such as anxiety, depression, cognitive deficits, fatigue, qualities poor sleep and somatic symptoms are common in patients with long-term COVID and could last weeks, even months, after recovery.

In this study, we tried to identify the psychiatric symptoms that can start after infection with SARS COV2, what could be the risk factors for the onset of these symptoms and how the quality of life is affected in these patients.

The study included 116 patients diagnosed with COVID-19 in the Suceava County Clinical Hospital, who were monitored for 12 months by applying standardized questionnaires for depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7) and cognitive disorders. (Montreal Cognitive Assessment), patients being periodically evaluated clinically, biologically, neurologically and psychologically.

A percentage of 26.9% of patients presented the following psychiatric symptoms more than 4 weeks after the diagnosis of SARS COV2 infection: anxiety (6%), sleep disorders (7.7%) manifested by insomnia or hypersomnia, lack of concentration and attention (10.3%), memory disorders (8.6%), depression (4.3%). The most frequent psychiatric manifestations were cognitive disorders (10.3%) expressed by deficits in attention and memory, followed by sleep disorders (7.7%). Women presented a higher percentage of psychiatric manifestations manifested by anxiety and depression, but we did not find a correlation between the age of the patients and the mental manifestations after COVID-19. The 2 patients with depression in the antecedents, presented an exacerbation of mental symptoms post COVID. Depression and anxiety were more frequent in patients who had prolonged hospitalizations or moderate and severe forms of the disease. In 12 patients who presented cognitive disorders, increased values of C-reactive protein and lactic dehydrogenase were found during SARS COV2 infection. The use of questionnaires showed an important impact on the quality of life, especially in patients diagnosed with depression, anxiety and insufficient sleep.

Recognition and treatment of psychiatric symptoms that started after SARS COV2 infection should be included in the management of the patient with chronic COVID. The use of screening questionnaires for depression, anxiety and cognitive disorders must be implemented in the current practice of post-COVID-19 monitoring. The collaboration between infectious disease specialist, psychiatrist and psychologist can be the key to success in the treatment of psychiatric disorders in patients with long-term COVID.

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This study investigates the predictive value of ferritin, CRP, and BMI levels in predicting COVID-19 outcomes among psychiatric patients.

Understanding these markers is crucial given the increased vulnerability of psychiatric patients to severe COVID-19 outcomes.

We conducted a retrospective analysis of 100 psychiatric patients diagnosed with COVID-19. We collected clinical outcomes (survival or death) data, demographic characteristics, and comorbidities. Blood samples were analyzed for ferritin and CRP levels, and BMI was calculated based on recorded weight and height. Statistical tests, including t-tests and chi-square tests, were used to assess the relationships between these variables and COVID-19 outcomes. Survival analysis was performed using the Log-Rank test to evaluate the impact of these markers on patient survival.

Our results showed that higher ferritin levels were significantly associated with poorer outcomes, with survivors having a mean ferritin level of 246.2 (SD = 150.3) compared to 416.9 (SD = 215.9) in non-survivors (p < 0.001). Similarly, mean CRP levels were lower in survivors (1.58, SD = 1.96) compared to non-survivors (3.46, SD = 2.92) with a p-value of 0.002. BMI did not show a statistically significant difference between survivors and non-survivors (p = 0.429). Survival analysis revealed that elevated CRP and ferritin levels correlated with decreased survival rates.

The study highlights the significant role of ferritin and CRP as prognostic markers in psychiatric patients with COVID-19, suggesting that elevated levels of these biomarkers are associated with worse outcomes. However, BMI did not significantly affect survival, indicating that inflammatory markers might be more relevant for assessing prognosis in this population. These findings emphasize the need for vigilant monitoring of these biomarkers in psychiatric patients to manage their COVID-19 treatment better and improve outcomes.

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Individuals at high familial or genetic risk of cancer face unique psychological challenges that can lead to significant distress, including worry, fear, and uncertainty about their future health and family members’ risk. This study assessed mental health challenges, including anxiety and depression, in this population and explored their preferred forms of psychological support.

To examine the prevalence of psychological distress in individuals at high hereditary cancer risk, the relationship between their current perceived support and distress, and preferred psychological support forms to inform the development of tailored mental health services.

Participants (N = 152; 95% female, 3% male, 2% non-binary; mean age = 42.6 ± 8.3) were cancer-free residents of the Republic of Ireland identified as high-risk for hereditary cancer through high-risk clinic attendance or self-reported genetic screening or family history. They completed a cross-sectional survey using standardised mental health assessments, including Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9), and self-reported adequacy of psychological support and preferences. Descriptive statistics and post-hoc tests were used to analyse psychological distress, support adequacy, and preferences.

Moderate to severe anxiety (GAD-7 ≥10) was reported by 23%, and moderate to severe depression (PHQ-9 ≥10) by 18%. Participants reporting inadequate support had significantly higher anxiety (M = 8.1 ± 6.2) and depression (M = 6.4 ± 5.7) scores than those with adequate support (GAD-7: M = 4.2 ± 3.9; PHQ-9: M = 3.6 ± 3.9). ANOVA indicated significant differences in anxiety (F (2,132) = 7.04, p = .001) and depression (F (2,130) = 4.68, p = .011) scores across support levels. Post-hoc Tukey tests showed poorer mental health for those without support (p < .001 for anxiety; p = .013 for depression). Mental health professionals (psychologists and counsellors) were the top preferences for support, chosen by 74.8% of participants, with 47.5% selecting a psychologist and 27.3% a counsellor. An additional 12.2% preferred a healthcare professional (e.g., General Practitioner or nurse).

This study provides important insights into the mental health challenges faced by individuals at high hereditary cancer risk, particularly those lacking adequate psychological support. Participants reporting inadequate support experienced significantly higher levels of anxiety and depression. These findings highlight the importance of ensuring adequate psychological support services for this population and their strong preference for professional psychological care. Integrating this care into routine genetic counselling and oncology services could help to address the unmet mental health needs of this underserved population.

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Gender dysphoria (GD) is defined by the presence of clinically significant suffering associated to the marked incongruence between the experienced gender and the one which was assigned at birth. The inherent duplicity to the human condition forces us to reflect on the fact that, in some cases, the body may be the most intimate piece of the Self, whilst also being the most foreign one. The experience of feelings of shame and hatred for oneself and the importance of the Other’s gaze are pressing in GD, which presents as deeply impactful in the individual’s functioning.

This review aims to identify and explore the phenomenology of the suffering so often mentioned by GD patients, but which has been ignored and remains mainly unidentified in the psychopathology realm.

Through the exploration of both the PubMed database and publications by philosophers who have been, throughout the years, approaching the gender theme and distinguishing its evolution along the years, I aim to review the qualitative literature available of the dissection of the different domains of GD.

GD is an ever growing psychiatric diagnostic, frequently presenting with psychiatric comorbidities. Its treatment poses as highly effective, while its consequences may be pervasive and affecting different domains of the individual’s functioning. The exploration of gender identity may be a never ending journey, which makes the acknowledgement of the associated psychopathology fundamental in the design of a truly empathic relationship with these patients.

None Declared

Obsessive-compulsive disorder (OCD) in children and adolescents presents similarly to that in adults, but with some particularities. In children, the most common obsessions are usually related to fears of contamination, harm to others, or catastrophic situations. The compulsions associated are often: excessive hand washing, repetitive checking, and the need for order.

Treatment of OCD is based on both pharmacological measures and psychological therapies. At the pharmacological level, it focuses on the use of selective serotonin reuptake inhibitors (SSRIs). In terms of psychological treatment, cognitive behavioural therapy (CBT) is the psychotherapeutic intervention of first choice for the treatment of OCD, and is considered the most effective intervention, both in monotherapy and in combination with pharmacological treatment. Within CBT, the most effective is Exposure with Response Prevention (ERP).

To present the adaptation of the different therapeutic interventions so that they are effective when applied to children, through a clinical case of a 10-year-old child with OCD.

Our patient first came to the emergency department due to intense anxiety, secondary to obsessive thoughts about suicide and sexual identity. Due to the incoercible anguish caused by these egodystonic thoughts and the secondary low mood, he was admitted to hospital. At the pharmacological level, sertraline was progressively administered up to a dose of 100mg/day and psychoeducation was provided. Despite the initial improvement in anxiety and hospital discharge, after a couple of weeks there was a further worsening, which persisted despite increasing the dose of sertraline. In successive outpatient consultations, psychoeducational intervention and review of confrontation techniques were carried out. The patient began with clinical symptoms typical of hypomanic turn, so SSRIs was lowered back to the initial dose, and aripiprazole 5mg was added. The importance of CBT was emphasised, teaching the parents to practice it daily with their child. In the next visits, psychotherapy work continued in the form of role-play, explaining the difference between distraction and confrontation, lowering the SSRI to 50mg and maintaining aripiprazole. Clinical stabilisation was achieved and has been maintained since.

We see with this case that pharmacological treatment, although necessary to obtain changes at the neuro-biological level, is not sufficient for clinical remission, and that intensive psychotherapy is the cornerstone of the intervention

In conclusion, in the treatment of childhood OCD, the combination of pharmacological and psychological interventions is essential. Although pharmacological treatment is important, it alone does not always guarantee complete remission, highlighting the need for a comprehensive therapeutic approach to achieve sustained results over time.

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Complex post-traumatic stress disorder (cPTSD) is a recently recognized condition characterized by the combination of core PTSD symptoms—re-experiencing, avoidance, and hyperarousal—alongside disturbances in self-organization (DSO), which include affective dysregulation, negative self-concept, and interpersonal difficulties. Emerging evidence suggests that these complex symptom domains not only lead to greater functional impairment compared to PTSD but are also closely associated with the onset of psychotic-like experiences (PLEs). PLEs, which encompass subthreshold cognitive and perceptual anomalies such as hallucinations and delusional thinking, are increasingly viewed as critical indicators of vulnerability to more severe psychopathological outcomes. Given the developmental vulnerability during adolescence, the intersection of cPTSD and PLEs during this period is of significant concern, particularly as it may signal the emergence of broader psychopathological trajectories.

The primary aim is to identify the key cPTSD symptoms driving the comorbidity with PLEs in adolescents using two different network analysis approaches. We indeed seek to clarify what symptoms explain are modt central in the relatioship between PTSD/cPTSD and PLEs and elucidate the directionality of these symptom relationships. We finally aim to also explore whether gender moderates these associations within the network structures. We hypothesize that cPTSD symptoms are central in understanding the relationship between trauma and PLEs.

A group of 1,010 late adolescents was assessed for post-traumatic symptoms and PLEs. The study involved estimating the Gaussian Graphical network structure for PTSD/cPTSD symptoms and PLEs, examining their bridge centrality indices. Subsequently, a Bayesian network analysis was conducted to create a directed acyclic graph (DAG). Gender was considered a moderator in both the Gaussian and Bayesian models.

Findings revealed that affect dysregulation, a domain of cPTSD, had the strongest connection with the PLEs cluster. The Bayesian network analysis showed a pathway linking cPTSD symptoms of worthlessness and interpersonal difficulties to PLEs symptoms like paranoia and social anxiety. Additionally, gender differences were observed in both network models.

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The study emphasizes the pivotal role of affect dysregulation and a negative self-concept in associating cPTSD with PLEs, highlighting gender-specific differences. These results point to the importance of gender-sensitive strategies in preventing and treating PLEs in adolescents, stressing the need for early intervention and customized treatment plans.

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In the Cognitive-Behavioral Conceptualization of Complicated Grief, avoidance strategies toward bereavement-related stimuli contribute to the development and maintenance of prolonged grief. Traumatic events, such as bereavement, often lead to intrusive negative thoughts and evoke painful emotions. For individuals experiencing prolonged grief, avoidant coping can deteriorate their symptoms. Deliberate rumination on the loss, as an active information-processing strategy to understand and find meaning in the traumatic experience, may promote adaptation to life after the loss.

This study aims to examine the impact of prolonged grief on approach-avoidance behaviors and to evaluate the effects of a deliberate rumination intervention.

Data were collected from 41 Korean adults aged 18 and above, who had experienced bereavement at least 12 months prior. Participants were randomly assigned to either a deliberate rumination intervention group (n=21) or a distraction intervention group (n=20). The Approach-Avoidance Task (AAT) was used to measure implicit approach-avoidance behaviors toward bereavement-related and neutral stimuli in each group, with assessments conducted both before and after the intervention.

The study results revealed no significant differences in approach-avoidance tendencies according to the level of prolonged grief for both bereavement-related and neutral stimuli. However, a significant interaction effect between group and time of measurement was observed for bereavement-related stimuli [F(1,39)=4.431, p<.05], but not for neutral stimuli [F(1,39)=.424, n.s.].

Although this study did not identify significant avoidance tendencies according to prolonged grief levels, it experimentally showed that deliberate rumination influences avoidance strategies among individuals experiencing prolonged grief. This finding implies significance in suggesting effective intervention approaches for those with pathological grief.

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Facial emotion recognition is a fundamental component in social interaction. Facial emotion recognition is disturbed both in women with Premenstrual Dysphoric Disorder (PMDD), and in those with a history of childhood trauma. PMDD affects up to 5% of women of childbearing age, exert influence on women’s recognition of emotions, and on the emotion recognition processing. Women with PMDD are more likely to have a history of childhood trauma.

To explore whether there is a link between a history of trauma and the perception of emotions in women with PMDD. We hypothesize that women with PMDD and a history of childhood trauma will show larger deficits in emotion recognition compared to women with PMDD but without a history of childhood trauma.

Data were derived from a sample of forty women diagnosed with PMDD (18-30 y.o., right handed, educational level >9y., regular cycle duration), who have visited Mental Health Centre of Rethymno (participants completed the Premenstrual Syndrome Questionnaire). The participants completed the Childhood Trauma Questionnaire (CTQ), which measures five types of maltreatment experiences. Three types are related to abuse (physical, sexual and emotional) and two to physical and emotional neglect. The Emotion Recognition Task (ERT) was also administered. ERT is a computer-generated paradigm for measuring the recognition of six basic facial emotional expressions: anger, disgust, fear, happiness, sadness, and surprise. During this test, video clips of increasing length are presented.

The majority of the participants (82.5%) reported a history of maltreatment during childhood. Women without trauma, when they completed the ERT did not show any significant emotion dysregulation. On the contrary, maltreated women, especially physically or sexually abused, had a distorted perception of emotions expressed on adult faces. Happiness is less detected, whereas fear and anger are recognized more rapidly and at a lower intensity compared to women not exposed to childhood trauma. The higher the score in abuse, the higher the emotion dysregulation is.

The main conclusion of this study contributes to the current knowledge on the link between the long-term effects of childhood trauma both to PMDD and to emotion dysregulation. Women with PMDD are more likely to have a history of childhood trauma, which is associated with poorer performance in facial emotion recognition. Trauma, however, is a treatable factor with. Therefore, interventions targeting both to heal trauma and to promote adaptive emotion regulation strategies, could be encouraged to improve the capability of women with a history of childhood trauma to challenge premenstrual symptoms.

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