Feigning is defined as “to represent falsely; to imitate so as to deceive” (McDermott et al. Int J Law Psychiatry 2013; 36:287-92). Malingering and dissimulation are subtypes of feigning: malingering involves intentionally producing symptoms for incentives (World Health Organization. ICD-11 2022), while dissimulation involves concealing symptoms to appear mentally well (Caruso et al. J Am Acad Psychiatry Law 2003; 31:444-50). The prevalence of feigning illness remains uncertain, and varies with context and incentives. Within the legal context, 17.5% feign incompetence to stand trial and 64.5% to plead not guilty by reason of insanity. Malingering has been reported in up to 56% of general offender samples (McDermott et al. Int J Law Psychiatry 2013; 36:287-92). In the public setting, the malingering prevalence constituted 30% of disability evaluations, 29% of personal injury evaluations, 19% of criminal evaluations and 8% of medical cases (Mittenberg et al. J Clin Exp Neuropsychol). In 2006, malingering resulted in approximately $150 billion in annual expenses for the US insurance industry (Mason et al. Perspect Psychiatr Care 2014; 50: 51-7).

To explore the challenges in differentiating psychiatric illness from feigning.

This case involves analysing the patient’s history, collateral information, and diagnostic interviews to distinguish psychiatric pathology from feigned symptoms.

A 31-year-old male with a history of paranoid schizophrenia, whose recent psychiatric admission was prompted by psychosis and charges of serious assault, property damage, and possession of a weapon. The admission raised suspicions of symptom feigning and patient wariness of the psychiatric stigma. Despite four years of engagement with mental health services (MHS), the patient disclosed shortly after admission that he had been feigning his symptoms to obtain an insanity plea, but now hopes to return to prison seeking a more favourable environment and the certainty of a confirmed guilty sentence. Collateral information from the community MHS and family members suggested underlying psychiatric concerns and manipulative tendencies of the patient, complicating the diagnosis and raising the possibility of dissimulation.

The case highlights the challenges of distinguishing genuine psychiatric illness from deceptive behaviour, emphasizing the importance of thorough history-taking, understanding symptom pathology, using diverse interview techniques, gathering collateral information, and conducting psychological assessments. Clinicians must carefully distinguish feigning from true pathology to provide accurate diagnoses, ensure proper treatment, reduce costs, and safeguard public safety.

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Autism spectrum disorder (ASD) is characterized by communication challenges, particularly in non-verbal aspects such as facial expressions.Research in this area is limited due to the lack of accurate methodologies. Existing literature generally agrees that individuals with ASD often show a disconnect between verbal communication and emotional expression, with facial expressions being diminished or inappropriate. Most studies have relied on ratings by highly trained observers, which can reduce accuracy and introduce biases, such as confirmation bias.

Our goal was to create a model for capturing and analyzing facial expressions using computer algorithms and assess its effectiveness in identifying individuals with ASD.

The study involved 100 participants, divided into two groups based on ASD diagnosis. The ASD group included 73 individuals, 51 (69.8%) of whom were male, while the control group comprised 27 participants, with 16 (59.2%) being male. ASD diagnoses were made by a specialist child and adolescent psychiatrist using developmental history and mental state examinations, confirmed with the ADOS-2 protocol. In the control group, ASD was ruled out using the same protocol. A significant age difference was found between the ASD group (mean age: 14 years; 95% CI: 13.5-14.5) and the control group (mean age: 16.3 years; 95% CI: 15.2-17.5), according to the Mann-Whitney U test.

All participants completed three tasks: a semi-structured conversation, recognizing facial expressions displayed on a screen, and imitating these expressions. Throughout the tasks, participants’ faces were recorded using five cameras positioned around them. Faces were then detected in the images using a sliding window algorithm in a multi-resolution representation of the Gaussian pyramid utilizing a linear classifier based on the Support Vector Machine (SVM) with a classical Histogram of Oriented Gradients (HOG) descriptor. An Ensemble of Regression Trees was applied to these detected faces to model facial landmarks in each frame. Using these landmarks, anthropometric distances and proportions were calculated, which were then used to train the SVM classifier.

The obtained model was able to predict the diagnosis of ASD in the study population with almost 100% accuracy. The mean difference between the probability of the correct class and the probability of the incorrect class determined by the SVM on the test set was 56%.

This method of facial expression analysis using an SVM classifier shows potential as a tool for diagnosing ASD. The technique could be applied using smartphones. However, further research is needed to evaluate its clinical viability, particularly when using non-standard devices. These findings also support the hypothesis that individuals with ASD display facial expressions significantly differently from neurotypical individuals.

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It is well established that living, or growing up, in poverty has a negative impact on both physical and mental health. The area our service covers includes Great Yarmouth and Lowestoft, 2 of the most economically impoverished areas of the UK. The vast majority of our patient group will have grown up in relative poverty. While there are associations between poverty and impaired physical health and increased risk of some mental health conditions, the actual causal link is unclear.

To explore if there appears to be a link between growing up in poverty and developing a significant mental illness.

Data anlaysis from Consultant caseload list.

We do know that there are some factors associated with both poverty and increased risk of mental illness and these include;

• - Parental drug or alcohol abuse

• - Parental mental health problems (if these are not well managed)

• - Early/premature death of a parent

• - Exposure to domestic violence

• - Physical abuse

• - Going into the Care System

• - Early drug or alcohol use

• - Early separation or loss of a parent

Findings

Total number of patients = 122

Number who have a specific factor associated with poverty =56

This equates to 46% of my current caseload.

Gender =35 female (62.5), male 21 (37.5%)

Summary of Findings – “The poor bear the greatest burden of mental illness” (2)

This would certainly seem to be the case, from the findings of this service evaluation. Our findings show that a significant percentage of our patient group have mental health issues directly related to poverty.

It is worth noting that the vast majority of my patient case load grew up in poverty, due the demographics of the area we work in (a quick analysis suggests about 97% of my case load are from working class, impoverished backgrounds). We abandoned recording “parental unemployment” in this analysis, because for all but a few, this was the case. Unemployment is an entrenched issue in this area, with the demise of the shipping and offshore industries, currently standing at 5.4% in Yarmouth and 3.5% in Lowestoft (3) (National average 3.8%). For those that are employed, poverty is a significant issue with many in low paid jobs. I have also not included here factors associated with poverty, such as poor diet, smoking, malnutrition, poor dentition, and obesity, but we know these are the case for many patients seen here.

None Declared

Interpersonal traumas affect women’s ability to rely on their social network to cope, which increases their reliance on maladaptive avoidance coping strategies such as drinking. According to psychodynamic models of trichotillomania hair pulling is a manifestation of unresolved sexual conflicts, disordered attachment, and dissociation from traumatic memories. (Houghton, D. C., Mathew, A. S., Twohig, M. P., Saunders, S. M., Franklin, M. E., Compton, S. N., Neal-Barnett, A. M., & Woods, D. W. (2016). Trauma and trichotillomania: A tenuous relationship. Journal of Obsessive-Compulsive and Related Disorders, 11, 91-95.)

Evidence suggests that rather than making hair pulling worse, alcohol is often used to avoid negative affect related to hair pulling. It slows the nervous system’s activity and may also be used to reduce the urge to hair-pull. (Grant, J.E., Collins, M., Chesivoir, E. et al. Hazardous Alcohol Use in Trichotillomania. Psychiatr Q 94, 361–369 (2023))

We present a 43-year-old patient who has been hospitalized several times due to alcohol addiction. She is divorced, has no children, is unemployed, and finished elementary school. The patient reported that she started drinking at high school during weekend parties and gradually her drinking became more frequent. Now she is drinking a liter of vodka a day. Her last hospitalization was after she left a domestic violence shelter for women where she escaped because her partner abused her. After she was placed in the alcoholism ward, the initial psychic examination discovered alopecia. Childhood anamnesis showed sexual trauma at a young age, and she reported that she started to pull her eyelashes in kindergarten after two members of a family sexually abused her. Now she is wearing a wig and she reported that there are areas on her scalp where hair doesn’t grow anymore because she pulled it while she was in a shelter. As she described, pulling her hair gave her a sense of relief from anxiety.

During hospitalization, her pharmacotherapy was corrected and titrated. She was included in psychotherapy, family therapy, group, and individual psychotherapy. The therapeutic procedures applied have improved her mental condition. She has been advised to continue outpatient psychiatric treatment, to regularly use pharmacotherapy, and to attend family therapy and rehabilitation club.

There is a clear need for future clinical studies not only in the area of trichotillomania’s relationship to substance use disorders but also in trauma coping mechanisms so we can truly understand how people adapt to and recover from trauma.

None Declared

Reduced ability to make adequate decisions significantly affects the daily functioning and social adaptation in depressive patients. Neurophysiological bases of reduced efficiency of decision-making based on both logical reasoning and emotional processes are not sufficiently studied.

The aim of the study was to search for possible links between signs of decision-making efficiency and EEG parameters in depressive patients.

The study involved 48 depressive female in-patients (F31.3-4, F34.0, by ICD-10), aged 16-25 years (mean age 18.4 ± 2.6). To assess the decision-making process, computer versions of the Wisconsin Card Sorting Test (WCST) and the Iowa Game Task (IGT) were used. Multichannel resting EEG recordings with spectral power analysis were performed at the same visit before the start of treatment. The rank correlation analysis (Spearman) was used for statistical data processing.

In WCST test, negative correlations (p<0.05) were found between the “percentage of conceptual level responses”, and the spectral power values of beta1 (13-20 Hz), beta2 (20-30 Hz) in the central and posterior areas, and theta1 (4-6 Hz) in anterior areas of the cerebral cortex. Delta (2-4 Hz) activity values in the left frontal areas positively correlated with the WCST parameters “number of moves spent on completing the first category”, “number of perseverations on the previous move”, “number of moves” and “test completion time”. Thus, patients complete the task longer and less effectively with frontal hypoactivity and increased activation of the posterior areas of the cortex that reflects a violation of the brain’s inhibitory mechanisms. In the IGT test, positive correlations (p<0.01) were revealed between the number of choices of the “bad” deck (A) and both “bad” decks (A and B), as well as negative correlations between the preference for “good” (C and D) over “bad” (A and B) decks in the second half of testing and the values of the alpha2 (9-11 Hz) spectral power in the anterior areas of the left hemisphere. The preference for “good” over “bad” decks on moves 40–60 negatively correlated with the values of alpha3 (11-13 Hz) and beta2 (20-30 Hz) in the right frontal and central areas. Thus, decision-making deficit in the IGT was associated with a relative decrease in the activation of the anterior regions of the left hemisphere and hyperactivation of the right hemisphere.

In depressive patients, impairments in the logical reasoning task (WCST) are associated with hypofrontality while impairments in the emotional learning task (IGT) − with disbalance of hemispheric activation, namely with hypoactivation of the frontal regions of the left hemisphere and increased activation of the right hemisphere.

None Declared

Studies have shown that postpartum women are more affected by sleep disorders than women who have not given birth. Reasons for sleep disturbances include insufficient sleep time, poor sleep quality, and postpartum depression. Having a sleep disorder has a negative effect on the formation of a close relationship between mother and child.

To determine the level of insomnia in postpartum women and study the correlation.

The study will be conducted by women who agreed to sleep disorder detection questionnaires specially prepared by the World Health Organization for doctors in primary health care institutions. The results of the research parameters were statistically processed using Microsoft Word 2016, Microsoft Excel 2016, and SPSS 26 programs.

Of the 100 women who participated in the study, 25% had no insomnia, 48% had mild sleep disorders, 27% had sleep disturbances, 23% had no stress, 42% had moderate stress, and 35% had high stress. 16% of women aged 20-24 have no insomnia, 72% have mild sleep disorders, and 12% have sleep disorders. 23.8% of women aged 25-29 have no insomnia, 47.6% have mild sleep disorders, and 28.6% have sleep disorders. 25% of women aged 30-34 have no insomnia, 40% have mild sleep disorders, and 35% have sleep disorders. 45% of women aged 35-39 have no insomnia, 20% have mild sleep disorders, and 35% have sleep disorders. 0% of women aged 40-44 have no insomnia, 70% have mild sleep disorders, and 30% have sleep disorders. 50% of women aged 45-49 have no insomnia, 25% have mild sleep disorders, and 25% have sleep disorders. 35% of women with children aged 0-3 months have no insomnia, 35% have mild sleep disorders, and 30% have sleep disorders. 15% of women with children aged 4-6 months have no insomnia, 50% have mild sleep disorders, and 35% have sleep disorders. 35% of women with children aged 7-9 months have no insomnia, 45% have mild sleep disorders, and 20% have sleep disorders. 15% of women with children aged 10 months to 1 year have no insomnia, 50% have mild sleep disorders, and 35% have sleep disorders. 25% of women with 2-year-old children have no insomnia, 60% have mild sleep disorders, and 15% have sleep disturbances.

As mothers age, insomnia rates increase, stress levels decrease, and postpartum depression rates increase. As children age, sleep deprivation rates decrease, stress levels decrease, and postpartum depression rates decrease. As maternal fertility increases, insomnia rates decrease, stress levels decrease, and postpartum depression rates decrease. Insomnia, stress, and postpartum depression are also affected by living conditions.

None Declared

Work-related stress significantly impacts employees’ overall health and can lead to unhealthy lifestyle behaviors, such as poor diet, lack of physical activity, and inadequate sleep.

This study aimed to explore the potential link between occupational stress and different lifestyle behaviors among workers in different companies in Sousse, Tunisia.

A cross-sectional study was conducted over a three-year period in Sousse, Tunisia, involving employees from various workplace settings. Data were collected using a pre-established questionnaire that assessed sociodemographic characteristics, health-related behaviors—including sleep quantity and quality, cigarette smoking, alcohol consumption, physical activity (measured with the Global Physical Activity Questionnaire), and eating habits—as well as occupational characteristics. Occupational stress was evaluated using a validated Arabic version of the Karasek scale. Binary logistic regression was employed to calculate adjusted odds ratios with 95% confidence intervals.

The study included 154 participants, predominantly female (56.5%), with a mean age of 39.99 ± 9.91 years. Approximately 34.6% had 11 to 20 years of seniority. Job strain and iso-strain were reported by 31.8% and 25.5% of workers, respectively. Job strain prevalence was observed in 32% of smokers, 41% of alcohol users, 40 % among those who do not meet the recommended levels of physical activity. In terms of sleep quality, 29.9% indicated poor sleep. Notably, our study revealed a significant association between job strain and good sleep quality (aOR=6.14; CI95%:1.72-21.95, p=0.005).

These findings highlight a concerning prevalence of unhealthy lifestyle behaviors among workers in Sousse, Tunisia, with significant associations between occupational stress and sleep quality. Addressing these issues through workplace wellness programs may enhance employee health and overall job satisfaction.

None Declared

The postnatal period is a time of great vulnerability in terms of mental health, with depression being one of the most common complications. This condition can significantly affect how women perceive and process the pain and stress associated with childbirth. Pain experienced during pregnancy and postpartum is linked to psychological distress, often influenced by pain catastrophizing a cognitive tendency to dwell on, magnify, or feel helpless in the face of pain. To manage these challenges, many women rely on coping mechanisms to navigate the significant stressors of this period.

The aim of this study is to explore the relationship between postpartum depression, pain catastrophizing, and coping mechanisms in the postnatal period.

We conducted a cross-sectional descriptive and analytical study targeting women in their first week postpartum who had been admitted to the gynaecology-obstetrics department of the Hedi Chaker University Hospital in Sfax, Tunisia. The study was conducted over a three-month period (October, November and December 2023). We used the Tunisian Arabic version of the Edinburgh Postnatal Depression Scale (EPDS). Pain catastrophisation was assessed using the pain catasrophizing scale (PCS). We used the French version of the coping scale Ways of coping checklist revised (WCC) to evaluate coping strategies.

The study included 220 postpartum women with a mean age of 31.1 ± 6.6. Psychiatric history was recorded in 5.5% of participants, predominantly bipolar disorders (4.1%). Medical or surgical history was reported by 14.1% of women. Among the participants, 28.6% were primiparous, and 71.4% were multiparous. A history of child loss was noted in 4.5% of cases. Spontaneous labor occurred in 65.5% of women, while 17.7% underwent induced labor. Vaginal deliveries were performed in 56.4% of cases, with forceps used in 8.2%. Postpartum recovery was uncomplicated for 86.4% of participants, while complications occurred in 13.6% of cases. Postnatal care was provided by family members for 55% of women. Postpartum depression was observed in 20.9% of participants.The average score of Pain Catastrophizing Scale (PCS) was 24 ± 11, and problem-focused coping was the most frequently employed strategy, with a mean score of 26.51 ± 6.3.

Women with postpartum depression had significantly higher PCS scores (p<0,001). Emotion-focused coping was the predominant strategy used by this group (p=0.003). Conversely, women without postpartum depression were more likely to use problem-focused coping (p<0.001) and social support-based coping (p=0.011).

This study reveals that postpartum depression is associated with higher pain catastrophizing and a greater use of emotion-focused coping. In contrast, women without depression tended to use problem-focused and social support-based coping, suggesting that these strategies may help mitigate postpartum psychological distress.

None Declared

Psychiatric patients, particularly those with severe mental illness, face an elevated risk of cardiovascular disease. This heightened risk stems from a combination of factors, including the effects of antipsychotic medications, unhealthy lifestyles, and socioeconomic disadvantages. Addressing cardiovascular risk in this population requires tailored approaches that consider both medical and mental health aspects. Traditional cardiovascular risk prediction models, such as SCORE2, often fail to accurately assess cardiovascular risk in psychiatric patients.

This non-systematic review aims to evaluate the evidence behind the use of cardiovascular risk prediction models in patients with mental illness, assessing their applicability and limitations.

Relevant and recent studies or reviews were selected from the PubMed electronic database using search terms related to cardiovascular risk prediction and mental illness. Articles were chosen based on their relevance to psychiatric populations and their focus on prediction models.

Recent cardiovascular risk prediction models, such as PRIMROSE and QRISK3, incorporate factors like the presence of severe mental illness, antipsychotic and antidepressant use, and lifestyle factors (smoking and alcohol consumption). These models are more effective than general population models in predicting cardiovascular events in psychiatric patients. Interventions based on these models, particularly pharmacological strategies such as the use of statins and metformin, have been effective in managing lipid levels and reducing cardiovascular risk in this population.

Psychiatric patients are at a significantly increased risk of cardiovascular disease, warranting early intervention and consistent monitoring. Tailored risk assessment models can significantly improve cardiovascular outcomes by guidind pharmacological intervention. Further studies are needed to improve and validate the available prediction models.

None Declared

While the immediate physical health consequences of hypertensive disorders during pregnancy are well-documented, their potential impact on children’s mental health and cognitive outcomes remains relatively under-investigated. Research exploring the link between hypertensive disorders during pregnancy and cognitive function has yielded conflicting findings. Some studies report associations, while others fail to establish a link or even suggest a protective effect. Many of these studies have focused on children with intrauterine growth restriction, low birth weight, small for gestational age, and/or preterm births—factors already known to influence cognitive development. Furthermore, almost all of this research focuses on early childhood, leaving a critical gap in our understanding of the long-term effects into adolescence, a period characterised by rapid cognitive development and academic achievement.

This study aimed to examine the associations between hypertensive disorders during pregnancy and intelligence quotient (IQ) in children at the ages of 8 and 16 years.

Our study sample comprised participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort, an ongoing population-based longitudinal birth cohort in Bristol, Avon, United Kingdom. Children’s IQ was measured using the Wechsler Intelligence Scale for Children (WISC-III). This study included over 4900 and 3300 mother-child pairs at ages 8 and 16, respectively. Binary and multinomial logistic regression analyses were used to estimate odds ratios for the associations.

Hypertensive disorders of pregnancy (gestational hypertension and/or pre-eclampsia) were not found to be associated with lower IQ scores in children at ages 8 and 16. In the multinomial logistic model, we found children born to mothers with gestational hypertension but not pre-eclampsia were more likely to have above-average IQ at age 16 compared to average IQ children born to mothers without gestational hypertension (OR = 1.42; 95% CI: 1.03 – 1.94). This association did not persist when children with below-average IQ were used as the reference category in the analysis, and no such associations were also observed at the age of 8 years.

Our findings revealed no evidence of associations between hypertensive disorders during pregnancy and lower IQ scores in children ages 8 and 16. The observed association between gestational hypertension and higher odds of having an above-average IQ at age 16 needs further investigation. Our findings were based on a cohort study with a longer follow-up period, offering a higher level of evidence than previous studies. The consistency of our findings across different developmental stages strengthens the validity of our results and suggests that any potential effects of hypertensive disorders during pregnancy on cognitive function may be limited or transient.

None Declared

Treatment motivation is very important in the treatment of alcohol and substance use disorders. The evaluation of motivation, which is seen as the first step in addiction treatment, will also help understand the person’s interest and compliance with treatment. The lack of motivation of the person during the treatment process causes treatment abandonment and relapses.

An important issue in the treatment of alcohol use disorder is the trust of the person in the treatment. It is also important for the addict to have someone around him who has benefited from treatment, which is very important in terms of treatment compliance. With the influence of a person who has benefited from addiction treatment, the likelihood of applying for treatment and benefiting from treatment increases in a “snowball” manner.

The aim of this study was to evaluate whether people who are treated for alcohol use disorder have a treatment motivation for those around them. It was aimed to examine whether the people who have been treated are important in increasing the trust in treatment for other patients.

The study included cases who applied to the Seferihisar State Hospital Psychiatry Outpatient Clinic with complaints of alcohol use. The sociodemographic information form was filled out during the individuals’ first applications. The participants were asked whether there were people around them who had received inpatient treatment for alcohol use disorder at the hospital where the study was conducted, and the individuals were then administered the Readiness for Change and Desire for Treatment Scale (SOCRATES), Treatment Motivation Questionnaire (TMQ), and Alcohol Use Disorders Identification Test (AUDIT). The individuals were given the standard treatment recommended in our country’s treatment guidelines for the diagnosis of alcohol use disorder. The individuals participating in the study were interviewed at 1 month, 2 months and 3 months after starting treatment. The individuals’ answers and the decrease in the frequency and amount of alcohol use were recorded.

The rate of treatment attendance is 2.7 times higher for people who have received treatment for alcohol use disorder in their circle.

The rate of treatment confidence in treatment is 4.1 times higher for people who have received treatment for alcohol use disorder in their circle.

The frequency and amount of alcohol use has decreased more for people who have received treatment for alcohol use disorder in their circle.

It has been determined that those who are surrounded by people who have received treatment for alcohol use disorder have higher levels of treatment confidence and compliance. The assistance of these people to those around them can play an important role in increasing the success of addiction treatment.

None Declared

There are clear unmet medical needs in the treatment of Cocaine Use Disorder (CUD), since there are no pharmacological treatments approved. The neurobiological circuitry of addiction has been described in recent years, and it provides a solid rationale to target specific brain regions to treat addictive behaviors, including CUD. The stimulation of the left Dorsolateral Prefrontal Cortex (DLPFC) with repetitive transcranial magnetic stimulation (rTMS) has proved to reduce craving for various drugs, including cocaine.

We present the results of a retrospective study performed in a private setting with 93 patients with CUD, who were treated with rTMS following the protocol from Terraneo et al. In 12 weeks patients received 32 sessions of 2400 pulses (100% MT; 10 Hz; 60 pulses per train, 15 seconds interval; 40 trains per session), for a total of 76800 pulses.

The main outcome was total abstinence of cocaine (self-reported plus urinalysis). Abstinence rates at days 30, 60 and 90 were 55,9%; 40,8%; and 34,4% respectively.

Psychiatric comorbidities (insomnia, depression and anxiety) were also assessed with validated questionnaires. Drop-out was directly related to recent cocaine use, but initial levels of psychological distress did not predict drop-out.

No relevant side effects were reported. Mild and transient headache was reported by a few patients after the first session.

In conclusion rTMS was well tolerated, drop out rates were high and 34% of the patients remained abstinent after the 90 days treatment period.

None Declared

Although the literature suggests a strong association between attention deficit hyperactivity disorder (ADHD) and obesity, the underlying mechanisms remain unclear. Eating attitudes and appetite-regulating hormones (ARH) are considered to play a role in this relationship. Recent studies have shown that ARH may be linked to executive functions, and dysregulation of these hormones may help explain the connection between ADHD and obesity.

We aimed to investigate the levels of ARH, executive functions, eating attitudes, and ADHD symptoms in adults with ADHD compared to healthy controls.

The study included 44 drug-naive non-obese adults with ADHD who had no comorbid psychiatric diagnoses and 44 healthy controls matched for age, gender, education, and body mass index (BMI). All participants were diagnostically assessed using the Structured Clinical Interview for DSM-5 Disorders-Clinician Version. Also, participants completed the Adult ADHD Self-Report Scale, the Mind Excessively Wandering Scale, the Hospital Anxiety and Depression Scale, and the Eating Attitude Test (EAT). A battery of neuropsychological tests—Stroop Test (ST), Cancellation Test, Serial Digit Learning Test (SDLT), Wisconsin Card Sorting Test (WCST), and Judgment of Line Orientation Test (JLOT)—was administered. The serum samples obtained from fasting blood, after centrifugation were stored at -80°C until the time of analysis, at which point ARH levels (insulin, leptin, neuropeptide Y, orexine A, ghrelin, adiponectin) were measured using the ELISA method. The study was approved by Selçuk University Local Ethics Committee with the decision numbered 2023/328.

Adults with ADHD exhibited worse ADHD symptoms, disordered eating attitudes, more severe anxiety and depression, and reduced executive functioning compared to healthy controls. Although ADHD groups showed more disordered eating attitudes compared to healthy controls, there was no significant difference in ARH levels between the two groups; however, these hormone levels were associated with specific parameters from ST, SDLT, WCST, and JLOT. Linear regression analyses to identify factors associated with each ARH separately revealed significant F values, except for ghrelin, which explained a unique variance ranging from 23.5% to 36%. These results indicated that visuospatial ability was associated with each ARH levels, even after controlling for age, gender, years of education, body mass index, severity of disordered eating attitudes, and the absence of an ADHD diagnosis.

Our findings suggest that dysregulation of ARH may associate cognitive processes related to executive functioning independent of disordered eating attitudes, BMI, and ADHD diagnosis. However, these hormones may be mediating factors in relation between ADHD and obesity, and to figure out this relation, longitudinal clinical studies with larger samples are needed.

None Declared

Artificial intelligence (AI) is reshaping mental health care by improving diagnosis, treatment, and patient support. AI-driven tools streamline administrative tasks, enhance clinical documentation, contribute to medical education, and enable continuous symptom monitoring. Additionally, AI augments text-based support programs, offering accessible psychological interventions. However, while AI applications have been assessed for perceived empathy, their impact on clinical outcomes remains uncertain, highlighting the need for evidence-based implementation.

AI can immediately enhance efficiency in routine clinical tasks. Automation optimizes billing processes and reduces clerical burdens, allowing clinicians to focus more on patient care. In clinical documentation, AI-powered transcription and natural language processing (NLP) help generate structured medical records. AI also supports medical education by offering adaptive learning, personalized training, and real-time feedback through large-scale data analysis.

Beyond administrative support, AI plays a role in patient monitoring and early intervention. AI algorithms analyze speech, facial expressions, and behavioral data from smartphones and wearables, detecting mood fluctuations and early psychiatric symptoms. This real-time analysis can facilitate timely interventions and improve overall mental health care. Additionally, AI-powered chatbots and virtual therapists are increasingly used in digital mental health services, providing immediate, text-based psychological support. However, rigorous studies are needed to assess their effectiveness in improving clinical outcomes. A well-established framework for technology evaluation in mental health highlights five key areas for development: equity, privacy, evidence, clinical engagement, and interoperability. Addressing these factors is crucial to ensuring AI-driven solutions are accessible, secure, scientifically validated, clinically integrated, and capable of working across diverse health systems. By prioritizing these advancements, AI can move from theoretical promise to practical application, meaningfully improving mental health care delivery.

None Declared

Infertile patients are more likely to experience psychiatric illnesses than fertile patients, therefore it is important to have early intervention for psychiatric illnesses in infertile patients.

This study aimed to determine the clinical factors affecting psychological distress and quality of life (QoL), and investigate the association between psychological distress and QoL in infertile women.

This was a prospective cohort study of 100 infertile women who voluntarily agreed to participate at their first visit from November 2018 to May 2019. Psychological distress and QoL were evaluated using the 2 questionnaires (SCREENIVF and FertiQoL) specifically designed for infertility.

The prevalence screening positive for anxiety and depression risk were 42% and 29%, respectively. The number of miscarriage and in vitro fertilization (IVF) treatments were significantly associated with helplessness risk factor. Furthermore, women with 2 or more IVF treatments had lower emotional, and mind/body QoL domain scores than women with less than 2 IVF treatments. Regarding the association between the levels of psychological distress and QoL in infertile women, the largest association was observed between helplessness risk factor and mind/body QoL domain (r=-0.795, p < 0.001). Patients with more risk factors for psychological distress had the worse emotional, and mind/body QoL domain scores.

The levels of psychological distress were significantly associated with QoL in infertile women. These psychologically vulnerable infertile women may receive psychological evaluations and interventions from various angles with conventional treatments for infertility.

None Declared

The Global Burden of Disease (GBD) study has generated a plethora of worldwide data on mortality and disability, including the disease burden due to mental disorders, often amenable to interventions, essential for health planning.

This work aims to report the burden of mental disorders in disability-adjusted life years (DALYs), from 2001 to 2021, globally and in the six World Health Organization (WHO) regions.

Retrospective descriptive study, using secondary data from the GBD 2021 Results Tool. Globally and for each of the six WHO regions, age-standardised DALY rates are reported and respective 95% uncertainty intervals, between 2001-2021, for both sexes and for males and females. All data analysis was performed using R version 4.0.5.

In 2021, the both-sex age-standardised DALY rate due to mental disorders was 1909.15 (1440.16 – 2437.88) DALYs per 100,000 globally, with great heterogeneity across regions: the Americas with 2379.96 (1786.30 – 3026.74) DALYs per 100,000, the highest burden, and the Western Pacific with 1517.45 (1159.48 – 1910.43) DALYs per 100,000, the lowest. Between 2001-2021, the global both-sex age-standardised DALY rate remained relatively stable and even decreased slightly until 2019 but a sharp increase occurred in 2020 and 2021. This pattern generally held up across regions, with the Americas consistently the region with the highest burden, followed by Eastern Mediterranean, Europe, Africa, South-East Asia and Western Pacific. The European region showed the largest increase in 2001-2021 (from 1895.12 (1435.12 – 2420.97) to 2162.03 (1609.92 – 2777.89)). The same pattern occurred in females across regions, but an important difference in males was observed, with the Eastern Mediterranean region presenting the highest burden in 2021 (2012.54 (1523.41 – 2569.42), after overtaking the Americas in 2008.

The burden of mental disorders remained relatively stable between 2001-2019 with a sharp increase in 2020-2021 globally, and great heterogeneity between regions and some important differences between sexes. Besides opportunities for mutual learning, essential for health planning, cultural sensitivities and social/economic contexts can be important factors associated to these patterns: the COVID-19 pandemic may have been an important trigger for this sharper increase in burden. These results highlight the different patterns of disease burden due to mental disorders in the world and the need for tailored strategies.

V. Pinheiro Conflict with: This article was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020)., J. V. Santos: None Declared

The process of successfully joining medical schools, represents an important event for each student globally. The transition from one year to another needs much effort, sacrifice and perseverance in order to obtain the final goal of being a practitioner.

To assess the strength of motivation for medical studies in foreign students.

We conducted a cross-sectional, descriptive and analytical study, carried out between July and September 2023 among foreign students at the Sfax Faculty of Medicine. Data collection was carried out using an anonymous self-questionnaire via “Google Forms shared among students via social media. We used the strength of motivation for medical school “SMMS” in its French validated version.

Seventy-two foreign medical students completed the survey. The average age was 25 ± 3.45 years. Males represented 57% of the total participants. The majority of respondents were single (77.8%). Sixty-one percent were enrolled in the third cycle of medical studies, 26.5% were enrolled in the second cycle of medical studies and 12.5% were enrolled in the first cycle of medical studies. Of those surveyed, 83.3% had chosen medical studies as their first choice. For 59.7% of students, this choice was their own. The mean score for the motivational strength questionnaire was 42.4, as for the sacrifice dimension 14.6, for the start-up readiness 13.7, and 11.02 for the perseverance dimension. The mean score for the strength of motivation for medical studies was significantly lower in students enrolled in second cycle of medical studies (p=0.043) and in those who did not have their own choice of medical studies (p=0.037). We found no statistical association between the strength of motivation and having a family member in the medical field.

Motivation is a crucial aspect of the academic life of international medical students, shaping their learning path and overall experience. These students, often driven by dreams of a medical career, face obstacles linked primarily to adapting to a new educational system. The motivating strength that drives them to embark on and pursue medical training may be fueled by the desire to acquire clinical skills that will contribute to the provision of healthcare in their home countries.

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This case of a 79-year-old patient with inferred past exposure to toluene and persistent paranoid delusions illustrates the potential neuropsychiatric consequences of solvent exposure. The patient’s work as a car painter (1990-1992) aligns with literature highlighting the neurotoxic effects of organic solvents. Despite no direct evidence of exposure, treatment with Zuclopentixol 200 mg Depot every two weeks led to symptom improvement, reflecting findings on toluene-related neuropsychiatric disorders such as psychosis.

• - Present a potential case of toluene-induced psychosis.

• - Review the etiopathogenesis and treatment.

• - Assess evidence linking chronic solvent exposure with neuropsychiatric disorders.

A literature search using PubMed databases was conducted with keywords: (toluene OR xylene OR volatile organic compounds OR organic solvents) AND (psychosis OR schizophrenia OR mental disorders). Case series and observational studies were reviewed. No randomized clinical trials on antipsychotic treatment for toluene-induced psychosis were found.

The patient’s exposure to toluene was inferred based on work history, without direct evidence such as biomarkers or occupational assessments. As most studies are case series, results must be interpreted with caution. There is a lack of randomized controlled trials exploring antipsychotic treatments in solvent-induced psychosis.

Chronic exposure to toluene is associated with cognitive impairment, memory deficits, personality changes, and psychosis. Neuroimaging often reveals white matter alterations and cerebral atrophy in chronic users. Rare cases of irreversible schizophreniform psychosis have been documented. Treatment with atypical antipsychotics like risperidone shows variable efficacy, but outcomes differ between patients. In this case, Zuclopentixol 200 mg Depot every two weeks led to significant symptom reduction.

Chronic toluene exposure can result in severe neuropsychiatric disorders, including psychosis, as demonstrated by this 79-year-old patient. Neuroimaging showed cerebral atrophy and white matter changes in long-term exposure cases. Treatment with Zuclopentixol effectively reduced symptoms, despite the limited literature, which is mostly based on case series. Randomized clinical trials are needed to develop standardized treatment protocols. Additionally, occupational safety measures are critical to preventing adverse effects from solvent exposure.

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Suicide represents one of the most discussed mental health issues in the world today and health challenges for the future. The burden of suicide is calculated in very high numbers (720.000 people per year) ranking it among the most frequent causes of death (World Health Organization. Suicide. WHO Fact Sheet. 2024 https://www.who.int/news-room/fact-sheets/detail/suicide). In the context of patients hospitalized in psychiatric services, the incidence of suicide attempts is particularly high, representing a major challenge for mental health professionals and the health care system.

This study aims to analyze the socio-demographic and clinical factors influencing suicide attempts in a sample of psychiatric patients in Albania and looks for statistically significant relationships between them.

A retrospective study was conducted on 138 psychiatric patients admitted after a suicide attempt and data from August 2022 to July 2024 were obtained. Socio-demographic and clinical data were collected and analyzed. The relationship between these variables were explored. A total of 28 different demographic, clinical and behavioral variables were sampled and pooled with the help of statistical software.

From the data it was found that suicide attempts were more frequent among women with a woman/man ratio of 1.42:1, age 25-44 years and among unemployed persons during the working age. It was more frequent in urban areas, with an uban / rural ratio of 2.85:1. The education level most frequent was primary (8-years of education) in 44.2% of the cases. Our data showed that 86.2% of cases did not live alone, which can be explained by the traditional Albanian family structure. However, only 28.3% of cases had good family support. Suicide attempts were most common in summer. The most frequent discharge diagnosis was a mood disorder in 69.6% of the cases, while a co-diagnosis was present in only 22.5% of cases. 59.1% were hospitalized for a first attempt. The attempt was reported as premeditated in 64.5% of cases, with prior preparation in 21.7% of cases and without asking for help in 62.3% of cases. There is a significant relationship (p<0.05) between the diagnosis and seeking help. A significant relationship was found between compliance and first or repeated attempts and also between diagnosis and first or repeated attempts. The most frequently used type of attempted suicidal method was the use of medications in 41.3% of cases.

The pattern presented in the study group in relation to the characteristics of patients who commit suicide attempts, is close to the patterns presented by similar studies. Differences and non-correlations are atributed to local factors. Identification of suicide behaviors pave the way for treatment and assistance for anyone considering suicide. Further research is needed to examine outpatient and community samples.

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Data from community samples have shown that the risk of negative outcomes during the transition to adulthood is greater for those who engage in substance use. Alcohol use is common among young adults in the U.S., with 82% using in the past year and 34% engaging in havy episodic drinking . Marijuana is the second most widely used substance among young adults and regular use has been connected to an increased risk of anxiety and depression, and linked to both psychoses and poorer outcomes in people diagnosed with schizophrenia.

The goal of the current study is to understand the role of adverse childhood experiences (ACEs) on the likelihood of frequent marijuana and alcohol use among a sample of low-income young adults (N=182) in the U.S.

Some original ACE study items were examined, such as types of child maltreatment. Additional items were added, including time spent in foster care as a child, involvement in a serious accident, experienced a serious injury, violent death of a family member or friend, and witnessed a serious injury or death. Frequent alcohol and marijuana use was defined as once a week or more in the past 30 days. Logistic regression models were developed to understand the magnitude of the contribution of each individual factor on the frequent use of both alcohol and marijuana. Separate models were developed to predict marijuana use and alcohol use.

The participants’ mean age was 20.5. The majority of the sample identified as Black (59%) or White (34%). A little more than half (53%) identified as female. Thirty percent reported using alcohol and 35% reported using marijuana at least once a week in the past 30 days.

The logistic regression model predicting frequent alcohol use showed several significant independent variables. Time in foster care (OR=2.88), childhood sexual abuse (OR=2.59), and childhood emotional abuse (OR=4.01) were all significant. Additionally, having a close family or friend who died violently (OR=6.63) and witnessing a serious injury or death (OR=2.92) were statistically significant.

The model predicting frequent marijuana use showed similar significant independent variables. Time in foster care (OR=3.48), childhood physical abuse (OR=3.67), childhood emotional abuse (OR=9.65), and having a close family member or friend who died violently (OR=4.99) all significantly increased the odds of marijuana use.

Study results show the sustained negative impact of both child maltreatment and out-of-home placement. While less studied than other forms of maltreatment, emotional abuse was predictive of both alcohol and marijuana use. Youth who experienced violence in their community also showed a greater likelihood of alcohol and marijuana use. These results highlight the importance of identifying and addressing child maltreatment. Efforts to prevent and address substance use in young adults should take experiences of violence and abuse into account.

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