Ekbom’s syndrome is a clinical term for delusional parasitosis, a condition characterized by the belief that one’s skin is infested by invisible parasites. Delusional infestation is a rare psychiatric disorder, is more common in the elderly, particularly in postmenopausal females. Psychiatric interventions are usually rejected by these patients and long-term treatments are frequently abandoned, they usually seek care from dermatologists. It is advocated to form a liaison between dermatology and psychiatry to ensure a full range of differential diagnoses, in order to form the most suitable management plan.

The objetive of this case is to illustrate the severity of Ekbom’s syndrome, providing detailed clinical information and highlighting the challenges in treatment.

The following patient will be presented, doing a thorough systematic bibliography review.

A 54-year-old female patient describes a clinical history of three years of visual hallucinations and generalized pruritus since a family weekend at a countryside house. She reported that, for the past three years, she has experienced itching all over her body and has occasionally seen “bugs” on her body that she believes to be fleas. She mentioned having been diagnosed with “scabies” and “seborrheic dermatitis”.Despite these diagnoses, her father noted that for the past year, the patient has been extremely anxious, spending hours examining her hair and skin, washing repeatedly, and searching for “bugs.” In recent weeks, she refused to eat.Throughout her stay in the unit attended therapy regularly, and participated actively. A psychopharmacological adjustment was made, starting with Abilify at 15 mg/day, which was well-tolerated and effective. A dermatology consult ruled out dermatological pathology. Over the days, a reduction in anxiety and partial improvement in somatic complaints were observed. As the patient’s condition improved, she committed to continuing with the treatment and attending mental health team consultations with her referring psychiatrist.

Delusional infestation is a serious and uncommon disorder that endangers the patients and the people around them, and can be complicated with secondary somatic complications, often requiring involvement of different medical specialists.The treatment is long and complicated, the effectiveness of pimozide, aripiprazol or risperidone for the Ekbom syndrome has been documented in the literature. In our case, we decided to introduce aripiprazol. The management of these patients requires a multidisciplinary approach between dermatologists and psychiatrists, as they often refuse treatment. Consultation and collaboration between both specialties are essential to ensure timely referral. Additionally, it is crucial for general physicians to have greater awareness of these conditions, perform early recognition, maintain good rapport with patients, and provide empathetic treatment.

None Declared

Ekbom syndrome, also known as delusional parasitosis, is a psychiatric disorder in which the affected person is firmly convinced that their body is infested with parasites, insects, or any other microorganism, despite the lack of medical evidence to support it.

A 56-year-old woman presents to the emergency department, referred by her primary care physician, due to a sensation of worms in her vagina and rectum. She reports that larvae are coming out of her nostrils, ears… and she feels them settling in her kidney. She is accompanied by her husband, who mentions that on some occasions, she has shown him the supposed parasite.

The objectives of this clinical case are to understand whether Ekbom syndrome can be related to any secondary organic pathology, as well as to identify the conditions with which the differential diagnosis should be made, and to determine the most effective treatments.

Examination: Sensory-perceptual disturbances in the form of cenesthetic hallucinations. High levels of anxiety with functional impact on her daily life.

Complementary tests: A referral was made to Internal Medicine to rule out the presence of parasites, and to Neurology for an MRI with contrast, which revealed a white matter lesion in the brainstem. Tests for anti-AQP4 and anti-MOG antibodies were also conducted, and both were negative. After these studies, it was concluded that the criteria for secondary Ekbom syndrome due to organic pathology were not met.

The differential diagnosis should be made with other psychiatric disorders such as schizophrenia, major depression, or substance-induced psychosis. Neurological diseases, such as dementia, multiple sclerosis, or meningoencephalitis, should also be ruled out. Lastly, it is advisable to rule out dermatological conditions, such as scabies.

Treatment was initiated with Risperidone and Alprazolam, with good response and improvement in delusional ideation.

Treatment with atypical antipsychotics is effective for this syndrome, reducing delusional ideas and significantly improving the psychiatric symptoms that accompany the delusion, such as anxiety, depression, and insomnia.

Good collaboration between different medical professionals is essential to rule out associated secondary pathology.

None Declared

Worldwide, obesity has become a major public health issue, affecting over 650 million people, and individuals with severe mental disorders (SMD) are disproportionately affected by higher rates of obesity and metabolic syndrome (MetS). These patients often face significant barriers to improving their lifestyle, including the metabolic side effects of psychiatric medications, which are associated with weight gain, insulin resistance, and dyslipidemia. Moreover, psychiatric patients frequently encounter challenges when seeking care, often due to the stigma surrounding mental illness. This can lead to inadequate medical attention for physical health issues, further exacerbating the vicious cycle between physical and mental health. For these reasons, attention to the physical health of patients with SMD has been increasing in the recent years. However, the attempts to improve physical health can be a trigger by the exacerbation of psychiatric symptoms in more vulnerable patients.

The report aims to highlight the reciprocal influence between psychiatric symptoms and physical health, emphasizing the importance of lifestyle interventions in patients with severe mental disorders.

In this case report, we present a 57-years-old patient with Bipolar I Disorder and class 3 obesity (BMI: 47.689) who experienced recurrent manic episodes triggered by past weight loss attempts, including one involving the use of liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist.

To prevent a new manic episode, the patient was admitted to our in-patient ward after he started to take orally liraglutide, a novel drug to treat obesity. As we expected, during hospitalization the patient experienced a manic episode and dysphoric mood, tachypsychia, and sleep disturbance emerged. After a treatment with a combination of valproic acid, risperidone, and gabapentin, the manic episode resolved at time of discharge, but despite the administration of liraglutide, no significant change in body weight was observed.

This case emphasizes the need for a tailored, integrated approach to lifestyle interventions in psychiatric care, in alignment with the “One Health” concept, which highlights the interconnection between physical and mental well-being. However, some patients may require the assistance of a mental health professional while attempting to change their lifestyle during their lifestyle improvement and weight loss attempts, as even modern pharmacological interventions for obesity can act as a psychopathological trigger.

None Declared

Cyberbullying has emerged as a significant concern in today’s digital age, particularly among adolescents. As technology becomes increasingly integrated into daily life, the prevalence of online harassment has risen, impacting the mental health and well-being of students.

This study aims to explore the prevalence of cyberbullying among Tunisian schoolchildren and to identify the associated factors that contribute to its occurrence.

This is a cross-sectional descriptive and correlational study among students from two public middle schools in the Sousse governorate (Tunisia) for the year 2020/2021 using an information sheet concerning: Socio-demographic data, schooling, peer relationships, child’s use of the Internet and also the ‘Cyberbullying Screening Test’ which is a self-administered questionnaire designed to assess cyber-bullying behaviour among young people aged 12 to 18.

We included 238 middle-school students.63.6% of the population were girls, with a sex ratio of 0.57. The majority of participants (83.1%) was between 13 and 15 years old. More than half of middle school students (51.3%) reported having been cyberbullied at least once and 30.2% having been sexually harassed at least once by cell phone or on the Internet. We identified a significant association between cyberstalking and the mother’s level of education (P=0.041). There was a statistically significant relationship between cyberbullying and the student’s place of residence (P=0.023). School repetition among students was also associated with cyberbullying with a strong significance (P=0.002). A notable relationship was found between cyberstalking and the frequency of digital technology use on weeends (P=0.055).

The findings of this study reveal a significant prevalence of cyberbullying among Tunisian middle school students, with notable associations linked to many environmental and individual factors. These results emphasize the urgent need for comprehensive strategies to combat cyberbullying and support affected students in educational environments.

None Declared

Children with Attention Deficit Hyperactivity Disorder (ADHD) often experience comorbid anxiety. While their anxiety is typically assessed through both children’s and parents’ reports, discrepancies between these reports are common and poorly understood. Children with ADHD also present sensory-motor dysfunctions, of which explicit expressions may mask children’s emotional state.

Here, we test whether parents of children with sensory-motor dysfunctions may underestimate their children’s anxiety levels.

Participants were 85 children: ADHD-only (n=28), ADHD+DCD (n=38), and typically developing (TD; n=19). Hyperactivity/Impulsivity was assessed by DSM-V. Anxiety was assessed by children and parents using the Screen for Child Anxiety-Related Disorders questionnaire (SCARED-C/P). Sensory-motor functions were evaluated using the Movement Assessment Battery for Children (MABC-2), balance subtest of the Bruininks Osteresky Test of Motor Proficiency (BOT-2), and vestibular tests of Dynamic Visual Acuity (DVAt) and standing posturography.

Anxiety ratings were higher by children with ADHD than TD children (t-tests, 0.001<p<0.05). Anxiety ratings were higher by children than their parents (t-tests, 0.001<p<0.05), and the correlation between child and parent anxiety ratings was lower in ADHD dyads (0.22<r<0.33, p<0.05) compared to TD dyads (0.60<r<0.70, p<0.01). Panic anxiety ratings by children correlated positively with vestibular dysfunction (r=0.22, p<0.05), indicating that anxiety ratings increase with vestibular dysfunction. Anxiety ratings by parents correlated negatively with motor dysfunctions on the vestibular, postural stability, balance, and motor function tests (-0.36<r<-0.22, p<0.05), indicating that anxiety ratings decrease with motor deficiency. Finally, the ADHD cohort was assigned to an “agreement” cluster (55%) with comparable child-parent anxiety ratings and to a “disagreement” cluster (45%) with anxiety ratings lower by parents than children. Children in the “disagreement” vs. “agreement” cluster demonstrated higher hyperactivity/impulsivity scores by DSM-V (p<0.05) and lower motor performance by MABC-2 (p<0.05).

Findings suggest that parents of children with ADHD underestimate their child’s anxiety, mainly when children’s sensory-motor symptoms are prominent. We summarize these results under the term “blinding effect,” which implies that parents’ primary concern is the child’s sensory-motor dysfunction, thus neglecting the expressions of anxiety. This “blinding effect” should be studied in the context of additional neurodevelopmental disorders sharing sensory-motor dysfunctions, and clinicians should be aware of the potential child-parent bias in reporting anxiety.

None Declared

Mood disorders (MD) have been consistently associated with alterations in the immune system. Evidence suggests a condition of systemic low-grade inflammation with abnormally decreased adaptive, increased innate immunity, and with higher levels of circulating cytokines, higher macrophage/monocyte inflammatory activation patterns, and higher neutrophils to lymphocyte counts. A dynamic pattern of premature immunosenescence and partial T cell defect starting early in adolescence, involving a reduction of naïve T cells and an expansion of memory and senescent T cells, parallels lifetime recurrence of illness episodes, worsening outcomes and fostering chronicity. Consistent systematic reviews and meta-analyses affirm that COVID-19 survivors show persistent psychopathology and neurocognitive impairment, with clinical significant depressive psychopathology being reported in around 31% of patients. Psychopathological features are the same observed in MD, along the same gradient of severity, and including a typically melancholic cognitive vulnerability. Neurocognitive impairment could possibly separate from depression in the long term, but not in the first year after infection, and it is largely overlapping with persistent cognitive deficits described in MD. We will discuss pathogenetic mechanisms shared by both, MD and post-COVID depression, with a specific emphasis on: (i) spread disruption of white matter microstructure, reduced grey matter volumes in anterior cingulate cortex, and abnormal functional connectivity in the cortico-limbic circuitries; (ii) abnormal cell trafficking across the blood brain barrier, essential for brain maintenance and repair in healthy conditions; (iii) altered immuno-inflammatory setpoints as observed in the peripheral blood, known to parallel white and grey matter abnormalities in the brain, and recently shown to disrupt neurovascular coupling and spontaneous neural activity. We suggest that post viral depression provides an invaluable model illness for the study of immune-inflammatory mechanisms involved in the pathogenesis of mood disorders, to identify new targets for treatment, with the aim of restoring mental health and brain homeostasis.

None Declared

Some people with a diagnosis of psychosis wish to minimize or avoid medications. A literture exists that intensive psychosocial treatment can mitigate psychotic symptoms with lilttle or no medication being used.

We provided services to people who wishers to reduce or avoid medications within the context of a private psychiatric practice and wanted to assess their outcomes. We wondered what factors led to success.

We report on a series of 62 patients, age 18 years or older, who engaged in psychotherapy, medication, and lifestyle management over at least six months, aiming to minimize or eliminate medication. An additional 217 patients who consulted us did not continue for six months. An anonymous, matched comparison group of 62 patients of the same age, socioeconomic status, diagnosis, and severity of illness was generated from electronic health records at another clinic where LMM also worked. We used the Brief Psychiatric Rating Scale, the Positive and Negative Symptom Scale, the MADRS depression scales, and the Clinical Global Inventory. Narrative interviews generated qualitative data. We compared patients who met their goals to those who did not.

Forty-one people eliminated medication. Another 16 managed well on low-dose medications. Five patients had psychotic episodes that led them to return to higher levels of medication. This group functioned at higher levels than the comparison population with much lower doses of medications. The five readmissions to hospital were signnificantly lower than the number of readmissions in the comparison and the control groups. The cost for one year of care was higher for our people; the costs over subsequent years were less related to fewer hospitalizations, crises, and diminished suicidality.

The results suggest the need for individualized client-centered psychosocial approaches that build upon the person’s previous successes, enroll family and friends in a community effort, and collaborate with those communities to apply those approaches desired by the people themselves. In this dialogical approach to psychosis, lived experience is granted full ontological reality, which appears to facilitate recovery. Lifestyle management and embeddedness in a community facilitate recovery.

None Declared

Smartphones and social media have become increasingly common in recent years. However, uncontrolled use can have negative effects on physical and mental health.

To evaluate the prevalence of social media and smartphone addiction in a group of young doctors

Descriptive cross-sectional study of a population of young doctors. Socio-professional and medical data were collected using a self-administered questionnaire on Google Forms. The Bergen Social Media Addiction Scale (BSMAS) was used for screening social media addiction, with a score of ≥24 indicating problematic use. The Smartphone Addiction Scale Short Version (SAS-SV) was adopted to determine the degree of smartphone addiction, where a very high score of >40 suggests severe smartphone addiction.

Our population consisted of 64 young doctors. Among them, 63.8% were female. BSMAS and SAS-SV means were respectively 16.14 ± 5.54 and 28.91 ± 7.62. A social media problematic use was assessed in 13% of cases. We identified severe smartphone addiction in 6.7% of cases. In bivariate analysis, female sex was associated with a higher BSMAS score (p=0.046) and younger age was associated with severe smartphone addiction (p=0.049). Moreover, strong correlation was found between smartphone and social media addiction (p=0.00, r=0.79).

Given the potential negative impacts on mental and physical health, it is crucial for healthcare institutions to implement strategies that promote balanced technology use and raise awareness about the risks associated with addiction. Addressing these issues can ultimately enhance the well-being of medical professionals, fostering a healthier work environment conducive to effective patient care.

None Declared

Neurobiological mechanisms of late depression include abnormal regulation and interaction of multiple biological processes, as well as abnormalities of brain structures and organs.

literature analysis

general scientific method

The results of the study show that the SASP index as an integral indicator of changes in proteins associated with the cellular aging secretory phenotype is significantly higher in patients with late depression. A high SASP index correlates with older age and age-related diseases. A high SASP index correlates with low cognitive function (low executive function, information processing speed), and high gray matter atrophy. According to the authors, this indicates a connection between late depression and the molecular picture caused by structural and phenotypes of brain aging. Postmortem studies of patients with late depression revealed a coincidence of abnormal gene expression with genes whose expression is regulated by age. Proteomic studies show that late-onset depression associated with cognitive impairment is associated with abnormal regulation of biological pathways related to immune inflammation control, proteostasis, cellular communication and signaling, and oxidative stress. These biological pathways were downregulated during aging, suggesting that depression is associated with lifelong biological abnormalities, limitations with aging. Studies have shown that some of the biomarkers associated with inflammation, growth factors, and cell surface proteins are abnormally regulated in late-onset depression (e.g., elevated sTNFR2 levels) or are associated with certain clinical characteristics such as cognitive impairment (e.g., angiogenin, IGFBP-6). The biological effects of SASP proteins are mediated by p53, p38MAPK, and NFκB signaling pathways. The SASP index correlates with poor executive function and information processing speed. Patients with late-onset depression associated with cognitive decline have been shown to have profound neurobiological abnormalities and significantly reduced BDNF levels, which is consistent with an enhanced molecular profile of aging. SASP proteins can be produced and secreted by senescent glial cells and activate neuronal intracellular cascades associated with nutrition, metabolic control, cell growth, and apoptosis.

Key to understanding the neurobiology of late-onset depression is how it interacts with brain and systemic biological changes associated with aging.

None Declared

As the accessibility of new technology becomes easier and its usage longer, especially among university students, the repercussions on content consumption and behaviors must be examined and addressed, both for prevention and remediation.

The aim of this study is to assess the degree of addictive behaviors associated with the use of the internet and social media. Through a questionnaire, data was collected from a random sample of university students in Kenitra.

58 students participated in the study (21.29 ± 1.69) (38 women and 20 men), distributed as follows: 31% in the first year, 32% in the second year, and 36% in the third year. Of these, 94% reported owning a smartphone for at least one year.

17% reported using internet for more than 12 hours per day. 37% recharge their balance immediately after it is depleted, and 41% become frustrated when they receive no response to a message, 38% are constantly awaiting new notifications. Nearly 30% reported that internet use affects their studies, health, and causes conflicts with their parents.

Girls are more connected than boys and cannot tolerate being without internet access (p < 0.05, respectively). The number of repeated semesters is highly correlated with the duration of smartphone ownership and significantly correlated with age (p < 0.05). Furthermore, a strong correlation is observed between the duration of internet use and the allocated budget (p < 0.05), as well as the ability to tolerate the absence of internet access (p < 0.05).

The regression test shows that an increase in the allocated budget for internet connection leads to an increase in the time spent using smartphone applications (β = 0.42), and the model explains 47% of this relationship. Additionally, the nature of the application used can explain 30% of the increase in the number of repeated semesters among university students (β = 0.30), this parameter is also explained by the duration of smartphone ownership by 10% (β = 0.33).

Internet access is facilitated by smartphones, which fosters attachment behaviors among university students that can lead to addiction and certainly have an influence on academic progress, health, and family relationships.

None Declared

Physical contact with the animal appears, on the basis of the latest research, acts as powerful calming factor on heart rate and breathing (Nose et al., 2022). Moreover, taking care of an animal stimulates a sense of responsibility and promotes empathy and kindness (Walsh et al., 2009). Studies have suggested that animals may serve as “social catalysators” involving feelings of safety and facilitation of interpersonal interactions. These effects are related to biophilia hypothesis which describes the affinity of humans to other living species (Tyssedal et al., 2023).

Our project aimed to assess effectiveness and feasibility of animal assisted intervention (AAI) in patients with psychotic spectrum disorders following a recovery-oriented psychiatric rehabilitation program.

In the present study ten patients from psychiatric residential facilities belonging to the EPASSS Foundation were approached to participated in this study. Patients followed a rehabilitation project named “Animal-Mente” and originated from the collaboration of the psychiatric residential facilities belonging to the EPASSS Foundation with “La coda di Ulisse”, a Third Sector Organization (ETS) which represents the Apulian reference centre for AAI. An observational study design was followed in which the new intervention based on AAI was added to treatment as usual (usual rehabilitation intervention and/or psychopharmacological treatment). All sessions were performed following the Italian National Guidelines for animal assisted interventions and required a multidisciplinary team capable of managing the complexity of the human-animal relationship. Outcome assessments were conducted at recruitment (time 0) and after animal-assisted intervention (time 1). Outcome assessments were conducted at recruitment (time 0) and after animal-assisted intervention ( time 1). They included : Personal and Social Functioning Scale (FPS of the V.A.D.O.), Brief Rating Psychiatric Scale (BPRS), Recovery Evaluation Scale (RAS), Quality of Life Index (Q-Index), S.T.A.I.-Y questionnaire.

All patients followed a psychosocial rehabilitation intervention and all but one had psychopharmacological treatment in the last six months. BPRS (p-value = 0.022) and RAS scale (p-value = 0.006) showed a significant variation at time 1 compared to time 0. No one reported worsening of psychotic or other symptoms during entire program.

Our data highlighted the feasibility of Animal-Assisted Interventions (AAI) in community mental health services. Moreover, our study underlined the opportunity of AAI in an integrative recovery oriented psychiatric rehabilitation program involving mental health department, psychiatric residential facilities and third sector organizations in a network activity.

None Declared

Neuromodulation technologies became the safe and effective alternative to treat psychiatric and neurological disorders. The current evidence from the up-to-date state in vagus nerve stimulation application in studies of emotional state modulation demonstrates a strong impact of vagus stimulation on the state of patients with a range of disorders. The normalizing effect of vagus nerve stimulation on abnormal sympathetic nerve activity may explain the beneficial effect on burnout, which is thought to be a manifestation of decreased vagus-mediated heart rate variability (HRV) under everyday stress.

Considering all of the above, we aimed to explore the influence of a novel VNS stimulation protocol on emotional state, as well as highlighting specific features of the activation-related neurodynamics and the effects on HRV time, frequency and non-linear metrics.

11 right-handed male volunteers aged 18-22 years participated in the 1st (EEG) study (6 persons-taVNS group and 5-SHAM) and 62 healthy volunteers 18-49 years old were recruited for 2nd (HRV) study (26-VNS group and 22–Sham). We used the combination of pleasant meditative classical music and a slow bi-polar wave of electrical non-invasive transcutaneous stimulation of auricular area (BrainPatch platform for non-invasive stimulation). Vagus nerve stimulation was arranged as a 4-day course. Psychological testing (State Anxiety, STAI; psychological stress level, PSM-25; severity of emotional burnout, MBI; depression, IDS) was carried out.

Non-invasive stimulation was rated by the participants as a positive experience. We detected beneficial changes in the psychoemotional state of the respondents (improvement of mood, reduction of job related stress – emotional burnout). The increase of vagally mediated parameter RMSSD and decrease of LF/HF ratio has reflected the activation of parasympathetic nervous system (PNS) during stimulation. HRV effects of VNS turned out to be short-term, which was manifested in a drop in the value immediately after the stimulation. EEG analysis indicated a long-term effect of VNS. Increased alpha and beta rhythms (generalized growth in the frontal and posterior cortex) and gamma activity (frontal region) after a series of 4 VNS sessions may indicate the improvement of mental processes and creative thinking (attention, information processing and memory storage). Enhanced activation level was mirrored in an increased beta/alpha ratio.

Our data suggests that VNS has a normalizing effect on the psychoemotional state shifting “sympatho-vagal balance” to the functional optimum. EEG data showed the prolonged stimulating effect on the brain processes related to the cognitive functioning while attenuating the stress impacts at the same time.

None Declared

The so called “silver tsunami” i.e. the unprecedented increase in the number of older patients often affected by multimorbidity is a serious health and socioeconomic concern for modern societies and the interconnected challenges of huge workload, premature burnout, and the shortage of primary care personnel represent a pressing issue for the near future. Addressing the complexity of this issue requires a comprehensive approach due to the scarcity of healthcare professionals in European primary care. The health and well-being of both the primary care workforce and the communities they serve are intrinsically intertwined. Enhancing working conditions is a priority: addressing issues like long hours, heavy workloads, bureaucratic demands, and burnout can enhance the appeal of rural primary care practice, attracting and retaining more professionals. Wonca Europe is actively involved in addressing this issue: in June 2023 at the WONCA Europe 2023 Conference in Brussels with the statement Shortage of European Primary Health Care Workforce and in October 2023 at the 73rd Session of the WHO Regional Committee for Europe, Astana, Kazakhstan. Policymakers, healthcare organizations and professional associations need to collaborate to develop tailored solutions that address the unique challenges faced in each region. By addressing the workload of primary care doctors and other professionals, we can enhance their professional satisfaction, improve patient outcomes, and strengthen primary care as a whole.

None Declared

The increasing prevalence of metabolic syndrome in persons with schizophrenia has driven research into the underlying mechanisms of its pathophysiology. Overlapping neurobiological profiles of metabolic risk factors and psychiatric symptoms, particularly shared genetic liabilities, suggest that oxytocin system dysfunction may be a common mechanism underlying both schizophrenia and metabolic syndrome. Given its prosocial and anorexigenic effects, intranasal oxytocin has been studied for its therapeutic potential in schizophrenia and obesity. However, the pathophysiology and mechanisms of oxytocin in schizophrenia are complex and it is too early to draw definitive conclusions.

This study aims to investigate the correlation between plasma oxytocin levels and metabolic syndrome and to test whether oxytocin system dysfunction could serve as a putative endophenotypic marker of schizophrenia.

This prospective cohort study involved 90 persons with schizophrenia, all of whom were responsive and maintained on stable monotherapy with either olanzapine, risperidone, or aripiprazole, without any alterations to their antipsychotic regimen, alongside 60 healthy controls. All participants were followed for 24 months. Anthropometric measurements, metabolic parameters, and the presence of metabolic syndrome were assessed. Plasma oxytocin levels were measured. The psychopathology of persons with schizophrenia was evaluated using the Positive and Negative Syndrome Scale (PANSS), and quality of life was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) scale. Other potential confounding factors, including dietary habits, caffeine and nicotine use, and menstrual cycle, were considered in the analysis.

Plasma oxytocin levels were inversely associated with the presence of metabolic syndrome in persons with schizophrenia, regardless of antipsychotic treatment. Persons with schizophrenia who had metabolic syndrome at baseline showed lower baseline plasma oxytocin levels. Among those with metabolic syndrome at baseline, higher plasma oxytocin levels were associated with better metabolic parameters at the end of the follow-up period. Conversely, for those without metabolic syndrome at baseline, lower plasma oxytocin levels were predictive of a higher risk of developing metabolic syndrome over time.

This study highlights the potential role of oxytocin in the pathophysiology of metabolic syndrome in schizophrenia. Lower plasma oxytocin levels were associated with both the presence and risk of developing metabolic syndrome, suggesting that oxytocin system dysfunction may contribute to metabolic dysregulation in schizophrenia. These findings support the hypothesis that oxytocin could be a putative endophenotypic marker for metabolic vulnerability in schizophrenia, while future studies should further investigate the therapeutic implications of targeting the oxytocin system.

None Declared

One of the great challenges for Mental Health Services is dealing with users who repeatedly use the facilities. This phenomenon, beyond representing an increase in the economic cost and in terms of human resources, generates high levels of frustration and dissatisfaction, both in professionals and in the consultants themselves. These users have been called “hyperfrequent users”. Users can frequent different services, including the Emergency service. The phenomenon of hyperfrequent use can lead to an inappropriate use of the Emergency services and gives rise to substantial costs for the health system, as well as a decrease in the efficiency of the service.

The objective of our work is to describe those factors associated with the hyper-frequent use of Mental Health Hospital Emergency Services by users who engage in suicidal behavior.

A descriptive, observational study was carried out. The population included all users of the Hospital Emergency Department treated by the Mental Health Service in one year who consulted for suicidal behaviour (self-harming ideas, suicidal attempts or self-harm). Patients who consulted on 4 or more occasions in the hospital psychiatric emergency departments for consultations related to suicidal behaviour were considered as frequent users.

860 consultations were attended to, corresponding to 546 users who consulted in the psychiatric hospital emergency departments for suicidal behaviour (self-harming ideas, suicidal attempts or self-harm). Of these users, 314 consulted on more than one occasion. Taking as a frequent user >=4 consultations, we have 14 users in one year. Regarding sex, the female sex stands out 86% over the male sex 14%. One user is considered a great frequent user, attending on 17 occasions. The most frequent reasons for suicidal consultation among frequent users are consultations for self-harm ideation (33%) and self-harm attempts (60%) and self-harm (7%). Anxiety and alcohol consumption are the most frequent comorbid diagnoses among frequent users. By sex, self-harm behavior stands out in both women and men and self-harm is more frequent in women. Regarding discharge after assessment, referrals to a community mental health specialist stand out in 45% after consultation and 28% of frequent users required hospital admission after care for suicidal behavior.

In our work, it is observed that the profile of frequent users with suicidal behavior is adult women who consult for self-harm attempts in their majority. These hyper-frequent users continue to demand attention from the health network devices, so knowing their needs would help to improve health care and use resources more efficiently and effectively for these users who engage in suicidal behavior.

None Declared

The 2020 Aegean Sea earthquake occurred on October 30, 2020, 23 km from the Seferihisar district of Izmir, with a magnitude of 6.9. It caused the death of a total of 119 people and the injury of 1053 people in Turkey and Greece. After this earthquake, many people were observed to have symptoms of post-traumatic stress disorder and received treatment. The two major earthquakes centered in Kahramanmaraş on February 6, 2023 also caused great destruction in Turkey. After this earthquake, an increase in the mental complaints of people who had previously experienced the earthquake in Izmir Seferihisar was observed and these people applied to the psychiatry outpatient clinic.

Revealing how much former earthquake victims are affected by similar events through the media.

Determining the situations that cause people to be re-traumatized.

Observing the effects of the media on mental health.

This study investigated the effects of former earthquake victims who applied to Izmir Seferihisar State Hospital after these new earthquakes, and who were not in the earthquake region at the time of the earthquake and who did not have any losses or injuries to relatives or acquaintances, through the media. For this purpose, after the earthquake centered in Kahramanmaraş, the Adult Resilience Scale and the Post-Traumatic Stress Disorder Checklist for DSM-5 were applied to these individuals at their first application, and it was questioned whether the individuals had received pharmacotherapy and psychotherapy after the previous Aegean Sea earthquake. It was also investigated how the individuals followed the news about the new earthquake. Afterwards, whether the individuals received treatment and the duration of this treatment were recorded, and the Post-Traumatic Stress Disorder Checklist for DSM-5 was applied to the individuals at the 1st, 3rd, 6th, 9th and 12th months.

People who have received psychotherapy are 1.9 times less likely to need treatment afterwards.

Women are 4.1 times more likely to be affected by the media and use SSRIs.

People who have lost their homes need treatment as often as those whose close relatives have died.

The risk of people who do not receive treatment after a disaster being affected by the media and receiving treatment is 3.4 times higher than those who received treatment during the first disaster.

After disasters, when another disaster occurs, PTSD symptoms can be observed again in former disaster victims. Post-traumatic psychotherapy can also be protective in terms of future situations. Watching traumatic events in the media can cause PTSD symptoms to be seen even if no relatives have been harmed.

None Declared

The advent of the Coronavirus Disease 2019 (Covid-19) pandemic in late 2019 precipitated a profound transformation in the daily lives of individuals across the world, with notable implications for global mental health. The fear of the virus became a significant source of anxiety and stress, compounded by the rapid dissemination of information, both accurate and inaccurate, through digital media. The growing reliance on digital platforms for health information during the pandemic underscored the significance of eHealth literacy, which pertains to the capacity to locate, comprehend, and utilize health data from digital sources. As reliance on digital platforms for health information increased, it became imperative to examine the potential impact of digital health literacy on fear and anxiety levels related to the novel coronavirus disease (2019-nCoV), also known as Coronavirus Disease 2019 (Covid-19).

The objective of this study is to examine the relationship between fear of the Coronavirus disease 2019 (Covid-19) pandemic and mental health, while investigating the influence of eHealth literacy on these fears.

The study was conducted on a sample of 158 individuals from the general population, representing a diverse range of demographic characteristics. The data were collected using a structured questionnaire comprising three sections: demographic information, the Fear of Coronavirus Scale (FCV-19S), and the eHealth Literacy Scale (eHeals). A statistical analysis was conducted to investigate the relationships between demographic factors, levels of fear, and eHealth literacy. Additionally, a comparative analysis was performed to assess the differences between individuals who had and had not contracted the virus.

The analysis revealed no statistically significant differences in the levels of fear regarding the novel coronavirus disease (Covid-19) or eHealth literacy between different demographic groups, including gender, age, education, and health status. Nevertheless, a statistically significant discrepancy was observed in the level of fear between individuals who had contracted the virus and those who had not. Specifically, those who had not been infected exhibited higher levels of fear compared to those who had previously contracted the virus. No significant differences were identified in eHealth literacy based on infection status.

In conclusion, the findings of this study indicate that while demographic factors do not appear to influence the level of fear or digital health literacy, personal experience with a confirmed case of infection does. Those who have not contracted the virus tend to experience greater fear, suggesting that familiarity with the disease may reduce anxiety. These findings underscore the necessity for interventions.

None Declared

Two high security Forensic Psychiatric Centers (FPC) were implemented in the last decade in Flanders (FPC Ghent and FPC Antwerp). FPCs provide court[1]ordered treatment for forensic psychiatric patients (called “internees”) that have committed a criminal offense related to their psychiatric disorder and who are at a high risk for recidivating.

Treatment is often mandatory and lengthy, and per[1]sonal rights are highly restricted, which has an impact on treatment motivation and overall patient wellbeing (Lutz et al., 2022). While the Risk Need Responsivity (RNR) model - which focuses on risk reduction – was and still is the prominent model for offender rehabili[1]tation, other aspects are currently given more atten[1]tion. This includes the Good Lives Model (GLM) and the recovery movement, that aim at improving the achievement of skills necessary to maintain a good live and give meaning and value in one’s existence (Lutz et al., 2022).

Data collection and statistical analyses The descriptive analyses of categorical and continuous variables was done using SPSS version 28. Valid per[1]centages were given. Assumption testing was per[1]formed and found that the data were not eligible for parametric examination. The significance level was set at .05.

Weight and BMI At the initial measurement, the mean weight was 89.3 kg (SD ¼ 21.64, range ¼ 46–222 kg). The mean weight at second measurement was 92.6 kg, with a standard deviation of 21.90 and a range of 46.6–185.6. The second weight measurement occurred 812.2 days or 2.2 years (SD ¼ 552.39, range ¼ 7–3084 days) after the initial measurement. The weight difference between the two measurements ranged from a weight loss of 53.8 kg to a weight gain of 51.6 kg and showed a mean weight increase of 2.2 kg (SD ¼ 10.41)1

The overall conclusion of the study is that obesity, MetS, smoking, as well as substance misuse are highly prevalent among our high security population. These are all risk factors associated with somatic morbidity and mortality. Our study showed that obesity and MetS were found across psychiatric diagnoses and the presence of metabolic syndrome was not limited to the use of SGA.

None Declared