The University of Bristol Medical School, United Kingdom, has student-selected components (SSC) making up a substantial proportion of its curriculum. This practice is common among UK medical schools. SSCs can inspire interest in specialities that students may have less exposure to during undergraduate training, such as psychiatry. Psychiatry has a broad range of sub-specialities and themes which can be explored in an SSC. The author supervised one such project in which a student researched and produced a series of podcasts about the science of happiness.

To explore the use of student-selected components (SSC) in increasing exposure to psychiatry in the undergraduate curriculum

To explore the impact of student-selected components (SSC) in increasing recruitment into psychiatric training

An initial literature review was performed with the following keywords using Medline on OvidSP.

Fourteen papers addressed the use of psychiatry student-selected components (SSC) in undergraduate medical education and their influence on career specialty choice.

Student-selected components (SSC) are an important strategy for increasing exposure to psychiatry in undergraduate medical education and recruitment into psychiatry.

Medical undergraduate education, elective, student-selected components, special study modules, psychiatry, mental health.

None Declared

Sarcopenia is a syndrome described as generalized and progressive loss of muscle mass, strength and function, leading to an increased risk of falls, fractures, disability and mortality. Recent studies have shown that sarcopenia is more common in patients with long-standing psychiatric illnesses compared to the general population, particularly in those with depression and dementia. There have also been reports of higher prevalence in patients with schizophrenia and bipolar disorder.

Our study aims to determine the prevalence of sarcopenia and the factors associated with the syndrome among the geriatric psychiatric population diagnosed with Alzheimer’s disease, depression, bipolar disorder, or schizophrenia in the central Slovenian region.

A single-centre cross-sectional study will be conducted over 3 months at the Department of Geriatric Psychiatry of the University Psychiatric Clinic Ljubljana. Admitted patients aged 65 years or older with a diagnosis of Alzheimer’s, depression, bipolar disorder, or schizophrenia will be eligible (50 patients per each diagnosis). The SARC-F (Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls) and the MSRA (Mini Sarcopenia Risk Assessment) questionnaires will be used as screening tools to identify sarcopenic patients. Additionally, calf circumference and handgrip strength will be measured. The patients’ cognitive functioning will be assessed using the Mini‐Mental State Evaluation (MMSE).

We expect to detect higher rates of sarcopenia among inpatients with mental illness. Subgroups will be analyzed according to different demographic and disease parameters.

This study is the first to evaluate sarcopenia among elderly Slovenian inpatients with a mental health illness. We believe that sarcopenia is an important yet underdiagnosed parameter of functional health in the elderly struggling with a chronic mental health illness and should be regularly screened for. Further research is required to identify sarcopenia in this vulnerable population, especially at an early stage, to counteract the progression of the disease.

None Declared

The management of Behavioral and Psychological Symptoms of Dementia (BPSD) remains a key challenge in clinical practice. This presentation will provide an overview of the latest German guidelines, highlighting evidence-based recommendations for pharmacological and non-pharmacological interventions. Key updates emphasize a patient-centered approach, focusing on prevention, risk assessment, and the integration of innovative care strategies. By examining these guideline revisions, the session aims to equip healthcare professionals with practical insights to optimize dementia care and improve patient outcomes in line with current best practices in Germany.

None Declared

Leadership styles can either mitigate or exacerbate psychological distress, influencing job satisfaction, burnout, and overall well-being among nursing staff.

This study aims to explore how different leadership styles impact psychological distress in nursing professionals.

We conducted a cross-sectional survey among nurses working in public hospitals and polyclinics in Sfax region. The questionnaire included socio-professional characteristics, assessment of leadership styles the Multifactor Leadership Questionnaire (MLQ) 6S and evaluation of nurses’ mental health using the Kessler Psychological Distress Scale 6 (K6).

A total of 200 physicians responded to the survey. The mean age was 33.24 ± 9.34 years with 70.3% being female. Mean scores of transformational, transactional and laissez faire styles were 25.6 ± 6.5, 12.8 ± 4.02 and 13.1 3.2 respectively. Psychological distress was likely to occur in 16.8% of the cases. Negative correlations were found between K6 score and transformational (p=0.00, r= - 0.81), transactional (p= 00, r=0.64) styles. However, laissez faire style was positively correlated with k6 score (p=0.024, r=0.16).

By emphasizing transformational and transactional leadership styles, healthcare leaders can reduce psychological distress among nurses, enhancing their well-being and improving the overall effectiveness of healthcare system.

None Declared

Paraphrenia is a chronic psychotic disorder characterized by persistent delusions, with preservation of cognitive function and personality, which distinguishes it from schizophrenia, where cognitive decline is more pronounced. Although initially defined by Kraepelin, paraphrenia has been excluded from current diagnostic systems, complicating its distinction from schizophrenia and delusional disorders. Over time, experts like Mayer-Gross, Roth, and Munro have debated whether paraphrenia constitutes a distinct diagnostic entity, raising questions about its relevance in contemporary psychiatry.

To present a case that resembles paraphrenia and explore the clinical presentation and diagnostic process, particularly in the context of the disorder’s exclusion from diagnostic systems.

This study is based on a case report, supported by a non-systematic review of relevant literature. Clinical data was collected throughout the patient’s treatment, and articles on paraphrenia were reviewed to provide historical and diagnostic context.

A 60-year-old woman, single, household cleaner, was brought by her sibling to the emergency department for presenting persecutory delusions, and auditory hallucinations in the prior four months. She believed her downstairs neighbors had installed cameras in her house, controlling her every move. She presented a depressed mood and difficulty falling asleep. Toxicology screening, blood work, and head-CT showed no changes. Due to treatment refractoriness, Clozapine was started. A formal neuropsychological assessment was carried out, which did not show cognitive deterioration. The patient revealed less preoccupation with delusions and hallucinations and was discharged two months after admission.

In this case, the patient exhibited a chronic psychotic disorder marked by persecutory delusions and auditory hallucinations, without encapsulated delusional thinking. These symptoms had persisted for four months, during which the patient maintained personality stability and interpersonal functionality, displaying appropriate emotional responses and no cognitive decline. The onset occurred in middle age, with no psychiatric family history or evidence of premorbid issues. Significant stressors before symptom onset were identified as a likely trigger. This case highlights the persistence of psychotic symptoms with preserved cognitive and emotional stability, aligning with the diagnostic characteristics of paraphrenia. Despite exclusion from modern classification systems, the clinical presentation supports considering paraphrenia as distinct from other psychotic disorders, particularly in terms of its preserved functionality and absence of cognitive decline. This case underscores the need to continue the study on paraphrenia, and possibly rethinking its role in diagnostic frameworks, particularly in cases of late-onset psychosis.

None Declared

Treatment-resistant depression (TRD) is a condition associated with multiple severe implications and high suicide risk. Esketamine is a pharmacological agent approved by the FDA and EMA recommended for adults diagnosed with TRD. The glutamatergic mechanisms of depression are currently the subject of numerous studies. Esketamine has glutamatergic neuromodulatory properties to enhance the effects of selective serotonin and norepinephrine reuptake inhibitors. Furthermore, the anti-suicidal effect of esketamine represents a reason to explore its properties since managing suicide risk in patients with MDD is complex.

The present observational, retrospective study aimed to assess the efficacy and tolerability of Esketamine in a real-world outpatient setting. A secondary objective was to explore the potential benefits on hopelessness and suicide risk(suicide ideation and suicide attempts) to establish future research directions that may enrich knowledge on the effects of esketamine on suicide risk in patients with resistant depression.

20 patients diagnosed with treatment-resistant depression disorder were treated with Esketamine.Depressive symptoms (MADRS and BDI), suicide risk(C-SSRS), and hopelessness(BHS)were assessed. Repeated measures analyses were conducted to evaluate changes from baseline(T0) and 3-month follow-up(T1).

11 patients(60%)were females, and the average age of the sample was 49.40 (SD= 17.38). 9 patients(45%)were single,and 11 patients (55%) were employees.At baseline,11 patients(55%)reported suicidal ideation,and 2 patients(10%)attempted suicide in the previous 3 months. Of the 20 patients, 4 patients did not complete the treatment and were excluded from analyses. Results showed that depressive symptoms decreased at the end of treatment (t1) compared to baseline (t0).Specifically,both clinician (t=7.32;p<.001) and self-report (t=4.34;p<.001)measures show lower levels of depressive symptoms(MADRS t0=33.31±4.35vs.t1= 20.13±5.31,and BDI t0=42.13±7.97 vs.t1=29.31±9.96, respectively).About suicide risk, at baseline 11 patients reported some level of suicidal ideation while at (T1) 7 patients did; the difference was not statistically significant(p=.125);conversely,a significant decrease in suicidal ideation intensity was found (t=2.48,p<.05; t0=5.37±5.77vs.t1=1.87±3.51). Finally,patients also reported decreased hopelessness levels(BHS;t=3.97,p=.001; t0=16.19±3.12 vs. t1=12.12±4.27).

Image 1:

Our findings demonstrated a robust overall response regarding depressive symptoms after Esketamine in TRD. A notable response concerning suicide ideation intensity was also observed in patients with resistant depression; however, further studies are necessary to better investigate the role of esketamine in suicide prevention.

M. Pompili Consultant of: M Pompili wishes to disclose that in the last five years, he has received lectures and advisory board honoraria or has engaged in clinical trial activities with Angelini Pharma, Allergan, Janssen, Lundbeck, Merck Sharp and Dohme, Otsuka, Rovi, Pfizer, Fidia, Viatris, Recordati,Boehringer Ingelheim and Teva, M. A. Trocchia: None Declared, L. Longhini: None Declared, E. Dispenza: None Declared, C. Di Legge: None Declared, S. Sarubbi: None Declared, D. Erbuto: None Declared, I. Berardelli: None Declared

The mental health of the population at the level of the psychiatric service has a number of main indicators: the levels of general morbidity (prevalence) and primary morbidity (incidence) of mental disorders. Population models allow you to demonstrate the scale of problems and assess the resources to solve them.

Building population-based epidemiological models of mental health of the Russian population to analyze the relationship between indicators of mental disorders and the human resource of psychiatric care, as well as demographic, socio-economic factors in the period 1992-2022.

The work uses data from Russian socio-economic statistics, materials from medical and research institutions and results published in scientific periodicals (see, [1] and references). In the formation of population models, the methods of systematic data analysis presented in the work [1] and statistical analysis in the framework of MS Excel were used.

At the first stage, correlation analysis was used to select demographic, socio-economic factors and the factor of the personnel resource of psychiatric care, which significantly affect the indicators of general and primary morbidity of mental disorders. It turned out that the most significant factors are: population size, life expectancy at birth, unemployment rate, number of psychiatrists and psychotherapists. The correlation coefficients between these factors and the indicators of general and primary morbidity of mental disorders are (in absolute value) in the range of 0.65-0.93 with a reliability level of 95%. At the second stage, linear regression (one-factor, two-factor) and nonlinear (logistic) models were obtained, linking the incidence of mental disorders with the selected factors. The obtained regression models are characterized by high reliability with a coefficient of determination R2 in the range 0.81-0.92 for single-factor and, respectively, 0.90-0.98 for two-factor models. The obtained nonlinear logistic model for the indicator of general morbidity allowed us to obtain a maximum morbidity value for the Russian population equal to 34.4% of the population. This result practically coincides with the result obtained in the well-known work [2]. In this epidemiological study on the European continent, it was found that 38.2% of European residents suffer from mental disorders.

The obtained models make it possible to quickly monitor the impact of medical, demographic, socio-economic factors and changes in the personnel resource of psychiatric care on the morbidity rates of the Russian population. 1. Mitikhin V., Yastrebov V. et al. Neuroscience and Behavioral Physiology. 2019; 49(2): 233-239. doi: 10.1007/s11055-019-00720-4. 2. Wittchen, H. U., Jacobi, F., Rehm, J., et al. European Neuropsychopharmacology. 2011; 21: 655-679. doi:10.1016/j.euroneuro.2011.07.018

None Declared

There is a growing interest in the field of men’s mental health, given that men experience elevated rates of certain mental health outcomes including suicide, substance use disorder and overdoses. Evidence suggests that certain male sub-populations are at particular risk, including fathers who are divorced or separated. This increased risk has been attributed to several factors including painful separation from children, an intense decrease in social support, and a sense of failure and shame associated with marital breakdown. Despite these risks, there is a lack of official services targeted at divorced or separated fathers with mental health issues, with only a few grassroots programs available for this demographic. One such service is a peer support program known as Pères Séparés (seperated fathers). This program is officially accredited by the ministère de la Santé et des Services sociaux du Québec to provide psychosocial support including one-on-one peer coaching, weekly support groups and financial/legal advice to divorced or separated men in Montreal.

We set out to conduct a project using a method known as participatory video. The aim was to elicit the lived experience of service users, including their experiences within the peer support program, and represent these experiences in a short video that can be used for the education of other peers, health care providers, family members and the general public.

The project involved creating a workgroup of program service users who were initially trained in basic video-techniques. Workgroup members then interviewed each other about their experiences on camera. All interviews were transcribed, with workgroup members reading the transcripts and distilling prominent themes from these interviews for inclusion in the final video.

The resultant 20 minute video contained three themes (i) the unique struggles of separated fathers including intense loneliness, isolation, depression, and suicidality; (ii) the important of the program in reducing this isolation and providing invaluable social support; and (iii) the rehabilitative role of peer support in providing psychosocial education regarding self-care, social reintegration and pathways to recovery from mental health issues. The video was shown in a series of screenings at targeted settings including health-care, community and educational venues. It was also uploaded to social media where it has been viewed over 5,000 times.

The results imply that such grassroots peer-support programs are very well-situated to help vulnerable fathers in their recovery. Moreover, this program provides a model that can be used as a template elsewhere. Indeed, relevant organizations, funders and service providers could consider creating and implementing similar peer support programs oriented towards seperated fathers. These can benefit such men, their families and society as a whole.

None Declared

Patients with schizophrenia spectrum disorders (SSD) are the most vulnerable category in terms of formation of self-stigmatization (Rayan A., Aldaieflih M., 2019). However, clinical and psychological features of their self-stigmatization were studied mainly at the longer stages of the disease. Self-stigmatization of patients at the initial stages of the disease rarely got to the attention of researchers, what determined the relevance of the study.

To identify characteristics of self-stigmatization patients with SSD at the initial stage of the disease; to determine their needs in psychosocial treatment.

Questionnaire for assessing the phenomenon of self-stigmatization of mentally ill people (Mikhailova et al., 2005) and PANSS were used. A group of 39 patients (23 women and 16 men) with SSD (F20.ххх, F23.ххх, F25.ххх according to ICD-10) were examined. The average age of the patients was 28.95±8.53 years. The duration of the disorder varied within 0.5-3 years.

Patients at the initial stages of SSD demonstrated relatively low level of self-stigma. The indicator «General level of self-stigma» was slightly lower than the average values and constituted 0.86±0.53 points. Patients believed that mental disorder and associated changes will not limit their education and work (0.80±0.57 points), social activities (0.78±0.49 points) and self-realization (0.60±0.48 points). Rejection to restrictions caused by mental illness, underestimation of possible social and interpersonal problems and desire to distance from people with mental disorders (0.74±0.56 points) were identified. Correlation analysis of the named Questionnaire on self-stigmatization and PANSS scales revealed the strongest correlations across parameters «Readiness to distance oneself from mentally ill people in the sphere of internal activity», characterizing the rejection of changes that have occurred as a result of the disease, with scales: P2 - judgment disorders, G-12 - decreased criticality to one’s condition and N-1 - dullness of affect (r=0.61 at p=0.003, r=0.54 at p = 0.003, r=0.52 at p=0.006, correspondingly). Thus, relatively low level of self-stigmatization of patients with SSD at the initial stage of the disease is associated with insufficiently critical self-assessment of their state, underestimation of possible social and interpersonal problems, and desire to distance from people with mental disorders.

It is necessary to carry out psychoeducation programs for patients with SSD, aimed at developing an adequate perception of mental disorder and prevention of possible consequences of self-stigmatization, as well as social and communication skills’ development trainings.

None Declared

Increasing access to short, evidence-based psychotherapies is essential for responding to the rapid increase of demand. This can be achieved only by implementing scalable digital solutions. The Finnish guided self-help (F-GSH) is a digitally supported treatment based on Cognitive Behavioral Therapy (CBT). It was implemented in 2020 onward as part of the national First Line Therapies initiative to face the increased demand and shortage of therapists in primary health care.

We describe the implementation and preliminary results of the Finnish Guided Self-Help (F-GSH) of GSH for depression and anxiety in adults.

Description of the digitally supported F-GSH and therapist training using e-learning platform. We report preliminary outcomes from F-GSH for depression (n=766) and anxiety (n=1043). As outcomes we report self-reported depression (PHQ-9) and anxiety (GAD-7) symptoms measured at the beginning and end of the F- GSH treatment, patient and employee satisfaction, and proportion of patients in need of further treatment after F-GSH. Results are gathered from a wide geopraphical area covering 12 well-being counties.

The training program includes a 5-7 hours online training. A multiple-choice exam must be passed at the end course to gain certification. The training can be enhanced locally by skills workshops, to refine abilities, discuss specific GSH programs and patient groups, or address local implementation issues. In August 2024 more than 2700 employees had undergone the F-GSH training. The symptom severity changes during the treatment in our sample were as follows: Depression program the mean PHQ-9 for depression were at the beginning and end of the treatment 15.4 (SD 5.4)- 11.2(6.0) and for anxiety symptoms GAD-7 10.3(4.7)-7.9(4.8). Respectively, for during the treatment program targeted for anxiety symptoms the GAD-7 levels were 12.25(4.8)- 8.8(5.0) and for PHQ-9 12.43(5.5)- 9.1(5.6). Worsening of the symptoms were reported for 0-2% of the patients. Further treatment needed 38% of patients after F-GSH for depression and After F-GSH 38% of patients had no need for any further treatment.

E-learning platform forms a scalable and acceptable solution for training large number of professionals on a short time period at low cost for an evidence based treatment model. The symptoms reductions during the digitally supported F-GSH for depression and anxiety were comparable with previously reported in other studies, and comparable with longer CBT treatments. The F-GSH seems to be acceptable for the patients and employees. Also, the symptoms seem to ameliorate clinically significantly during the treatment.

None Declared

This study explores sleep health disparities among adults with depressive episodes, focusing specifically on sexual and gender minorities (SGM). Given the high prevalence of sleep disturbances in this population, we aim to understand the influence of sexual orientation, alongside sociodemographic factors, on sleep health.

• - To determine the prevalence of sleep difficulties among sexual minorities with depressive episodes.

• - To assess how sociodemographic factors, including education and ethnicity, relate to sleep health in this population.

Using data from the 2020-2021 National Survey on Drug Use and Health (NSDUH), we analyzed a sample of 15,244 individuals who experienced depressive episodes. The study employed weighted estimates to accommodate the survey’s multistage sampling design. Descriptive statistics were used to assess the prevalence of various factors, including tobacco and nicotine use, age, gender, ethnicity, income, marital status, and education. To evaluate the relationships between these factors and sleep difficulties, we utilized generalized linear models with Poisson distribution and log-link function to estimate adjusted prevalence ratios for each covariate.

The study identified notable disparities in sleep health among individuals with depressive episodes based on sexual orientation and sociodemographic factors. Gay/lesbian individuals and bisexual individuals were both found to have a higher likelihood of reporting sleep difficulties compared to heterosexuals, with an increased prevalence of 1.06 times (p = 0.038 for gay/lesbian and p = 0.009 for bisexual). Educational attainment appeared to play a significant protective role; those with a college degree or higher were 0.89 times less likely to report sleep difficulties than individuals without a high school diploma (p < 0.001). Additionally, ethnicity influenced sleep health, with Hispanic individuals being 1.05 times more likely to report sleep issues than non-Hispanic Whites (p = 0.015).

Image 1:

The findings emphasize the presence of sleep health disparities among sexual and gender minorities experiencing depressive episodes. Gay/lesbian and bisexual individuals face a higher risk of sleep difficulties, highlighting the need for mental health interventions that are sensitive to sexual orientation. The protective effect of higher educational attainment suggests that enhancing access to education and related resources may improve sleep health outcomes. The increased prevalence of sleep difficulties among Hispanic individuals points to the need for culturally tailored approaches in mental health care. Addressing these disparities through individualized and culturally sensitive therapeutic strategies can contribute to better sleep health and overall well-being for these populations, underlining the importance of integrated, comprehensive care in managing depressive disorders.

None Declared

Familiarity with, social distance from people with mental illness and socio - demographic characteristics has been linked to conditions that lead to weaker prejudiced beliefs and a more positive opinion about mental illness.

The relation of the attitudes and perceptions of the citizens of Larissa city towards mental illness and their desire for social distance from the mentally ill people, in relation to their familiarity with mental illness and their demographic characteristics.

A convenience sampling survey was conducted in Greece, Larissa City (n=220). The research tools which were used were: a) Familiarity was assessed using the Level of Contact Report, b) The Social Distance Scale, to measure the desire for social distance from people with mental illness c) Attitudes about mental illness were assessed using The Opinions About Mental Illness (OMI) Questionnaire and finally d) a questionnaire for the socio - demographic information.

Univariate and multivariate analysis was applied for the statistical analysis of the data, which showed that: Desire for social distance from people with mental illness is positively related with the familiarity (with mental illness) but on the other hand is negatively related to the opinions / attitudes about mental illness.

The results from this study highlight and emphasize the important role of familiarity (with mental illness) and the desire for social distance (from people with mental illness) in the formation of positive/negative (prejudiced) attitudes and perceptions about mental illness.

None Declared

Workers on helplines such as the “10306 Support Line” play a critical role in offering confidential, empathetic support to individuals in crisis, providing a secure environment for those grappling with anxiety, depression, or suicidal ideation. However, the high level of responsibility, extended hours, and often distressing nature of the calls can place substantial strain on the mental and physical health of these support line professionals.

The primary aim of this study is to examine the psychosocial risk factors and resulting physical and psychological impacts on employees of the “10306 Psychosocial Support Line”, with the intention of contributing to strategies for managing employee challenges, preventing stress-related symptoms, and promoting best practices for the mental and physical wellbeing of staff.

This cross-sectional quantitative study will involve all health professionals working on the 10306 Support Line, using survey methods to evaluate psychosocial and physical impacts. The following validated psychometric tools were used:

• - Copenhagen Burnout Inventory (CBI): measuring burnout levels and the emotional toll associated with support line work.

• - Sense of Coherence Scale (SOC): assessing individuals’ capacity to manage stress and maintain well-being.

The study results indicate burnout levels among “10306 Support Line” workers. CBI scores reveal that 55.3% of participants experience personal burnout, 47.4% report work-related burnout, and 39.5% face burnout related to caller interactions. A strong negative correlation was found between burnout and the Sense of Coherence (SOC) scores, suggesting that a higher SOC is associated with reduced burnout. Additionally, younger participants reported higher personal and work-related burnout levels than their older counterparts, highlighting age as a potential risk factor for increased burnout symptoms among support line professionals.

The high prevalence of burnout among 10306 Support Line employees highlights a critical need for ongoing mental health support and targeted stress management. Strengthening the Sense of Coherence (SOC) and addressing age-related risk factors may enhance resilience and well-being among support line professionals, supporting both their health and the quality of psychosocial care provided to those in need.

None Declared

According to the press service of the National Police of Ukraine, the number of domestic violence complaints in 2023 amounted to 291,000 statements from victims, which is almost 2 times more than in 2022. This trend determines the relevance of improving the model of comprehensive assistance to victims of domestic violence in Ukraine.

To develop and study the effectiveness of a comprehensive system of psychotherapy for women victims of domestic violence.

We have been examined 85 women victims of domestic violence during 2022-2023; 59 % of them were suffered from physical violence, 100 % – psychological violence, 6 % - economic violence. The following methods were used: Spielberger-Y.L.Khanin scale of reactive and personal anxiety (STAI), Eysenck Personality Questionnaire (EPQ) to determine the level of neuroticism, The Thomas–Kilmann Conflict Mode Instrument (TKI), The Hamilton Depression Rating Scale (HDRS).

The most common form of psychological violence against women was manipulation of the child’s interests during divorce proceedings, when men tried to insult and humiliate the authority of their wives, displaying aggressive forms of behavior. Most aggressors are characterized by emotional instability, irritability and cruelty. An aggravating psychological factor in conflicts in such families was the abuse of alcohol by men.

Women who suffered from domestic violence showed psychopathological personality changes not only in the form of victim character traits, but also in the form of aggression. Other women, on the contrary, were passive, conformist, and could not protect themselves. We used the following methods of psychotherapy: telephone and online counseling, psychological counseling, behavioral psychotherapy, systemic family psychotherapy, and rational psychotherapy. Psychological counseling solved the problems of resolving the difficulties of women victims by creating conditions for expressing strong emotions and helping them gain a sense of control over themselves. The comprehensive system of psychotherapy was aimed at assessing the psychotraumatic situation of a case of violence and forming new ideas about family life and developing new reactions and forms of behavior, forming victim personality traits in women.

The comprehensive system of psychotherapy for women victims of domestic violence was developed. As a result, 82% of women who received the indicated therapy experienced a decrease in manifestations of neurotic and somatoform syndromes, an increase in self-esteem, self-confidence, an improvement in the well-being of women, and an improvement in the psychological climate in these families.

None Declared

Schizophrenia is a major cause of severe global functional disability with negative symptoms that greatly affect functional outcomes. These symptoms are divided into expressive (e.g., facial affect and voice tone) and experiential (e.g., amotivation and asociality) dimensions.

This study assessed the effectiveness of Cognitive Behavioral Social Skills Training (CBSST) in enhancing functioning in individuals with schizophrenia. It examined the link between defeatist performance attitudes and functional changes post-CBSST.

We conducted a comprehensive search of PubMed, Embase, and Cochrane databases up to September 2024 for studies comparing CBSST with standard treatments for schizophrenia. We calculated the mean or standardized mean differences (MDs and SMD) for continuous outcomes along with 95% confidence intervals (CIs). Heterogeneity was evaluated using the I² statistics.

Our review included 7 studies with 462 patients, of whom 219 (47.4%) received CBSST. There were no significant differences between the groups regarding positive symptoms (SMD 0.19, 95% CI -1.01 to 0.64, I² = 95; Figure 1A), negative symptoms (SMD -0.84, 95% CI -1.85 to 0.17, I² = 93; Figure 1B), Depression Scale scores (SMD 0.18, 95% CI -0.20 to 0.57, I² = 62; Figure 1C), or the Independent Living Skills Scale (MD 0.05, 95% CI 0.04 to 0.06, I² = 0; Figure 2). However, the independent living skills scores were significantly lower in the control group.

Image 1:

Image 2:

CBSST is effective in enhancing functioning in individuals with schizophrenia. Along with other supportive goal-oriented interventions, it can alleviate symptom distress, boost motivation and self-esteem, and enhance life satisfaction. Individuals with severe defeatist performance attitudes may experience the greatest benefit from cognitive-behavioral approaches that target functional improvements.

None Declared

Measurements of event-related potentials (ERP), recorded through electrophysiology (EEG) during sensory and cognitive processing tasks, have been widely employed to investigate the pathophysiological basis of mental health disorders. In the last two decades, the analysis of EEG microstates (MS) has been increasingly applied to ERP data. This methodology allows the detection of spatio-temporal changes in neuronal activity potential at the scalp level, providing new insights into neurobiological alterations detectable in psychiatric disorders.

The current systematic review aims at providing an extensive and detailed description of the studies that characterized alterations in ERP-microstates in psychiatric and neurodevelopmental disorders.

A systematic review of English articles using PubMed, Scopus and Web of Science databases was undertaken in April 2024. The review included case-control studies that employed ERP-microstates analysis to compare MS features between subjects (age > 10 years) diagnosed with a mental health disorder and healthy controls.

Out of the 756 records screened, 15 studies were included in the final qualitative synthesis. The studies included patients with schizophrenia (n=7), alcohol use disorder (n=2), borderline personality disorder (n=1), panic disorder (n=1), autism (n=1), major depressive disorder (n=1), post-traumatic stress disorder (n=1) and attention-deficit/hyperactivity disorder (n=1).

The studies investigated alterations of MS characteristics through different types of tasks. Cartool and RAGU were the main software used for MS analysis. Only rarely studies used similar tasks, showing comparable microstate maps. Fourteen of 15 studies showed a significant difference (p<0.05) in MS characteristics between patients and healthy controls. Main differences regarded parameters such as duration, area under the curve and the order of occurrence of MS.

The present literature review aims to highlight the effectiveness in using microstate analysis to identify spatio-temporal alterations in brain electrical activity in subjects with psychiatric disorders, showing the possible implications of the use of this technique in clinical practice and its advantages, as compared to ERP peak analysis.

None Declared

Autism Spectrum Disorder (ASD) is often underdiagnosed in women due to gender-specific manifestations and the use of diagnostic criteria primarily based on male presentations. This underdiagnosis can lead to delayed or inadequate support and interventions for women with ASD. There is a growing recognition of the need for gender-sensitive diagnostic approaches to better identify and support women on the spectrum.

This study aims to explore the unique manifestations of ASD in women, identify key diagnostic challenges, and propose recommendations for refining diagnostic criteria to improve accuracy and timeliness of diagnosis in female populations.

A mixed-methods approach was employed, combining quantitative data from standardized ASD diagnostic tools (e.g., ADOS-2, ADI-R) and qualitative data from in-depth interviews with 50 women diagnosed with ASD. Participants were recruited from clinical settings and ASD support groups. Data were analyzed using thematic analysis to identify gender-specific behavioral patterns and diagnostic challenges, while statistical analysis compared symptom presentation between male and female groups.

Women with ASD exhibited distinct behavioral patterns, such as enhanced social masking abilities, higher levels of camouflaging, and differences in special interests compared to men. Table 1 highlights the frequency of common ASD symptoms in women vs. men, demonstrating significant differences in social communication (p < 0.05) and repetitive behaviors (p < 0.01). Table 2 illustrates the discrepancy in diagnostic ages between genders, with women receiving a diagnosis on average 5 years later than men. Table 3 outlines the diagnostic tools used and their respective sensitivity rates for female ASD presentation. Figure 1 visually represents the comparative analysis of symptom profiles by gender, showing a higher prevalence of internalizing symptoms in women.

The study confirms that ASD in women often presents differently, leading to significant diagnostic delays and underdiagnosis. Gender-specific manifestations, such as social masking and camouflaging, challenge the current diagnostic criteria, which are largely based on male-centric data. To improve the diagnosis and care of women with ASD, it is crucial to adapt existing diagnostic tools to account for these gender differences and develop new guidelines that reflect a broader spectrum of presentations.

None Declared

Ehlers-Danlos Syndrome (EDS) is a group of hereditary connective tissue disorders that primarily involve skin hyperelasticity, hypermobility of joints and fragility of blood vessels.This syndrome shows heterogeneous features.Recent studies have shown that patients with EDS have a higher risk of psychiatric conditions such as depression, suicide and schizophrenia.The existing literature on safe administration of ECT defines several case reports which incorporates connective tissue disorders.

This case report aims to define a rare case of EDS related psychosis including the clinical presentation and management.Furthermore, to show the administration of ECT in patients suffer from this medical condition after their assessment.

Comprehensive presentation of patient’s case and review of systematic literature using database, in regards to connective tissue disorders and psychiatric conditions.

A 42-year-old female patient,diagnosed with anxiety disorder 7 years prior, who has shown no remission and has experienced multiple hospital admissions over the past year due to various psychotic and depressive episodes, presented to our hospital with complaints that a “sorcerer” had cast spells on her.She reported delusions of mystical and somatic nature, describing that as a result of these spells, supernatural entities had caused her teeth to shrink, her skull to shift, the brightness in her eyes to diminish, her internal organs to decay and her physical presence to fade away.Additionally, she expressed paranoid-persecutory delusions that these entities would ultimately lead to her death.Treatment history included multiple SSRIs, antipsychotics and 6 sessions of TMS therapy, all with limited response.Her family history revealed that her father had died by suicide and her siblings were also diagnosed with depression/anxiety disorders.

The patient was admitted with a preliminary diagnosis of psychotic depression.Physical examination findings included hyperflexibility and hyperlaxity, suggestive of EDS.As the patient was at increased theoretical risk for complications; several consultations were requested to assess fitness for treatment prior to ECT.Based on these evaluations, ECT was deemed safe to proceed.Bifrontal ECT was successfully administered, resulting in marked improvement in the patient’s psychotic symptoms.

Even delusions are remarkably indicative for psychosis, it is crucial to recognize the underlying medical conditions may contribute to its onset and/or exacerbation.Psychiatric evaluations should be performed during EDS patients’ routine follow-ups.Additionally, as is already shown in other case reports, administration of ECT in patients with EDS should be considered.However, further research is required to understand the eligibility of ECT on connective tissue disorders also to expand our repertoire in the treatment.

None Declared

Alexithymia is a relatively stable personality construct that reflects the difficulty in distinguishing and describing one’s own emotions along with a concrete and externally directed style of thinking. Alexithymia increases the risk of development and worsens the course of several psychiatric illnesses, such as depression or addiction. It is also associated with the development of eating disorders and psychosomatic illnesses. Additionally, it has a negative impact on the ability to regulate emotions and is also associated with a reduced empathic capacity, interpersonal problems and even violent behaviors. Interestingly, in intimate partner violence, it has been observed that alexithymia is associated with both exercising and receiving abuse. However, social behavior, in dynamics of cooperation within pairs and groups of several individuals, has not been studied much in relation to alexithymia.

We evaluated the impact of alexithymia in social behavior in three aspects: generosity, trust and submission.

After completing an online survey that evaluated their levels of alexithymia using the TAS-20, as well as depression and loneliness, 67 participants (27 men), aged 19 to 46, attended our laboratory. There, after answering the PANAS survey, they played three economic games using tiles: the Dictator game, the Trust game, and the Public Goods game. Each participant played in a group of four, with three of the group members being confederates whose contributions were pre-established and consistent across all sessions and participants. In the Public Goods game, confederates initially contributed a significant percentage (80-95%) of their endowment in the first round, but in subsequent rounds, they drastically reduced their contributions to nearly nonexistent levels. After playing all three games, the PANAS was reassessed. Finally, on the same day as the face-to-face session, participants completed a second online survey that assessed cognitive and emotional empathy, early life adversity, resilience and perceived stress.

In the Public Goods game, the number of rounds in which participants contributed more than their initial contribution in the first round was used as a measure of submissive behavior. This variable correlated with the participants’ level of alexithymia (β=0.544). Additionally, this same index was also negatively associated with empathy and positively related to reported loneliness. A similar pattern was observed between alexithymia and empathy (β=-0.323) and loneliness (β=0.473). In contrast, total contributions made in the Public Goods game, the Dictator game (generosity), and the Trust game did not correlate with alexithymia.

Our results suggest that alexithymia is connected to greater submissive behavior in group interactions. It is possible that its link to reduced empathy and increased loneliness contributes to this behavior.

None Declared

Adjustment Disorder (AD), introduced in DSM-III-R, is an emotional or behavioral reaction to a psychosocial stressor that causes significant distress and impairment. Symptoms include excessive worry, sadness, anxiety, and sleep disturbances. U.S. prevalence ranges from 11.5% to 21.5%, higher in those with suicide attempts and twice as common in women. Diagnostic criteria include symptom onset within 1-3 months, significant distress or impairment, and resolution within 6 months after the stressor or its consequences. Subgroups are based on predominant symptoms of anxiety, depression, or behavior (DSM-5).

Analysis of Adjustment Disorder cases in patients admitted to medical-surgical Units in 2023 at Hospital de Matosinhos.

Review of Clinical Records of all internal consultation requests made to the Liaison Psychiatry Team during 2023 at Matosinhos Hospital. Demographic data, psychiatric history, medical-surgical history, multidisciplinary intervention, and post-discharge guidance were obtained.

Out of the 420 patients observed in internal consultation in 2023, 67 were diagnosed with AD, representing 15.9%.

53% were men and 47% women.

The age distribution is represented in figure 1. Most of patients have an age gap between 50-70 years old. 58% is married, 9% single, 9% divorced and 22% widower.

79.1% of the patients live with their family and 20.9% lives alone.

All comorbidities found in patints with adjustment disorder is represented in figure 2. We can see that metabolic diseases and cardiovascular events are the most common comorbidities associated with AD.

Only 32% had seen a psyhiatrist before, while 68% had never contacted with a psychiatrist.

75% of the requests were made by internal medicine and general surgery.

According with the results of figure 3 we can tell that most of the patients started a new medication and just a few had psychological support.

Image 1:

Image 2:

Image 3:

The diagnosis is subject to a degree of subjectivity and requires clinical judgment. There is a lack of clearly defined diagnostic criteria. It depends on a stressor and a reaction to the stressor that is considered excessive relative to what would be expected in the patient’s cultural and social context.

Treatment is underinvestigated. The basic pharmacological management consists of symptomatic treatment of insomnia, anxiety and panic attacks. The use of benzodiazepines to relieve these is common. In this study it is clear the need of giving medication to treat the symptoms even though we know that most of them would stop naturally. However, there is a lack of brief psycological interventions even though they are recommended.

It is now a critical time for advancing our knowledge of the disorder and further studies should be done.

None Declared