This presentation explores the intersection of psychotherapy interventions and AI, focusing on how AI can be leveraged to augment traditional therapeutic methods. AI-powered tools such as chatbots, virtual therapists, and predictive analytics will be covered. Additionally, the talk will address the ethical implications, challenges, and opportunities posed by the use of AI in mental health care, emphasizing the importance of maintaining the human element in therapy. Drawing on current research and case studies, possible opportunities of AI assisted therapists in identifying patterns in patient behavior, improving treatment efficacy, and reducing barriers to mental health care, especially in underserved populations will be explored. The presentation will conclude with a forward-looking perspective on how AI and psychotherapy can collaboratively evolve to shape the future of mental health care.

Artificial Intelligence, Psychotherapy, Mental Health, Chatbots, Virtual Therapy, Ethical Considerations, Personalized Treatment.

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Cyberaddiction, characterized by excessive and uncontrollable internet use, has been linked to various psychological and behavioral issues. Adolescents are particularly vulnerable to these risks, as they are heavy users of digital platforms, often spending long hours online for social interaction, entertainment, and gaming. While research on this issue is expanding, our study seeks to contribute further insights into the factors associated with problematic internet use and its implications for adolescent well-being.

The objective of our study was to determine the prevalence of cyberaddiction among adolescents in Sousse, Tunisia and to investigate its relationship to self-esteem.

We conducted a descriptive cross-sectional study with analytical objectives among adolescents aged 12 to 18 from schools in Sousse Medina, Tunisia during February, March, and April 2024. We used a demographic information form, the Young Internet Addiction Test and the Rosenberg Self-Esteem Scale for data collection.

Our population consisted of 416 adolescents. The most represented age group was 14 years old (22.1%), with a mean age of 15.05 ± 1.7 years. The sample comprised 236 females (56.7%) and 180 males (43.3%). Our findings indicate that 83.2% of participants exhibited problematic internet use with potential life consequences, 11.3% showed occasional excessive use but maintained control, and 5.5% experienced severe repercussions from their internet use. Additionally, 43% of participants spent more than 2 hours per day online. A statistically significant relationship was observed between the amount of time spent online and cyberaddiction (p = 0.009, with higher levels of cyberaddiction associated with increased internet usage. According to the Rosenberg Scale, 51.9% of adolescents had low self-esteem, however, no statistically significant relationship was observed between self-esteem and cyberaddiction.

Our findings highlight a concerning prevalence of problematic internet use among adolescents, with no significant correlation identified between self-esteem and cyberaddiction. This suggests that other underlying factors may contribute to the challenges faced by this population. It is crucial for healthcare professionals and policymakers to prioritize preventive measures and awareness campaigns, promoting healthier online habits and ultimately fostering the well-being of young people in an increasingly digital world.

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Mental disorders, such as Bipolar Disorder (BD), Schizophrenia (SZ), and Schizoaffective Disorder (SA), are prevalent and often debilitating conditions that significantly impact individuals’ lives (Scangos et al. Nat Med 2023; 29(2): 317-33). Recent findings have identified blood RNA editing gene modifications that may aid in distinguishing between healthy controls, depressed patients, and those with BD and unipolar depression, improving diagnostic accuracy and treatment strategies (Salvetat et al. Transl Psychiatry 2022; 12(1):182).

This study demonstrates that RNA editing biomarkers can accurately differentiate individuals with SZ, SA, BD, and healthy controls, highlighting the potential of artificial intelligence (AI)-based predictions for diagnosis.

A comparative analysis was performed with 85 healthy controls subjects, 39 BD, 31 SZ, and 14 SA patients. Patient samples were collected from two cohorts. Diagnostic assessments were conducted using SCID-1, HDRS, YMRS, and M.I.N.I., while healthy controls had no history of mental disorders or psychotropic medication use.

Significant biomarkers were combined using a multiclass Random Forest algorithm. The algorithm was trained on 70% of the population. Then, the test was performed on the 30% of the population who never saw the algorithm. The analysis shows clear differentiation between the control group and individuals with BD, SZ, and SA with high sensitivities and specificities for ROC area under the curve (AUC).

This proof-of-concept analysis provides strong evidence for using RNA editing signature in diagnosis, and potentially in prognosis and treatment prediction. Further validation will be performed using a larger cohort.

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Chronic oral health issues, particularly periodontal disease, are significant contributors to systemic inflammation. Emerging evidence indicates that this inflammation can influence neurophysiological processes and contribute to psychiatric disorders, including depression and anxiety. Recent literature review has revealed that periodontal disease and depression share common biomarkers, such as lipopolysaccharide (LPS), C-reactive protein (CRP), interleukin-6 (IL-6), and cortisol.

To elucidate the connection between poor oral health and psychiatric disorders through the lens of systemic inflammation and its neurophysiological impacts.

A comprehensive literature review was conducted using PubMed, PsycINFO, and Google Scholar, focusing on studies from the past decade that examine the relationship between periodontal disease, systemic inflammation, and psychiatric disorders. Key findings regarding the involvement of pro-inflammatory cytokines and their neurophysiological effects were synthesized.

The review highlighted that periodontal disease leads to elevated levels of pro-inflammatory cytokines. Such cytokines as CRP, IL-6, and tumor necrosis factor-alpha (TNF-α) can cross the blood-brain barrier, contributing to neuroinflammation and dysregulation of neurotransmitter systems. One significant effect is on serotonin metabolism, which is critical in the pathophysiology of depression. Pro-inflammatory cytokines can lead to reduced serotonin availability by upregulating genetic expression of serotonin transporters and increased serotonin metabolism. Given the interplay between inflammatory cytokines and neurotransmitter metabolism, the studies indicate that individuals with periodontal disease are more likely to exhibit depressive and anxiety symptoms, with neuroinflammation serving as a mediating factor.

Table 1: Impact of Pro-inflammatory Cytokines on Neurophysiological Processes

Systemic inflammation resulting from poor oral health significantly impacts neurophysiological processes associated with psychiatric disorders. These findings underscore the need for integrated healthcare approaches that consider both oral and mental health to mitigate the adverse effects of neuroinflammation on psychiatric well-being.

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Interpersonal Psychotherapy (IPT) has been recognized as an effective treatment for various eating disorders, particularly Binge Eating Disorder (BED) and Bulimia Nervosa (BN). IPT focuses on addressing interpersonal difficulties, such as role transitions, interpersonal disputes, and social deficits, which are common in individuals with eating disorders. While evidence supports its use for BED and BN, its effectiveness for Anorexia Nervosa (AN) remains limited. Group-based IPT has also shown promise by targeting interpersonal deficits that perpetuate disordered eating behaviors.

This literature review aims to evaluate the efficacy of IPT in treating eating disorders, with a focus on BED and BN. Additionally, it explores the role of interpersonal deficits as a central focus of IPT and compares the outcomes of individual and group-based IPT formats.

A review of peer-reviewed studies, clinical trials, and meta-analyses published between 2000 and 2024 was conducted. The review assessed the effectiveness of IPT in reducing disordered eating behaviors, improving interpersonal functioning, and maintaining long-term treatment gains. Studies on both individual and group IPT formats were included, with a focus on binge eating reduction, interpersonal relationship improvements, and relapse prevention.

The literature consistently shows that IPT is effective in reducing binge eating behaviors and improving interpersonal relationships in individuals with BED. Group IPT, in particular, has been shown to effectively address interpersonal deficits, providing social support and improving interpersonal skills, which contributes to sustained treatment outcomes. IPT has demonstrated comparable short-term efficacy to Cognitive Behavioral Therapy (CBT), with studies indicating superior long-term maintenance of treatment effects. However, evidence for IPT’s use in AN remains sparse.

IPT is a promising treatment for eating disorders, particularly for individuals with BED and BN who exhibit significant interpersonal deficits. Group IPT appears to be especially effective in addressing these interpersonal issues, providing long-term benefits. While CBT remains the most widely used therapy, IPT offers a valuable alternative, particularly for individuals who do not respond to CBT. Future research should focus on exploring IPT’s mechanisms and expanding its application to other eating disorders, including AN, where evidence is currently lacking.

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A number of medicinal plants have produced noticeable results in depression treatment including, Rhodiola rosea and Crocus Sativus (saffron).

To evaluate the efficacy and safety of a combination of rhodiola and saffron in patients with moderate depression.

Adults with moderate depression (International Classification of Diseases [ICD-10]) of moderate intensity (Hamilton Depression Score [HAM-D] ≥ 17 and ≤ 23) were recruited (n=126; 64 students, 62 non students). Patients took 2 tablets of the supplement (i.e. 308 mg rhodiola and 30 mg saffron) or a placebo daily for 6 weeks. Main criterion was the evolution of HAM-D score between Day (D) 0 and D42. Other criteria were evolution of HAM-D, Hospital Anxiety and Depression Scale (HADS)-anxiety and HADS-depression, Patient’s Global Impression of Change (PGIC), Clinical Global Impression of severity and improvement (CGI-S and -I) at D0, D21 and D42, tolerability and compliance.

A significant 10-point decrease in HAM-D score was observed only in the supplemented non-student population between D0 and D21 (from 18.9±1.7 to 8.6±3.4 in Supplement group versus 18.5±1.8 to 11.2±4.2 in Placebo group, p=0.005). At D42, a 12-point decrease was observed in the Supplement group; the difference between the two groups being marginally significant (from 18.9±1.7 to 7.1±5.0 in Supplement group versus from 18.5±1.8 to 8.8±4.2 in Placebo group, p=0.087). The percentage of patients with a HAM-D score reduction >75% was higher in the Supplement group (p<0.05). The HAM-D score decrease was particularly marked in patients with HADS-anxiety ≥11 at D21. The distribution of patients by severity HAM-D classes (no, mild, moderate depression) was significantly different between the two groups (p<0.05 at D21 and D42), with a greater number of patients with no or mild symptoms in the Supplement group. The remission rate (HAM-D ≤ 7) was higher in this group (p<0.05 at D21 and D42). These results by classes were also found with HADS-depression scale. Results for CGI-S and CGI-I were in favor of the Supplement group (p<0.05 at D21). These results were not observed in students. Compliance and tolerability were good.

As expected, the rhodiola plus saffron combination improved psychological well-being of non-student patients with moderate depression. The poor results observed in students suggest that health professionals should ascertain the real depressive state of students confronted with stressful and/or anxiety-provoking situations linked to exams, professional future or precarity. When prescribing, clinicians should not only rely on quantitative scales, but above all on their clinical feelings.

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Clozapine has the strongest evidence for efficacy for schizophrenia that has proved refractory to adequate trials of standard antipsychotic medication. Its use is limited to these cases due to the uncommon but severe adverse effect agranulocytosis or severe neutropenia, defined as a neutrophil count under 500/microL. It is seen in 0,4 % of clozapine patients and it usually occurs in the first three months. Risk is managed with close blood count (BC) monitoring protocol.

This work aims to improve the understanding and management of this condition.

With this purpose, we present a clinical report and rewiew its management in literature.

We present the case of a 60-year-old man with the diagnosis of resistant schizophrenia who is hospitalized in the acute Psychiatry Unit due to decompensation, where clozapine is initiated with gradual dose augmentation and weekly BC. After improvement of psychotic symptoms, the patient is transferred to a subacute care facility. Two months later, BC revealed mild neutropenia (1000/microL; defined as 1000-1500/microL) becoming severe (100/microL) on the next test one week later. Clozapine is then interrupted and replaced with olanzapine. Neutrophils descend to zero within one day and three days later, with all granulocytes in low levels, the patient presents fever and diarrhea, being finally hospitalized in Internal Medicine. Empirical intravenous antibiotic therapy is prescribed as well as filgastrim, a granulocite-colony stimulating factor (G-CSF). Antibiotic is adjusted after Enterococo Faecalis is isolated in blood cultives. Despite eleven days without clozapine and eight days with G-CSF, agranulocytosis persisted. Taking in consideration the severity of the case and the non existence of acute psychotic symptoms, olanzapine is interrupted and benzodiacepine medication is increased, with BC normalization within three days and remission of digestive symptoms and fever. G-CSF is interrupted and the patient is re-transferred to the subacute unit, with initiation of aripiprazol in the following days.

Upon the appereance of mild neutropenia, closer blood monitorization is recommended (three times a week); with interruption of clozapine and daily monitoring in case of moderate or severe neutropenia. In relation to when to reintroduce antipsychotic treatment, clinical guidelines are cautious, emphasizing the need of close hematological monitoring and careful evaluation of risks and benefits. However, most recommend waiting for complete neutrophil recovery, taking into account the severity of the psychotic symptoms. Olanzapine, with similar mechanism of action but much lower risk, is usually the election.

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Although clozapine-induced agranulocytosis is rare, its complexity and severity requires a fine review of its management, considering that this probably has an impact on the patient’s clinical evolution.

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In the high-stress world of healthcare, the intertwined relationship mental health and the life quality is pivotal.

Prioritizing healthcare professionals’ mental health and nurturing a positive safety climate are essential to enhancing overall job satisfaction.

Evaluate the mental health status of the physiotherapists.

his is a cross-sectional study among Physiotherapists (PTs) working in the city of Sousse. A self-administrated questionnaire was distributed either manually or via e-mail to collect information about the personal and occupational history of participants. The mentel health was assesed by the the mental component score (MCS-12) of the the Short Form Survey SF-12.

A total of 93 questionnaires were collected. The PTs were 35±8 years old on average. Women made up 65.6% of the PTs. Sixty-six (71.7%) and sixty-two (67.4%) did not provide any medical or surgical history respectively and the majority of the population (54.5%) had a normal BMI. Among all respondents, nineteen (20.4%) PTs were regular smokers and an alcoholic beverage was consumed by 14 (15.7%) PTs. The sport was the common hobby of PTs (53.8%). In this group of PTs, 37 (40.2%) worked in the public sector, and 55 (59.8%) worked in the private sector. The mean seniority was 11.9±7.8 years and the average workweek for the population was 42.42 hours. The mean MCS-12 score was 43.94 (9.05 SD). The findings showed that 35 PTs (37.6%) had MCS-12 scores below the standard value. Male PTs showed slightly higher MCS-12 means than female PTs with a modest difference between PTs working in the public and private sectors. PTs who had more than 15 years of work experience scored the lowest MCS-12 mean 41.40 (SD 9.94) which is a score underneath the reference value indicating in this case low mental health functioning among PTs.

This study showed that Tunisian PTs had low mental health statuts highlighting the need for approaches to improve interventions that effectively enhance well-being, retention, and sustainability of practitioners, and thus the care delivered, in the healthcare system

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Autism spectrum disorder (ASD) presents specific characteristics in child development. Behavioral and, mainly, communicative aspects are the most frequent for diagnostic closure (APA Artmed 2014; Asperger Archiv F. Psychiatrie 1944; 117 76-136). The absence, delay or difficulties in establishing expressive language are important social markers in early childhood, being one of the main reasons that lead families to seek therapeutic guidance (Amato USP 2006; Andrade UFPB 2017; Andrade Pró-Fono 2023). One of the aspects related to the communication of children with ASD is the interest in foreign languages, which manifests itself from early childhood (Avelar Universidade Presbiteriana Mackenzie 2018). The use of a foreign language for interpersonal communication presented spontaneously, by children with ASD, is something that needs to be evaluated within the functional aspects of social communication, since the major communicative difficulties faced are related to pragmatic aspects (Andrade Pró-Fono 2023; Balestro et al. Rev Soc Bras Fonoaudiol 2012; 17 279-86). The form and means of communication, length of permanence and communicative quality are fundamental elements to be analyzed when comparing expected child development to chronological age. In a research process involving humans, it makes perfect sense to anticipate and understand linguistic, cultural and educational differences, in order to avoid contextual and communicative variables that conflict with the proposed aims.

The objective of this study is to evaluate the functional communication of children with ASD in Portuguese and English language contexts.

16 children were selected, aged 42 to 72 months, without relatives and/or living with multilingual people. Samples were collected by recording spontaneous communication between patient and therapist in a natural intervention environment. 5-minute clips of greater interaction were made and, from these, the analyzes were carried out. This research has an opinion approved by the Ethics Committee, under number 6,890,786.

Parents’ perception of their children’s communication difficulties were unanimously reported. Greater communicative ability was demonstrated in the Portuguese language, however, communicative ability and functionality was verified in the English language, without significant statistical differences when comparing the two languages. In the production of grammatical classes, there was greater production in the Portuguese language, with greater lexical production.

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The children under observation and evaluation in this study showed satisfactory correlation and performance in the proposed tests. There was communicative performance, with results without significant statistical differences in the Functional Communication Profile in both languages. More studies will be needed to support these results.

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Bulimic behavior has been increasingly recognized in patients with bipolar disorder (BD). Even during euthymic phases, individuals with BD may remain vulnerable to disordered eating patterns such as bulimia and binge eating.

This study aims to examine the occurrence of bulimic behavior in euthymic patients with BD and identify associated clinical and sociodemographic factors.

We conducted a cross-sectional, descriptive, and analytical study of 93 patients followed for bipolar disorder at the psychiatry outpatient unit at the Hedi Chaker University Hospital in Sfax. The questionnaire included sociodemographic data, medical and psychiatric history, and anthropometric characteristics. Bulimic behavior was assessed using the Bulimic Investigatory Test Edinburgh (BITE).

The mean age of the participants was 41.49±12.33 years, with a M/F sex ratio of 2.58. Among the patients, 58.1% were married, 45.2% had secondary education, and 47.3% were unemployed. Personal somatic history was reported by 35.5%, while 11.8% had psychiatric comorbidities in addition to bipolar disorder.

The mean body mass index (BMI) was 27.4 kg/m² (SD=5.96), with 29% of patients being overweight and 31.2% classified as obese.

Eight patients (8.6%) had BITE scores above the threshold of 20, indicating bulimic behavior.

Significant associations were found between elevated BITE scores and female gender (p=0.012), comorbid medical conditions (p=0.005), family history of schizophrenia (p=0.024), weight (p<10⁻³), BMI (p<10⁻³), hypomanic residual symptoms (p<10⁻³), irregular follow-up (p=0.027), and delayed management of BD (p=0.04).

Our results highlight the importance of early identification and comprehensive management of disordered eating in bipolar patients, even during periods of mood stability, to optimize overall health and psychiatric outcomes.

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Many beneficiaries are stuck and find it difficult to act creatively because they are used to being in a different place than where they are at that moment:

they lose their balance and the ability to move in harmony with the forces of the environment which, in the end, will support the expression.

They expect something different from what they are doing at that moment or they think that what they are doing is inadequate; they get stuck, they get caught in negative and confused thoughts.

Even if a finished object or image is obtained, the research pursues, first of all, the way and the extent to which the creative process and execution of the artifact contributes to the improvement or healing of the studied beneficiaries. Correlative objective being the increase of their quality of life and their socio-professional integration. In assessing the motor functions of the beneficiaries, it is essential that the emphasis is placed on the outstanding and hidden motor abilities of each individual. The aim is to improve: coordination disorders, spatialization disorders, fine motor skills, sensoriality, creativity, socialization.

ORGANIZATION OF ACTIVITIES is done in three types of workshops, with different objectives and interventions,

• - Occupational therapy workshop in the category that includes art therapy.

• - Occupational therapy

• - Relaxation, play therapy

CASE STUDY: Placement center Jucu PA, sex M, 16 years old.

Diagnosis: Secular infantile encephalopathy, behavioral disorders

• - heteroaggressiveness, severe mental retardation, alalia.

• - Uses modeling for self-expression and self-fulfillment. During work, he is not aggressive and relates to people who appreciate his work.

An advanced level is observed in modeling, even compared to normal people. Spatial abstract compositions from plasticine, expressive and balanced, are made at the beginning, the evolution is observed in the modeling of the figures (he starts to model personalized human figures), which he pairs chromatically, groups them into dancing figures, or groups them affectively and vertically. He also showed changes in his behavior: he smiled while working, clapped and recognized us when we entered the workshop, wanted to be photographed and petted (although normally he can’t stand being touched). He showed interest in the camera and in the modeling works of other children from Placement center.

Work in visual arts and design therapies aims to create a product. The benefits arise from experiences based on artistic creativity: materializing ideas and solving unexpected results.

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The artistic image becomes significant in strengthening the verbal exchange between the beneficiary and the art therapist, solving problems and formulating new perceptions that in turn lead to positive changes, growth and healing.

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Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder and accurate diagnosis is essential but remains challenging due to the potential for malingering. Additionally, the increasing demands of a fast-paced society place, prompting quick solutions, may lead to simulated presentations or feigning. This paper examines the complexities of distinguishing genuine ADHD cases from malingering, emphasizing the need for refined diagnostic protocols. Malingering, in fact, involves deliberately fabricating symptoms to achieve a desired result, such as:

• - Academic Advantages

• - Access to Medications

• - Avoiding Responsibilities

Given all these challenges, we explored how current scientific literature addresses this issue. Inspired by the work of many colleagues, we aimed to summarize their efforts in this systematic review to propose a possible solution for collaborative improvement.

We analyzed over 296 papers from major scientific databases focusing on “malingering and ADHD” to create a comprehensive overview of this increasingly widespread problem.

The main results, after a thorough analysis of all parameters, emphasize the need for:

1. Advanced Assessment and Objective Measures: dynamic assessment techniques, combined with psychophysiological measures and parental input.

2. Enhanced Diagnostic Protocols and Tools Integration: ADHD rating scales and Symptom Validity Tests (SVTs) like TOMM (Test of Memory Malingering) and WMT (Word Memory Test) to minimize diagnostic errors, make the criteria more robust.

The following table summarizes the criteria analyzed in the 37 articles selected after a thorough review.

Traditional ADHD assessments, based heavily on self-reported symptoms, are becoming less reliable, especially with the growing trend of self-diagnosis and malingering. To address this, adding performance-based tests like TOMM and WMT is key for spotting malingering and improving diagnosis accuracy. Our study aims to elucidate this issue, which has subtle but profound implications for the quality of life of thousands of patients, who may receive a superficial diagnosis that could affect them for a lifetime, even pharmacologically.

None Declared

A heightened susceptibility to mood disorders among women at specific junctures throughout their reproductive lifetime has been reported. Previous studies have suggested that the probability of developing Major Depressive Disorder (MDD) during the menopausal transition is amplified from 2 to 4 times when contrasted with both premenopausal and postmenopausal periods and also increased mood symptom severity in the menopausal transition in bipolar disorder (BD) has been cited (Chen et al. Arch Womens Ment Health 2017; 20 463-8). A considerable body of evidence suggests that mitochondrial dysfunction plays a crucial role in the pathophysiology of various psychiatric disorders, including MDD and BD. Researchers have proposed that the mitochondrial DNA copy number (mtDNAcn) may serve as an essential marker of mitochondrial health, which is the ratio of mitochondrial and nuclear DNA (Malik et al. Mitochondrion 2013; 13 481-92).

In this review, we aimed to compile and present existing data regarding mtDNAcn alterations in women during the menopausal transition by comparing the mtDNAcn numbers of the women in premenopausal, perimenopausal and postmenopausal periods thereby establishing a foundation for future research on the origins of these conditions.

A literature search was conducted on the electronic databases PubMed, Cochrane Library, Medline (OVID), Scopus, Web of Science and CINAHL to identify the relevant studies published until 14 October 2024. The search was performed using the following keywords (Menopause OR Premenopause OR Pre-Menopause OR Premenopaus* OR Perimenopause OR Postmenopause OR Post-Menopause OR Postmenopaus*) AND (mitochondrial DNA copy number OR mtDNA copy number) and limited to English language.

According to the search results, 66 publications were reached in total. After detecting and removing duplicate publications, there were 21 publications left. After screening, any of the studies met inclusion criteria for the systematic review, because most of them were conducted in different patient groups and healthy controls in the menopausal transition periods, but the main findings of these studies can be summarized as; mtDNAcn varies between the patients groups and healthy controls in the menopausal transition periods with the conflicting results. Some of the studies found higher mtDNAcn in patient groups such as breast cancer and pelvic organ prolapsus, whereas some of them found lower mtDNAcn numbers in patient groups such as osteopenia and osteoporosis.

Considering above findings, there is mtDNAcn alterations in women during the menopausal transition. These findings may highlight the need for future studies to elucidate the link with mtDNAcn and mood disorders in the menopausal transition period by comparing the women in different menopausal periods.

None Declared

Lumateperone, an atypical antipsychotic drug, has a dual mechanism of action by combination of activity at central serotonin (5-HT2A) and dopamine (D2) receptors.

This subgroup analysis of an Indian Phase 3 study was conducted to evaluate the efficacy and safety of Lumateperone 42mg compared to Quetiapine 300mg in treatment of Bipolar II depression when stratified based on prior hypomanic episodes.

The phase-III, randomized, multi-centric, assessor-blind, parallel-group, active-controlled, comparative, non-inferiority study included Indian patients with Bipolar II depression with moderate severity having a Montgomery-Asberg depression rating scale (MADRS) score ≥20 and Clinical global impression–bipolar version–severity (CGI-BP-S) score ≥4. The study was conducted after receiving regulatory and ethics committee approvals. The patients were randomized (1:1) to either receive Lumateperone 42mg [Test] or Quetiapine 300mg [Comparator] for 6 weeks. The patients were stratified based on number of prior hypomanic episodes in lifetime: Subgroup 1 [S1]: 1 episode and Subgroup 2 [S2]: >1 episode. For efficacy outcomes MADRS score, CGI-BP-S (total score, depression subscore and overall bipolar illness subscore), and Quality of life enjoyment and satisfaction-short form questionnaire (Q-LES-Q-SF) score were evaluated and for safety outcomes treatment emergent adverse events (TEAEs) were assessed. [Clinical trial registration: CTRI/2023/10/058583]

This subgroup analysis included 462 patients, out of which 251 in S1[Test=129; Comparator=122] and 211 in S2[Test=102; Comparator=109]. The baseline demographic characteristics were comparable in between treatment arms across subgroups. The primary endpoint of reduction in MADRS score from baseline to Day 42 in Test arm was non-inferior to Comparator arm in both subgroups [Figure 1] as the upper 95% CI was below the pre-defined margin of 3.0. The reduction of CGI-BP-S (total score, depression subscore and overall bipolar illness subscore) from Day 14 to Day 42 were comparable in both Test and Comparator arms in both subgroups. The improvement in Q-LES-Q-SF score from baseline to Day 42 were comparable in both Test and Comparator arms in both subgroups. The incidence of TEAEs were similar in both treatment arms [S1: Test=37.2% and Comparator=35.2%; S2: Test=31.4% and Comparator=35.8%] and no serious adverse events were reported.

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This subgroup analysis demonstrated that Lumateperone 42mg is non-inferior to Quetiapine 300mg in treatment of Bipolar II depression as assessed via MADRS score from baseline to Day 42, irrespective of number of previous hypomanic episodes and both treatments were found to be well tolerated.

A. Dharmadhikari: None Declared, P. Chaurasia: None Declared, Y. Patel: None Declared, D. Choudhary: None Declared, P. Dasud: None Declared, M. Bhirud: None Declared, P. Meena: None Declared, F. Shah: None Declared, G. Ganesan: None Declared, B. P. Rathour: None Declared, K. Mistry: None Declared, M. Dutta: None Declared, A. Ramaraju: None Declared, S. Mangalwedhe: None Declared, S. G. Goyal: None Declared, G. Kulkarni: None Declared, A. Mukhopadhyay: None Declared, P. Chaudhary: None Declared, G. T. Harsha: None Declared, M. Parikh: None Declared, S. Dey: None Declared, S. Sarkhel: None Declared, N. Jyothi: None Declared, A. Kumar: None Declared, N. Sooch: None Declared, A. Shetty Employee of: Sun Pharma, S. Saha Employee of: Sun Pharma, P. Devkare Employee of: Sun Pharma, A. Shetty Employee of: Sun Pharma, D. Patil Employee of: Sun Pharma, P. Ghadge Employee of: Sun Pharma, A. Mane Employee of: Sun Pharma, S. Mehta Employee of: Sun Pharma.

In this study, the scale’s psychometric properties are estimated among South African high school learners during a period of the coronavirus-19 crisis. The study was a cross-sectional design. The data were collected from 1603 high school learners in four South African districts. The PHQ-4 was administered for data collection, and was anchored from 0 (not at all) to 3 (nearly every day) over a two-week period, with higher scores indicating the extent of symptom severity (Kroenke et al., 2009).

The study sought to validate the PHQ-4 among South African school learners in various South African districts, and tested a model that included the PHQ-4 to investigate the obtaned factor structure’s usefulness.

Useful questionnaires were collected from 1562 high school learners within a cross-sectional design. Grades 10 to 12 learners completed the PHQ-4 from March to May 2022.

Confirmatory Factor Analysis (CFA) was conducted to validate the factor structure of the scale. CFA results show that all PHQ-4 items load onto a single factor. The factor structure reported in this study is unique. Whilst the PHQ-4 is commonly considered to measure anxiety and depression, the results suggest that the scale measures a unidimensional, psychological distress factor among the learners. The total score of the PHQ-4, characterized as psychological distress, could be predicated by associated factors, although the coefficients obtained were statistically significant but weak. The PHQ-4 was predicted by the Perceived Vulnerability and the Germ Aversion subscales but not the Fear of COVID-19 scale in girls. But the PHQ-4 was predicted by the Fear of COVID-19 scale and not the Perceived Vulnerability and the Germ Aversion subscales among boys.

Contrary to existing studies, the PHQ-4 did not consist of 2 factors. Evidence from the current study suggests that it should be used as a unidimensional, single factor scale. The PHQ-4 total scores of girls and boys were predicted by different factors, suggesting that gender should be considered an important factor when using the PHQ-4 in reseaerch.

None Declared

The World Health Organization (WHO) defines adolescence as the developmental stage between childhood and adulthood, spanning ages 10 to 19. This period is characterized by significant physical, cognitive, and psychosocial growth.

This study aims to understand the clinical profile of adolescents hospitalized for the first time in the psychiatric department.

• - It’s a retrospective and descriptive study covering the files of patients who consulted the Avicenna Psychiatry department of Razi hospital aged under 18, during the year 2023.

• - The collection of anamnestic and clinical data was established using a pre-established form

Our study included 24 patients aged between 16 and 18 years, with a mean age of 17 years, comprising 13 males and 11 females.

Patients presented voluntarily in 42% of cases, were brought in by law enforcement in 25%, and were referred by a private psychiatrist in 17% of cases. The reasons for consultation were as follows: behavioral disturbances in 63% of cases, a suicide attempt in 21%, and incoherent statements in 8% of cases. 60% of cases used medication ingestion as the method during the suicide attempt. A family history of psychiatric disorders was found in 50% of cases, as well as a family history of suicide attempts in 13% of cases. Additionally, 71% of cases had prior follow-up with a private psychiatrist, 21%of cases had previously attempted suicide, and 33%of cases had personal somatic histories.

The onset of disturbances was progressive in 71% of patients. Upon hospitalization, anxious symptoms were noted in 25% of cases, while depressive symptoms with suicidal ideation were recorded in 29% of patients. hallucinations and delusions were noted in 50% of cases, and behavioral eccentricity was observed in 25% of cases.Instinctual disorders were present in 75% of cases, with sleep disturbances observed in 71%of cases, sexual disorders in 25%of cases, and appetite disorders in 13 %of cases.

Verbal hetero-aggression was identified in 83% of cases, while physical hetero-aggression was noted in 67%of cases. Self-harming behaviors were recorded in 48% of patients.

The diagnoses made according to DSM-5 criteria were distributed as follows: bipolar disorder in 29% of cases, schizophrenia in 17%of cases, and 13%of cases related to a life stage.

Adolescent psychiatric hospitalizations are rising, emphasizing the need to understand clinical characteristics of this population. This study analyzes clinical aspects of adolescents admitted to a psychiatric unit over one year. The findings aim to enhance treatment strategies and patient outcomes.

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Methamphetamine use disorder (MUD) and associated conditions impose a significant burden not only on affected individuals and their families but also on communities. Neurotransmitter system imbalances, mitochondrial dysfunction, oxidative stress, and activation of the inflammasome have all been implicated in methamphetamine-induced neurotoxicity. However, whether MUD is associated with peripheral mtDNA alterations remains uncertain.

This study aimed to investigate the relationship between mtDNA copy number and clinical parameters in individuals diagnosed with MUD, comparing them with healthy controls.

Our study is a case-control research involving 52 patients diagnosed with MUD based on DSM-5 criteria and 52 healthy controls. Peripheral blood samples were collected, and leukocytes were isolated using the ELK Biotech Genomic DNA Extraction Kit for genomic DNA extraction. DNA samples were diluted to a concentration of 0.5-2 ng/μl for mtDNA copy number analysis, which was performed using the ScienCell qPCR Assay Kit. Two qPCR reactions were carried out for each sample using mtDNA and SCR primer sets. Known mtDNA copy number samples were used as references, and mtDNA copy numbers for each sample were calculated using the comparative ∆∆Cq method.

When comparing the mtDNA copy numbers between patients diagnosed with MUD and the control group, the mtDNA copy number in individuals with MUD was found to be significantly lower than that of the control group (p=.001). After controlling for age and gender, clinical parameters (suicide attempt, non-suicidal self-injury, duration of disorder, withdrawal symptoms, psychosis) and scale scores were compared based on mtDNA copy numbers. Among these, only substance use duration showed a statistically significant difference between the groups (p=.045). Additionally, in this study, a significant negative correlation was found between mtDNA copy numbers and the duration of disorder in MUD patients (r=-.369, p=.008).

This is the first study examining the relationship between peripheral mtDNA alterations and clinical parameters in individuals diagnosed with MUD. A previous study showed that individuals with MUD exhibited decreased mtDNA copy numbers and increased mtDNA damage compared to healthy individuals in the Chinese population. Consistent with these findings, it was suggested that methamphetamine could lead to mitochondrial dysfunction and a reduction in mtDNA copy numbers in cell lines and animal models. In conclusion, individuals with MUD show decreased mtDNA copy numbers in peripheral blood samples, potentially related to increased autophagy. In this context, the reduction in mtDNA copy numbers could be used as a biomarker for MUD, and preventing this reduction may be beneficial in the clinical treatment of addiction.

None Declared

Suicide Crisis Syndrome (SCS) is an acute suicidal state characterized by feelings of entrapment, affective disturbances, loss of cognitive control, hyperarousal, and social withdrawal. It has been demonstrated that SCS predicted suicidal behavior post discharge and that could help identifying high risk patients (Galynker I. Oxford University Press 2023; Yaseen ZS et al. Suicide Life Threat Behav Aug 2019;49(4):1124-1135). Until today, there is no valid consensus on which medication class is more effective in reducing the acute symptoms of SCS, which often accompany suicidal patients.

The present study aims to evaluate medication response to SCS along hospitalization into a psychiatric unit and to determine if certain drug classes can alleviate SCS symptoms.

The sample consisted of 133 participants, aged 18 to 85, recruited across four Mount Sinai Health System hospitals in New York City, USA and admitted to the psychiatric units for suicidal behavior in the past week. Patients were assessed at intake and discharge with the Suicide Crisis Syndrome -Checklist (SCS-C) to evaluate the presence of SCS symptoms. Administered medication were divided into 5 classes: antipsychotics, antidepressants, mood stabilizers, benzodiazepines and opioids.

Looking at administered medications, descriptive analysis showed an overall decrease in mean SCS-C scores from intake to discharge with antipsychotics and opioids being associated with greater SCS symptoms reduction throughout hospitalization. On the other hand, participants taking antidepressants, mood stabilizers or benzodiazepines did not show different SCS-C results than participants who were not administered these medications.

Our results are preliminary and to gain a clearer perspective a larger sample size would be needed. Nonetheless, antipsychotics drugs given their broad psychopharmacological properties might be able to address the difficult and heterogeneous symptomatology of suicidal patients, especially loss of cognitive control aspect of the SCS. Given that opioids are used to treat emotional pain, they may be an effective treatment for symptoms of SCS as well. These results highlight the need for further studies and randomized clinical trials to adequately assess the effectiveness and safety of these medications in treating SCS.

None Declared