While depression trajectories have been extensively studied in recent decades, research has predominantly focused on younger and middle-aged individuals, often overlooking vulnerable older patients. Classifying patients based on treatment trajectories may enhance personalized care efforts and long-term treatment management for older adults.

This study investigates the varying patterns of depression treatment trajectories and examines the influence of social factors on these trajectories in older adults initiating first-time depression treatment over a three-year period.

We conducted a nationwide cohort study using Danish registers, including all adults aged 65 and older who filled their first-time antidepressant prescriptions between 2006 and 2015 (with no prescriptions in the previous decade). Depression treatment patterns were assessed through antidepressant prescription redemptions and psychiatric hospital contacts for depression. Latent class growth modeling identified distinct treatment trajectories over the three years, while multinomial logistic regression analyzed the association between social factors and trajectory group membership.

Among the 66,540 older adults included in the study (55.2% female, mean age: 77.3 years), three unique depression treatment trajectories emerged: ‘brief treatment’ (33.7%), where treatment ended within six months; ‘gradual withdrawal’ (26.5%), where treatment tapered off over two years; and ‘persistent treatment’ (39.8%), where treatment continued throughout the three years. Association analyses showed that female sex, living alone, and residing in less-urbanized regions were associated with higher odds of membership in the persistent treatment group. In contrast, older individuals, those who were widowed or separated, and individuals of non-Danish ethnicity were associated with lower odds of membership in the persistent treatment group.

This study identifies three distinct depression treatment trajectories in older adults. Social factors such as sex, household composition, place of residence, and ethnicity were associated with treatment duration and trajectories. Tailored interventions based on patient characteristics may enhance depression care for older adults, ensuring more personalized and effective treatment strategies.

K. Ishtiak-Ahmed: None Declared, C. Rohde Grant / Research support from: CR received the 2020 Lundbeck Foundation Talent Prize, O. Köhler-Forsberg Speakers bureau of: OKF reported honoraria for lectures for Lundbeck Pharma A/S and consultant fees for WCG Clinical, all unrelated to the present work., K. Christensen : None Declared, C. Gasse: None Declared

Reproduction in mammals relies on complex interactions involving the genital and olfactory systems, which can be influenced by environmental factors, such as manganese (Mn). Although essential for survival, Mn is potentially toxic over long periods, potentially affecting sexual and reproductive behaviors.

This study aims to assess the long-term effects of Mn exposure on sexual and reproductive functions in male Wistar rats, focusing on Mn-induced neuroaffective and olfactory dysfunctions.

Male Wistar rats received intraperitoneal injections of Mn at doses of 6 mg/kg, 25 mg/kg, and 30 mg/kg for 12 weeks. Each experimental group consisted of one Mn-intoxicated male and four non-intoxicated females. After six days of cohabitation, the females were isolated to evaluate fertility outcomes. The study also monitored weight changes and conducted behavioral assessments for anxiety, depression, and olfactory functions in males.

Higher Mn doses (25 mg/kg and 30 mg/kg) resulted in significant behavioral changes in males, including anxiety, depression, and olfactory dysfunctions, which were associated with decreased reproductive success. Specifically, pregnancy rates were 33% (4 out of 12) at 25 mg/kg and zero at 30 mg/kg. In contrast, males treated with 6 mg/kg Mn exhibited no significant neuroaffective or olfactory impairments, maintaining fertility rates comparable to those of the control groups.

Chronic Mn exposure adversely affects sexual behavior and reproductive success in male Wistar rats, probably due to olfactory and neuroaffective disruptions. Further research is recommended to elucidate the mechanisms underlying these effects.

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Psychiatric issues are prevalent among the elderly, and as people age, they often face both medical and psychiatric comorbidities, creating significant challenges. However, there is a notable lack of literature on inpatient studies focused on this demographic.

This study aims to assess the socio-demographic profile of patients over the age of 60 admitted to a psychiatric unit at Razi Hospital, Tunisia, while identifying the prevalence of various psychiatric disorders.

This was a retrospective and descriptive study. It included patients aged 60 and above who were first-time psychiatric admissions at the El Jazzar department of CHU Razi between 2020 and 2024. Data were collected from medical records, covering variables such as gender, age, year of admission, marital status, education level, occupation, socioeconomic status, medical history, prior treatments, diagnoses, admission type, and discharge treatments.

In this study, we reviewed 40 case files. The analysis revealed that the majority of patients were male (80%), with most falling within the 60-70 age range. The majority were married (65%), and educational attainment was typically low, with 60% having a primary education level or below. Retirees accounted for 65% of the sample. Regarding comorbidities, 70% of the patients had both medical and psychiatric histories. The primary reasons for admission included behavioral disorders, delusional syndromes, and depressive disorders. Prior to admission, treatments mainly consisted of mood stabilizers and first- or second-generation antipsychotics. The most frequent mode of admission was hospitalization at the request of a third party (HDT), followed by involuntary hospitalization (HO). During hospitalization, prescribed treatments included antipsychotics (both atypical and typical), benzodiazepines, and antidepressants. No significant adverse drug reactions were reported. Dementia, recurrent depression, and psychotic relapse in the context of schizophrenia were the most common diagnoses.

This study provides valuable insights into the socio-demographic and clinical profile of patients over 60 admitted to psychiatry at Razi Hospital, highlighting key trends in mental health and treatment approaches. The frequent presence of somatic comorbidities emphasizes the need for a multidisciplinary therapeutic approach. These findings underscore the importance of specialized treatment for the complex needs of this elderly population.

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This presentation sheds light on a group of patients with schizophrenia that are often overlooked. These minority groups include homeless patients and patients with very poor social functioning. Homeless patients with schizophrenia often have complex problems and are difficult to diagnose and treat. While many resources are allocated to early detection and prevention of psychosis programs, few resources are spent on treating the patients who have fallen through the cracks of society and various support systems. These patients are undeniably among the most severely ill psychiatric patients of our time. Patients who are not homeless (domiciled patients) with schizophrenia and very poor social functioning are also often challenging to treat, and they often end up living an isolated existence in their own homes.

This presentation will examine the pathways and barriers to care for patients with schizophrenia who are homeless or have serious social function impairment.

The presentation is based on results from an explorative, cross-sectional study of 85 patients with schizophrenia spectrum diagnosis and severely impaired social function, who either were homeless or domiciled but in need of an outreach team to secure continuous treatment. The study was conducted in Copenhagen in 2020-2024.

We found striking delays in both groups, but most severe in the homeless group. We found a duration of untreated psychosis of ten years and a service delay (period from first contact to psychiatry until a schizophrenia spectrum diagnosis) of four years. Possible reasons for the alarming delays will be discussed, including diagnostic overshadowing and the difficult-to-recognize presentations of schizophrenia. Potential solutions for moving forward will also be highlighted, such as rekindling the diagnostic process.

The overall results from this presentation indicate that there are highly vulnerable minority groups of patients with schizophrenia who have not benefited from the improvements in diagnosis and treatment that we have witnessed in psychiatry in the last 100 years. Acquiring a better understanding of these patients’ conditions, symptom presentations, and barriers to timely diagnosis is highly warranted.

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Psychiatry faces numerous challenges that significantly affect mental health of people in Europe, from climate change, wars, migration, pandemics, to rapid advance of artificial intelligence. Among the most pressing issues are deteriorating mental health of children and adolescents and the lack of trained professionals. At the same time, progress in neuroscientific research contributes to the development of new effective treatments, e.g., monoclonal antibodies for Alzheimer’s disease; repurposing of drugs for psychiatric disorders, such as GLP-1 agonists, showed potential in treatment of alcohol addiction. There is also a renewed interest in psychedelics, recent studies verified their therapeutic efficacy in treatment of several mental disorders. Neurostimulation methods (rTMS, tDSC) are recognized non-pharmacological interventions; utilization of new technologies (AI, virtual reality, mobile apps, etc.) can help us in treatment and prevention of mental disorders.

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Hemispheric imbalance might underlie the genesis of psychosis. In patients with schizophrenia left eye dominance was higher than in control subjects. The aim of the study is to investigate sexual differences in left eye dominance as a biological marker of neuronal dysontogenesis in schizophrenic patients and control subjects. This study is part of a larger investigation project on the intriguing relations between six groups of markers of neuronal dysontogenesis - left-handedness, left-footedness, left-eyedness, minor physical anomalies, digit ratio, and cognitive (attention and memory) deficit.

Altered cerebral lateralization is a key trait found in many neurological and psychiatric disorders. This study investigates the gender difference in eye dominance between patients with schizophrenia and controls.

The study was conducted in the Clinic of Psychiatry at the University Hospital in Sofia and the State Psychiatric Hospital in Radnevo. The sample included 98 (56 men, 42 women) consecutively admitted schizophrenic inpatients with a mean age 34.45 years for men and 42.20 years for women and 82 control subjects (30 men, 52 women) with a mean age 34.70 for men and 44.50 years for women. Three tests for eye dominance were administered as performance tasks- Looking through a monocle, Hole test and Porta test.

The non-parametric Mann-Whitney test was used to analyse the data.

The mean left-eyedness is significantly higher in schizophrenic patients than in control subjects in the three eye tests: Looking through a hole - .81 vs. .39, p<.001, over two times increase; Looking through a monocle - .78 vs. .39, p<.002, two times increase; Porta test - .86 vs. .41, p<.002, over two times increase.

In male subjects the difference between schizophrenia and controls reaches statistical significance for Looking through monocle (p=.037), but does not reach statistical significance for Hole test (p=.196) and Porta test (p=.077). In contrast, all female intra-gender comparisons between schizophrenia and controls reach statistical significance- Looking through monocle (p=.013) and Porta test (p=.015) reach statistical significance at p<.05, while Hole test at p=.001.

The patients with schizophrenia have significantly higher mean left-eyedness than the controls in both sexes, but this difference is much more pronounced in women than in men for all three eye tests. Altered eye dominance in patients with schizophrenia is related to a prenatal maldevelopment and exhibits clear gender difference.

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The institution of child fostering aims to protect minors who lack a secure family environment. In Greece, the implementation of Law 4538/2018 and the Anynet electronic system sought to de-institutionalize minors. This paper, based on a doctoral thesis, investigates the law’s impact and identifies best practices in child fostering.

This study aims to evaluate the implementation of Law 4538/2018 in Greece and the Anynet electronic system, focusing on their impact on de-institutionalizing minors. Additionally, it seeks to identify best practices in the foster care system and their application in child protection settings.

A mixed-method approach was used. The first part involved a quantitative study targeting Directors of Child Protection Frameworks across Greece and foster parents. The second part employed a qualitative case study method, using semi-structured interviews with social workers from four selected Child Protection Frameworks recognized as examples of best practices

The research revealed that, despite the introduction of Law 4538/2018, foster care in Greece remains underutilized, especially for adolescents. Long-term fostering is the most common form, with most children aged four to six. Contact with biological parents is limited, often leading to adoption. Social workers lack sufficient training and familiarity with Anynet, impacting foster placements. However, child protection frameworks that applied specialized strategies for difficult cases saw fewer placement failures. A Unified Foster Care Protocol could standardize and improve foster care practices nationwide.

Though Law 4538/2018 and Anynet are steps forward, Greece’s foster care system is still underdeveloped, with minimal increases in placements. Targeted case management and better social worker training are essential for success. Implementing a Unified Foster Care Protocol could enhance consistency and improve outcomes for fostered children.

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Emotion dysregulation (ED) is a core feature of bipolar disorder (BD), impacting patients’ ability to manage intense emotional responses and maintain mood stability. Predominant polarity (PP) is a clinical specifier in BD with important implications for prognosis, treatment planning, and outcomes. PP categorizes patients based on the mood episode type they experience most frequently: depressive PP (DPP), manic PP (MPP), or undetermined PP (UPP) when no episode type prevails. Given that PP reflects the types of symptoms most commonly experienced by patients, and that ED is closely linked to mood symptoms in BD, it remains unclear whether ED differs across PP subgroups.

We aimed to compare overall levels of ED and specific emotion regulation (ER) domains across patients with BD and DPP, MPP, and UPP.

We analyzed data from patients with BD enrolled in the Bipolar Exposome-Gene Interaction Naturalistic (BEGIN) study. ED and ER strategy alterations were assessed using the Difficulties in Emotion Regulation Scale (DERS-28) and its subscales: Lack of Control, Non-Acceptance, Interference, Inattention, and Confusion. PP was defined based on the Barcelona proposal. Due to non-normal DERS score distributions (Shapiro-Wilk p < 0.05), the Kruskal-Wallis test was applied to compare DERS total and subscale scores across PP groups, followed by Dunn’s test with Bonferroni correction for pairwise comparisons.

The sample included 64 patients with BD (mean age=51±12.5; 46.9% female). Of these, 17 had DPP, 7 had MPP, and 40 had UPP. Significant differences across PP groups were observed in overall ED (p=0.04), with the UPP group showing higher total DERS scores than the MPP group (Z=2.55, p=0.03). In the Lack of Control subscale, both the DPP and UPP groups scored higher than the MPP group (Z=2.43, p=0.04 and Z=3.14, p=0.01, respectively). No other significant differences were found.

These findings indicate that ED varies across PP groups, emphasizing the potential advantages of tailored interventions within a precision psychiatry framework. Personalized approaches to managing ED may improve long-term outcomes and decrease the risk of recurrence across mood states in BD.

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By 1920, the Rockefeller Foundation had set out to systematically improve medical education and clinical practice. This wealthy, formidable agent for change initially focused on surveying the state of medical education world-wide and then targeting individual research institutes and universities with funding aimed at improving their facilities.

The aim was to increase understanding of how the Foundation’s focus on improving medical education and practice changed over time.

The Rockefeller Foundation archive documents the philanthropic activities of the Foundation. Employing a social-history methodology, the primary sources utilised involved officer diaries, including that of Alan Gregg who directed support for medical research and education globally throughout the 1930s and 1940s. Also examined were contemporary journals such as The British Medical Journal, the New England Journal of Medicine, and The Lancet; contemporary newspapers such as the New York Times, The Illustrated London News, and the Times of India, among others. The evidence from the diaries was compared with that of journals, newspapers, and other primary sources.

Initially the Foundation employed a disease-control model aimed at eradicating hookworm, malaria, and yellow fever. However, over time the Foundation changed its focus and developed a special interest in building the discipline of psychiatry. Gregg came to firmly believe that the funding of mental health research and teaching should be given the same resources as any other branch of medicine. Gregg supported initiatives to include psychiatry in standard medical school curricula and he also directed Foundation funding toward individual researchers in the field of mental health. He eventually came to serve as an advisor to the National Institute of Mental Health and the psychiatry section of the Department of Veterans Affairs.

The focus of the Rockefeller Foundation changed over time. Using meticulous planning, the Foundation moved from a laboratory-based, disease-eradication model to developing a deep commitment to promoting scientific psychiatry internationally.

None Declared

Obsessive-compulsive disorder (OCD) is a chronic mental health condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions), which significantly impair daily functioning and quality of life. While common obsessions often revolve around contamination, symmetry, or safety, rarer forms of OCD can involve highly specific and unusual fears.

The aim of this case analysis is to comprehensively examine the possible causes and treatment approaches of obsessive-compulsive disorder, focusing on the investigation of various obsessive conditions that are rarely observed in the literature.

The patient’s history was thoroughly examined, and interviews conducted with the patient’s family were also included in the evaluation. Possible causes of the disorder (from a biopsychosocial perspective) and treatment approaches such as psychotherapy and pharmacotherapy were analyzed through a literature review. Additionally, the patient was assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS), Brown Beliefs Scale, Beck Anxiety Inventory, and Beck Depression Inventory.

The patient, N.C., is a 64-year-old woman whose general appearance is somewhat older than her age, with partially diminished self-care, having insight, divorced, and living with three of her six children. The patient experiences intense anger when any product containing sweets enters her home, including fruits. She feels discomfort even when using or hearing the word “sweet.” The patient insists that no family member brings any sweet-containing products into their home, leading to frequent arguments on the subject. She reports high levels of anxiety, difficulties in social relationships, and significant limitations in daily life activities. Her relatives have also observed and reported these challenges. The patient mentions feeling a sticky sensation on her hands when she sees sweets and experiences a compulsion to wash her hands when this sensation occurs. Her symptoms are consistent with the classical symptoms of obsessive-compulsive disorder, including obsessions (persistent thoughts about sweets and associated anger) and compulsions (the need to wash her hands). The diagnosis was made by Dr. Ece Ilgın.She has been started on fluvoxamine 50 mg/day, which will be titrated. She will return for a follow-up appointment at the clinic in one month.

The symptoms of obsessive-compulsive disorder in patient N.C. include obsessions related to sweets, fruits, a sense of ‘stickiness’ that cannot be clearly identified, and avoidance obsessions linked to these. These symptoms significantly impact the patient’s quality of life and family relationships. It is believed that a combination of psychotherapy and pharmacotherapy will be effective in alleviating the patient’s symptoms and improving their quality of life.

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The majority of antipsychotic users at some point want to stop their antipsychotic medication and many do so without consulting their attending physician. So-called non-adherence to antipsychotics has been estimated to be as high as 60% and it has been identified as the most important predictor for relapse, resulting in a four times higher risk of relapse. When asking antipsychotic users, different reasons for wanting to stop are mentioned. These reasons include severe side effects, reduced functioning, experiencing no benefits and long-term physical health concerns. From the perspective of patients, wanting to stop can be considered an understandable and rational reaction given the burdens that antipsychotic use often imposes. Given the current uncertainties surrounding stopping antipsychotics, and given the patients’ wish to be involved in treatment decisions and a move away from a paternalistic mental health care model, several shared decision initiatives have been formed to involve patients more in the decisions about stopping or reducing the dose of their antipsychotic. In order to support shared decision-making, insight is needed in which questions antipsychotic users have.

The current study aims to gain insight in which questions antipsychotic users and their relatives have, and which factors influence stopping or reducing the dose of antipsychotics, by qualitatively analysing questions posted on an online expert Q&A.

Data were used from a Dutch existing publicly available anonymous expert Q&A. Questions about stopping or reducing the dose of antipsychotics were analysed using an inductive thematic approach. Questions antipsychotic users and their relatives had about this topic and factors that influences the process were identified.

In total 194 out of 3000 screened questions were about stopping or reducing antipsychotic dose. The most common question was whether it was sensible to stop or reduce the dose. Questions focused on how fast to reduce the dose, what their minimum dose should be and where they could find support. Those that were phasing out their antipsychotic asked when withdrawal symptoms or side effects would subside. Motivations to stop were side effects, difficulties in assuming a normal life and social roles and experiencing no benefits. Barriers were lack of support and return of symptoms. Facilitators were support from others and experiencing a relief from side effects and/or symptoms. Finally, questions were asked about activities that might support discontinuation.

Antipsychotic users continue to be left with many questions about stopping or reducing the dose of antipsychotics. These questions reveal attitudes, preferences and concerns regarding antipsychotic treatment that are important to address when discussing antipsychotic treatment.

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Emerging mental health crises in the global south highlight challenges in applying psychological frameworks that primarily originate from wealthy nations in the global north. The concept of modern-type depression (MTD), first recognized in Japan, has recently gained attention due to its divergence from the DSM criteria. MTD manifests itself as a reluctance to engage in social roles, a withdrawal from social norms, and vague omnipotence. Oman, a rapidly developing nation, shows patterns of social withdrawal similar to MTD. This study aims to validate the Arabic version of Tarumi’s Modern Depression Trait Scale (TACS-22), evaluate its factor structure, and explore the prevalence and risk factors of MTD in Oman.

The entrance of urbanization and digitation has heralded ‘de novo psychopathologies’ such as those that go under the umbrella of modern-type depression (MTD). To date, the presence of the MTD and the factors associated with it have yet to be explored. Related aims are to conduct exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to confirm the factorial validity of the 22-item Tarumi’s Modern-Type Depression Trait Scale.

An online survey was conducted in March 2023 with a convenience sample of Omanis aged 18 and over. The survey included the Arabic-translated TACS-22 scale and the PHQ-9 to assess depressive symptoms. An exploratory factor analysis (EFA) was performed to determine the structure of the TACS-22 factor and internal consistency was assessed using Cronbach’s alpha. Sociodemographic and clinical data was collected to explore possible risk factors for MTD and univariate and multivariate logistic regression analyses were performed to examine associations.

A total of 1009 participants completed the survey, with a response rate of 50%. The majority were female (70.3%) with a mean age of 31.1 ± 8.5 years. The prevalence of MTD was 25.3%, with significant associations found between MTD and sociodemographic factors such as sex, marital status, age, and occupation (p < 0.05). Furthermore, clinical factors such as mental illness, adverse childhood experiences (ACE), and depressive symptoms were also significantly associated with MTD. The EFA revealed a three-factor structure: Avoidance of social roles, low self-esteem, and complaints, consistent with previous studies, with acceptable internal consistency (Cronbach’s α = 0.77).

MTD is prevalent in Oman, particularly among younger individuals, students, and the unemployed. The Arabic TACS-22 scale demonstrates acceptable validity and reliability, providing a useful tool for identifying MTD traits in non-Western contexts. Socioeconomic changes in Oman can contribute to the emergence of MTD, and further research is needed to explore tailored interventions for this population.

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The literature review on anxiety/depression rates and quality of life (QoL) in youth in Kosovo are scarce. Studies on anxiety and depressive symptoms in Kosovo mostly, have revealed high prevalence rates pre and during COVID-19.

This study aimed to explore the relationship between anxiety, depression, and quality of life in Kosovo youth. The significance of this study lies in the fact that these variables are being examined together for the first time in Kosovo after COVID-19.

Its cross-sectional study. The sample consisted of 563 students aged 18 to 25 (Mage=20.88; SD=1.52). Participants recruited online in the period of May 2023, and completed the Albanian version of GAD-7, PHQ-9 and GQOL (Global Quality of Life Scale). Data processing was done with SPSS 27.0 and Microsoft Excel 2019.

The prevalence of anxiety (measured with GAD-7, ≥10) was 42.6 % while the prevalence of depression (measured with PHQ-9, ≥10) was 45.5%. Significant negative correlations were observed between anxiety and QoL (r = -.335, p < 0.00) and between depression and QoL (r = -.326, p < 0.00). A partial correlation indicated that anxiety and depression had very much influence in controlling for the relationship with QoL reciprocally; for anxiety (r = -.133, p < 0.02) and for depression (r = -.109, p < 0.13). Females and low SES emerged (but not employment status) as factors associated with higher levels of anxiety/depression and low Quality of Life.

Our anxiety/depression prevalence rates are mostly above those found in Kosovar youth both before and during COVID-19, and also in comparison to other European countries. Anxiety and depression, both separately and especially when co-occurring, significantly affect the quality of life of young people. Despite the fact that prevalence rates can vary depending on the specific methodology, sample size, and population demographics of each study, these findings should be taken seriously and addressed by mental health authorities in Kosovo through preventive and treatment programs. Additionally, further studies with sound scientific quality are necessary.

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Obsessive-compulsive disorder (OCD) has an estimated prevalence of 1-2% and causes a significative reduction in functionality and quality of life with a high socioeconomic impact.

First and second line treatment includes serotonin reuptake inhibitors, clomipramine, antipsychotics augmentation strategy and cognitive behavioural therapy. It is ineffective in 20-60% of patients whose approach may include transcranial magnetic stimulation (TMS).

The aim of this study is to assess the effect of treatment with TMS on obsessive-compulsive, anxious, and depressive symptoms in patients with OCD.

A prospective observational study was conducted including all patients diagnosed with OCD who underwent TMS in our department since March 2023.

Our protocol targets the dorsolateral prefrontal cortex and includes a total of 25 sessions using the Food and Drug Administration approved parameters (20 Hz, 100% of the leg resting motor threshold, 50 trains of 2s duration, inter-train interval 20s, 2000 pulses per session). Before each session, symptom provocation is performed. TMS was performed using the Cool D-B80 coil and a MagPro stimulator.

Symptoms before and after treatment were assessed using the Yale Brown Obsessive-Compulsive Scale (Y-BOCS), the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D).

As of 01/09/2024, 21 individuals with OCD completed TMS treatment, 57% male, with a median age of 37 years (interquartile range (IQR) 17). The median duration of illness was 25 years (IQR 15), with 24% of patients having very severe OCD, 52% severe, and 19% moderate—all refractory to psychotherapeutic and pharmacological treatment.

There was a statistically significant reduction in Y-BOCS scores (pre-TMS median score 29 (IQR 6), post-TMS 21 (IQR 13), p=0.003), with 32% of patients achieving a complete response (Y-BOCS reduction ≥35%) and 5% a partial response (Y-BOCS reduction ≥25%). No correlation was found between the change in Y-BOCS scores and other variables such as age, duration of illness, and pre-TMS scores on Y-BOCS, HAM-A, and HAM-D.

Additionally, a statistically significant reduction was observed in HAM-A scores (pre-TMS median 20 (IQR 18), post-TMS 16 (IQR 11), p=0.026) and HAM-D scores (pre-TMS median 19 (IQR 17), post-TMS 15 (IQR 14), p=0.029).

No severe adverse effects were reported.

This study shows significant reductions in Y-BOCS, HAM-A, and HAM-D scores after TMS treatment, with many patients achieving complete or partial response. These findings align with previous research, suggesting TMS is an effective option for treatment-refractory OCD. The absence of severe adverse effects supports its safety.

In conclusion, this study adds to real-world evidence by demonstrating the efficacy and safety of TMS in a clinical setting. Continued data collection is crucial to identify predictors of response.

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In schizophrenia, depressive and negative symptoms often overlap, complicating the diagnosis. Symptoms such as lack of energy, anhedonia and association make the distinction difficult. A subjective state of sadness may indicate depression, while affective flattening is characteristic of schizophrenia. Other symptoms relevant to diagnosing depression include hopelessness, negative self-assessment, guilt, anxiety, and self-destructive thoughts.

This study, conducted over 6 months, aims to establish both the rate and the total number of patients with schizophrenia, suffering from depression to provide a better understanding of the clinical particularities of this type of comorbidity.

The research provided for a cross-sectional study to assess the incidence of depression among patients with schizophrenia hospitalized in the Clinical Psychiatric Hospital of Chisinau during the reference period. The Calgary depression scale for schizophrenia (CDSS) has been used as an evaluation tool to highlight the presence of depressive symptoms, while PANSS (negative symptoms) has been used, to measure their severity in schizophrenia. The data collection process involved structured questionnaires, semi-structured interviews with patients and clinical history analysis to obtain additional information.

The study included 155 women diagnosed with schizophrenia, aged between 18 and 55. Of these, 28.39% had more than two admissions during the year. Most of the patients included in the study (73.55%) suffered from F20.0, the rates of other forms of schizophrenia being: F20.1 (1.29%); F20.2 (14.84%); F20.3 (9.68%) and F20.9 (0.65%). According to the questionnaire applied to patients with different types of schizophrenia, it was observed that, 40.65% achieved a total score of more than 6 points on the CDSS scale (clinically significant depression) and 34.92% required repeated hospitalisation in the same year. Of those repeatedly admitted, 74.6% suffered from F20.0; 14.29% (F20.2) and 11.11% (F20.3), which probably could be a confirmation of the increased severity of the patient’s condition in case of comorbidity – schizophrenia-depression.

It can be assumed that the comorbidity of schizophrenia-depression negatively influences the social recovery process, but also the quality of life of patients; increases the risk of relapse. Patients with depression often experience higher rates of hospitalization because depressive symptoms can lead to emotional instability, cognitive impairments, undermining interpersonal relationships, social networking and reintegration. It is essential that mental health professionals identify and treat depression in patients with schizophrenia in order to increase their quality of life.

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Pregnancy induces significant physiological and psychological changes. This study evaluates self-esteem, body image satisfaction, and psychological well-being among pregnant women at Monastir Maternity Center, Tunisia.

1. 1. To assess self-esteem and body image satisfaction among pregnant women.

2. 2. To evaluate the psychological well-being and the adequacy of support provided during pregnancy.

Conducted over two months (March-April 2022) with 62 participants (88.57% response rate) at Monastir Maternity Center. Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES), and body image satisfaction was assessed with the Body Image States Scale (BISS). Sociodemographic, obstetric, and psychosocial variables were collected.

The study included 62 participants, with an average age of 31.68 ± 7.49 years. Most participants (62.9%) were stay-at-home individuals, and two-thirds reported their current pregnancy as desired.

Body image satisfaction, measured by the Body Image States Scale, averaged 5.32 ± 3.67, indicating moderate satisfaction.

Self-esteem was low in 79% of participants, while 74.2% had no depressive symptoms and 90.3% had no anxiety symptoms.

Half of the participants (50%) reported their psychological well-being was addressed during pregnancy, with the majority (41.9%) receiving support from family members. Three-quarters (75%) considered pregnancy consultations the best time to discuss psychological issues. Almost all (98.4%) wanted additional psychological support. Over half (56.5%) talked about their pregnancy difficulties with someone, while 22.6% did not address them, and 21.0% did not experience any difficulties.

The study highlights a significant prevalence of low self-esteem and moderate body image satisfaction among pregnant women.. The study also reveals that while many women discuss their difficulties with others, there remains a gap in addressing psychological issues adequately, particularly considering the majority of participants desire more support.

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Equitable access to mental health services is a challenge in Brazil, marked by socioeconomic and regional inequalities. Despite advances in policies such as psychiatric reform and the Psychosocial Care Network (RAPS), barriers persist, especially for vulnerable populations. Issues such as the unequal distribution of resources, stigma, and a lack of professionals impact both access and the quality of care.

To analyze the inequalities in access to mental health services in Brazil and identify strategies to promote equity.

A systematic review was conducted using the PubMed, Scielo, and Lilacs databases, covering studies published between 2015 and 2023. The keywords used were “mental health access,” “health equity,” “Brazil,” and “mental health inequalities.” Inclusion criteria focused on studies addressing access to mental health services in Brazil, highlighting barriers, facilitators, and strategies to promote equity. Data were qualitatively synthesized to identify trends and challenges.

The review revealed significant disparities in access to mental health services, influenced by socioeconomic, geographic, and cultural factors. Remote regions, such as the North and Northeast, suffer from a lack of infrastructure and specialized professionals. While urban centers offer more services, rural areas face considerable limitations. The unequal distribution of professionals, such as psychiatrists and psychologists, exacerbates these inequalities. Stigma surrounding mental illness and a lack of awareness further hinder help-seeking behavior. Vulnerable populations, including Indigenous peoples and residents of favelas, face additional barriers such as discrimination and a lack of culturally adapted services.

The Unified Health System (SUS) provides a model of universal access but faces challenges related to funding, infrastructure, and capacity to meet the growing demand. Despite the efforts of RAPS, many services are overwhelmed, resulting in long waiting times and insufficient care. Strategies like integrating mental health into primary care have shown effectiveness but require more support and expansion.

Equitable access to mental health care in Brazil is impacted by various barriers, including regional disparities and stigma. To promote equity, it is crucial to invest in expanding the mental health care network, focusing on underserved areas and vulnerable populations. Effective policies should include professional training, stigma reduction, and culturally sensitive services. Integrating mental health services with primary care, strengthened by the SUS, is essential to ensure more accessible and comprehensive care.

None Declared

Effective approaches exist to prevent and treat mental illness and to promote mental health but most people who could benefit from evidence-based interventions (policies, programmes, and individual-level practices or services) do not receive them. Too often, research produces interventions and implementation strategies that are difficult to scale owing to misalignment with the political, cultural, policy, system, community, provider, and individual realities of real-world settings. The Lancet Psychiatry Commission on Transforming Mental Health Implementation Research considers strategies for changing how research is done to produce more actionable evidence. It examines how to integrate research and real-world implementation; centre equity in mental health intervention and implementation research; apply a complexity science lens to mental health research; expand designs beyond the randomised clinical trial; and value transdisciplinarity across endeavours. Most mental health implementation research has been done in high-income countries but the Commission’s recommendations incorporate research from low-income and middle-income countries and call for strategies to expand mental health implementation research globally.

J. Marsh Employee of: Elsevier