Postictal delirium (PD) following Electroconvulsive Therapy (ECT) and Post-Anesthesia Delirium (PAD) are significant postoperative cognitive disturbances often encountered in the post-anesthesia care unit (PACU). While both manifest with cognitive impairments, their etiologies, clinical features, and management strategies differ. Recognizing these distinctions is essential to enhance patient care and outcomes, particularly in critical recovery settings where prompt recognition and intervention are paramount.

This study compares delirium’s onset, duration, and course following ECT-induced seizures and general anesthesia. It aims to elucidate the clinical features of PD and PAD and offer evidence-based recommendations for distinguishing and managing these conditions in the perioperative setting.

A comprehensive literature review was conducted, focusing on studies from 2000 to 2023 sourced from PubMed, MEDLINE, and Cochrane Library. Search terms included “postictal delirium,” “Electroconvulsive Therapy,” “post-anesthesia delirium,” and “perioperative cognitive disorders.” Key variables analyzed included onset, duration, cognitive and behavioral symptoms, associated risk factors, and treatment protocols for both conditions.

The analysis revealed key differences between PD and PAD. PD generally presents immediately after ECT and resolves within minutes to hours, whereas PAD has variable onset, occurring immediately after surgery or several days later, with symptoms lasting hours to days. Cognitive symptoms also differ. PD is characterized by brief confusion and both anterograde and retrograde amnesia, while PAD presents with prolonged confusion, disorientation, and short-term memory impairment. Behaviorally, PD often involves repetitive, patterned, involuntary movements (stereotypies), such as hand flapping and rocking, whereas PAD is characterized by non-patterned agitation, including both voluntary and involuntary movements. PD typically includes fatigue and altered consciousness, while PAD may present with hallucinations, delusions, and significant sleep disturbances. Risk factors for these syndromes also vary. PD is linked to the intensity of the ECT stimulus and pre-existing neurological conditions, while PAD is influenced by factors such as patient age, type of surgery, anesthesia duration, and baseline cognitive status.

PD and PAD share clinical overlap, particularly in cognitive symptoms, but they differ in onset, duration, behavioral patterns, and associated risk factors. PD following ECT is typically brief and marked by stereotyped movements, while PAD presents with prolonged confusion and non-patterned agitation. Accurate differentiation between these conditions is crucial for appropriate diagnosis and management in the PACU setting. Further research is needed to uncover the underlying mechanisms and enhance therapeutic strategies for these syndromes.

None Declared

Trigeminal Neuralgia (TN) is a rare condition characterized by recurrent brief episodes of unilateral and excruciating facial pain, typically triggered by innocuous stimuli. It is historically known as the “suicide disease”, emphasizing the severity of the attacks and its impact on patients’ mental health.

We aim to highlight the risk of psychiatric comorbidities following TN diagnosis and discuss the potential burden depicted by the phrase “suicide disease”.

We presented a case report and conducted a non-systematic review of the literature.

A 72-year-old female patient with history of diabetes, hypertension, dyslipidemia, recurrent thrombophlebitis but no previous relevant psychiatric history, presents with depressive mood, anhedonia, insomnia, reduced appetite and feelings of hopelessness, which began 3 months prior. These symptoms started shortly after she began experiencing paroxysms of intense electric shock-like pain in the right hemiface, allodynia (specially triggered by the wind, talking, chewing and light touch) and lacrimation of the right eye. The patient had multiple consultations with neurology and psychiatry physicians. TN was presumed and the patient initiated treatment with pregabalin and intravenous infusions of lidocaine, as well as antidepressants. Magnetic resonance angiography revealed neurovascular compression of the right trigeminal nerve, supporting the diagnosis. Depressive symptoms aggravated and she experienced recurrent suicidal thoughts as she became aware of the TN diagnosis and experienced debilitating symptoms due to initial suboptimal pain relief. Oxcarbazepine was later introduced in the treatment plan and pain relief was slowly achieved. Suicidal ideation waned despite maintenance of depressive mood. Evidence shows there is a higher risk of newly diagnosed depressive, anxious and sleep disorders following TN diagnosis, most likely due to its deleterious effect at a psychological, behavioral and social level. Currently, however, the phrase “suicide disease” may be an ill-suited one as the lack of information on suicide rates among patients with TN and the availability of new and more efficient therapeutic options do not support its present use.

This case exemplifies the increased risk of new psychiatric comorbidities following TN diagnosis, further aggravating patients’ quality of life. Despite its historical significance, the label “suicide disease” seems to lack current applicability and may not only harm patients’ understanding and acceptance of the diagnosis, but also exacerbate fear and stress concerning its prognosis.

None Declared

The societal pressure to maintain a thin appearance combined with the academic stress has a significant influence on eating disorders in young people.

Anorexia Nervosa (AN), a severe eating disorder characterized by a distorted body image, restrictive eating habits, and an overwhelming fear of gaining weight, is often misdiagnosed.

Early detection is critical to improve treatment management.

The present study aimed to determine the prevalence of Anorexia Nervosa among Tunisian military nursing students.

A cross-sectional descriptive survey was conducted from March to May 2024 on nursing students at the Military Health School of Tunisia, using a data file for data collection and an Arab version of a self-report questionnaire: Eating Attitudes Test (EAT40), validated in Tunisia. The EAT40 is designed to assess attitudes related to eating and body image serving also as a tool to identify Anorexia Nervosa. To analyze the obtained data, Excel software was used.

The study enrolled 148 students, mostly male (57.4%), with an average age of 21.3 [19-24] years. Of them, 48.6% were in their third year and 19.6% in their second one. Geographically, 57.4% was from the north of Tunisia. The majority (85.8%) was in a middling socioeconomic position and 9.5% was in a high one.

With an average weight of 75.1±14.8kg and extremes between 48kg and 105kg, 52.7% of the population weighed less than 70kg. Also, 67.56% of them were taller than 1m70 of whom 35.81% stood between 1m70 and 1m80. The average Body Mass Index was 23 [17-32]. Among the students, 71.6% had a normal BMI, whereas 2.7% were underweight.

Regarding outward look, 89.9% of respondents said they were happy with their bodies’ looks and 67.6% with their weight. When they were younger, the majority (73.6%) did not experience any weight issues. Prior to completing the EAT40, 57.4% said they had no eating disorders.

Of the surveyed, 83.3% expressed dissatisfaction with school meals for a variety of reasons, the most common being insufficient quantity, poor quality, or tasteless food.

According to the study, the average of the EAT40 score was 20±14. Of the participants, 10.8% (N=16) had Anorexia Nervosa; their ETA score was 30 or higher. The majority (62.5%,N=10), were female; females’ EAT40 average score was 23±15 [1-44] while males’ EAT40 average score was 21±10 [1-41].

The results also revealed that students suffering from AN had an average BMI of 19±4 [weight: 60±10kg, height: 1m60±.08m], compared to students without eating disorders with a BMI of 25±3 [weight: 69±12kg, height: 1m70±0.15m].

This study reveals a concerning prevalence of Anorexia Nevrosa among Tunisian military nursing students, highlighting the necessity of early detection for effective management and of interventions such as raising awareness within educational institutions aspiring to better mental health outcomes for healthcare students.

None Declared

Following the COVID pandemic, there has been an increase in mental health consultations in recent years, often referred to as a ‘fourth wave’. However, what has been observed in mental health centres is that these consultations are not so much about serious mental disorders, but rather occasional disorders due to social and work-related factors.

The aim of this study is to analyse the data collected from referrals to psychology in a mental health centre.

Referrals to psychology from primary care at the Majadahonda Mental Health Centre were analysed for the period from October 2022 to April 2024 in a specific weekly consultation for the psychology waiting list.

The data collected are the diagnoses of these patients, whether or not they attend the assessment consultation and whether or not they are discharged after the first consultation.

A total of 115 patients were seen between October 2022 and April 2024. These patients were all notified of the appointment one week in advance.

Of the total number of patients who attended, 29 consulted for depressive-anxiety-adaptive disorder, 22 were referred for work-related reasons (burn out), 12 for marital problems, 7 for parenting problems, 12 had no clinical reason for referral to Mental Health and 25 did not attend the consultation.

Those who were discharged at the first consultation were 33.

Given the scarce resources and long waiting lists, it is important at all levels of patient care not only to adjust expectations with regard to specialised care, but also to promote an appropriate setting. In this way it will be possible to run an efficient mental health care system.

None Declared

Eco-anxiety, a term that encapsulates the anxiety and distress associated with climate change and environmental degradation, has emerged as a significant psychosocial issue affecting individuals across various demographics. This phenomenon is particularly pronounced among younger generations, who often experience heightened awareness of climate-related threats and their potential impacts on future well-being. The interplay between eco-anxiety and psychosocial problems is complex, involving emotional, cognitive, and social dimensions that can significantly influence mental health outcomes. Research indicates that eco-anxiety is characterized by a future-oriented worry about the potential impacts of climate change, distinguishing it from other eco-emotions such as eco-grief and eco-despair. While many individuals experience eco-anxiety in a non-clinical form, there are instances where it can escalate to pathological levels, leading to significant mental health challenges. This is particularly relevant for young people, who may face multiple life stressors, such as academic pressures and social expectations, which can exacerbate feelings of eco-anxiety and contribute to the development of mental health issues.

In this study, the negative effects of climate change will be emphasized and its effects on human health and psychology will be emphasized. The main purpose of the study is to prepare the ground for future studies on eco-anxiety, which addresses the connection between climate change and psychology, and to increase social awareness.

The study will conduct between October 2024 and January 2025 2023 in 3 databases (PubMed, Cochrane Library, Science Direct) using the keywords “eco-anxiety” “psychosocial problems” and “mental health”. These databases were preferred because they contain a significant amount of evidence-based literature in the field of biomedical sciences and psychology. Studies conducted between 2000 and 2024, whose full texts were accessed and written in Turkish and English were included in the study.

20 national and international research articles on the subject have been reached and the literature review continues. When the literature review is finalized, all study results will be presented together.

Conclusions: In summary, eco-anxiety represents a significant psychosocial challenge that intertwines with various mental health issues. Understanding the emotional, cognitive, and social dimensions of eco-anxiety is crucial for developing effective interventions that address the mental health impacts of climate change. By fostering emotional regulation, acknowledging the role of grief, and promoting community engagement, mental health professionals can better support individuals grappling with eco-anxiety and its implications for overall well-being.

None Declared

Psychiatric disorders are risk factors for suicidality, but it is also considered a multifactorial phenomenon. Genome-wide association studies may provide an insight into the etiological background of distinct phenomena along the suicidal continuum, and may also help disentangle their overlapping genetic architecture with psychiatric disorders.

Our aim was to carried out a GWAS for suicidal ideation in a well-phenotyped sample.

We conducted a genome-wide association study (GWAS) in the NewMood (New Molecules in Mood Disorders, Manchester and Budapest) database, 1820 subjects were involved (533 males, 1287 females), the suicidal ideation and behaviour were investigated with a suicide-focused item of the Brief Symptom Inventory (BSI). SNP-level association was assessed employing linear regression models, assuming additive genetic effects, using PLINK2.0, with gender, age and the first ten principal components (PCs) of the genetic data as covariates. Bonferroni-corrected significance threshold on SNP-level was p ≤ 5.0 × 10-8, and the suggestive significance threshold was p ≤ 1.0 × 10-5. GWAS results including the identified significant results were interpreted using FUMA v1.5.2.

9 SNPs were identified, 2 with genome-wide significance and 7 with suggestive significance. The most significant SNP, rs79912020 (β=, P=3.21x10-10, Chr4) was located in the MANBA gene and the other genome-wide significant variant, rs10236520 (β=, P= 1.706x10-8, Chr7) is located near the gene LOC124901613. Furthermore, we have found more important variants with suggestive significance, rs117677616 (β= , P=1.199x10-6, Chr20) is identified in PTPRT gene, rs34475 (β= , P=1.981x10-6, Chr12) is located in CFAP54, rs711180 (β= , P= 2.934x10-6, Chr12) is near the gene VWA1 and the variant rs2655484 (β= , P=5.717x10-6, Chr12) is located near the GRIP1. No genes were identified in gene-level analysis with genome-wide significance.

We identified 9 SNPs with genome-wide or suggestive significance in association with suicidal ideation, with several lines of converging evidence supporting their involvement in the development of suicide risk. MANBA gene has role in the development of unipolar depression, PTPRT is associated with appearance of major depressive disorder, and the GRIP1 gene may be considered also as a potential biomarker for suicide, as it has been previously associated with psychiatric phenotypes indirectly linked to suicidal behaviour and in patients with increasing suicidal ideation during antidepressant treatment. The prevention of the suicides is a prominent aim in mental healthcare and these new variants may be helpful in establishing novel, focused and more filters for this vulnerability.

Funding: NAP2022-I-4/2022, K143391, 2019-2.1.7-ERA-NET-2020-00005, TKP2021-EGA-25

None Declared

Accumulating research has suggested a possible role of the immune/inflammatory response system in the pathophysiology of suicidal behavior, more specifically of specifically high-lethality suicide attempts (SA). To count with reliable and affordable biological markers of high-lethality SA to complement clinical assessment for early detection of individuals at a high risk of committing suicide is thus mandatory.

To assess if immune/inflammatory parameters may differ between suicide attempters with and without SA, taking into account the type of suicide method. The odds of repeating a high-lethality SA in the future will also be explored.

In this retrospective observational single center study, medical records of suicide attempters admitted to the Emergency Department at Vall d’Hebron University Hospital (Barcelona, Spain) between 2017-2021, will be reviewed. The following immune/inflammatory parameters (i.e., total and differential white blood cell count, platelet counts, C-reactive protein levels) will be extracted for comparisons between subjects without a history of previous suicide attempt (SA), and those with a history of previous SA. Additionally, the following ratios/indexes will be calculated as a proxy of subject’s inflammatory status: neutrophil-to-lymphocyte ratio (NLR), basophil-to-lymphocyte-ratio (BLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory response index (SIRI). Analyses will be controlled for clinical and sociodemographic variables, such as age, gender and/or primary psychiatric diagnosis. Analyses will be also stratified according to the attempt method. Moreover, the capability of the previously mentioned parameters to predict a high lethality SA or to commit suicide in the coming two years will also be evaluated.

Results from the interim analysis will be presented at the congress.

Peripheral immune/inflammatory parameters may allow us to discriminate subjects at risk of committing suicide. In case of positive findings, immune/inflammatory parameters could be incorporated in the comprehensive evaluation of high-lethality SA in individuals admitted to the emergency setting, contributing to improve early detection of suicide risk.

L. Martorell Mensua Shareolder of: First authorship, W. Vidal Cachay Shareolder of: First authorship, M. Quesada Franco: None Declared, A. Beneria Gonzalez: None Declared, J. Ramos Quiroga: None Declared, A. Motger Albertí: None Declared, G. Arteaga-Henriquez Shareolder of: Last authorship, D. Braquehais Conesa Shareolder of: Last authorship.

Stressful events are important causes of numerous psychiatric disorders, including anxiety disorders, depression and other psychiatric disorders.

The COVID-19 pandemic affects individuals and then all segments of society, and has threatened both physical and mental health.

We have noticed increasing number of the new patients seeking psychiatric help in period after COVID - 19 infections.

Also, tremendously increasing number of sick days.

In this case study, we described a 52-year-old female patient. She is a psychologist, an employee in High school in Podgorica working with students. She has achieved 25 years of work experience.She is divorced, has one child. She has never asked for psychiatric help before Sars Covid-19 infection.

She faced first symptoms in terms of bad mood, withdrawal from social contacts, fear, insomnia, problems with attention and concentration. Those symptoms appeared after COVID -19 infections. The patient was hospitalized at the Psychiatry Clinic due to persistent symptoms Admission was due to organic personality changes of the anxious-depressive type, which occasionally reach the level of psychosis. She was absent from the work more than a year.

Case study

During hospitalization, the patient was treated with anxiolytics, antidepressants and small dosses of antipsychotics medicine.

Her general condition improved after month spent in hospital. She received supportive psychotherapeutic support on a daily basis. She participated in occupational therapy.

A CT scan of the endocranium was normal.

The patient still taking prescribed therapy and regularly attends psychiatrics checks - ups.

She went back to a work after two months.

Based on our daily work with patients, we came to the conclusion that sars covid-19 infection has led to a significant increase in mental health symptoms among the population in Montenegro. This problem must not be ignored”You don’t need to fear anything in life, you just need to understand each other.” Now is the time to understand more so that we would fear less” – Marie Currie

None Declared

Attention-Deficit/Hyperactivity Disorder (ADHD) In my talk, I will present the latest evidence, mainly based on previous meta-analyses, network meta-analyses, dose-response meta-analyses, and umbrella reviews, that can inform clinical decision-making in the field of pharmacological treatment for ADHD, including the choice of initial medication, titration, treatment of stimulant-refractory cases, management of cases with comorbid conditions, and management of adverse event.

None Declared

Gardner-Diamond Syndrome (GDS), also known as psychogenic purpura, is an uncommon psychosomatic disorder characterized by painful, ecchymotic, purpuric lesions that typically appear after a period of stress, surgical operations or hard physical work, predominantly affecting women. The pathophysiology of GDS is still poorly understood, and diagnosis is often challenging due to its overlap with other hematological, dermatological, or psychosomatic disorders. Appropriate diagnosis is essential for symptom management and patient risk reduction.

This review aims to synthesize the current knowledge on GDS, encompassing its etiology, clinical presentation, diagnostic criteria, and treatment approaches while identifying areas for future research.

We performed a narrative literature review by searching PubMed, Google Scholar, and ScienceDirect articles written in English. Relevant studies, case reports, and reviews published from 1955 to 2023 were included.

Gardner-Diamond Syndrome predominantly affects middle-aged women, but the literature has also published reports concerning men and children. It is often associated with psychological stress, anxiety, or depression. Many authors suggest the presence of histrionic personality traits and a tendency toward somatic reactions in affected individuals. In 1955, Frank Gardner and Louis Diamond identified and described Gardner-Diamond Syndrome after observing four women who experienced recurrent bruising, accompanied by localized pain, erythema, and swelling, following minimal or no trauma. The spontaneous bruising observed in GDS lacks a hematological cause, with most studies suggesting a psychosomatic origin. The diagnosis is made with a detailed medical and psychiatric history, physical examination, laboratory examination, and exclusion of other possible causes. Psychological therapies, such as cognitive-behavioral therapy, alongside pharmacological treatments, have shown variable success in symptom management. However, most patients experience long-term cycles of remission and relapse, and a standardized treatment protocol has yet to be established.

Gardner-Diamond Syndrome represents a complex interaction of psychological and somatic factors, highlighting the importance of a multidisciplinary approach to both diagnosis and treatment. Diagnostic challenges persist due to the absence of definitive biomarkers and reliance on exclusionary criteria. Also, GDS lacks treatment options. While psychological interventions play a central role in management, further research is needed to clarify the underlying pathophysiology and improve therapeutic outcomes. Most patients benefit from a combination of cognitive behavioral therapy and antidepressant treatment. Increasing clinician awareness may help reduce diagnostic delays and improve the quality of life for patients.

None Declared

Adropin is a unique hormone or biomarker that is produced in the liver, brain, and peripheral tissues such as the heart and gastrointestinal tract. It was discovered in 2008 by Kumar and others. It is encoded by a gene associated with energy homeostasis. Adropin plays a key role in the development of various CNS disorders such as stroke, schizophrenia, bipolar disorder, Alzheimer’s disease, and Parkinson’s disease.

Depressive disorder affects a large number of people worldwide, with symptoms such as loss of energy and motivation, sadness, fatigue, and weakness significantly impacting quality of life and functionality. Numerous studies have shown that depression has various neurobiological mechanisms. Deregulation of energy metabolism in the brain is one of the mechanisms associated with the onset of depressive disorder. Adropin can activate BDNF, and since BDNF plays a crucial role in neurogenesis, synapse formation, plasticity, learning, memory, and has a neuroprotective function, adropin may play an important role in the development of depression.

We conducted a study in which we examined adropin concentrations in depressive disorder in individuals who were diagnosed with depression for the first time and compared adropin levels with healthy controls. We followed up with depressive patients after six months of introducing SSRIs (Selective Serotonin Reuptake Inhibitors) antidepressants.

The adropin values after the introduction of antidepressants and improvement of depressive symptoms were significantly higher after six months compared to the initial blood draw.

Our study measured serum adropin levels in patients who had not previously been treated for depressive disorder. After introducing SSRIs (Selective Serotonin Reuptake Inhibitors) and six months after the initiation of therapy, we repeated the adropin measurements. The results showed a statistically significant difference between the first and second measurements. In the second measurement, adropin levels were higher than in the first. We can conclude that with the improvement of depressive symptoms, the serum adropin levels, as a neuroprotective biomarker, also increased.

None Declared

Ekbom syndrome, also known as delusional infestation (DI), is a rare mono-symptomatic psychosis in which the patient has the firm and unshakable belief that one’s body, mainly their skin, is infested by parasites or bugs. DI primarily affects middle-aged women and it can be classified as primary or secondary, often associated with other psychiatric conditions like psychotic depression, or induced by substances such as cocaine or amphetamines. Understanding that DI may not represent a single, uniform disease or diagnostic entity and can have various underlying causes is essential for accurate diagnosis and effective treatment.

This study aims to examine the clinical presentation, etiology and therapeutic approach for a patient presenting with DI while comparing approaches for different DI etiologies.

A case report was conducted on a 61-year-old woman presenting with delusion of infestation, skin lesions, depressive symptoms and a toxicology screening positive for cocaine. Addicionally, a literature review using the PubMed database was performed to identify relevant clinical articles on DI.

In evaluating the patient’s condition, the initial differential diagnosis included formication, a condition where patients experience sensations such as stinging or crawling on the skin without developing fixed delusions. Formication can arise from multiple neurological or systemic causes, including exposure to substances. A unique subtype of formication, known as “cocaine bugs,” is seen in cocaine users and produces similar tactile sensations. Cocaine-induced formication is often part of a broader cocaine-related delirium that involves hallucinations and ideas of contamination. For these patients, detoxification is a priority in treatment, addressing the substance use disorder directly. In cases where delusions develop alongside these sensations, particularly in individuals with pre-existing psychiatric conditions such as schizophrenia or depressive disorder, the diagnostic focus shifts.

Delirium of infestation can occur in individuals with cocaine use and those with psychotic depression. More than half of the patients with DI have a history of depression and both conditions often coexist. There are individuals for whom DI appears to cause depression and patients for whom depression appears to precipitate DI. This case highlights the complexity in diagnosing and treating DI, particularly when cocaine use and psychotic depression co-occur. The patient’s symptoms reflect overlapping etiologies, with cocaine use likely exacerbating formication, while psychotic depression contributed to fixed beliefs of infestation. Given the frequent co-occurrence of DI and depressive symptoms, further research is needed to refine neurobiological insights and treatment strategies for DI across these patient groups.

None Declared

Alcohol Use Disorder (AUD) is a pervasive condition with substantial psychological, social, and physical consequences. Traditional treatment approaches often struggle with high relapse rates, highlighting the need for more effective interventions. Recently, ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has emerged as a potential treatment for AUD due to its unique pharmacological properties.

The aim of this study is to evaluate the current evidence of ketamine treatment for alcohol use disorder and its efficacy.

The authors did a non-systematic review of the current literature.

The results suggest that ketamine combined with psychotherapy reduces alcohol consumption and prolongs abstinence in AUD patients. The mechanism is hypothesized to involve ketamine’s ability to enhance neuroplasticity and modulate glutamatergic pathways, which may improve motivation and cognitive control. Additionally, ketamine’s rapid antidepressant effects could address comorbid conditions like depression and anxiety, often observed in AUD patients, thereby reducing the overall risk of relapse.

Ketamine presents a promising adjunct to existing therapies for AUD, offering benefits that extend beyond traditional treatment approaches. However, while preliminary findings are encouraging, further research is necessary to confirm the long-term safety and efficacy of ketamine in treating AUD, particularly concerning optimal dosing strategies and the integration with psychotherapeutic interventions.

None Declared

Childhood trauma (CT) and bullying have been shown to be associated with autistic traits (AT) and to mediate the relationship between AT and psychotic experiences (PEs). Understanding how different childhood adversity subtypes influence distinct domains of PEs can provide important insights for preventing PEs in individuals with high AT.

This study aimed to investigate the impacts of childhood adversity subtypes on the relationship between AT and PEs in a general population twin sample.

We analyzed data on 792 twins and siblings from the first wave of the TwinssCan Project, a longitudinal general population twin cohort. AT were measured using the Autism-Spectrum Quotient (AQ), and PEs using the Community Assessment of Psychic Experiences (CAPE) which consists of three subscales (positive, negative and depressive). CT subtypes were assessed using the Childhood Trauma Questionnaire (CTQ), evaluating emotional, physical, and sexual abuse, as well as emotional and physical neglect. Bullying was assessed using the Retrospective Bullying Questionnaire (RBQ). Multilevel linear regression analyses were conducted. Positive, negative, and depressive PEs were regarded as the dependent variables, interactions of CT subtypes and bullying with total AQ were regarded as independent variables in separate models. All models were adjusted for age and sex. Bonferroni correction (p<0.008) was applied for multiple comparisons.

The mean of the age of the participants was 17.5 ± 3.6 years and 60.2% of the sample was female. Emotional abuse (B = 0.12, 95% CI: 0.08 to 0.15), physical abuse (B = 0.15, 95% CI: 0.07 to 0.22), sexual abuse (B = 0.10, 95% CI: 0.03 to 0.16), emotional neglect (B = 0.05, 95% CI: 0.02 to 0.09) and physical neglect (B = 0.07, 95% CI: 0.03 to 0.11) significantly moderated the positive relationship between AT and positive PEs. However, only emotional abuse uniquely moderated the relationship between AT and both negative and depressive PEs (B = 0.09, 95% CI: 0.04 to 0.13; B = 0.09, 95% CI: 0.04 to 0.14) with physical neglect showing a trend toward significance for depressive PEs (B = 0.08, 95% CI: 0.02 to 0.13). Bullying did not moderate any domain of PEs.

Emotional abuse may play a unique role in moderating the relationship between AT and PEs, affecting all domains of psychosis expression. Conversely, other forms of CT predominantly influence positive PEs. Further research is needed to clarify the distinct pathways through which distinct types of childhood adversity impact the association between AT and PEs.

M. Karaçam Doğan: None Declared, T. Prachason: None Declared, B. Lin: None Declared, L.-K. Pries: None Declared, A. Arias-Magnasco: None Declared, R. Bortoletto: None Declared, C. Menne-Lothmann: None Declared, J. Decoster: None Declared, R. van Winkel: None Declared, D. Collip: None Declared, P. Delespaul: None Declared, M. De Hert: None Declared, C. Derom: None Declared, E. Thiery: None Declared, N. Jacobs: None Declared, J. van Os: None Declared, B. Rutten: None Declared, N. Brondino : None Declared, M. Colizzi Consultant of: GW Pharma Limited, GW Pharma Italy SRL and F. Hoffmann-La Roche Limited, outside of this work. , L. Fusar-Poli: None Declared, S. Guloksuz: None Declared

Strength training approaches have seen a significant increase in popularity in the fitness and wellness industries in recent years. This rise is fueled not only by the desire for physical prowess and muscle development, but also by a growing awareness of its potential impact on mental health. While the traditional focus of research on strength training has primarily been on its physical benefits, there exists a developing enthusiasm within the scientific community to explore deeper into its implications for mental health, particularly with anxiety levels.

The purpose of this study is to examine the link between strength training intensity and anxiety levels among active gym-goers in Tunisia.

This is a cross-sectional study, conducted from February to March 2024. Participants were recruited online through social media platforms ( Tunisian facebook groups and fitness forums) using a posted survey link. We’ve included respondents who are 18 years of age or older who have been active in strength training with a gym membership for 1 month or more. The respondents were required to answer a questionnaire that included socio-demographic questions and to provide strength training intensity related details ( sessions frequency, duration, perceived overall intensity using likert scale). Anxiety levels were evaluated using the Generalized Anxiety Disorder 7 (GAD-7) scale.

The overall number of participants was 72, with 86% being male. The majority of responders (n=65, 90.2%) indicated that they performed strength training exercises at least three times per week, with an average session length of 45 minutes. In terms of strength training intensity, 38.8% (n= 28) of participants reported high-intensity sessions, 48.6%(n=35) moderate-intensity sessions, and the remaining participants reported low-intensity sessions.

Analysis showed a mean anxiety score of 6.1 (SD = 3.8) on the GAD-7 scale, indicating absent to mild anxiety symptoms among respondents.

Further analysis revealed a negative association between strength training intensity and anxiety levels (r = -0.59, p = 0.026), implying that higher intensity sessions were linked with lower anxiety scores.

In conclusion, this study provides insight into the level of anxiety of Tunisian gym-goers who participate in strength training, emphasising the potential of exercise interventions to improve mental health in this society. Moving forward, these findings can help to shape targeted interventions and wellness efforts, promoting holistic approaches to well-being that prioritise both physical and psychological health.

None Declared

Our team faced two challenges in prescribing for patients with ADHD. On 27 September 2023, a shortage of methylphenidate prolonged-release capsules and tablets, lisdexamfetamine capsules, and guanfacine prolonged-release tablets was announced in the UK.

SCP is an agreement between secondary care, patient and GPs, which asks GPs to continue prescribing ADHD medication when young person is stable on a dose, this also applies to when the doses are changed. However, many GP practices in Oxfordshire declared a position statement that they would decline prescribing ADHD medication to adult or child patients on a “shared care” basis due to funding issues to support specialist reviews. These challenges led us to adapt our practices and create a protocol.

To make all staff members aware of recent updates on ADHD medication stock availability at local depots to ensure continuity of care and minimise distress.

To help reduce the number of declined shared care requests by GPs in 6–17-year-olds.

To identify the patients of GP practices that do not prescribe ADHD medication to adults so that a planned discontinuation of treatment can take place prior to discharge from CAMHS services.

Young people’s and their carers’ feedback regarding the medication shortage were carefully recorded.

Concerns were raised and discussed in multi-disciplinary meetings via MS Teams and in person.

Team members shared information with each other with a view to creating a protocol to minimise the risk to patients’ safety and distress in families.

Regular updates on ADHD medication availability, along with equivalent conversions of long-acting medications were sent to all staff members via email by the Trust.

Our service developed a “protocol for CAMHS ADHD when the children and young people’s (CYP) shared care protocol is declined and how to handle discharges at age 18.”

We agreed to make young people and carers aware of the current situation for prescribing ADHD medication in adults within Oxfordshire to explore the need for continuing medication in reviews.

ADHD medications were planned to be discontinued prior to discharge, if patients are 17, on ADHD medication, whose GP practice declines SCP. and do not meet threshold for community adult mental health team referral.

We agreed to consider prescribing for a brief time beyond age 18 on a case-by-case basis if patients are preparing for, or are currently taking, A-level (or other) exams or whereby discontinuing medication poses significant risk.

Patients and staff members were greatly affected by the ADHD supply issues as well as current changes in SCP. However, team members took necessary steps to address the current issues proactively.

We plan to develop guidelines about stopping stimulants under supervision prior to discharge from CAMH services.

None Declared

Clinical stageing models are well-established in many areas of medicine, most notably in oncology. These models are used to determine personalised treatment options and indicate prognosis. In psychiatry, staging models have been developed most prominently for psychosis and mood disorders. These models are being used to guide treatment and service provision, e.g. through development of high-risk and early intervention services and stage-appropriate treatment delivery. Clinical staging models for obesity, incorporating medical history, clinical and functional assessments and routine diagnostic investigations also exist and appear to show improved clinical utility in assessing obesity- related risk and prioritising treatment. Recent generic frameworks for staging in mental health have highlighted that there is much individual variability in people’s progression through different illness stages, and therefore there is a need to also specify stage modifiers (disease progression factors (e.g. cognitive or neural factors) and extension factors (e.g. physical complications)). Several staging models for eating disorders have been developed. Most of these focus on anorexia nervosa (AN). Criteria for stage differentiation are mostly based on combinations of cognitive, behavioural and physcial features, and illness duration. As yet most of these models are untested. In my talk I will summarise the available evidence on illness stages, stage modifiers and extension factors and their utility in AN and present evidence on what is known about stage-appropriate interventions. I will discuss implications for research and clinical practice.

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Psychoactive substance use among pregnant women has reached alarmingly high rates and is considered a public health problem. Pregnancy is a period in which women become more sensitive and concerned about their well-being, in view of how that will affect their baby. Therefore, pregnancy becomes a favorable period for therapeutic intervention, especially with regard to drug use. Despite this, there is still a small number of studies that address the issue of female drug users in Brazil, especially due to stigma and prejudice.

Our main aim was to characterize the clinical and psychiatric profile of pregnant crack users in Brazil, with a focus on comorbidities, the severity of crack use, and the use of other substances.

This was a cross-sectional study of 24 pregnant crack users admitted to a referral hospital for psychiatric disorders in pregnant women, in Porto Alegre, Brazil, over three years. Most women tend to remain hospitalized for a long time, often months, until giving birth. This scenario directly influenced the sample size of this study. The following instruments were applied: a clinical-obstetric questionnaire; the condensed version of the Addiction Severity Index; a diagnostic interview for psychoactive substance use based on DSM-5; the Mini International Neuropsychiatric Interview for DSM-IV; and the Semi-Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II).

Most patients had severe crack dependence and used other substances, such as tobacco, cannabis, and alcohol. The median duration of crack use was three years, ranging between three and 12 years. Most women subsisted from illegal or informal activities; a fifth had previously been arrested and often had relationship problems. Twenty percent had HIV (n = 5), and 37.5% (n = 9) had syphilis. Borderline personality disorder was the most prevalent mental condition (62.5%), followed by suicidal tendencies (45.8%), hypomanic episodes due to substance use (37.5%), and past major depressive episodes (33.3%).

This is one of the few studies exploring and characterizing social, economic and health aspects of pregnant crack users in Brazil. An alarmingly high prevalence of consumption of other drugs, psychiatric disorders, and difficult-to-treat personality disorders was observed in our study. Investigating the psychiatric profile of women who use substances is essential to minimize the impacts on the mother and child, optimize therapeutic approaches to comorbidities, and enable more effective relapse prevention.

None Declared