Eating disorders (ED) are one of the most pressing problems of modern society. Eating disorders, due to their heterogeneity, can be considered both an independent form of mental disorders and as part of the manifestations of other mental illnesses. In the vast majority of cases within these pathologies, eating disorder coexists with depressive symptoms, which significantly worsens the prognosis of the disease.

Identification of the association of depressive disorders with eating disorders to improve the criteria for nosological diagnosis, prognosis and therapeutic approaches.

A total of 74 patients aged from 15 to 25 years old (all female, average age 16.2), who were on outpatient and inpatient observation of the clinic were studied.

The study made it possible to establish the characteristics of depressive disorders and the nature of the current course of depression associated with eating disorders. In eating disorders with a predominance of anorexia nervosa, the structure of depression was more dominated by the asthenia radical with symptoms of apathy, melancholia, anhedonia, irritability, episodes of anxiety after eating, and sleep disturbances. Patients noted a decrease in performance, mental activity, and a narrowing of their range of interests and communication. Depression became severe as exhaustion progressed. For eating disorders with bulimia nervosa. depressive states varied in the severity and polymorphism of their manifestations. Their structure was largely dominated by the apatho-adynamic radical of affect, along with asthenia and anxiety, which often reached the level of panic states. Often, along with this, there were pronounced a guilt feeling and low self-esteem ideas with self-deprecation and self-hatred, which led to the manifestation of auto-aggressive behavior (both non-suicidal and suicidal). Depression reached a severe degree as exhaustion progressed, as well as against the background of more frequent attacks of overeating and vomiting.

The identified associations between depressive disorders and eating disorders allow us to form a clearer picture of the expected course of psychiatric disease and optimize therapeutic intervention algorithms.

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The relationship between obesity and mental health in old age is complex and widely impacted by different biological, psychological, and social factors.

The primary objectives of this qualitative research study are: a) To understand the influence of obesity on older adults’ well-being; b) to assess emotional experiences related to obesity in old age and; c) to explore how obesity influences the mental health of older adults.

This study included 346 participants aged 65 to 84 years (M=73.9; SD=5.61) from three different nationalities (English, Spanish, and Portuguese). All interviews went through content analysis.

This study identified four main themes regarding the influence of obesity on older adults’ well-being: (1) Insatisfaction with Body Image (66%); (2) Feeling embarrassed (65%); (3) Feeling Social Isolated (57%); and (4) Lost Opportunities (46%)Three main themes for emotional experiences were frequently verbalized by the participants: (1) Shame (81%); (2) Guilt (78%); and (2) Incompetence (76%). Finally, three main influences in mental health due to obesity were reported: (1) Self-concept (88%); (2) Stress (78%); and (3) Melancholia (63%).

These results highlighted that obesity negatively influences older adults’ well-being and emotional experiences and has serious mental health-related negative outcomes for older adults. Interventions like community-based weight loss programs can be effective in controlling weight and improving the social interaction of obese older adults.

Keywords: Emotional experiences; mental health; obesity; older adults; well-being.

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Orthorexia is defined as a dependence on healthy food or an obsession to consume healthy food. One area deemed influential upon disordered eating and dietary intake is perfectionism.

To investigate the relationship between orthorexia and perfectionism in medical students.

We conducted a cross-sectional, descriptive, and analytical study in the faculty of medicine of Sfax (Tunisia), between February and April 2023. A self-reported questionnaire was distributed to students via social media. We used ORTO-15 for the assessment of orthorexia, and the Big Three Perfectionism Scale (BTPS) to assess perfectionism.

The research has enrolled 220 students. Their mean age was 21.40±1.68 years, with female predominance (70%). The ORTO-15 mean total score was 36.88±6.76. A total of 60% of participants had an orthorexic behavior. The BTPS mean total score was 45.52±12.45 with a mean score of 13.25±4.35 for rigid perfectionism, 18.31±6.37 for self-critical perfectionism, and 13.99±5.47 for narcissistic perfectionism.

Students with orthorexic behavior had significantly higher scores of perfectionism (p= 0.048).

Our study has drawn a significant association between orthorexia and perfectionism among medical students. This result suggests that students experiencing highly critical and judgemental beliefs associated with perfectionism are more susceptible to orthorexic eating behaviors.

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The Eating Disorder Examination Questionnaire short version (EDE-Q7) presented better psychometric properties than the Fairburn’s 28-items original version, not only in girls (Machado et al. 2018), but also in older women (Pereira et al. 2021; Pereira et al. 2022). It comprises 7 items in three subscales: Dietary Restraint/DR; Shape and Weight Overvaluation/SWO and Body Dissatisfaction/BD. In a more recent clinical study in men (Laskowski et al. 2023) the factors associated with body concerns and dissatisfaction weren’t fully represented in the questionnaire, possibly indicating differences in body ideals, specially relating to musculature.

We aimed to analyze the psychometric properties of the Portuguese version of EDE-Q7 in males.

Participants were 227 male individuals with a mean age of 30.41 years (±13.96; range: 14-73 years). They answered an online survey including the Portuguese versions of the Screen for Disordered Eating/SDE; the Body Image Concern Inventory/BICI and the Muscle Dysmorphia subscale of the Eating Disorder Assessment for Men/DM-EDAM.

Confirmatory Factor Analysis showed that the second order model presented good fit (χ2/df=2.437; RMSEA=.0794; CFI=.986 TLI=.974, GFI=.967). Cronbach’s alpha was .856 for the total, .876 for DR and .917 for SWO and .900 for BD. All items contributed to internal consistency and presented high internal validity. Pearson’s correlations of EDE-Q7 with BICI (.465), DM-EDAM (.384) and SDE (.361) were significant (p<.001) and moderate.

Also in men, the Portuguese version of EDE-Q7 demonstrates good validity (construct and convergent) and reliability.

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Although symptom presentation varies by gender, almost all eating disorder/ED instruments have been developed and validated on females. The Eating Disorder Assessment for Men (EDAM; Stanford & Lemberg 2012) is a male specific self-report measure, composed of four sub-scales, proved to be useful to assess gender differences in ED presentations (Nagata et al. 2021). The MD comprises 5 items about the overwhelming concern with muscularity and the false perception of having an underdeveloped body.

Having already valid measures of body image and eating behaviors in men, we now aim to analyze the psychometric properties of the Portuguese version of MD, in order to have a quick and rigorous measure of this specific construct.

Participants were 227 male individuals (mean age=30.41 years±13.96; range: 14-73 years). They answered an online survey including the preliminary DM and the Portuguese validated versions of the Eating Disorder Examination Questionnaire (EDE-Q7) and the Body Image Concern Inventory (BICI).

Confirmatory Factor Analysis showed that the unidimensional model presented good fit indexes (χ2/df=.6829; RMSEA=.0000; CFI=1.00 TLI=1.01, GFI=.995). Cronbach’s alfa was .891; all the items contributed to the internal consistency and had high internal validity. Pearson correlations of DM with EDE-Q7 and BICI were significant (p<.001) and moderate-high, respectively,.384 and .522.

The Portuguese preliminary version of DM-EDAM demonstrated validity (construct and convergent) and reliability. can be used for clinical and research purposes, namely in an ongoing project we have in progress, about body image, disordered eating, gender and age.

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The Screen for Disordered Eating/SDE was created as a primary care screening method for eating disorders, including binge eating disorder (Maguen et al. 2018). The SDE comprises five items (yes/no answers), extracted from other validated self-reported questionnaires assessing eating psychopathology. Its validity and reliability has proved in a Portuguese psychometric study, that only included woman (Pereira et al. 2022). It psychometric properties have yet to be evaluated in men.

We aim to assess the psychometric properties of the Portuguese version of SDE in males.

Participants were 227 male individuals with a mean age of 30.41 years (±13.96; range: 14-73). They answered an online survey including the Portuguese preliminary versions of the seven-item Eating Disorder Examination Questionnaire/EDE-Q7; the Body Image Concern Inventory/BICI and the Muscle Dysmorphia subscale of the Eating Disorder Assessment for Men/DM-EDAM.

Confirmatory Factor Analysis showed good fit for the unidimensional model (χ2/df=1.483; RMSEA=.0460; CFI=.980 TLI=.961, GFI=.988). Cronbach’s alpha was .621 which although inferior to .7 can be explained by the small number of items and the fact that each one assesses different dimensions. All items contributed to the internal consistency and presented high internal validity. Pearson’s correlations of SDE with BICI (.317) and EDE-Q7 (.361) were significant and moderate. The correlation with DM-EDAM was non-significant, probably due to its focus on muscle dysmorphia, which is not included in SDE’s items.

The Portuguese version of SDE demonstrated adequate validity (construct and convergent) and reliability.

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In recent times, Health Professionals (HPs) people may feel a sense of discomfort and nervousness when disconnected from their smartphones, causing the emergence of the new phenomenon of “No Mobile Phone Phobia,” or Nomophobia.

We aim to study lifestyle-related factors that influence HPs’ Nomophobia.

From April- June 2023, a global cross-sectional study was conducted using the modified Nomophobia questionnaire (NMP-Q). The original 20 NMP-Q questions (Qs) were reduced to 14 to avoid repetitive Qs with similar meanings. The Qs were categorized into 4 sections, A- Not Being Able to Access Information; B- Losing Connectedness; C- Not Being Able to Communicate; and D- Giving Up Convenience. A new section, “E- Daily Habits”, and “F- Smartphone Type”, and “Hours Spent Daily” were added. Before the launch, it was internally and externally validated by trained psychiatrists as well as experienced researchers. We utilized social media, WhatsApp, text and emails to share it with HPs of different specialties worldwide. The survey was anonymous and IRB-exempt.

Total 105 countries’ HPs participation led to 12,253 responses. Total 47.3% of HPs agreed/strongly agreed (A/SA) that they prefer to use their smartphone before bedtime. Over half (57.8%) of HPs A/SA checked their notifications immediately after waking up in the morning. Only 19.4 % of HPs A/SA that woke up in the middle of the night to check notifications. Total 40.5% of HPs A/SA, 22% were neutral, and 37.3% of HPs disagreed /strongly disagreed (D/SD) with using smartphones while eating their meals. A total of 52.7% of HPs preferred smartphone usage over exercising as a break, while 454.9% of HPs A/SA that they chose smartphones over exploring other hobbies for relaxation. A total of 44.2% of respondents A/SA with smartphone usage in the restroom, 39.8% D/SD. 37.4% of participants D/SD with getting distracted by notifications and resisted the urge to answer any calls or texts while performing a focused task, whereas 39.6% A/SA and 23% were neutral. A total of 80% of respondents met the modified criteria for moderate-severe nomophobia.

In a large-scale survey-based study on Nomophobia, additional Qs in NMP-Q may help recognize that nomophobia can be a result of daily lifestyle decisions rather than an isolated issue.

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Serotonin syndrome is a potentially life-threatening condition that is precipitated by the use of serotonergic medications, Selective Serotonin Reuptake Inhibitors (SSRIs) and Monoamine Oxidase Inhibitors (MAOIs). It usually occurs when high doses of serotonergic drugs are prescribed. It is a medical emergency that requires prompt recognition, cessation of offending drugs and supportive therapy.

We present a case of serotonin syndrome that occurred in a patient who was prescribed a low dose of sertraline, and aim to highlight the importance of early detection of this severe condition.

Details of the case were described. Information was gathered based on medical records.

Patient M was a 29-year-old Malay male with a history of major depressive disorder, who was previously trialed on fluvoxamine 100mg every night but subsequently switched to and maintained on sertraline 75mg every night in 2020. He then defaulted follow up appointments. In 2023, he presented to the emergency services for a suicide attempt and was diagnosed with major depressive disorder with psychotic features. He was restarted on sertraline 50mg every night and risperidone 0.5mg every night was newly started. Two days later, sertraline was increased to 100mg every night. Two days following this increase, he was noted to have altered mental state, fever of 39.3-degree celcius, tachycardia of 120 beats per minute, ocular clonus and generalized hyperreflexia. Sertraline and risperidone were immediately stopped. Blood tests including creatine kinase, lumbar puncture and magnetic resonance imaging (MRI) of the brain did not show any abnormalities. After stopping of the medications, the patient’s symptoms resolved within 24 hours. Based on clinical symptoms and a normal creatine kinase level, neuroleptic malignant syndrome (NMS) was ruled out. Subsequently, he was restarted on risperidone 0.5mg and mirtazapine 7.5mg every night. He developed symptoms of serotonin syndrome with a low dose of sertraline. Symptoms resolved after the discontinuation of the SSRI.

In this case, differential diagnoses of serotonin syndrome were also considered, such as NMS, encephalitis, meningitis and thyroid storm. NMS was less likely due to the rapid onset of onset and resolution of symptoms. Encephalitis and meningitis were unlikely in view of normal MRI brain and lumbar puncture findings.

There have been case reports of serotonin syndrome developing with lower doses of an SSRI in the pediatric population. There is, however, a lack of literature describing serotonin syndrome with low doses of SSRI in the adult population. To avoid a missed diagnosis, clinicians should monitor closely for SSRI toxicity, including serotonin syndrome, even when low doses of serotonergic drugs are used.

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Mental health at work is increasingly an essential element to assess, especially in sectors with a high risk of psychological and physical stress. Working in a healthcare environment and particularly work in a psychiatric environment can constitute a psychological risk for workers. Among the risks faced by emergency psychiatric medical staff is the risk of developing PTSD (post traumatic stress disorder), which occurs after a traumatic event and results in moral suffering and physical complications that profoundly alter life:personal, social and professional life.

Screening psychiatric emergency nurses for post-traumatic stress disorders.

This is a cross-sectional study carried out in the psychiatric emergency department of the Arrazi University Hospital in Salé, using an anonymous questionnaire distributed to nurses. It includes a 1st part on sociodemographic and professional data, a 2nd part focused on the evaluation of mental health through the GHQ12 and a 3rd part which evaluates post-traumatic stress made by the scale of post-traumatic stress disorder (PCLS).

60 pourcent of women are more able to have ptsd disorder

40 pourcent men 95 pourcent are under the age of 30 and 5 pourcent have more than 30 years

80 pourcent have morked less than 5 years in the emergency hospital

and 20 pourcent have worked more 73 pourcent have scored more than 44 in pcls score

23 pourcent have scored less than 44 in pcls score

This work highlighted an extremely high rate of exposure to a violent event among psychiatric emergency nurses, even if in this study the prevalence of PTSD found among nurses is lower than expected, in this professional environment overexposure a violence requires special attention to protect and prevent the development of PTSD in professionals

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Cannabinoid hyperemesis syndrome (CHS) is an underrecognized condition characterized by acute episodes of intractable nausea and vomiting, colic abdominal pain and restlessness related to chronic cannabis use. Antiemetics commonly fail to alleviate the severe nausea and vomiting. A very particular finding is the symptomatic relief with hot water. Antipsychotics (such as haloperidol), benzodiazepines and/or capsaicin cream appear to be the most efficacious in the treatment of this unique disorder. Precisely, it has been studied that transient relief of symptoms with topic capsaicin or hot water share the same pathophysiology. Nevertheless, abstinence from cannabis remains the most effective way of mitigating morbidity associated with CHS.

The objective is to study this phenomenom in our hospital and to alert of its existence in order to avoid a suspected misdiagnosis and overdiagnosis.

We report a case series of seven patients who attended the Emergency Room (ER) of a third level hospital located in Cantabria (Spain) where a psychiatric evaluation was demanded.

The reasons for consultation were agitation and/or compulsive vomit provocation and showers. They were all women, with a median age of 29 years (range 21 to 38), who all smoked cannabis and in probable high doses (seven to up to twenty joints per day, information was missing in three of the patients) and probable long duration of consumption (more than nine years up to twenty-three, information was missing in three of the patients).

One of the most striking findings is the time to diagnosis, being the median of years of more than eight (range from two to twenty-one). In all of the cases there is a hyperfrequentation to the ER for this reason (not counting other emergency centres we have in Cantabria which we don´t have access to), being the average of almost twenty-two times (thirteen up to thirty times), not diagnosing it until last visits. Another interesting fact is that Psychiatric evaluation is done approximately in a third of the visits, being the department that makes all of the diagnosis except in one case. In all of the cases there are a lot of diagnostic orientation doubts from different medical departments, being the two most common psychiatric misdiagnosis: Other Specified Anxiety Disorder and Other Specified Feeding or Eating Disorder. Two of the patients were hospitalized in an acute psychiatric unit for this reason, one of them nine times and the other patient, twice.

CHS has a very particular presentation which makes its recognition very simple. From our experience, it is an unknown entity for most of the doctors, something that needs to change in order to make a correct therapeutic management. Larger studies need to be done to make this findings more solid and for further information.

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Zolpidem is a nonbenzodiazepine, which acts as a sedative- hypnotic that binds to GABA (A) receptors at the same location as benzodiazepines and increases GABA effects in the central nervous system (Kovacic et al. Oxidative medicine and cellular longevity 2009, 2(1), 52–57). Literature shows that behavioral changes including amnesia, hallucinations, and other neurocognitive effects are some of the known side effects (Edinoff et al. Health psychology research 2021, 9(1), 24927). We present a case about Ms. A, a female in her sixties with a history of major depressive disorder with psychotic symptoms who was brought into the hospital by the EMS under police custody after stabbing her granddaughter with a knife. During the evaluation she was dissociating with impaired memory of the circumstances of her presentation. Collateral information about Ms. A revealed that she had no history of being violent, or any history of psychoactive substance use. Ms. A’s home psychiatric medications consisted of Sertraline 100mg, Bupropion 150 mg, Zolpidem 5mg.

To better understand the potential risks with prescribing zolpidem in patient with insomnia.

In depth literature review about zolpidem. In addition, observation of Ms. A in the emergency with a full medical workup including but not limited to urine drug screen, brain imaging, lumbar puncture, etc.

Ms.A medical workup was positive for a urinalysis revealing asymptomatic bacteriuria and she was treated empirically with cefdinir. Her medication regimen consisted of Bupropion 150 mg and Sertraline 100m, both daily. Zolpidem was discontinued and changed to Clonazepam 0.5mg for insomnia. She was also started on Olanzapine 5mg in the AM and 10mg in the PM. Her mental status was noted to have improved after discontinuation of Zolpidem. Patient received one dose in the hospital but after two days since discontinuation her mental status improved. Upon literature review previous reports have been published citing cases of patients on Zolpidem physically acting out while sleeping in a parasomnia-like behavior, with no recollection of memories upon awakening. (Inagaki et al. Primary care companion to the Journal of clinical psychiatry 2010, 12(6)). There are case reports of Zolpidem associated homicide (Paradis et al.The primary care companion for CNS disorders 2012, 14(4).

One limitation of our study is the patient was noted to have a sudden change in behavior with altered mental status which may be attributed to an underlying asymptomatic bacteriuria. It should be noted that this may have been an incidental finding. This does not exclude the possibility of Zolpidem as the primary cause of the change of her altered mental status or further exacerbating the change in her mental status. Though Zolpidem can be therapeutic and safe, we as clinicians have to be aware of the potential side effects of Zolpidem when prescribing medications.

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In Spain and other European countries, patients coming to the emergency room (ER) are usually classified as “organic” or “psychiatric” on arrival, but this may be complicated when psychiatric history is present as the focus can be misplaced (Leeman. IJPM 1975;6(4):544-40; Alam et al. Psychiatr. Clin. North Am. 2017;40(3):425–33).

To describe three cases seen in the psychiatric emergency room (PER) in which triage errors occurred and to review whether it is widespread for psychiatric patients with organic pathology or in need of medical care to be wrongly triaged.

We retrospectively reviewed three cases seen in the PER of Hospital Clínic in July 2023 in which triage errors happened. Triage error was considered when patients triaged directly to the PER presented symptoms that either needed medical treatment or required medical clearance before being considered purely psychiatric.

Case 1: A 27-year-old woman with history of depressive syndrome was triaged for a speech disturbance that had occurred fifteen minutes after intercourse. After being evaluated, she was referred to neurology where she was diagnosed with an acute ischaemic stroke in left middle cerebral artery territory, requiring thrombectomy and posterior admission to neurology.

Case 2: A 50-year-old man with history of alcohol use disorder was brought to the PER after saying that “he was seeing people doing magic” at home. When evaluated, significant distal tremor, tachycardia and hypertension were observed, being compatible with withdrawal symptoms, so he was transferred to the ER. There he was monitored and treated, finally requiring admission to internal medicine due to persistent symptoms.

Case 3: A 26-year-old man with history of substance use disorder was triaged for loss of consciousness and “spasms”. After evaluation, he was transferred to the ER, where organic screening was carried out, being oriented as a probable tonic-clonic seizure and discharged with outpatient follow-up.

The cases presented are instances in which somatic diseases in patients pre-labelled with psychiatric histories were wrongly assumed to be recurrences of their psychiatric disorders. In all cases, they needed to be re-examined by the corresponding medical specialty and required diagnostic tests, in two cases hospital admission was needed. Emergency physicians and emergency psychiatrists often disagree on how to medically clear patients (Alam et al. Psychiatr. Clin. North Am. 2017;40(3):425–33; Janiak et al. JEM. 2012;43(5):866–70), some authors have even proposed protocols for doing this in a more systematic way (Shah et al. JEM. 2012;43(5):871–5). To avoid a delay in diagnosis and treatment and the consequences that may result from it, establishing guidelines for proper triage of patients with psychiatric history should be considered.

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Attention–Deficit/Hyperactivity Disorder (ADHD) is a heterogeneous neurodevelopmental disorder encompassing developmentally inappropriate inattentiveness, hyperactivity, and increased impulsivity (DSM-5). Symptoms presentation is different for different stages of life; moreover, individuals with ADHD symptomatology can develop abilities and strategies that help them adapt and mask the distinctive features of the condition, thus reducing the functional impairment usually seen in ADHD subjects, and ultimately not receiving neither a clinical diagnosis nor a proper therapeutic support. They might express their lack of well-being through other transdiagnostic symptoms, and finally reach psychiatric attention for potential comorbidities. Hence, it was argued that the existence of children and adolescents with subthreshold and underrecognized symptoms that subsequently develop into a full diagnosis suggests that ADHD should be significantly more considered in adult mental health settings.

Here we aimed to analyse the prevalence of ADHD symptoms and traits in a heterogeneous clinical psychiatric sample of young adults (aged 18 to 24 years old), who referred to a specialized outpatient clinic for various psychiatric and psychological disturbances.

259 participants completed three validated self-report screening questionnaires for ADHD: the Wender Utah Rating Scale (WURS), the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5 (ASRS-5), and the Conners’ adult ADHD rating scale (CAARS).

12.4% of our sample scored above the cut-off at both the WURS and the ASRS-5 and was considered at risk of ADHD.

The prevalence rate in our sample is higher than the one found in the adult general population (6.76%), and in the lower range of the one found in the adult clinical population (6.9% to 38.8%). We discuss the potential role of sociodemographics (age, sex, gender identity, and employment) and comorbidity factors. Differences in the clinical presentation of ADHD according to sex assigned at birth and age should be considered during every psychiatric evaluation to minimize the risk of underdiagnosis. We advocate for further studies investigating the prevalence of ADHD in different psychiatric services for adults, and for a stronger presence of specialistic ADHD services and trained clinicians on the territory: this would increase diagnostic reliability, consequently providing a better treatment for ADHD in adults, and facilitate the transition from pediatric to adult’s services.

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There are more than ten thousand homeless people in Hungary. Earlier studies confirmed the connection between mental health issues and homelessness. Furthermore, homeless care places a significant burden on the healthcare system, with psychiatric departments being no exception.

to compare demographic and treatment characteristis of homeless and not homeless inpatients in the psychiatric department of Jahn Ferenc South Pest Hospital (JFSPH), and thus providing a different perspective compared to previous studies, shedding light on the relationships from a different angle.

In our retrospective study, we analyzed all inpatients’ data treated in the psychiatric department of JFSPH over a 4-month period (03/2023-07/2023). Patients were divided into two groups: those with housing and those who were homeless. We compared the two groups based on the following variables: gender, age, length of inpatient treatment, diagnosis, psychiatric history, employment status; smoking, alcohol and drug use; valid health insurance, invalidity pension and guardianship status; and long-acting injectable antipsychotic treatment.

The percentage of homeless individuals treated in the psychiatric department of JFSPH was 18%. There was a significant difference in the length of inpatient stay between the two groups, homeless patients spent more than 100% longer time under inpatient treatment. Regarding psychiatric history, there was no significant difference between the two patient groups. When examining the employment status of the sample, we found significantly more unemployed patients im the homeless group. Comparing to the control group, there were significantly more alcohol consumers, smokers, and substance users among the homeless. Long-acting antipsychotic injections were administered significantly more frequently to homeless patients. A significantly higher percentage of homeless individuals were declared invalidated, and a significantly higher proportion of them were placed under guardianship compared to the group with housing. Homeless individuals were significantly more likely to have no social insurance compared to the control group.

In summary, we can conclude that significant difference have been found between the homeless and not homeless groups in most of the examined variables. These results implicates that the inpatient care of homeless patients poses significant bourden on the inpatient system. Early prevention and effective rehabilitation of substance use disorders could decrease this burden. Establishing a proper social safety network and enhancing community psychiatric care could potentially also relieve the burden of inpatient care system.

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Previous research has shown that:

• - problem focused coping strategies aim to change the reaction to the stressful situations

• - self-compassion may reduce anxiety and depression. It is associated with happiness, it increases with age, it is negatively correlated with perceived stress and in older adults seems to be associated with higher levels of wisdom, integration, acceptance of one’s past life experiences and higher levels of meaning in life.

• - job related low LPLA (Low pleasurable Low arousal emotions) and high LPHA (Low pleasurable High arousal emotions) levels corelate to depression, anxiety, and stress.

Case report of 60 years old computer scientist

Psychiatric interview and scales:

Self-reported questionnaires: The Brief-COPE, The Self-Compassion Scale (SCS-SF), The Perceived Stress Scale (PSS 10), The Depression Anxiety Stress Scale (DASS-10), The Job-related Affective Well-being Scale (JAWS), The Subjective Happiness Scale (SHS), The Meaning in Life Questionnaire (MLQ)

60 years old male computer scientist, single, without children, multiple times a week in recreative activities and physical activities. He is not satisfied with close friendships, he sleeps 6 hours in day, he didn’t have traumatic experiences in life. He is not religious. He works 45 hours per week, from that 5-10 hours weekly works at the site of primary employment.

The Brief-COPE: High score for using problem focused coping strategies-acceptance, planning, positive reframing, and informational support. Maladaptive coping strategies used in lower grade: self-blame and self-distraction.

SCS-SF: Much higher levels of self-compassion than the norms established by previous research.

DASS-10: low.

SHS: lower happiness level than the norms established by previous research.

JAWS: High negative emotional reactions to job and low level of overall job-related affective wellbeing together with lower HPHA, higher LPHA, and lower LPLA in comparison to previous research. According to previous research this person is not satisfied with his job and have a lot of negative emotions regarding his job.

PSS 10: Levels of perceived stress are lower than the norms established by previous research.

MLQ: this person scored below 24 on the scale- presence of meaning and below 24 on the scale search for meaning. According to previous research person with this score do not feel their life has a valued meaning and purpose and they do not not actively explore that meaning or seeking meaning.

Problem focused coping strategies and high self-compassion can be seen as protective factors to lower stress, negative emotional reactions to job and anxiety

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The diagnosis of Autism Spectrum Disorders is currently witnessing several changes, with direct consequences on the prevalence rates in the general population. However, little is known about ASD traits prevalence in clinical samples, and how much these traits interact with other mental health conditions, especially in young adults, a critical age for the outbreak of many psychiatric diseases.

The aim of this study was to assess the prevalence of ASD traits in a sample of young adults (aged between 18 and 24 years old) referring to a specialized mental health outpatient clinic.

We administered to 259 patients the Autism Quotient (AQ) and the Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS‐R), along with a detailed sociodemographic and anamnestic interview.

We found that 16.2% of our sample scored above the cut-off at both scales (a percentage that went down to 13.13% when restricting the RAADS-R cut-off at >119, as suggested for clinical samples).

This prevalence seems considerably higher than the one reported in the general population, and not negligible. The association with sociodemographic features such as sex assigned at birth, gender identity and employment status, and the validity of the screening tools we implemented, are discussed. In conclusion, we suggest that an assessment for autistic traits should be implemented in young adults seeking help for unspecified psychiatric symptoms and psychological suffering and that, despite the not unanimous consensus over self-report screening tools, a positivity to both the AQ and the RAADS-R should lead the clinician to conduct a full diagnostic evaluation with structured or semi-structured interviews.

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Long-term leave for psychiatric illness is the most frequently prescribed reason for leave, and appears to be on the increase in recent years.

To draw up a sociodemographic, occupational and clinical profile of workers who have taken long-term sick leave for psychiatric illness

Retrospective descriptive study involving the medical files of workers from both the public and private sectors, having benefited from long-term sick leave over a period going from August 17, 2022 to September 12, 2023, referred to the occupational medicine and pathology department of Charles Nicolle Hospital in Tunis for medical fitness-for-work assessment. Data collection was based on a pre-established synoptic form.

During the study period, we identified 639 long-term sick leave prescribed for psychiatric illnesses. Our study population was predominantly female, with a sex ratio of 0.29 and a mean age of 46.82 ± 25.06 years. Sixty percent of employees were married. The most represented occupational category was nurses (33%). Average job seniority was 17.21±10.41 years. Depressive syndrome was the most common psychiatric pathology in our population (80.3%), followed by bipolar disorder (6.4%) and anxiety disorder (5%). Long-term sick leave was prescribed by a psychiatrist working in the private sector in 90.3% of cases. The average duration of leave was 63.70±31.58 days. The triggering factor was work-related and social in 33.6% and 30.1% of cases respectively. The agents returned to work after the long-term sick leave in 92% of cases.

Long-term sick leave for psychiatric reasons is a handicap to productivity in society. Non-occupational factors are thought to be responsible for these mental health disorders. Setting up and improving social structures in the workplace would reduce the number of cases of long-term sick leave

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The use of technology in many areas of daily life is widespread among both children and adults. Excessive and inappropriate use of technological aids causes significant problems in physical, psychomotor, psychological and social stages of development, especially in childhood. One of the reasons for some problems that arise in adulthood, such as communication problems, anxiety disorders, obesity, musculoskeletal disorders and tendency to violence is the excessive and inappropriate use of technology in childhood. For this reason, it is of great importance to complete the developmental stages in childhood in a healthy way.

The aim of this study was to qualitatively assess the technology use habits of 48-72 month old preschool children and their parents.

The study is a qualitative research conducted among the parents of children in Eskişehir and Bolu between March and June 2023. A semi-structured form was used for the personal interviews with the 25 parents who constituted the study group. The interviews were recorded. The audio recordings were then transcribed and a thematic content analysis was conducted. The main themes of the interviews concerned the habits of parents’ and children’s in the use of technology at home, the content used on technological devices and how it is controlled, and the arrangements for technology use at home.

In the interviews, parents reported that when they needed to use technological devices, they most often chose a time and place when the children were not present or asleep. When children spent more time at home, this was the most common reason for increased technology use, while the most common reason for decreased use was that children spent more time outside the home. Most parents limited the amount of time their children’s daily technology using time. It was found that children generally complied with these restrictions, and when they did not, they often expressed themselves with reactions such as sulking/angry/crying.

This study emphasizes that the most important factor determining children’s attitudes towards technology use is their parents’ attitudes towards technology use In order for children to develop a positive attitude towards technology use, it can be beneficial for parents to regulate and control their children’s technology use as well as their own.

None Declared

Emotion regulation is the conscious or automatic control of emotions to adapt, cope, and maintain well-being. Effective emotion regulation is central to mental health, impacting work, and relationships. University students, facing academic pressures and social transitions, represent a unique demographic where emotion regulation challenges are particularly relevant.

This study aimed to explore the emotion regulation difficulties in university students.

A descriptive study was led from August to September 2023. An online questionnaire was distributed to a population of Tunisian university students. We administered a socio-demographic questionnaire and the Arabic version of the difficulties in emotion regulation scale short form (DRES-SF), a self-report measure developed to assess clinically relevant difficulties in emotion regulation.

Participants in this study consisted of 307 undergraduate students, with 78.1% being women and 21.9% men, representing various academic disciplines at Tunis el Manar University in Tunisia. The mean age of the participants was 22 years, with a standard deviation of 2.84.In the assessment of emotional regulation difficulties, participants reported a mean total score of 42.47 ± 12.68. Participants who repeated years in college had more difficulties in emotional regulation (p<0.05). Limited access to emotion regulation strategies had a mean score of 7.64 ± 3.0, while nonacceptance of emotional responses was rated at 7.40 ± 3.17. Additionally, impulse control difficulties were reported with a mean score of 6.46 ± 3.31, and difficulties in engaging in goal-directed behavior were observed with a mean score of 9.44 ± 3.18. Moreover, participants expressed a lack of emotional awareness, which was quantified with a mean score of 8.45 ± 2.69, and a lack of emotional clarity, which yielded a mean score of 7.12 ± 2.69. Additionally, a significant association was noted between gender (p < 0.05), age (p < 0.05), and the lack of emotional awareness, suggesting potential gender and age-related variations in emotional regulation difficulties within this university sample.

Overall, these findings suggest the necessity of emotion regulation training in the university setting. Further studies are important to understand the impact of emotional regulation difficulties.

None Declared

Antipsychotic (AP) are increasingly prescribed off-label and used as, but not limited to, anti-aggressive, anti-impulsive, and anti-suicidal medication. The use of second-generation AP (SGAs) has progressively increased compared to first-generation AP (FGAs). FGAs cause more extrapyramidal motor side effects and tardive dyskinesia than SGAs, whereas SGAs generally cause more weight gain and cardiometabolic adverse effects.

Aim of this observational study was to describe the socio-demographic and clinical features of the patients receiving new AP treatment and the features of the pharmacological treatment itself in “real world” context. Furthermore, we aimed to compare socio-demographic and clinical characteristics of the subjects who were prescribed either FGAs or SGAs.

Data were collected on the latest new AP prescriptions issued across different settings (two psychiatric wards; five outpatients clinics; and one rehabilitation community) belonging to ASST Fatebenefratelli Sacco (located in Milan) in reverse chronological order from May 2023.

Socio-demographic and clinical variables of the subjects who received new AP treatment were collected through medical records. We compared age, age at onset, age at first pharmacological treatment, duration of illness, duration of untreated illness, treatment duration, number of hospitalization and admissions to Day Hospital services, involuntary commitments and suicidal attempts in patients who received either FGAs or SGAs. Chi-square was used for qualitative variables and t-test for quantitative variables. Data were collected anonymously and analyzed using SPSS v.27.

The sample included 155 new AP prescriptions, out of which 29.2% were formulated in the psychiatric wards, 66.9% in the outpatient clinics e 3.9% in the rehabilitative community. Mean age of the subjects was 41.1 ± 16.9 years, 53.2% were male.

The most represented diagnoses were psychotic disorders (32.2%), personality disorders (24.8%), bipolar disorder (16.1%) and depressive disorder (12.8%).

90.7% of new AP prescriptions were SGAs. The most prescribed were aripiprazole (30.5%), quetiapine (21.2%) and olanzapine (15.2%); while the most prescribed FGAs were haloperidol (5.3%), zuclopenthixol (2%) and chlorpromazine (1.3%). 26.2% of the prescriptions were in monotherapy and 83.8% were for oral administration.

The reasons for introduction were partial or absent response to previous treatments (52.3%), disease onset (23.5%), non-compliance (8.3%), adverse effects to previous treatments (6.8%) or other (9.1%). Patients treated with FGA had a longer duration of untreated illness (p<0,001) and a greater number of lifetime hospitalizations (p<0,001) and involuntary commitments (p=0,002).

Patients treated with SGAs have a shorter duration of untreated illness and also lower chance of lifetime hospitalization and involuntary commitment.

None Declared