The incidence of suicide is much higher in people with mental health disorders, estimating that up to 9 out of 10 people who commit suicide suffer from at least one of them. For this reason, suicide is considered by many authors as the most serious complication of psychiatric disorders. The literature and the experience of clinicians support the potential usefulness of specific measures and programs aimed at its prevention.

Congruently, throughout the last decade, consecutive strategic mental health plans in the Autonomous Community of Madrid, Spain, have included suicide prevention plans among their priorities, setting the objective of reducing suicidal behavior in the population of Madrid by implementing practical measures in the healthcare system.

In the presented work we aim to summarize the multidisciplinary therapeutic process in the context of this program and the results obtained during its years of experience.

Retiro Community Mental Health Treatment Center launched a specific program in 2013 to meet these objectives. This initiative, that received the name PRISURE (Spanish acronym for Suicide Risk Prevention Program in Retiro), is an outpatient intervention program for immediate care, as the first appointment is scheduled within a week after referral. Intensive, comprehensive and multidisciplinary care is provided for patients with moderate to severe suicide risk.

All professional categories that work in the Community Mental Health Treatment Center actively participate. In parallel with clinical performance, these professionals also carry out coordination tasks with other entities that are dedicated to suicide prevention, as well as with patients’ and families’ associations.

No significant relationships.

An important task of psychiatrists and psychologists is the prevention of suicidal behavior in adolescents.

Highlighting the stages of the formation of reflexive skills for the development of training sessions on the prevention of adolescent suicide.

Analysis of the results of theoretical and empirical studies of reflection and suicide by psychiatrists and psychologists.

Reflexive skills are a system of deliberate actions aimed at understanding and evaluating “I” and one’s own behavior. Theoretical analysis made it possible to distinguish three stages in the formation of reflexive skills. EMOTIONAL - evaluation of “I” as the basis of positive emotions. COGNITIVE - understanding (awareness) of one’s own capabilities for solving a problem. OPERATIONAL - solving a problem based on an assessment of the “I” and an understanding of their capabilities.

The identification of three stages of the formation of reflexive skills, as prevention of adolescent suicide, makes it possible to develop an effective training program for adolescents at risk in the Centers for psychiatric and psychological assistance.

No significant relationships.

Alcohol-based hand sanitizers containing ethanol or isopropanol are being used in order to prevent person-to-person transmission during the COVID-19. Early signs and symptoms of this ingestion include nausea, vomiting, headache, abdominal pain, blurred vision, loss of coordination, and decreased level of consciousness. After hand sanitizer ingestion we have to suspect about methanol poisoning, monitoring the start of anion-gap metabolic acidosis, seizures, and blindness is essential. Treatment includes supportive care, acidosis correction, and the administration of an alcohol dehydrogenase inhibitor. In servere cases hemodialysis may be required.

To present a case of an 29-year-old woman who was taken to the emergency department after voluntary ingestion of alcohol-based hand sanitizer in a suicide attempt. To describe the most common side effects of hand sanitizer ingestion and the literature review.

Clinical case presentation and literature review of similar cases.

A 29-year-old woman, with diagnosis of borderline personality disorder and previous suicide attempts was taken to the emergency department after 3 hours of voluntary ingestion of an unknown quantity of alcohol-based hand sanitizer. Initial laboratory findings showed laboratory a blood methanol concentration of 66 mg/dL, with an anion gap of 30 mEq/L, arterial blood pH of 7.2, serum bicarbonate concentration of 12 mEq/L. Patient complained of abdominal pain and nervoussness.

Most common signs and symptoms of alcohol-based hand sanitizer ingestion include nausea, vomiting, headache, abdominal pain, blurred vision, loss of coordination, and decreased level of consciousness. Treatment includes supportive care, acidosis correction, the administration of an alcohol dehydrogenase inhibitor and sometimes may be required.

No significant relationships.

Suicide can be defined as a deliberate act performed by the individual, whose intention is the death, in a conscious, intentional, even if ambivalent way, using a means that he believes to be lethal. They are also part of what we usually call suicidal behavior: thoughts, plans and attempted suicide.

Prevention is a critical step in treating suicidal behavior. Create strategies to reduce and treat the ideation, planning and suicide attempt.

Based on a large increase in the number of people who present ideas, plan and attempt suicide, the Clinic created techniques for the treatment of inpatients: Life Appreciation Group, Groups applying Cognitive Behavioral Therapy, Group Dynamics, Lectures, Art Therapy and Physical activities .

The actions are developed by a multidisciplinary team that is divided by applying the various techniques and participating in all the proposed activities.

Patients who remained hospitalized fully complying with the suggested treatment and left with medical discharge had full benefit, unlike some cases of patients removed by the family against our indication.

No significant relationships.

Definitions used for suicide attempts and self-harm have been discussed for many years and is used differently in European countries, sometimes even interchangeably. Therefore, it is difficult to compare relevant rates across nations.

This study aims at estimating the rate of suicide attempts and self-harm in chosen European countries in the more recent years when distinguishing between applied definitions.

A systematic search for relevant articles published between 2010-2020 will be performed in databases such as PubMed, Embase, PsycINFO, and Web of Science. Only articles in English or Danish will be included. Data will be collected for all age groups above 15 years of age. The prevalence of suicide attempts and self-harm will be calculated by a random effect model. Subgroup analyses will be performed to compare the rates according to age.

from the performed systematic review and meta-study will be presented at the conference.

The conclusion will be presented when results have been analysed.

No significant relationships.

The last two decades have seen the timeliness of studying the connection between suicides and drunkenness

To evaluate the significance of suicidal risk factors in patients who had committed suicides while being under the effect of alcohol so as to be able to forecast suicidal risks and prevent suicides within this group

The authors have carried out an analysis of medical documentation of suicides committed in the Sverdlovsk region. The data on suicides has been taken from forensic expertise acts. The following factors have been taken into account: age, gender, social status of suicide victim, supplementary somatic pathology, and concentration of alcohol in the victim’s blood

Alcoholic addiction is a behavioral indicator of suicidal risk. The level of suicidal activity in persons with the syndrome of alcoholic addiction is much higher than within the general populace. The age of 25-49 is the peak of suicidal attempts among patients with chronic alcoholism. Genuine suicides prevail during the first stage of chronic alcoholism. The patients are inclined to demonstrate pathological suicidal reactions to social misplacement that show themselves in the form of conflicts within the family and at work. In addition to genuine suicidal attempts made by males in the state of abstinence

The results received confirm the role of the alcoholic factor in the formation of suicidal behavior and have the aim of elaborating new forms and methods to help prevent suicides committed in the state of alcoholic drunkenness

No significant relationships.

Testosterone is an anabolic androgenic steroid hormone involved in brain development, reproduction, and social behavior. Several studies have shown that testosterone can cause impulsivity in humans. This impulsivity could modify the mood and increase the risk of suicidal behaviour.

Testosterone is an anabolic androgenic steroid hormone involved in brain development, reproduction, and social behavior. Several studies have shown that testosterone can cause impulsivity in humans. This impulsivity could modify the mood and increase the risk of suicidal behaviour.

Clinical case and literature review.

A 33-years male (biological female), single, gypsy ethnicity, with an 11-years daughter. Psychiatric history of one admission in a hospitalization unit. Diagnosed of depressive disorder and personality disorder NOS. Intermittent follow-up in Mental Health consultations. 8 years later, he consulted due to gender dysphoria. He refered not to be feeling identified with his body for a long time. He rejected his sexual characteristics. After his mental evaluation, he was refered to Endocrinology Service. He had been prescribed with testosterone. Three days after starting the treatment, he maked anattempt of suicide with medication. The patient had not presented previous suicide attempts or ideation. With the withdrawal of the testosterone, the suicidal behaviour dissapeared.

Due to the association of testosterone and suicidal behavoiur, we consider that is important to pay attention to people who have just started the androgenic treatment in order to avoid a high risk of suicide. In the same way, we should focus on evaluating the hostility, impulsivity and irritability in patients strongly related to suicidal behaviour.

No significant relationships.

Suicide rates in people diagnosed with a psychotic disorder can be up to 50 times higher than in the general population, with the lethality of attempts being significantly higher in this group, compared to people diagnosed with other psychiatric disorders. Furthermore, it is known that being male is associated with more serious suicide attempts and higher rates of completed suicides.

To reflect on the increased risk of suicide associated with psychotic disorders.

Case report and literature review.

Case report 40-year-old male, recently diagnosed with Schizophreniform Disorder and currently with persistent positive symptoms. He was admitted to our psychiatric hospitalization unit due to a voluntary overdose of almost 100 tablets (antihypertensives, antiarrhythmics, and benzodiazepines) and alcohol. He admits taking the pills with the aim of committing suicide. Literature review: - Around 10% of people diagnosed with schizophrenia commit suicide. - In young patients diagnosed with schizophrenia, suicide is the leading cause of death. - Between 15 and 65% of patients diagnosed with schizophrenia have depressive symptoms such as hopelessness. - Depressive symptoms in these patients seem to be directly proportionally with awareness of the disease (stigma, awareness of its severity and a sudden decrease in quality of life and social integration). - The risk of suicide increases especially in the first 10 years of the disease.

Psychosis is an important risk factor of suicide and active preventive measures should be carried out in these patients.

No significant relationships.

Description of a specialized treatment program for people attempting suicide in an academic health service focused on psychiatry and drug addiction in the city of Rio de Janeiro.

Describe actions developed to treat suicidal behavior.

Based on a survey of the prevalence of suicidal behavior in the Brazilian population over a lifetime, reaching a total of 12,000 cases per year of the Brazilian population, this academic service of psychiatry and drug addiction established the following actions for hospitalized patients: 24-hour surveillance, reduced access to methods of committing suicide (forks and knives removal, shoelaces and ropes removal), strengthening the GVV (Life Valuation Group), strengthening the Cognitive Behavior Therapy application groups, conducting group dynamics, lectures, art therapy and physical activities.

Of 370 patients admitted to this service from January 1st, 2019 to September 1st, 2019, 137 had suicidal behavior and only 2 died.

Of these two cases, one abandoned treatment and the other occurred during the treatment period.

No significant relationships.

Like in the general population, in the medical community the most common mental disorders reported are depression and anxiety. Suicide risk was increased, especially in medical-related professions.

To evaluate male and female psysician suicide risk.

Review all studies involving suicides, suicide attempts or suicidal ideation in health-care workers published in the last five years.

Suicide decreased over time, especially in Europe. Some specialties might be at higher risk such as psychiatrists, general surgeons and anesthesiologists.

Psysicians are an at-risk profession of suicide, with women particularly at risk.

No significant relationships.

Melatonin is often prescribed to patients experiencing sleep disturbances, which has been linked to elevated risks of suicide. However, it remains to be assessed whether melatonin is associated with suicide and suicide attempts.

We aimed to investigate whether individuals in treatment with melatonin had higher rates of suicide and suicide attempt when compared to individuals not in treatment.

Using longitudinal data on all persons aged 10+ years living in Denmark between 2007-2016 were obtained. Data from the National Prescription Register was used to identify periods of being in treatment with melatonin based on number of tablets and daily defined dose. Suicide and suicide attempt were identified in hospital and cause of death registries.

Among 5,798,923 included individuals, 10,577 (0.18%) were in treatment with melatonin (mean treatment length 50 days). Out of 5,952 individuals who died by suicide, 22 (0.37%) were in melatonin treatment, while 134 (0.53%) out of 25,136 had a first suicide attempt. After adjustment for sex and age-group, people in treatment with melatonin were found to have a higher rate of suicide (IRR: 4.2; 95% CI, 2.7-6.4) and suicide attempt (IRR: 6.7-fold (95% CI, 5.7-7.9) when compared to those not in treatment.

Treatment with melatonin was associated with higher rates of suicide and suicide attempt. The association might be explained through mediators, such as psychiatric comorbidity and sleep disorders. Our findings indicate that attention towards these issues might be warranted.

No significant relationships.

Parkinson’s disease(PD) is a progressive, neurodegenerative nervous system disease.Psychiatric symptoms are common in PD,it is important to consider the suicide risk of these patients.

The aim of this study is to investigate the risk of suicide in PD with a case control study and to determine the factors that may be associated.

126 Parkinson’s patients and 117 age,gender matched healthy controls were included.Montreal Cognitive Assessment Scale(MoCA),Suicide Probability Scale(SPS),Beck Hopelessness Scale(BHS),Apathy Rating Scale(AES) and Multidimensional Scale of Perceived Social Support(MSPSS) were completed by participants.The PD group completed Parkinson’s Disease Quality of Life Questionnaire(PDQ-39) and data on disease duration,Movement Disorders Society-Unified Parkinson’s Disease Rating Scale(MDS-UPDRS),levodopa-equivalent daily doses(LEDD) were obtained.Hamilton Anxiety Rating Scale(HAM-A) and Hamilton Depression Rating Scale(HAM-D) were administered to all participants.

SPS total scores were significantly lower and total scores of HAM-A,HAM-D and MSPSS were found to be significantly higher in the PD group.There was no significant difference between the two groups in terms of BHS total scores.In PD group a linear relationship was found between SPS total scores and BHS,PDQ39, HAM-A and HAM-D and an inverse relationship with AES.In the regression analysis,it was concluded that a one-unit increase in BHS total scores increased the probability of suicide by 17.1%.

It is seen that SPS scores in patients are lower than controls and observed that SPS is correlated with hopelessness,depression,anxiety and quality of life.Although the possibility of suicide is found to be low in PD,this risk increases in patients with untreated depression and anxiety.Therefore,psychiatric evaluation may be recommended in these patients.

No significant relationships.

Exposure to potentially morally injurious events (PMIEs) among combat veterans has been acknowledged as a significant stressful combat event that may lead to mental health problems, including suicide ideation (SI). Several studies have examined the risk and protective factors that can explain the conditions in which PMIEs may contribute to the development and maintenance of SI. However, the contribution of social-emotional factors has yet to be examined.

In the current study, we examined the association between PMIE-Self and SI among combat veterans and explored the mediating role of trauma-related shame and the moderation role of collective hatred in this association.

A volunteer sample of 336 Israeli combat veterans was recruited, completing self-report questionnaires in a cross-sectional study.

indicated that PMIE-Self was positively associated with SI, and trauma-related shame mediated this association. Moreover, collective hatred moderated both their direct (PMIE -SI) and indirect (PMIE-Shame-SI) association. Notably, collective hatred had an inverse role for each of the associations. Thus, collective hatred was found to comprise both a risk and a protective factor for SI following PMIE-Self.

The current findings highlight the crucial contribution of trauma-related shame and collective hatred to the association between moral injury and suicidality. Moreover, the findings demonstrate that even years after their military service release, combat veterans exposed to PMIEs may still feel consumed by painful memories and maintain premonitions of a foreshortened future. Furthermore, the findings help to better understand the dynamics of collective hatred and the challenge of modifying it.

No significant relationships.

Suicide is a dramatic suicidality complication and a significant worldwild public health problem. Sixty percent of suicidal deaths are preceded by at least one suicide attempt.

to search and estimate the factors predicting a suicidal recidivism

We conducted a retrospective descriptive survey, achieved in psychiatric departement A of Razi hospital on 60 patients hospitalized during a period of 10 years (from January 2010 to December 2019) and have committed at least a suicide attempt. Data collected from medical folders in order to explore sociodemographic and clinical characteristics of the patients.

The mean age of the sample was 30 years. A high prevalence of female was objectified. There were a low level of education for 53%, most of patients (55%) were unemployed and came from urban area. Among our patients, 39% attempted suicide for a one time. 61% of patients attempted suicide for several times. The main risk factors related to recidivism of suicidal behavior were unemployment, family history of psychiatric disorders and family instability.

The analysis of these results justifies preventive actions in order to face the increase of suicidal recidivism by searching for these associated factors. Therefore, a multidisciplinary intervention approach is required.

No significant relationships.

Suicidal thoughts and behaviors (STB) are a serious public health problem. Suicide prevention programs have been established over the years but many people who are suicidal do not seek treatment, and when they do they will end up in low-threshold sectors such as the Emergency Department in general hospitals. Previous studies about STB are mostly narrative, rather than a date-driven approach and limited in sample size.

The main goal of this study is to describe the prevalence and evolution of STB (ideation, plan or attempt) of the psychiatric patient referred to the Emergency Department of the University Hospital Gasthuisberg (Leuven, Belgium) over a 12 year period.

During a 12 year period (2003-2015), all patients with a psychiatric referral to the Psychiatric Emergency Room (PER) of the University Hospital Gasthuisberg (Leuven, Belgium) were included (N˜25.000). We use descriptive statistics to summarize the data set, focusing on STB in terms of raw numbers, symptoms at referral, mental disorders and demographic characteristics.

Around 1/9 patients presents with suicide attempt; another 1/5 with suicidal thoughts. STB accounts for 35% of psychiatric primary complaints at the PER. Women were more likely to present with STB. The proportion of STB referrals remains stable over the years.

Despite several reforms in mental health care, the PER remains a major entry point into mental healthcare for large proportions of STB patients.

No significant relationships.

During the COVID-19 pandemic, telesimulation became particularly important to continue the education of medical students during disrupted clerkships while maintaining social distancing.

To describe our experiences of adapting to telesimulation and evaluate this from student and faculty perspectives.

The intervention was evaluated using anonymous surveys consisting of statements rated on a five-point Likert scale from strongly disagree to strongly agree and open-ended questions asking students and facilitators what went well, what they would change and why, and for any other comments.

Adaptations addressed the logistics of online delivery and the structure and content of scenarios. Logistical considerations included central organization of sessions to relieve pressures on clinicians. Pre-session case discussions were introduced to maximise time with simulated patients and give students space to socialise. Content was modified to ensure functionality online and reflect the context of the pandemic. A total of 278 students and 24 facilitators participated in the telesimulation sessions. 98.1% of students (N=109) rated the sessions as very good or good. Students benefited from practicing skills, especially clinical situations which they would rarely encounter as students, and receiving feedback. Facilitators (N=6) felt that students learnt both skills for online consultations and skills that can be transferred to face-to-face situations, but were ambivalent on whether students would benefit more from face-to-face sessions.

Telesimulation is a safe and effective option that offers additional opportunities for students to develop telemedicine skills. Going forward, telesimulation should complement face-to-face delivery to develop future clinicians who are proficient in both remote and face-to-face working.

No significant relationships.

The therapeutic interview is one of the cornerstones of psychiatric practice. When practitioners are skilled in the art of interviewing, patients are allowed to share their narratives and explore their emotions, while the clinician can diagnose and treat more effectively. Discussions with colleagues can be used to share knowledge and experience. As part of a student project undertaken in Summer 2021, two students were tasked with producing a series of educational podcasts to be used for psychiatric training. Both students chose to complete several interviews with professionals in psychiatry. In this study, they will reflect on the efficacy of interviews as a learning tool, their experiences of podcast interviewing, and the transferable skills that they learned.

To reflect on the use of interviews within podcasts and how this can be transferred to practice.

Based on the literature review, medical students conducted interviews with specialist clinicians in order to gain information around patient treatment. They then reflected on this experience.

The practice of interviewing allowed for the development of a range of skills. It improved communication with senior professionals, provided a deeper knowledge of different psychiatric fields, and developed the written skills needed for the creation of engaging questions.

Interviews are a useful tool in educational podcasts and producing these helped medical students gain specialist insight and learning into different medical fields not thoroughly covered in the undergraduate curriculum. Producing the podcasts helped to develop the key skill of interviewing and communicating with more senior colleagues.

No significant relationships.

The European Psychiatric Association (EPA) Summer School allows psychiatric trainees and early career psychiatrists (ECPs) from all over Europe to meet, network, and learn together. After the 2020 edition being cancelled due to COVID-19, the 10th edition in 2021 focused for the first time on research and was conducted remotely.

To provide an overview and feedback about the first Virtual EPA Research Summer School as a new way to encourage international networking during COVID-19.

The School was organized by the EPA Secretary for Education, and 4 Faculty members. It started with a “breaking the ice session” one week before and then a two-days meeting on 23-24 September 2021 using an online video-platform. This was preceded by all the 21 participants (from 18 different countries) recording a short 4-minute video presentation, which was uploaded and shared with other participants and Faculty.

Participants were divided on a voluntary basis into three working groups: 1) “Drug repurposing: overcoming challenges in pharmacoepidemiology” 2) “Psychopathological research in psychiatry”; 3) “How to conduct a cross-sectional survey?”. The Summer School program was composed of plenary sessions with lectures by the Faculty members, discussion sessions, and working groups time. At the end, each group presented a summary of the work done to the rest of the participants.

Although the remote format limits social interactions during the Summer School, overall participants’ high satisfaction and productivity indicate that not only online formats, but also the topic of research might be covered in future editions.

No significant relationships.

Covid-19 pandemic caused a pivot to online clinical education and assessment across the globe.

To explore the views of psychiatric trainees and examiners on assessment of communication skills during online high stakes postgraduate examination.

This study was designed as interpretive descriptive qualitative research. All candidates and examiners of the online Irish Basic Specialist Training exam in September and November 2020 were included. The respondents were interviewed by Zoom which were transcribed verbatim. Data was coded using NVivo20 pro and Braun and Clarke thematic analysis was used to draw various themes and subthemes.

A total of seven candidates and seven examiners from different training deaneries and specialties were interviewed with average duration of 29m 45s and 24m 20s respectively. The participants were largely satisfied with the online examination but did not consider it equal to face-to-face for picking nonverbal cues. The candidates were very conscious of eye contact while examiners placed more emphasis on overall professional behavior and patient engagement. All candidates preferred to continue online format post pandemic for practical reasons e.g., avoiding travel and overnight stay, while all examiners preferred to go back to in-person Objective Structured Clinical Examination due to some limitations in assessing physical and cognitive examination. However, continuation of online Clinical Formulation and Management Examination was agreed by both groups.

The results of the study have shown different insights of two important stakeholders in a professional postgraduate psychiatry examination which can be useful to improve same exam and design similar assessments in other settings.

No significant relationships.

The updated programme for postgraduate psychiatry training in Malta was implemented in 2017. The trainees’ perspective was identified as an important and untapped resource in implementing positive change.

1. Identification of lacunae within the training programme 2. Acquire ideas regarding new initiatives 3. Identify what is particularly good. 4. Present a comprehensive report to the relevant stakeholders 5. Use of findings to work on concrete changes, with re-audit in 1 year.

Data from a national online survey of 12 Maltese Psychiatric Trainees from a total of 19 (63%% response rate) were examined. Both qualitative and quantitative data was gathered by making use of Likert scales as well as open ended questions. Various areas were surveyed, including 1. Ease of accessibility and quality of Clinical Supervision & Educational Supervision 2. Lectures and Teaching Seminars 3. After hours Duties 4. Psychotherapy Module 5. Preparation for MRCpsych Examinations

A noticeable difficulty in accessing clinical supervision (66%), the lack of research presentation opportunities (75%), as well as difficulties in the psychotherapy module (66.7%) were noted.

All results were collated into a six-page report. This report was presented to both the Maltese Postgraduate Training Committee as well as the Executive committee of the Maltese Association of Psychiatry and the Chairman of the Psychiatry Department. Various suggestions were flagged for Implementation including: 1. Rotation specific teaching 2. Restructure of the Psychotherapy module including training 3. Annual Research Day 4. Complex Case Discussions Follow up plans include reaudit in one year following the implemented changes.

No significant relationships.