Weight gain and obesity are important health problems associated with psychiatric disorders and/or with psychotropic drug treatments. There is a high inter-individual variability in the susceptibility to drug induced weight gain and/or other cardiometabolic disorders.

To study the genetic, clinical and environmental risk factors for weight gain and onset of metabolic syndrome during psychotropic treatment.

Analysis in PsyMetab, a large (n>3000) ongoing longitudinal prospective cohort study investigating cardiometabolic disorders in psychiatric patients.

Aside from well-known clinical risk factors for metabolic worsening (e.g. young age, first episode status, rapid weight gain during the first month of treatment and/or low initial BMI), we recently identified additional risk factors, such as the socio-economic status, a low status being associated with increased worsening of cardiometabolic parameters. Results from ongoing studies on the moderate dose dependencies of the metabolic effects of antipsychotics will be shown, as well as the clinical consequences. An epigenome-wide association study (EWAS) performed in 78 patients before and after one month of treatment (Dubath et al., submitted) and a genome-wide association study (GWAS) in 1924 patients (Sjaarda et al. submitted) will also be presented, as well as the use of polygenic risk scores to predict patients at risks for dyslipidemia (Delacretaz-Reymond et al., in preparation)

Many factors contribute to the differences in weight gain and metabolic disorders induced by psychotropic drugs. The use of specific algorithms and/or polygenic risk scores can help to identify patients at risks. However, when starting a psychotropic drug at risk, a prospective monitoring of clinical (e.g. weight and blood pressure) and biochemical (fasting glucose, lipid levels) parameters is essential.

None Declared

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by a persistent pattern of inattention, hyperactivity, and impulsivity, which begins in childhood and often persists into adulthood. ADHD has a heterogeneous expression with diversity in behavioral symptoms, cognitive deficits, and comorbidities. So, it is possible to consider it a spectrum with different losses.

To describe clusters of multiple neuropsychological, attentional, and behavioral measures in adults with symptoms of ADHD. It could help to seek new directions to examine heterogeneity from a dimensional approach to ADHD.

120 adults between 18 and 52 years old (m= 29.5) with ADHD symptoms participated in this study. Performance indices on computerized neuropsychological tests of attention (voluntary, automatic, temporal, and sustained), behavioral self-report scales for ADHD (ASRS-18), impulsivity (BIS-11) executive dysfunction (BDEFS), and functionality, emotional and behavioral problems (Adult Self-Report - ASR of ASEBA) were analyzed. Cluster analysis processed the data to find subgroups based on the scores of instruments. The NbClust tested the best number of clusters that converge to a solution.

The 3 clusters solution was obtained by comparing Z scores for each indicator. In cluster 1, the ADHD symptoms were equivalent but expressed more hyperactivity than in other clusters. Also, higher levels of functional impairments and executive dysfunctions (motivation, emotional regulation, and anxiety/depression) were identified. In the attentional neuropsychological tasks, the indices express a lower level. Cluster 2 expressed a higher level of inattention and attentional, motor, and non-planning impulsivity, and functional impairments in the academic, professional, and legal risk areas. Cluster 3 was the subgroup with the lowest level of symptoms of ADHD.

This study identified differences in performances that contribute to understanding the cognitive, behavioral, and emotional expressions of ADHD. Three groups of different prejudices levels should be considered in the development of evaluative models in new studies to consider the spectrum of ADHD.

Financial support: FAPESP [grant 2019/20757-5, 2019/21773-4, 2020/14800-2]; CAPES Proex [grant 0426/2021, 23038.006837/2021-73]; Mackpesquisa; CNPq [grant 307443/2019-1]

None Declared

Waiting and stopping are essential and distinct elements of appropriate behavioral control with its dysfunction implicated in various impulsivity related mental disorders. Although rodent and human studies have investigated both phenomena, the role of preparing to stop in waiting impulsivity has rarely been investigated. Furthermore, convergent evidence from multi-modal investigation tools remains a poorly utilized approach in addressing such questions.

Here, we conducted two separate, but hierarchical studies, using functional magnetic resonance imaging (fMRI) to map the neural circuit involved in waiting impulsivity and proactive stopping, and subsequently provide mechanistic and causal evidence of disruption of this circuit by transcranial magnetic stimulation (TMS). In the second study, based on our fMRI study data, we attempted to investigate possible causation between the LIFG and waiting impulsivity by modulating LIFG, i.e. non-invasively producing a “virtual lesion” with an inhibitory transcranial magnetic stimulation (TMS) protocol called continuous theta burst stimulation

We recruited 41 healthy volunteers who performed an adapted version (1CSRT) of the well-established 5 choice serial reaction time task to capture waiting impulsivity. We developed a novel task measuring proactive inhibition. We scanned participants while completing these two tasks. Our fMRI data showed a strong association between LIFG activity and waiting impulsivity on the 1CSRT task. We conducted a single-blind, randomized, between-subjects design of cTBS of the LIFG on a sample of 51 healthy volunteers who completed an adapted version of the 1CSRT task (2CSRT task). Our a priori hypothesis was that cTBS would transiently decrease local cortical activity of the LIFG and increase the frequency of premature responses on both fixed and delayed cue-target interval trials on the 2CSRT task.

We first show a shared neural network comprising the pre-supplementary motor area and bilateral anterior insula underlying both waiting impulsivity and proactive stopping. We further demonstrate activity in dorsomedial prefrontal cortex and left inferior frontal gyrus (LIFG) negatively correlated with waiting impulsivity in trials with additional target onset delay. We demonstrate active stimulation significantly increased waiting impulsivity.

In these two studies, we validated a novel task measuring proactive inhibition. We further validated the significance of task structure for assessing distinct aspects of impulsivity, which is of translational interest. We further established a causal role of lIFG for waiting impulsivity thus highlighting the integrity of LIFG and related neural circuitry required in waiting impulsivity.

None Declared

This umbrella review is the frst to systematically examine psychological trauma as a transdiagnostic risk factor across psychiatric conditions.

This review aimed to be the frst to evaluate whether psychological trauma fulflilled criteria as a transdiagnostic risk factor cutting across various diagnostic categories and spectra. Transdiagnosticity will be assessed against the framework of the TRANSD criteria (Fusar-Poli, World Psychiatry 2019; 18 361-362). The paper additionally aimed to analyse the association of psychopathology with specifc trauma type.

We searched Pubmed, Scopus, and PsycNET databases from inception until 01/05/2021 for systematic reviews/meta-analyses evaluating the association between psychological trauma and at least one diagnosed mental disorder. We re-calculated the odds ratio (OR), then classifed the association as convincing, highly suggestive, suggestive, or weak, based on the number of cases and controls with and without psychological trauma, random-efects p value, the 95% conf- dence interval of the largest study, heterogeneity between studies, 95% prediction interval, small-study efect, and excess significance bias. Additional outcomes were the association between specifc trauma types and specific mental disorders, and a sensitivity analysis for childhood trauma. Transdiagnosticity was assessed using TRANSD criteria. The review was pre-registered in Prospero CRD42020157308 and followed PRISMA/MOOSE guidelines.

Fourteen reviews met inclusion criteria, comprising 16,277 cases and 77,586 controls. Psychological trauma met TRANSD criteria as a transdiagnostic factor across diferent diagnostic criteria and spectra. There was highly suggestive evidence of an association between psychological trauma at any time-point and any mental disorder (OR=2.92) and between childhood trauma and any mental disorder

(OR=2.90). Regarding specifc trauma types, convincing evidence linked physical abuse (OR=2.36) and highly suggestive evidence linked sexual abuse (OR=3.47) with a range of mental disorders, and convincing evidence linked emotional abuse to anxiety disorders (OR=3.05); there were no data for emotional abuse with other disorders.

Image:

Image 2:

These fndings highlight the importance of preventing early traumatic events and providing trauma-informed care in early intervention and psychiatric services.

None Declared

Studies have shown that dementia family caregivers to be significantly more burdened than non-dementia caregivers.

The aim of the present study was to analyze factors affecting the quality of life and the burden of dementia family caregivers.

70 dementia family caregivers who lived in the Attica Region, Greece participated in the study from February to April 2022. An anonymous questionnaire was used including 16 items regarding demographic and socio-economic factors. The 22 -item Zarit Burden scale was used to estimate the burden of dementia family caregivers. Statistical analysis was performed with SPSS 21.

1.4% of caregivers showed minimal to no burden (n = 1). 28% of caregivers (n = 20) a mild to moderate burden. 40.6% (n = 29) presented a moderate to severe burden, while 28% (n = 20) a very serious burden. According to the results of the present study, there are three main factors that affect the quality of life of caregivers. Caregivers who spend more time with the patient have an increased burden compared to caregivers who spend less time. The patient’s low Mini Mental score is associated with an increase in burden. Caregivers who have attended training and management programs for the care of a patient with dementia have a lower burden than those who have not attended programs.

The study highlights an increased burden on caregivers. Social supports with multiple coping strategies focusing on different levels of patients with dementia and caregivers’ needs should be planned to relieve the caregiver burden.

None Declared

The spectacular progress of the last decade in the field of genetics is allowing a new development of medicine and the ability to make a better diagnosis. A great example of this is the diagnosis of chromosome 22q11 deletion, which occurs in 1:4000 live births.

This case wants to illustrate the difficulties in the diagnosis, despite technological advances.

Exhaustive review of the literature

This is a 38-year-old male patient diagnosed with chromosome 22q11 deletion in adulthood.

Family history of medical problems: mother with genetic diagnosis of chromosome 22q11 deletion, in adulthood, after the diagnosis of her own son.

Personal history of medical problems:

- Psychiatry: he has been followed up intermittently in psychology since he was 6 years old, due to cognitive difficulties and behavioral alterations. He has had several hospital admissions in psychiatry during adolescence for behavioral disorders and intellectual disability, with possible psychotic symptoms. In treatment with antiepileptics and antipsychotics.

- Cardiology: aortic aneurysm and bicuspid aortic valve were detected. The patient underwent surgery in 2018.

- Genetics: he is diagnosed with chromosome 22q11 deletion in 2019. This is an inherited mutation of maternal origin that is detected later.

- Rheumatology: seropositive rheumatoid arthritis, non-erosive.

- Rehabilitation: treatment to improve psychomotor skills, from 6-12 years of age.

It is important to emphasize that the diagnosis was made at the age of 35 years, after a more deep study which had been carried out after the debut of the cardiac pathology. In addition, it is very striking that the diagnosis of his mother was made later than the one of the patient himself.

Currently, the patient presents serious difficulties in respecting the rules of coexistence at home and in understanding social norms, so that he has not been able to integrate in any environment and remains isolated at home. Serious behavioral alterations with tendency to physical and verbal heteroaggressiveness, difficulty in accepting limits and sexualized and uninhibited behaviors.

Clinical judgment: chromosome 22q11 deletion.

Early diagnosis is essential to be able to treat and, above all, prevent the possible complications that this syndrome may present. However, diagnosis is sometimes very complex, despite advances in molecular diagnostic techniques. Therefore, an integrative approach is very valuable, looking at the individual as a whole and not only by systems or medical subspecialties. In addition, it would be very interesting to establish a means of communication between specialties. Finally, it would be a real step forward to integrate all the medical information of each person in a single medical record, an apparently simple aspect, but so far from being possible.

None Declared

Positive psychology theory sustains that the construct of the Self and its components, such as self-evaluation, social self-esteem, and self-coherence, determine our behavior. Personal daily habits and lifestyle modalities lay on these personality components. Problematic and addictive behavior is also strongly influenced by our Self and its main elements.

This study aims to determine those personality components related to the central Self-construct that actuates problematic smartphone use.

Our further objective is to identify targeted, self-enhancing activities that prevent problematic smartphone use.

Participants were teenagers and adults (N=147) from the 17-73 age group (mean age 37.5 years), 31 male and 116 female.

Respondents provided self-reported data on their demographic characteristics, perceived self-esteem, social self-esteem, sense of coherence, and problematic smartphone use through an online survey attainable on a web-based platform.

Instruments were the Core Self-Evaluation Scale (Judge et al., 2003), the MOS-SSS Social Support Assessing Scale (Sherbourne & Stewart, 1991), the Sense of Coherence Scale (Rahe & Tolles, 2002), and the Smartphone Application-Based Addiction Scale (Csibi et al., 2018).

Respondents who reported being more familiar with smartphone applications and spending more time online scored higher on the problematic smartphone use scale. Our study found significant associations between age and problematic smartphone use, with those from younger groups scoring higher.

Participants characterized by lower self-esteem proved a more pronounced problematic smartphone use. In our sample, social self-image and social support did not show relevant correlations with the total score of problematic smartphone use.

However, a high sense of coherence showed a significant negative association with problematic smartphone use.

A more mature Self-construct characterized by a positive self-evaluation and increased sense of coherence act as protective factors against problematic smartphone use.

Providing adequate self-evaluation and social support among young through targeted activities will have a higher role in younger age groups, preventing problematic smartphone use.

None Declared

The positive attitude towards students with Diabetes Mellitus type 1(DM1) and the teacher’s knowledge seem to be important conditions both for the practical support of children with type 1 ED in primary education and for the self-efficacy of teachers in the school context. Self-efficacy involves the belief that a person has the ability to create change through personal actions.

To investigate the level of knowledge of Primary Education teachers about DM1, their attitudes towards students with insulin-dependent diabetes, as well as their levels of self-efficacy in the management of diabetes in the school environment.

This is a cross-sectional study, where the sample consisted of 150 teachers working in Public Primary Schools of Athens, the capital of Greece. The following questionnaires were used to collect the data: (a) socio-demographic characteristics questionnaire, (b) primary education teachers’ knowledge and attitudes questionnaire about insulin-dependent diabetes, and (c) the generalized self-efficacy scale.

24.7% of participants were male and the mean age was 43.79 (±10.11). The average percentage of correct answers to the knowledge questionnaire was 86.00 (±9.01), also, the average score of perceptions about the role of the school nurse was 90.53 (±9.39), for the role of students with DM1 89.17 (±11.42), for the readiness of teachers/educational system to manage students with DM1 48.10 (±13.22), and of the self-efficacy was 30.71 (±13, 67). The questions with the lowest percentage of correct answers were: “What is the normal range of blood sugar values when we are fasting?” (62.70%) and “If you find a child with DM1 unconscious what should you do immediately?” (52.70%). The percentage of correct responses was found to have a positive statistically significant correlation with self-efficacy score (p=0.05), years of service (p=0.003), age (p=0.014), teachers who had at some point students with DM1 in their classroom versus those who did not (p=0.045).

Experienced and qualified staff could effectively support students not only practically by assisting them with daily activities but also by creating an environment based on understanding and acceptance.

None Declared

Teaching is considered by the International Labor Organization as one of the most stressful professions, with consequences on the mental and physical health and on their professional performance. Intervention programs focused on physical activity usually present a significant decrease in the level of stress and an improvement in the quality of life of teachers. Physical activity is considered one of the main non-pharmacological strategies to reduce stress, generating a positive influence on mental health.

To evaluate the impact of an intervention program based on the practice of physical activity on the level of stress and motivation for the regular practice of physical activity in teachers.

This study employed a pretest-posttest design. Measures: Portuguese versions of Stress Perception Scale and Motivation Inventory for Regular Physical Activity Practice. Sample: 33 teachers from Portugal and Brazil, 57,6% females, 54,5% from Portugal, 63,6% with age between 26 and 35 years. The intervention ran for 8 weeks, with a total of 40 sessions with cardiorespiratory conditioning exercises, muscle strengthening and stretching, relaxation and meditation techniques.

On baseline we found significant relationship between “years of teaching experience” and the level of stress (p=.027). After the intervention, the level of stress significantly decreased in Portuguese teachers (p=.031). In 83% of the sample, there is a decrease in the levels of perceived stress. Concerning Brazilian teachers (p=.006), in 73% of the sample, there is a decrease in the levels of perceived stress. Regarding motivation, there is a significant increase in Portuguese teachers related to “stress control” (p<.001), “sociability” (p=.001), “competitiveness” (p<.001), and “esthetic” (p=.004). In Brazilian teachers there is an increase related to “stress control” (p=.003), and “competitiveness” (p=.001).

Both samples showed positive results, attesting the efficacy of the intervention based in physical exercises to reduce stress and increase motivation to practice physical activity regularly. After intervention, more motivational dimensions are changed in Portuguese teachers, comparing with Brazilian teachers.

None Declared

The prevalence of mental disorders in Higher Education Students (HES) is high and has shown a worrying growth. However, only a small percentage of HES in need of psychological support request it, due to the stigma related to mental illness, requesting informal help from friends and family. Training and increasing Mental Health Literacy (MHL) have been stated as appropriate strategies to reduce stigma and increase the demand for professional psychological support. However, with the increase in the demand for help, the difficulty of providing an adequate response from psychological support of HE services also increases. Therefore, procedures that develop socio-emotional skills in the HES and strategies that enhance the responsiveness of these services are necessary.

Taking in consideration the literature review in this field, we develop a project to improve the mental health of HES. The project objectives’: a) the reduction of stigma related to mental disorders through the promotion of MHL in the academic community; b) the promotion of mental health and socio-emotional skills of HES; c) increasing detection and active search for professional mental health support, and d) the implementation of psychological intervention based on a stepped care model that provides an adequate response to most of the students’ mental health needs, according to individual needs.

The project proposes to perform the following methods: a) training in mental health open to the academic community, which will aim to train volunteers to be Gatekeepers, in order to promote awareness, detection and referral of students in need of professional psychological support; b) implementation of a Student Observatory, with tracking of psychopathological symptoms, supported on the Web; c) implementation of a psychological intervention program based on a stepped care model, which will include the following progressive phases by severity: 1) digital self-help manual; 2) web-based self-help groups; 3) psychological intervention groups supported by the Web; 4) face-to-face intervention groups and 5) individual psychological intervention.

Students will be assessed before and after each step of care, with the following psychological instruments: Mental Health Inventory (MHI); Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7).

The implementation of the presented methods expect to achieve improvements on HES’ mental health, namely improvement of MHI, reduction of PHQ-9 and GAD-7 after each step of the psychological care.

The project presented encloses evidence-based interventions, with inspiration on psychoeducation and cognitive behavioral approaches, and it is expected to contribute to the improvement of mental health of HES. The results will be collected and disseminated. We encourage other researcher and clinicians to perform studies about the mental health of HES.

None Declared

In recent years there has been an ongoing search for alternatives to psychiatric hospitalizations, which might overcome the barriers of social stigma and institutionalization. Nonetheless, there is a paucity of empirical studies which address the effectiveness of these potential alternatives as compared to the traditional medical model.

The purpose of the current study is to compare the effectiveness of psychiatric hospitalization with two alternatives: Soteria homes, which emphasize the cultivation of empathetic and non-intrusive relations, and technologically assisted home hospitalization, which places the emphasis on the provision of psychiatric care in a manner which resembles the medical model, but in close proximity to the patient’s family.

Subjects and staff completed self-report measures of their symptomatic distress, social functioning, interpersonal relations, quality of life, self-stigma, therapeutic alliance, global functioning (GAF) and positive and negative symptoms of schizophrenia (PANSS). Measurements were completed at baseline, at discharge, and at three months, half a year, a year and a year and a half after discharge.

Overall, the study included 214 subjects, which were non-randomly allocated to one of the three acute care modules: psychiatric hospitalization (N=66), Soteria homes (N=94) and technologically assisted home hospitalization (N=54). The average age in the total sample was 36 years (SD=14.2) and 49.1% of them were women. The majority of patients (47.7%) were diagnosed with a psychotic or bipolar diagnosis, followed by mood disorders (29.4%), PTSD or a personality disorders (19.6%) and others (3.3%). About 68.5% earned less than the average, 10.2% earned an average salary and 21.4% earned above the average.

Full description of the results elaborating on the differences between treatment modules across the three acute care settings will be presented and discussed. The results of the current study can provide significant insights about the effectiveness of psychiatric hospitalization alternatives for acute mental states and can influence decision-making processes and policy trends worldwide.

None Declared

Short term and immediate interventions are an essential tool to combat distress in times of community crises. The combination of cognitive behavioral interventions and art practice provides a unique tool for the transformation of stressful visual images into less threatening and more manageable images. Previous research has demonstrated the efficacy of cognitive behavioral- and art-based (CB-ART) interventions in reducing distress related to different types of community crises.

The aims of the current study were (1) to compare the effectiveness of CB-ART interventions in reducing distress associated with two types of ongoing community crises: actual war conditions and the Covid-19 pandemic; and (2) to compare the mechanisms used in these contexts to transform the stressful image associated with the community crisis into a more manageable image.

CB-ART workshops were conducted during both the 2014 Israel–Gaza conflict and the first wave of COVID-19 in Israel. The CB-ART workshops included drawing pictures related to three topics: (1) emotions and thoughts related to the ongoing community crisis; (2) coping resources; and (3) integration of the stressful image and the resource picture. To examine the intervention effect, the Subjective Units of Distress (SUDs) values of the two affected groups were measured using a pre-post design.

In both groups participants’ distress levels significantly decreased after the intervention. A significantly larger decrease was found among the group that participated in the CB-ART workshops during war conditions. The dominant compositional changes within the integrative picture that emerged in both groups included a diminished size of the stressful image; use of several mixed-sized objects scattered all over the drawing, as opposed to one large–sized object placed at the center of the drawing, which typically characterized the stress drawing; and use of lighter optimistic colors.

Similar mechanisms of alterations in the stressful image were found in the two groups, accompanied by reduced distress, as depicted by the SUDs values reported by the participants. Future studies would benefit from examining the effectiveness CB-ART interventions in reducing stress and enhancing coping strategies during additional community crises.

None Declared

Well-being encompasses positive emotions and good physical health as well as, positive meaningful social relationships and connections or social well-being. Philosophies about the healing powers of nature, the value of spaces as a determinant of health and the impact of design of buildings on human health and wellbeing can be traced back for centuries. Bringing hospitality experience to inhospitable environments and humanizing’ healthcare environments according to a healthy architecture map and architecture health indices become currently an emergency to improve to improve the health of architectural environment and to promote the social and human wellbeing, in particular in healthcare environments.

Given the increase in mental and social health problems, We aim through this review of literature to identify as architect what is a healthy architecture map and what are the architecture health indices in healthcare environments, in particular in hospitals for mental disorders.

We comprehensively review the scientific literature using Pubmed database and Google scholar to state the presence of consensual healthy architecture maps and architecture health indices in mental healthcare environments.

Our bibliographic review revealed that, more than for other buildings, the construction of a hospital is extremely constrained involving highly complex program and multifaceted and interconnected factors with which the architect must deal. Medical and technological progress as well as the strong involvement of the healthcare personnel, who are requested, to turn towards the patient who must be at the heart of the medical and the space process make the program more complex. This lead all professionals, to have a deep reflection on the various and multi-layered challenges of the transformation of the hospital landscape especially when it is designed for patients with mental illnesses.

At this era of wellness revolution and precision medicine, despite some ambitious projects there are not yet a consensual healthy architecture map and precise architecture health indicators focusing on how the architectural composition of a mental health hospital may be planned.

None Declared

BIM for Building Information Modeling is a process that ensures the planning, design, and construction of buildings in an efficient collaborative manner. BIM software encompasses computer files, which can be extracted, exchanged or networked to support decision-making regarding a built asset. It provides physical and functional/semantic digital data representations for building components as a single point of accuracy for all system users. As the design of the built environment plays an important role as a determinant of health, architectural health indicators provide quantitative and empirical data upon which all operators such as architects, customers, BIM users and other stakeholders (public health advisors, construction professionals, healthcare providers, social prescribers, etc.) might monitor and assess the healthiness of architectural design.

The objective of this research is to explore the current state of knowledge about architectural health indicators for use in BIM models that address mental health and diseases.

We comprehensively reviewed the scientific literature using PubMed and Google Scholar as well as electronic bibliographic databases to assess architectural health indicators currently in use by the BIM process, to explore their potential usage and to state the value of indicators focusing on factors affecting mental and social health.

Our bibliographic review revealed that used architectural health indicators in BIM computer systems are very limited. Most of them addressed communicable diseases through simple measurements e.g., air and water quality, etc. However, there is a gap in architectural health indicators pointing non-communicable diseases and their poor health outcomes. Very few indicators focusing on factors affecting mental and social health have been considered in scientific literature.

The research reveals serious gaps in architectural health indicators that address mental health. As there is worldwide a decline of the mental health and given the increase in mental and social health problems, there is an urgent need to address this situation through the incorporation of mental health data, mental disorders and mental disabilities data to enrich the health information of the BIM models and provide an efficient decision support.

None Declared

For over two decades, much has been written about the role of heritage buildings and historic places on individual and societal well-being. Numerous manuscripts have been devoted to study the relationship between built and cultural heritage and well-being and to decrypt their mental and physical health benefits at the personal and societal levels. Other studies have focused on the diverse types of heritage experiences that enable these health benefits, ranging from perceptions, to the individual and societal engagements through exposure, protection and conservation of historic places and environment. Social benefits encompass enhancing of collective memories and identities, sharing experiences, social interaction, creative opportunities, etc.

The objective of this research is to explore the relationship between personal and societal health and well-being, and cultural heritage. The main objective is to disclose international strategies and programs for assessing and promoting heritage-led wellbeing benefits.

We comprehensively reviewed the scientific literature using qualitative data-analysis methods to state, international frameworks for promoting heritage-led wellbeing benefits.

Our bibliographic review revealed that there has been rising recognition that the conservation of cultural heritage is not just about the preservation of materials, but rather about safeguarding and sharing heritage for the improvement of people’s lives. According to the WHO, culture and cultural heritage are recognized as fundamental determinants of what makes personal and social lives meaningful. Consequently, many countries such as the UK and Canada, have developed people centred approaches achieved by local authorities as a means of ensuring inclusivity and diversity, so that heritage is able to contribute to people’s wellbeing. Politically, few agendas promoting wellbeing and engagement with the historic environment included guidelines of community-oriented projects and management systems that benefit people with building the relationship between people and place, while demonstrating the public value of the historic environment.

All professionals, at the architectural and urban level, as well as health and psychology level should have awareness about the concept of heritage-led wellbeing benefits and strategic views of the value of cultural heritage as process, as participation, as mechanism, as healing, as place and as environment to raise the planned positive effects by local authorities when promoting the perception of the role of cultural heritage in health and wellbeing.

None Declared

Mental health problems among adolescents have been on the rise particularly among adolescents in sub-Saharan Africa (SSA) due to impoverished living conditions and a high burden of chronic diseases including HIV/AIDs. COVID-19 pandemic has further exacerbated the risk and placed additional stress on adolescents’ mental health. While the burden might be high, there are fewer mental health services in the region.

To evaluate the psychological and mental well-being of adolescents living in and co co-design with civil society organizations (CSOs) interventions aimed at enhancing mental health and psychosocial well-being.

Firstly, we conducted a formative phase to assess the burden of various mental health problems in Kenya. We conducted a cross-sectional survey in which we assessed the mental health status of 1541 adolescents using standardized tools. The participants comprised in and out of school adolescents, adolescents with disability, and those living with HIV/AIDS. Furthermore, we undertook a qualitative study through FGDs and KIIs to identify the factors contributing to mental health problems.

Secondly, we aim to adapt interventions that seek to promote mental health. Finally, we aim to implement effective mental health interventions targeting over 2000 adolescents living in Kenya’ informal settlements.

We found the prevalence of depression to be higher among out-of-school adolescents at 36.0% compared to school-going adolescents at 20.6%. Furthermore, out-of-school adolescents had statistically significantly higher anxiety scores as well at 27.7 % when compared to their school-going counterparts at 19.1%. In-school adolescents had a better quality of life scores, lower pandemic anxiety scores, and lower emotional scores compared to their out-of-school counterparts. Results from regression models indicated that being out of school, having a COVID-19 infection, having poor relationships with parents and peers, loneliness, and living in an unsafe neighborhood were factors associated with poor mental health outcomes. During the qualitative interviews, participants noted that COVID- 19 brought about financial stress, joblessness, led to early pregnancies, involvement in commercial sex work by adolescents, school dropouts, lead to stress, and depression among other issues.

Image 3:

Adolescents, especially those out of school are at a high risk of poor mental health outcomes due to exposure to a host of psychosocial risk factors. We have identified two interventions that we are keen to implement: the Shamiri Wellness Intervention (https://www.shamiri.institute/the-shamiri-intervention) and the Mental Health Literacy Programme (http://mentalhealthliteracy.org/). We hope that by working with CSOs, the study will support the development of their capacity to offer mental health services that are sustainable, and contextually appropriate.

None Declared

A natural disaster like flooding causes loss of properties and evacuation and effective mental health. Resilience after natural disasters is a crucial area of research which needs attention.

To explore the prevalence and associated factors of low resilience a year after the 2020 floods in Fort McMurray.

A cross-sectional study was conducted in Fort McMurray using online surveys. The data were analyzed with SPSS version 25 using univariate analysis with the chi-squared test and binary logistic regression analysis.

The prevalence of low resilience was 37.4%. Respondents under 25 years were nearly 26 times more likely to show low resilience (OR= 0.038; 95% CI 0.004 - 0.384). Responders with a history of depression and anxiety (OR= 0.212; CI 95% 0.068-0.661) were nearly four to five times more likely to show low resilience. Similarly, respondents willing to receive mental health counselling (OR=0.134 95%CI: 0.047-0.378) were 7.5 times more likely to show low resilience. Participants residing in the same house before the flood were almost 11 times more likely to show low resilience (OR=0.095; 95% CI 0.021- 0.427), and support from the Government of Alberta was a protective factor.

The study showed demographic, clinical, and flood-related variables contributing to low resilience. Receiving support from the Government was shown to be a protective factor against low resilience. More robust measures must be in place to promote normal to high resilience among flood victims in affected communities.

None Declared

As psychiatrists, we are taught not to disclose and to present a blank canvas to the client

Should mental health professionals be reconsidering this stance if aiming to effectively manage their clients who live in a world that promotes vulnerability and lived experience as powerful therapeutic strategies?

Promote mental health and remove the shame and stigma limiting client engagement by advocating for ‘real’ psychiatrists

• - Discuss therapeutic disclosure and its history

• - The impact of social media and current trends in mental health promotion

• - Suggestions for improving client engagement through reclaiming the expert role in mental health promotion and the value of sharing lived experience within professional boundaries. To

• - Clients improve communication and openness

• - Mental health engagement promoted and encouraged

Clients respond favourably to psychiatrist vulnerability and authenticity with therapeutic disclosures

None Declared

According to international research, chronic diseases affect people’s life expectancy. There are many risk factors for Chronic Disease, both communicable and non-communicable. Chronic Disease can cause a variety of problems for the person suffering from it, such as physical, social and psychological distress. Therefore, patients’ coping strategies can affect their quality of life and the progression of the disease

This research aimed to investigate the relationship between Coping Strategies of patients with Chronic Diseases and their Psychological Distress experienced as a consequence of the disease.

Survey participants were recruited via social media groups for chronic disease. So,106 people suffering from diseases, such as diabetes, arthritis, asthma, Multiple Sclerosis and other disabilities were involved in the study and were asked to respond to an internet-based questionnaire consisted of demographic questions and two scales: (1)Toulouse’s Scale for Coping, (2) Kessler Psychological Distress Scale (K6).

From the results derived by correlating specific parameters and factors such as gender, occupational status, marital status, educational level, place of residence and age, it was found that Chronic Disease’s management is related to psychological distress of patients. Namely, withdrawal and denial were associated with negative mental health state. Therefore, participants’ psychological distress and the strategies they chose to cope with their chronic illness were determined by a reciprocal relationship.Table 1:correlations of coping strategies with psychological distress

In light of the results, psychoeducational interventions aimed at alleviating psychological distress in patients with chronic diseases and improving their coping strategies are crucial.

None Declared

Positive psychiatry is broadly defined as the science of understanding and promoting well-being through interventions that involve positive psychosocial characteristics (PPCs) in people suffering from, or are at high risk of developing mental and physical illnesses (Jeste et al. JCP 2015; 76 675-683). Over the past 3 years, as the pandemic tested the limits of what our minds and bodies can handle, there has been an upward trend in the incidence of mental health conditions, including overdoses, suicide, and substance use (Czeisler et al. MMWR 2020; 69 1049-1057). COVID-19 has highlighted the relationship between the environment and individual mental health, most notably as people have faced increased social isolation, loneliness, and stress (Jeste. SB 2022; 48 533-535). The tools of positive psychiatry can be utilized to further address and target these deteriorations in mental health in hopes of improving outcomes.

To educate about the modality of positive psychiatry and how it can be an especially critical tool in treating mental health in the post COVID-19 era. To advocate for the incorporation of positive psychiatry practices into the training curriculum of mental health care providers.

A literature review was conducted using Google Scholar and Pubmed databases with the term “positive psychiatry” in the title. The search showed 26 results, including 6 systematic reviews and 1 clinical trial. Subsequent searches of “COVID-19” and “mental health” were conducted to create formulations and recommendations for the post COVID-19 era.

Growing evidence shows that PPCs are modifiable constructs that may be associated with improved mental and physical health outcomes. Research during the pandemic has demonstrated that PPCs such as resilience and optimism moderated the trajectory of OCD, depression, and anxiety, and that those with more resilience and optimism displayed lesser decline in their function (Hezel et al. JPR 2022 150 165-172). Beyond mental health, various PPCs, such as social support, have also shown positive outcomes in medical conditions such as hypertension and cardiovascular disease, and ultimately improved well-being (Jeste et al. JCP 2015; 76 675-683).

Based on our literature review, practices of positive psychiatry in conjunction with traditional psychiatry can serve as an invaluable modality in treating patients with various psychiatric conditions and improve mental health outcomes. These positive factors have historically been under-recognized among individuals with or at-risk for mental illnesses. As social distancing, fear of the “unprecedented” and loss of agency became more prevalent over the past couple years, the need for tools to target these notions increases. Further research into optimal incorporation of positive psychiatry into routine clinical practice can help address the trends in mental health brought on by the pandemic.

None Declared