Primary insomnia is frequently present in the general population, with epidemiologic research reporting prevalence values from 10% to as high as 60%. Chronic insomnia is associated with a significant impact on professional, academic, and daily life functionality, and it also may be responsible for decreasing the quality of life. Multiple generations of drugs for insomnia have been launched in clinical use in the last decades, but each class of pharmacological agents has its shortcomings (i.e., low efficacy, risk of addiction, diurnal sedation, risk of falls and fractures, etc.). Initially, research on orexin receptor antagonists has been considered with enthusiasm, due to these agents’ low risk of adverse events and good safety profile in the medium and long term.

To assess the evidence supporting the efficiency and safety of orexin receptor antagonists in the treatment of insomnia.

A literature review was performed through the main electronic databases (PubMed, Cochrane, Clarivate/Web Of Science, and EMBASE) using the search paradigm “primary insomnia” AND “orexin receptor modulators”. All papers published between January 2000 and September 2022 were included.

Suvorexant is a dual antagonist of orexin 1 and 2 receptors (DORA), FDA-approved for the treatment of insomnia, both for difficulties in falling and staying asleep. Daridorexant is another DORA, approved by FDA and EMA for the same indications as suvorexant, but EMA considers „additional monitoring” necessary for this drug. Lemborexant is a DORA approved for use in US and Japan, while vornorexant, which is included in the same class, is under development for the treatment of insomnia and sleep apnea (in phase 2 and 1 clinical trials, respectively). Almorexant is a DORA that was discontinued from clinical research due to hepatic safety concerns. Seltorexant is an orexin 2 receptor antagonist (SORA2) explored in phase II trials for the treatment of insomnia. Somnolence and fatigue are the most frequently reported adverse events of DORAs, but sleepwalking and sleep driving, sleep paralysis, or hypnopompic and hypnagogic hallucinations have been described in clinical studies. Seltorexant was associated with somnolence, headache, and nausea.

Dual antagonism of orexin 1 and 2 receptors is a mechanism that produced three currently available drugs for insomnia, and other clinical applications of these agents are still under investigation. At least one other agent from this class is under investigation, therefore the potential clinical utility of DORAs is far from being exhausted. Also, the selective orexin 2 receptor antagonism could be a promising mechanism of action for the treatment of insomnia.

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Sleep disorders (e.g., insomnia) are extremely prevalent in our population and are intimately associated with distress and productivity impairment. It is estimated that between 40 to 60% of people suffering from a sleep disorder have an underlying psychiatric diagnosis.

Mindfulness, which is described as the quality or state of being self-conscious or aware of something, has shown to be a potential helpful therapy in insomnia.

Therefore, and due to the lack of new and effective treatment approaches, we did a non-systematic review of the positive impact of mindfulness in quality of sleep.

Bibliographic research through PubMed, Web of Science and Springer Link.

The mindfulness tools that may be linked to its therapeutic effects include the awareness state and conscious posture to respond when perceiving insomnia symptoms, as well as the modulation of sleep-related arousal courses. These can be primary when directly related to the inability to sleep, or secondary if considering the relationship with thoughts about sleep (such as the tendency to create bias in the attention and perception of sleep related thoughts).

Formerly, mindfulness-based cognitive therapy (MTPC) was designed for the treatment of chronic depression and has shown to be efficacious. It was hypothesized that interoceptive dysfunction in the insula, commonly observed in anxiety and depression, may respond to MTPC by the gained interoceptive awareness, which provides advantage to adapt to life challenges and ongoing adjustments.

Based on the currently available literature, mindfulness-based strategies may be a valuable treatment option in sleep disorders, especially for patients with concomitant mental illness. Therefore, it is necessary further research to standardize in terms of type of approach, duration, and outcome measures since it seems promising as an intervention for insomnia.

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Numerous preclinical and clinical studies established the contribution of childhood adversity to acute stress vulnerability at adulthood. Several different physiological, psychological and behavioral factors have been suggested as putative mediators of this association. Sleep, and more specifically sleep disruption, has emerged as one such promising candidate. First, adverse childhood experiences have been repeatedly associated with adult sleep disorders. Second, individuals that suffer from stress-related psychopathology at adulthood often exhibit sleep disturbances, to the extent that sleep difficulties are diagnostic criteria for many of these disorders. Third, inefficient sleep pre and post exposure to acute stress was shown to increase the likelihood for maladaptive outcome, potently by impairing critical processes that occur during sleep as arousal regulation and memory consolidation.

To date, very few studies integrated these independent lines of research. Also, previous studies mostly assessed sleep via self-reported diary or a single night measurement at laboratory settings. The current study aimed to provide a more ecological and continuous account for sleep patterns, and their putative associations with childhood adversity on the one hand and vulnerability to acute stress at adulthood on the other hand.

Ninety-six healthy adult female participants completed the well-established childhood trauma questionnaire (CTQ) before wearing a wearable sensor for seven consecutive days and nights while maintaining their regular life routine. Following that, participants all underwent an acute laboratory stress induction procedure while their psychological and endocrine responses were recorded at multiple time points throughout.

Sleep patterns fully mediated the association between childhood adversity and psychological response to acute stress at adulthood (Figure 1). Specifically, elevated levels of childhood trauma were associated with more variation in sleep duration across the recording period, which in turn was associated with higher stress-induced negative affect. Interestingly, this association did not emerge with respect to mean sleep time nor with stress-induced cortisol release.

Results imply that childhood trauma may lead to irregular sleep patterns which in turn contribute to exaggerated emotional response to acute stress at adulthood. These findings support the mediating role of sleep in the link between childhood adversity and acute stress vulnerability at adulthood, and highlight sleep as a viable target for early or even preventive intervention.

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Excessive daytime sleepiness is a frequent symptom in the general population. It may be fleeting, due to transient circumstances, or it may be related to certain pathologies. Indeed, following their infection with SARS-COV2, several healthcare workers (HCWs) have complained of excessive daytime sleepiness.

This study was conducted to assess excessive daytime sleepiness in the SARS-COV2-affected HCWs during the “OMICRON” wave.

Cross-sectional descriptive study, conducted among the HCWs of Charles Nicolle Hospital with COVID-19 during the period from 22 December 2021 to 31 January 2022. Sleepiness was assessed using the Epworth Sleepiness Scale administered during the return to work medical visit.

During the “OMICRON” wave, 58 HCWs joined our study. The average age was 39 +/- 10 years. The sex ratio (M/F) was 0.2. The participants had no previous history of sleep disorders. Excessive daytime sleepiness was found in 21 participants (36% of cases). Excessive daytime sleepiness was mild in 81% of cases, moderate in 14%, and severe in 5%. The category most affected was senior technicians in 57% of cases. Most of the HCWs suffering from daytime sleepiness were working in the gynecology department (19%) and the neurology department (19%).

Early and systematic screening for sleep disorders after any SARS-COV2 infection is necessary to ensure the good health of the HCWs and to reduce accidents and errors in professional procedures.

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Sleep quality depends on several factors such as smoking, physical activity, diet, and certain pathologies such as obstructive sleep apnoea syndrome. Indeed, following a COVID-19 infection, several trainee doctors complained about a deterioration of their sleep quality.

To evaluate the quality of sleep of medical trainees working at Charles Nicolle Hospital who were infected by SARS-COV2.

We conducted a descriptive cross-sectional study, among medical trainees at Charles Nicolle Hospital, infected by COVID-19 during the period from July 2020 to November 2020. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Trainees were contacted during the period August 2022 to September 2022.

Fifty-three trainee doctors have joined our study. Forty-five of them had a significant sleep disturbance with a Pittsburgh Sleep Quality Index (PSQI) greater than five. The average age was 29.4±3.07 years old with a female majority (75%). No psychiatric history was found. The most affected category of trainees were residents (74%), particularly those working in the general surgery department (18%) and the anaesthesia and intensive care department (9%). Among those trainees, 80% had night shifts with an average of six shifts per month. Sleep latency was high in 20% of cases. A sleep duration of less than five hours per night was found in 18% of the cases. Six participants reported using sleeping pill three to four times a week.

Our study revealed a significant sleep disturbance among trainee doctors. This could be due to the SARS-COV2 infection but can also be explained by the night shifts burden and the great mental load at work during this pandemic period.

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There are about 10 million inmates in the world, of which 6 million are held in American prisons. While in Europe there was a 6.6% reduction in the detention rate, in Italy the number of prisoners is constantly growing. Due to the worldwide importance of the phenomenon in the field of public health, it is necessary to analyze the relationship between detention and prisoner health, as well as the change in the psychophysical state of a subject after a period of incarceration.

The analysis of the results deriving from the completion of forensic examinations was carried with the aim of assessing the compatibility of the health conditions of prisoners with imprisonment.

We report the results of a preliminary study on a sample of fifty prisoners held in Southern and Central Italy prisons.

The average age of the prisoners was 41. The prevalence of psychiatric disorders in the sample examined was about 39 %. 45 % of subjects with mental disorders made one suicide attempt in prison at least. We emphasize the pathogenic role of prison in the development or aggravation of psychiatric disorders. This happens particularly in subjects coming from degraded socio-family backgrounds.

In order to reduce the prevalence of psychiatric disorders and the risk of suicide, it is necessary to carry out careful medical and psychological evaluation at each new entry, so as to be able to frame the inmate’s state of health and plan periodic monitoring of diagnosed diseases. This evaluation should include a psychiatrist, so as to be able to set up an adequate drug treatment when it’s necessary. The correct management of psychiatric disorders is essential in order to improve the inmate’s mental health and prevent medico-legal consequences for health workers.

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An inpatient suicide is a tragic event that, despite not very prevalent, should not be overlooked. It occurs in 250 in 100 000 psychiatric hospital admissions (which represents a suicide risk fifteen times greater than general population) and in 1.7-1.9 in 100 000 in general hospitals (4-5 times greater risk). Together they constitute 5-6% of all suicides.

The purpose of the authors is to explore the epidemiology, the risk factors and the prevention of suicide in inpatient setting.

A brief non-systematized review is presented, using the literature available on PubMed and Google Scholar.

The risk was higher at admission (first week) and immediately after discharge (first 24 hours, up to two weeks).

It was found to be correlated to pour staffing, an increased number of patients with severe mental illnesses and accessibility to lethal means. Many risk factors were identified, some of them specific to context. Risk Factors at admission in a psychiatric hospital – personal or familiar suicide history, schizophrenia or mood disorder, alcohol use, involuntary admission, living alone, absence from the service without permission. Later till discharge - personal suicide history (or attempts after admission), relational conflicts, unemployment, living alone, lack of discharge planning and lack of contact in the immediate post-discharge period. In General Hospitals – chronicity and severity of somatic disease, poor coping strategies, psychiatric comorbidities and lack of liaison psychiatry.

Strategies to prevent inpatient suicide should take in environmental modification (specific to environment and specific to patient – as planned levels of supervision), optimisation of the care of the patients at suicidal risk, staff education and involvement of families in care. There are few studies on the efficacy of pharmacotherapy on reducing suicidal ideation in inpatients (just for clozapine and ketamine); some psychotherapies show promising results. The post-suicide approach cannot be neglected, whether in supporting the family, the team involved and even other patients.

The assumption of the predictive and preventive value of the risk assessment has been under scrutiny. Depressed mood and a prior history of self-harm are well-established independent risk factors for inpatient suicide; however they lose their predictive value due to their high prevalence. Up to 70% of inpatients who committed suicide didn’t express suicidal ideation on the previous interviews. Most effective measures to prevent suicide are environmental modifications and staff education approaches, giving appropriate responses to each patient’s circumstances.

There is a paucity of literature on suicide in this setting. It should become a priority in national programs of Suicide Prevention.

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Non-suicidal self-injury (NSSI) – the deliberate, self-directed damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned – is a highly prevalent phenomenon in adolescents and young adults. Motivation for the NSSI is known to be heterogenous in different patients. However, biological and especially genetic markers associated with different motivation for the NSSI have not been studied to date. One of the possible candidates are mu- (OPRM1) and kappa-opioid receptor (OPRK1) genes, since opioid system is known to be involved in the NSSI. Another perspective candidate is the DCC gene, encoding the netrin 1 receptor, which plays vital part in the formation of the prefrontal cortex.

We conducted a pilot cross-sectional study to test the impact of the rs1779971 OPRM1, rs6473797 OPRK1 and rs8084280 DCC gene polymorphisms on the characteristics and motivations for the NSSI in young adults.

28 patients of European ancestry with NSSI (89,3%; n=25) women, median age (Q1-Q3) – 23 (21,25-25) years) were included in the pilot sample. The majority of the sample had a diagnosis of bipolar disorder (78,6%; n=20). Characteristics and motivation for the NSSI were measured by the Inventory of Statements about Self-Injury (ISAS). The Childhood Trauma Questionnaire (CTQ) was used to control for adverse childhood experiences, a potent environmental factor, associated with NSSI. Genotyping was performed using RT-PCR. The genetic effect was evaluated using the dominant model. For statistical analysis multiple linear regression with the presence of minor alleles, different types of childhood trauma, diagnosis, age and sex as factors and ISAS scores as dependent variables were used.

Multiple linear regression showed that minor C allele of rs6473796 OPRK1 gene polymorphism was associated with an increase of the “Affect regulation” (B=2,23; CI95% [0,39–4,06]; p=0,022), “Anti-dissociation” (B=3,31; CI95% [0,18–6,44]; p=0,039) subscales of ISAS scores. Moreover, the minor T allele of the rs8082480 DCC gene polymorphism was associated with a decrease of the “Affect regulation” subscale score (B=-1,74; CI95% [-3,30 – -0,18]; p=0,032).

To our knowledge, this is the first study on the genetic markers of motivations for NSSI. Our pilot results showed that, controlling for diagnosis, age, sex and childhood trauma, OPRK1 and DCC gene polymorphisms may be associated with the heterogeneity of motivations for NSSI. However, these results require confirmation on the larger samples.

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The number of suicidal patients who are consulting hospitals is increasing. Therefore nurses are more frequently faced to dealing with these patients. Empathy plays an essential role in the nurse-patient relationship and influences therapeutic effectiveness.

Assess the impact of empathy level and investigate its factors on psychiatric and emergency department nurses’ attitudes toward a suicidal patient.

This is a cross-sectional analytical study that focused on nurses working in emergency and psychiatric departments in two Tunisian Hospitals. It was conducted between February and April 2022.

We used the Cognitive and Affective Empathy questionnaire (QCAE) to evaluate the empathy level.

Our study involved 60 nurses with an average age of 35,23 and a sex ratio of 0.76. Forty-seven percent of the nurses feel pity for the suicidal person while 16.7% remain indifferent.

Fifty-seven percent of respondents believe that attempting suicide is primarily a sign of weakness and 45% believe that its a sign of suffering.

While dealing with a suicidal patient, 45% of caregivers choose to reassure family and friends while 6.7% prefer to call the police to investigate.

Among the nurses, 58.4% had an affective empathy score greater than or equal to 30 while 51.9% of them had a cognitive empathy score greater than or equal to 40.

There was no statistically significant association (p>0.05) between the QCAE score and: age, gender, marital status, number of years in current service, number of children, and personal psychiatric history.

There is a significant association between The department and both emotional Contagion and Perspective taking ( p<0.05), while no significant association between Proximal Responsiveness, Peripheral Responsiveness, and Online Simulation.

It is undeniable that empathy level affects the quality of the relationship between suicidal patients and caregivers with many influencing factors.

The nurse has a therapeutic role but also a preventive one with regard to the problem of suicide, Therefore, the training of medical and paramedical teams is essential in order to limit any negative attitudes.

None Declared

This given study was designed to qualitatively and quantitatively examine the Psychosocial – emotional consequences of infertility on female infertile patients . Suicidal risk amongst infertile patients was a incidental yet significant finding with 25 percent of the study population reporting a positive result by the MINI scale. There are very few studies conducted in the Indian context that analyses the psychosocial aspects of infertility and the impact of ART treatment on the quality of life.

The finding in our study indicates that both infertility and stress associated with ART treatment contributes to psychological turmoil namely depression , anxiety, psychopathology and quality of life impairment in addition to suicidal ideation and suicidal risk.

Aims

To assess the psychosocial impact of infertility amongst female infertile patients including suicidal risk/ suicidal ideation in the given study population.

A total of 300 women attending the Obstetrics and Gynecology out patients department of a tertiary hospital in Kolkata, India were selected by simple random sampling. 100 fertile women attending the routine ante natal clinic were selected as cases and 100 infertile women seeking fertility treatment were selected as controls. 100 women didn’t follow up with the study. The following questionnaires were administered to both case and control group- BAI, BDI, SCL-90-R, SF-36, MINI and socio demographic proforma ; by trained clinic psychologist .

The raw scores & adjusted scores were analysed statistically by SPSS using the following tests, independent t test, chi square test and Z test.

The results of the MINI scale indicate that up to 25% of the infertile cohort suffer from suicidal risk/ suicidal ideation which is statistically significant in comparison to the control group.

The other psychosocial parameters are also statistically significant in the case in comparison to the control population.

Although the psychosocial impact of infertility has been well researched and documented. Few studies have been conducted globally which assess suicidal risk amongst infertile patients.

Our results corroborate earlier studies such as the Danish administrative population-based registry study by Trille Kristina Kjaer et al which found a causative link between infertility and suicidal risk.

Further research is needed in this direction

None Declared

Suicide rates in Azerbaijan rank among the top 3 highest of all Muslim majority countries. Further, approximately 40% of women in Azerbaijan report being physically or sexually abused. Women experiencing interpersonal violence report higher rates of suicide ideation and attempts (34%) than women in the general population. No prior studies have specifically explored protective factors against suicide and interpersonal violence in Azerbaijan.

This study aims to address this gap and to identify culturally relevant protective factors against suicide and violence against women in Azerbaijan.

A total of 51 women with lived experience and mental health providers participated in either in-depth qualitative interviews or focus groups. The interview guide for the focus groups and one-on-one interviews were developed by the study PI. A list of questions served as the basis for the discussions and was revised and expanded as the groups progressed. For the qualitative analyses, conventional content analysis following a systematic process of coding and classification was utilized.

Three main protective factors against suicide were identified: 1) psychological support (33%); 2) psychoeducation to raise awareness of suicide and reduce stigma (28%); and 3) providing financial opportunities/supports (10%) and for violence against women 1) advocacy (28%); 2) psychological support (28%); and 3) changing cultural values (17%).

This study fills a much-needed gap in our understanding of suicide and violence against women in Muslim populations. Our findings suggest that for intervention to be relevant and effective, prevention programming needs to span micro, mezzo, and macro levels.

None Declared

Despite studies pointing to the important role of relational and community factors in influencing mental health during times of crises such as the current pandemic, little research has examined protective factors at the relational/community level that serve protective factors against mental health impairment in response to the current pandemic.

This study aims to address this gap and examines protective factors against adverse mental health consequences related to the pandemic at the relational and community levels among individuals residing in high-risk marginalized low-resourced settings in Guatemala at one and a half years post onset of the pandemic

Telephone surveys were administered to 100 participants to assess sociodemographic characteristics, psychosocial functioning, and protective factors (interpersonal support, psychoeducation, community resources, and adaptive coping) against psychological distress. (anxiety, depression, stress, burnout). Multiple linear regressions were used to examine predictors of mental health impairment.

Our findings demonstrate that only psychoeducation serves a protective factor against psychological distress.Interpersonal support was found to predict increased levels of anxiety and depression and adaptive coping was found to predict increased levels of anxiety, depression, and burnout. No significant relationship between community resources and any type of mental health impairment was found.

Public mental health efforts should capitalize on the effectiveness of psychoeducation to promote strategies for managing symptoms of psychological distress as well as providing information regarding resources and services. In the context of complex emergencies that have an immediate effect on already scarce resources at a personal, community, and institutional levels, psychoeducation has the advantage of a low-cost intervention, easily transferable between communities, providing immediate support as well as sustainability over time.

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Medical-related professions are at high suicide risk. Suicide is a major cause of premature death among physicians, but the prevalence of suicide-related behaviors is inconsistent across studies.

Presenting a review of the prevalence and risk factors of suicide among physicians.

Search on Pubmed® and Medscape® databases with the following keywords: “physicians” and “suicide”. We focused on data from systematic reviews and meta-analyzes. The articles were selected by the authors according to their relevance.

Female and US physicians were at higher risk of suicidal behavior. Suicide decreased over time, especially in Europe. Some specialties might be at higher risk such as anesthesiologists, psychiatrists, general practitioners and general surgeons. It is well established that anesthesiologists tend to have much higher rates of substance abuse than other physicians. Psychiatrists are also known to have more mental distress, mental illness and burnout compared with other physician groups and have concerning rates of depression and psychotropic. Physicians are less likely to seek mental health services out of career concerns, culture and/ or a predisposition toward self-reliance. Additionally, retrospective toxicology screening of suicide data finds that physicians are more likely than nonphysicians to have positive results for antipsychotics, benzodiazepines, and barbiturates but not antidepressants.

Physicians are an at-risk profession of suicide, with women particularly at risk. The rate of suicide in physicians decreased over time, especially in Europe. The high prevalence of physicians who committed suicide attempt as well as those with suicidal ideation should benefits for preventive strategies at the workplace. Physician suicides are multifactorial, and further research into these factors is critical. Appropriate preventive and treatment measures should be implemented to reduce the risk of suicide-related behaviors in this population.

None Declared

Another pandemic besides COVID-19 stalks the land. This one takes a heavy toll on the young.

Suicide occurs throughout the lifespan and is the second leading cause of death among 15-29 years old globally.

The objective of this review is to highlight for another tragic pandemic, with main emphasis on the preventable character.

Data was obtained through an internet-based literature review, using the research platform Pubmed and the World Health Organization website. Seven articles from the last two years were included.

Improved surveillance and monitoring of suicide attempts and self-harm is a core element of suicide prevention and desirable worldwide.

A public health surveillance system based on medical records would provide and disseminate data that would guide and prioritize the best interventions in each context and contribute to an effective overall suicide prevention strategy.

Close to 800 000 people die due to suicide every year, which is one person every 40 seconds.

According to current data, for each adult who died by suicide there may have been more than 20 others attempting suicide.

Effective and evidence-based interventions can be implemented to prevent suicide and suicide attempts.

None Declared

The phenomenon of suicide and self-harm is one of the most intriguing and disturbing human behaviours. Suicide is global public health problem, with multiple and complex contributing factors. Global trend show a stabilizing or descending curves in the last years. The Portuguese atlantic archipelago of Azores has had an opposite trend that together with regional proctective and risk factors ought to be addressed for further tailored interventions.

Review of the up-to-date literature on this topic and present the recent suicide-related data in the Azores.

Unsystematic review of the most recent and relevant literature.

Epidemiology, risk and protective factors, preventive and treatment measures were described.

The Azores region has a ascending trend in the suicide mortality rate, opposing the portuguese trend. The azorean suicide mortality rate has a bimodal distribution and has higher values in every age group, except for the +75yo, when compared with the portuguese rates.

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Multiple complex factors contribute to the suicide phenomenon. Suicide protective and risk factors mostly overlap with mental disorders’ factors and those of other health and socio-economic conditions.

Azorean suicide rates are growing against the global and national descending trends.

Prevention and treatment strategies to be implemented regionally must be fine tailored, accounting for the most relevant factors in place, in order to be most effective.

None Declared

Suicide presents itself as a serious public health problem, with universal characteristics. Though world rates dropped between 2010 and 2016, they are still very high and in regions like the Americas there has been a raise in the same period in Brazil, contrary to the word trend and surpassing the avarage of the Americas (6%), the rate of suicides in each 100 thousand inhabitants has raised in about 7% in the period (WHO, 2019).

Considering the relevance of these aspects, this study presents the results of actions for treatment and prevention of suicidal behavior, developed by a psychiatry and chemical dependency inpatient service in the city of Rio de Janeiro.

This showed the necessity of the creation of a specific program of suicidal treatment and prevention and the Institution established the following actions of intervention to hospitalized patients: permanent watching , reduction of access to instruments and methods to commit suicide, strengthening of the Life Appreciation Group (LAG) and the Cognitive Behavioral Therapy group, art therapy and physical activities.

It was observed that among the 370 patients hospitalized in the Institution in the period of the study, 137 presented suicidal behavior and only 2 died. From these two cases, one abandoned treatment and the other ocurred during the period of treatment.

The developed program reached positive results in the intervention of the cases and the actions of prevention had expressive reach in the number of people, especially because the press promoted wide dissemination of information for immediate help.

None Declared

In the general population, the authors have noted that most suicides are commited by men, this gender difference also includes the methods that suicidal people use to commit suicide; women tend to use less immediately lethal means such as drug ingestion in contrast to the methods that men adopt, which often include poisoning, hanging or the use of firearms. This is partly due to the fact that men verbalize their suffering less in the context of the hegemony of masculinity which delays the request for help.

Our objective is to describe the profile of female patients admitted to the AR-RAZI hospital in Salé for suicide attempts and/or with a previous suicide attempts and their treatment and to identify the risk factors, which will allow us to develop preventive therapeutic strategies, taking into account their age, their reasons for hospitalization and clinical presentation on admission; their physiological characteristics, their somatic and psychiatric co-morbidities and their socio-cultural factors.

We have performed a cross-sectional study of 59 female patients admitted to Ar-Razi Psychiatric Hospital for suicide attempt or having already committed at least one suicide attempt, by means of a questionnaire specifying their age, marital status, occupation, socioeconomic level and residence.

The patients in question were recruited within a 2-year time frame, coming for the most part from the regions of the kingdom that our center covers.

• - 13 are between 21-25 years old, 10 are between 15-20 years old, 9 are over 51 years old, 7 are between 31-35, 6 are between 26-30, 4 are between 41-45 and only one patient who is in the age range between 46-50.

• - 31 are single, 16 are married, 11 are divorced or in the process of being divorced and only one widow.

• - 36 have children between 1 and 6 years old and 23 have never given birth.

• - 39 women never had a job or have not had one for at least 2 years, 10 are students, 5 are working in the public sector, 3 are working in the private sector and 2 are living from personal or family businesses.

• - 30 live in a modest socioeconomic level, 25 in a medium level and 4 in a high level.

• - 21 patients live in Rabat, 14 in Salé, 4 in Témara, and the rest are spread over the urban, rural and urban periphery of the territory that our center covers.

The notion of suicide is quite wide to be reduced to suicide attempts, given the multitude of semiological equivalents of the suicidal act. apart from the etiology, the sex of the suicidal person strongly influences all the parameters of the suicidal person and the suicidal act, including the risk factors, the means used and the means of protection, hence the interest in adapting the preventive, diagnostic and therapeutic approach, both medical and social, by taking into account the sex of the suicidal person for optimal care.

None Declared

Irish Travellers are an indigenous minority group in Ireland. Health inequalities have been widely reported within the Traveller community, with a shorter life expectancy of 11 years less than the general population. Travellers also have higher mortality rates of 3.5 times higher than the general population in Ireland. Suicide is a serious problem in the Traveller community with a suicide rate of 11% among Travellers: 6 times higher in women and 7 times higher in men compared with their counterparts in the general population.

There is a paucity of research into the clinical characteristics of self-harm and suicidality among Irish Travellers despite the elevated suicide rates in this community. This study aims to bridge the knowledge gap in the mental health of Irish Travellers, focusing on the clinical factors associated with self-harm and suicidality in a community sample of Irish Travellers.

This is a cross-sectional study. Study participants completed self-report and interview-based validated questionnaires that screen for anxiety (General Anxiety Disorder assessment: GAD-7), depression (Patient Health Questionnaire: PHQ-9), and suicidality (Suicide Behaviours Questionnaire-Revised: SBQ-R and Adult Suicidal Ideation Questionnaire: ASIQ). Ethical approval was granted through the Clinical Research Ethics Committee, University College Dublin.

Despite an active recruitment campaign, participation rate from Irish Travellers in this study was low, with only five participants completing this study. Three were male. The mean age of the study participants was 39±14.7 years. All had pre-existing mental health diagnoses, most commonly anxiety disorder. All had at least one previous episode of self-harm and 80% had a positive family history of self-harming behaviour. No participants reported a history of alcohol or substance misuse. Over half of the participants reported severe anxiety and depressive symptoms with median GAD-7 score of 19 and PHQ-9 score of 21 respectively. All participants demonstrated significant risk of suicidal behaviour based on their SBQ-R and ASIQ scores.

Despite elevated rates of suicidality and mental illness in this ethnic minority group, Irish Travellers demonstrated lower participation in mental health research, including this study. These recruitment challenges suggest that factors such as stigma, shame and lack of trust may be contributory. These factors may also act as barriers to them accessing mental healthcare when they develop mental health symptoms such as anxiety and depression, associated with increased risk of self-harm and suicidal behaviours. There is a need for better engagement strategies with Travellers to promote awareness into their needs and reduce mental health problems in this population.

None Declared

Every year at least one million people die by suicide, with major depressive disorder (MDD) being one of the major causes of suicide deaths. Current suicide risk assessments rely on subjective information, are time consuming, low predictive, and poorly reliable. Thus, finding objective biomarkers of suicidality is crucial to move clinical practice towards a precision psychiatry framework, enhancing suicide risk detection and prevention for MDD.

The present study aimed at applying machine learning (ML) algorithms on both grey matter and white-matter voxel-wise data to discriminate MDD suicide attempters (SA) from non-attempters (nSA).

91 currently depressed MDD patients (24 SA, 67 nSA) underwent a structural MRI session. T1-weighted images and diffusion tensor imaging scans were respectively pre-processed using Computational Atlas Toolbox 12 (CAT12) and spatial tract-based statistics (TBSS) on FSL, to obtain both voxel-based morphometry (VBM) and fractional anisotropy (FA) measures. Three classification models were built, entering whole-brain VBM and FA maps alone into a Support Vector Machine (SVM) and combining both modalities into a Multiple Kernel Learning (MKL) algorithm. All models were trained through a 5-fold nested cross-validation with subsampling to calculate reliable estimates of balanced accuracy, specificity, sensitivity, and area under the receiver operator curve (AUC).

Models’ performances are summarized in Table 1.Table 1.

Models’ performances.

Overall, although overcoming the random classification accuracy (i.e., 50%), performances of all models classifying SA and nSA MDD patients were moderate, possibly due to the imbalanced numerosity of classes, with SVM on FA reaching the highest accuracy. Thus, future studies may enlarge the sample and add different features (e.g., functional neuroimaging data) to develop an objective and reliable predictive model to assess and hence prevent suicide risk among MDD patients.

None Declared

More than 90 percent of patients who attempt suicide have a psychiatric disorder. The diagnosis of schizophrenia is associated with a decrease in life expectancy of about 10 years, with suicide being the most important related factor. Literature suggests that the risk of suicide death in this population has been found to be 10 to 20 times higher than that in the general population

To present a case report of a patient with a first psychotic episode and suicide attempt focusing on clinical features and risk factors.

Presentation of a clinical case supported by a non-systematic review of literature containing the key-words “suicide”, “Suicidal ideation”, “psychosis” and “schizophrenia”.

This is a case report of a male 28-year-old patient, with no known psychiatric history, admitted to our inpatient service after a suicide attempt by precipitation. In a first evaluation, the patient presented psychotic symptoms consisting of paranoid delusions, auditory hallucinations, tendency to social isolation and the appearance of self-harming ideation in the days prior to the episode. After initiation of antipsychotic medication, a significant improvement in positive symptoms was observed. The patient has since had no delusions or hallucinations and is living independently at home.

Contemporary research studies indicate that the lifetime rate of completed suicide in individuals with schizophrenia is between 4% and 13%. Several specific risk factors have been described in the schizophrenia population, such as early stage of the illness, lack of adherence to treatment, recurrent relapses, comorbid depression and the paranoid subtype. The antipsychotic treatments with the most scientific evidence are clozapine, risperidone, olanzapine and quetiapine. Within psychotherapy, cognitive behavioral therapy appears to be the most effective.

• - It is important to know the risk factors that are associated with an increased risk of suicide in patients diagnosed with schizophrenia.

• - An early intervention and specific treatment can improve prognosis of this population.

None Declared