Human gut microbiota plays an important role in metabolic health. Atypical antipsychotics can lead to metabolic abnormalities and changes in the gut microbiota. Multiple studies have examined the role of probiotics in suppressing antipsychotics-induced weight gain, but they have never been examined in a meta-analysis.

This network meta-analysis aims to compare the effect of probiotics + fibers, probiotics only, and fibers only on metabolic abnormalities induced by atypical antipsychotics.

We searched PubMed, Scopus, Web of Science, and Cochrane Controlled Register of Trials (CENTRAL) for all relevant studies. We used mean difference with its 95% confidence interval as our effect size. Primary outcomes were body weight and body mass index (BMI), while secondary outcomes were changes in other cardiometabolic risk factors.

We included 4 randomized controlled trials comprising 319 patients. For body weight, probiotics + fibers (MD -3.96, 95% CI [-5.16, -2.76]), fibers only (MD -1.91, 95% CI [-3.81, -0.01]), and probiotics only (MD -1.37, 95% CI [-2.07, 0.66]) were significantly superior to placebo. Probiotics + fibers (MD -1.52, 95% CI [-2.11, -0.92]), but not fibers only or probiotics only, was associated with significant changes in BMI. Probiotics + fibers was also associated with significant changes in cholesterol (MD -0.37, 95% CI [-0.67, -0.07]), insulin levels (MD -3.37, 95% CI [-5.35, -2.10]), and insulin resistance index (MD -1.35, 95% CI [-1.94, -0.76]). There were no significant adverse events reported in the included studies.

Probiotics + fibers, probiotics only, and fibers can be effective in controlling antipsychotics-induced metabolic abnormalities, with probiotics + fibers being the most effective regimen. All three treatments were safe and well tolerated by patients.

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Nurse presenteeism has long been of global concern, with impacts on nurse staffing levels, patient care, and hospital costs.

This international study aimed to explore the factors associated with presenteeism among frontline nurses and nurse managers in acute, primary, and long-term healthcare settings in Portugal and Switzerland.

A qualitative descriptive study involving online Focus Groups (FGs). The FGs included 55 participants and lasted 5 months (from March 2021 to July 2021). A purposive sampling strategy was used to select nurses. The inclusion criteria were as follows: (a) working in a public or private healthcare setting with at least one month of experience in their current workplace (which is officially considered the time required for integration); (b) working at least 20% of a full-time equivalent position; and (c) having a bachelor’s, master’s, or PhD degree. This study followed the COREQ checklist.

Participants included 55 nurses: 49 females and 6 males. Three main reasons for presenteeism were identified: unfamiliar terminology; the paradoxical effect of `being present’ but absent; and presenteeism as a survival strategy. Six contributing factors were also recognized: (a) institutional disinterest toward employees; (b) paradigm shift: the tension between person-centered and task-centered care; (c) sudden changes in care practices due to the COVID-19 pandemic; (d) a lack of shared work perspectives with hierarchical superiors; (e) the financial burden of being absent from work; and (f) misfit of human responses (Laranjeira et al., 2022).

This study has generated in-depth knowledge about concepts and causes of presenteeism and has instructive for a broad audience of nurse managers and leaders. Our thematic analysis shows that presenteeism can be explained by factors related to the pressure to attend work, by individuals’ constraints and commitment and by the organizational environment.

Laranjeira, C., Pereira, F., Querido, A., Bieri, M., & Verloo, H. (2022). Contributing Factors of Presenteeism among Portuguese and Swiss Nurses: A Qualitative Study Using Focus Groups. International journal of environmental research and public health, 19(14), 8844.

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Patient-reported outcome and experience measures (PROMs and PREMs) are increasingly acknowledged as critical to enhancing patient-centred, value-based care. However, research is lacking on the function and relevance of these instruments in acute psychiatric care.

The main objective of this study was to evaluate the domain of subjective well-being as a relevant indicator of the quality of hospital care, distinct from measures of symptom improvement and satisfaction with care reported by patients, assuming they only incompletely reflect inpatients’ unmet needs and expectations. [YA5] [SE6]

We hypothesised that the patients’ measures of subjective well-being (generic PROMs) at discharge are only partially related to the satisfaction with the experience of care (PREMs), that in turn differs from the clinician’s experience of the provided care, and symptom improvement (disease-specific PROMs).

Two hundred and forty-eight inpatients of a psychiatric university hospital were included in the study between January and June 2021. Subjective well-being was assessed using standardised generic PROMs on well-being, symptom improvement was assessed using standardised disease-specific PROMs, and experience of care with PREMs. PROMs were completed at admission and discharge, PREMs were completed at discharge. Clinicians rated their experience of provided treatment using adapted PREMs items.

Change in subjective well-being (PROMs) at discharge was significantly (p<.001), but moderately (r²=28.5%), correlated to improvement in symptom outcomes, and weakly correlated to the experience of care (PREMs) (r²=11.0%), the latter being weakly explained by symptom changes (r²=6.9%. Patients and clinicians assessed differently the experience of care.

Findings confirmed our hypothesis showing that across mental disorders improvement in subjective well-being was weakly correlated to the experience of care and moderately, negatively, correlated to symptom outcomes. Improvement in symptoms was found to be the strongest predictor of increase in subjective well-being at discharge, but it explained only a moderate part of its variance.

In conclusion, this study shows that PROMs and PREMs have potential as key indicators of high quality care across mental health services, and supports the case for measuring subjective well-being as a relevant indicator in its own right, particularly in psychiatric hospital treatments. Patient-reported measures enable the implementation of patient-centred therapeutic management and the delivery of services focused on achieving outcomes that matter to patients across the full pathway of care.

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Motivation is an essential determinant of performance, particularly for those working in difficult conditions, such as the conditions facing many health workers. The relationship between motivation and performance is influenced by the health workers’ organizational environment and social context. Many intrinsic and extrinsic factors may influence the impulse to head for and maintain and effort to achieve the objectives of the organization these may include acknowledgements, status and incentives, but also auto efficacy perception, personal growth, welfare and physical and mental health.

In the last years and particularly during COVID-19 pandemic health organizations have suffered a crisis of lack of motivation and high turnover rates in health professional, particularly among highly specialized professions.

to develop a quality program to promote mental health and motivation, detect risk of mental disorders and improve communication skills in the health workers of the Health Area of El Bierzo (GASBI).

A committee with four members form the psychiatry and mental health service, two from the Quality and Security Unit and 1 from the Occupational Risk Prevention Service analyzed the GASBI with a SWOT-CAME matrix analysis. Actions to be implemented were ordered with a Hanlon method score according to a representative sample of the employees of GASBI.

The CAME matrix recommended an offensive strategy, given a number of strengths and the opportunities for an administration sensible to new paradigms. The program proposed included 6 main lines (evaluation, access to mental health consultation, prevention of suicide behavior, resilience group, communication and relation groups and a group of actions to improve motivation and prevent burnout called “10 actions to dream together”, displayed in figures 1 and 2. The Hanlon classified suicide behaviour as the highest priority (score: 16,25 points), mental disorders the second (score: 13.75), then fatigue (13 p), burnout and resilience (12p) and the less prioritary was motivation (7 points). The project was displayed in a canvas business model (figure 3)

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Mental health, fatigue, burnout and motivation of health workers is a complex problem that affect health organizations and quality of services. Mental Health service have an important role in the promotion of wellbeing and prevent burnout in the health system.

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A need arose to divert patients with psychiatric complaints from the emergency department to alternative settings for psychiatric assessments to reduce footfall and to conduct consultations in a timely manner during COVID-19.

We assessed the effectiveness of alternative referral pathway in reducing COVID-19 infection in our service, and its effect on service quality: response time and number of patients leaving before review. We evaluated the satisfaction of patients, General Practitioners (GPs) and mental health service (MHS) staff with the pathway.

All patients referred to the mental health service over a 2-month period following the introduction of the pathway were included. Findings were compared against the cohort referred for emergency assessment during the same period in 2019. Feedback surveys were distributed to patients, staff and GPs. χ ² and independent sample t-test were used to compare the variables.

Over 2 months, 255 patients received an emergency assessment via the pathway, representing a 22.3% decrease in the volume of presentations from the same period in 2019. There were no COVID-19 cases among our patients or staff on the roster for assessing patients. In comparison to 2019, response times were improved (p<0.001), and the numbers of patients who left the hospital before the review were reduced by 3.2% during the study period (p<0.001). Patients and GPs were highly satisfied with the referral pathway and believed that the pathway should be retained post-COVID-19. Mental health service staff were divided in their opinions about its sustainability.

The pathway was successful in reducing the spread of infection, improving response times and reducing the numbers of patients who left without an assessment. Given the improved outcomes and acceptability, this is a preferable pathway for emergency referrals into the future.

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According to CEOWORLD Magazine‘s 2019 “Health Care Indicators” rating of 89 countries in the world, Taiwan ranks first in the world. The coverage of the National Health Insurance covers all necessary medical treatment, including outpatient, hospitalization, and prescription drugs etc. The psychiatrist was wondering which item with the highest service cost–performance (CP) ratio of the psychiatrist performance in a general hospital and used proportion of PPF as performance indicator. He used allocation to distribute the hours across job activities.

The purpose of this study is to investigate items allocation proportion for outpatient and inpatient ward in a specific month, examining the distribution of performance and figure out an appropriate model to optimal medical service.

Demographic data were collected through PPF projects included 15 outpatient items and 19 inpatient ward items from the third-month of the psychiatrist’s employment in the general hospital, as shown in Table 1. Items related to physiological examination has been excluded. The performance is calculated by combining outpatient and inpatient wards.

Demographic data analysis found that proportion of inpatient ward PPF (67.01%) was significantly greater than proportion of outpatient PPF (32.99%) (Figure 1). The inpatient ward performance was 2 times the outpatient performance. This result showed that most performance came from inpatient ward. Among all items of the proportion of PPF unit, the highest two for inpatient ward items were general hospital bed inpatient consultation (32.58%) and special treatment for psychiatric inpatients (14.35%), and for outpatient, the highest was psychiatric outpatient consultation - more than two (11.31%) (Table 1).

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National Health Insurance is an important system to assist in epidemic prevention during the COVID-19 period. The most PPF of psychiatrist service in a general hospital came from the service of inpatient ward items, including the general hospital bed inpatient consultation with the highest CP ratio. These findings may suggest that the inpatient service could offer psychiatrists fair PPF, and the hospital environment could be favorable for recruitment.

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Employment as a critical domain of functioning is an important target of recovery-oriented programs for people with psychiatric disabilities. Evidence shows that persons participating in competitive employment which meets their vocational needs are more likely than people in sheltered work programs to feel included in their communities, to report satisfaction with work and a high quality of life.

The Vineyard Project is a program engaging young people with different forms of mental ill-health in local practices of hand-harvesting grape. The program stems from a pilot carried out in September 2022 with a group of people aged 16-25, who worked with professional vine growers in the renowned area of Langhe (Italy). Aims were manifold: i) for the group: involvement in a culturally meaningful activity that is part of the transformative process of winemaking, as a way to overcome social anxiety symptoms and poor self-efficacy; ii) for the community: to attempt overcoming structural stigma that may undermine an employer’s willingness to hire a person with a psychiatric diagnosis; iii) to develop an evidence-based rehabilitation program aimed at competitive employment.

To foster community integration, the program was hosted in a real-world setting. The program is multidisciplinary, involving psychiatrists, psychologists, rehabilitation specialists and sociologists. Clinical assessment and semi-structured interviews with participants are performed.

Preliminary research findings provide evidence to develop the program according to the following principles: on-site practical training provided in a 1:1 relationship with professional workers (i.e. natural supports), supplemented by extra educational resources available in the community (e.g. local School of Enology); covering of all the vineyard activities throughout the year (pruning, binding, harvesting…); growth of expertise on an individual as well as on a group level, to foster the building of a cohesive team that can compete on the labour market and that provides participants with a sense of membership and identity; opportunity for new participants to join the team on an annual basis, acknowledging their peers as experts who can in turn pass on their knowledge; continual assessment of the ever-changing needs of participants and qualitative inquiry of their perspective, to provide time-unlimited support and ongoing adjustment of the program.

The Vineyard Project aims to eventually establish a rehabilitation tool, resulting from the combination of multi-disciplinary approaches, that can be tested and applied to work settings different from the viticultural environment where it had its origin.

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The VML (Verbal Motor Learning) method (Vashdi, 2013, Vashdi, 2014, 2017) is an organized, structured method which includes unique evaluation, algorithmic analysis, manual techniques, motor learning principles and unique treatment principles. The VML method targets the Apraxia of speech syndrome deficits, while teaching the learner how the plan the speech movements and time the speech systems for an accurate pronunciation.

Being a multidimensional entity in nature, as a speech therapy tool developed by a physical therapist, the VML method crosses disciplinary boundaries of agreement and proposing new policies for treatment. The speech tool serves other professions then speech therapists and is also given to parents for practice and learning. The parent’s role in the therapeutic team is controversial, however, we have found that parent’s intervention in some cases can be very effective, contributing to treatment process.

The purpose of this retrospective study is to answer two major questions; What is the efficacy of the professional and non-professional VML treatment.

A retrospective study was conducted analyzing 900 evaluations of which 136 longitudinal treatment processes of children diagnosed with CAS or suspected CAS, were extracted. The participants contacted the early age intervention clinic for VML speech evaluation on their own will, and were examined by a VML expert. The data was collected over the years 2006-2018 based on children evaluated at the clinic in Israel. A set of variables based on the VML method assessment (Vashdi, 2013; Vashdi, 2014) was established for the retrospective data collection

136 speech treatment processes passed the inclusion criteria and were examined (59 professional treatment and 77 non-professional treatment

There were no differences between the professional and non-professional group’s baseline data. The entry syllables score for all participants was 16.32%. The average improvement in syllables for all participants was significant (33.18% , p<0.05, paired t-test). It was also found significant for the professional and non-professional treatment groups ( 45.49% and 23.75% respectively, p<0.001, t-test). Single syllables improvement was found higher for professional group (P=0.02).

Both groups demonstrated significant improvement in the single syllables production skill, while the professional group was found significantly more effective than the home-based treatment. The findings regarding the professional group are not surprising, however support the efficacy of the VML intervention for children with severe CAS, even with one session per week of intervention. The non-professional home based treatment results were surprising and promosing for future practice.

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In the framework of the EU-Erasmus+, the European Alliance for Sport and Mental Health (EASMH) project has been funded, aiming to promote the improvement of good clinical practice for sport-based psychosocial interventions throughout Europe. A specific training programme tailoring professional sport coaches has been developed in order to improve their skills in engaging and involving patients with severe mental disorders in sport-based rehabilitation activities.

to evaluate the perceived quality and utility of the EASMH training programme by sport coaches from different European countries (including Italy, UK, Romania, and Finland).

As part of the EASMH project, the University of Campania “L. Vanvitelli” has coordinated the development of training materials for professional sport coaches. The training programme has been tested in a pilot training programme. An ad-hoc questionnaire has been developed and administered at the end of the training, during a meeting held in Brussels in July 2022.

The EASMH training programme consists of six modules, dealing with the following topics: definition of mental health/mental disorders; classification systems; essential clinical features of severe mental disorders; personal and social burden associated with severe mental disorders; how to build a therapeutic relationship with a patient with severe mental disorders; verbal and non-verbal communication; evaluation of patient’s preference in selecting sport activities; definition of a personalized plan; motivational interview/problem-solving strategy. A total of eight professional coaches involved in different sport coming from Italy, Romania, United Kingdom and Finland participated in the entire training, consisting of six 4hr training modules. Seven out the eight coaches compiled the questionnaire. The overall feedback has been extremely positive. Overall, coaches have judged the modules as very clear, useful and of high standing. Each question has been rated with an average of 4.35 related to the overall content.

The present survey confirms that a short online training programme focused on professional sport coaches is well received by participants and can provide them with useful information on how to engage patients with severe mental disorders. The next step of the EASMH project foresees the implementation of several local pilot actions with the active involvement of patients with severe mental disorders.

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Mental health problems increase the risk for long-term sick leaves, early transitions to disability pensions and unstable career paths. Individual Placement and Support (IPS) is an evidence-based program integrated into psychiatric care aiming to support individuals with serious mental illness in finding employment. One key element in the implementation of the program is that the program is adequately integrated into the psychiatric care. However, knowledge on implementation challenges as well as best practices experienced by the practitioners, especially from the perspective of professionals in psychiatric care, is limited.

The Finnish Individual Placement and Support Evaluation Study (2020-2023) aims at investigating the implementation, feasibility as well as perceived benefits and outcomes of IPS program. The present study focuses on experiences on implementation of the program in the psychiatric care.

Both quantitative and qualitative data from different stakeholders have been and will be collected. The data collection will be finished at the end of 2022. For the present study, data among professionals (psychiatric nurses and psychiatrists) in the psychiatric care has been and will be collected using questionnaires (n=58) and individual interviews (n=17). Among IPS employment specialist delivering the program, the data have been / will be collected using focus group interviews (6 focus groups, n=29) and workshops.

The preliminary findings of the study show that the key elements in successful implementation of the IPS program into the psychiatric care are sufficient information about the program among professionals in the psychiatric care, adequate flow of information between IPS employment specialists and psychiatric care (including regular meetings) and facilities promoting the co-operation (including physical space and common information system). Majority of professionals in psychiatric care reported that the client-related communication with the IPS employment specialist had been active (81%) and adequate (76%).

Successful implementation and integration of the IPS program into psychiatric care requires seamless cooperation and communication between mental health professionals and IPS employment specialists, especially in cases when the IPS employment specialists do not have access to patient information due to confidentiality legislation.

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Rehabilitation services are supposed to facilitate recovery. However, there is no concrete evidence in Taiwan.

This study examined the patterns of rehabilitation service use and the association between the pattern of use and personal recovery.

Thirty-two community psychiatric rehabilitation centers in Taiwan agreed to participate in this study. A sample of 592 participants filled out the questionnaires. Eight kinds of rehabilitation services were included: Independent living and self-care training, interpersonal and social skills training, daily life arrangement and community life rehabilitation, physical activities, symptom management training, occupational therapy, sheltered workshops, and vocational training. Recovery was measured by the Stage of Recovery Scale. Cluster analysis was utilized to classify service use patterns among the participants. ANOVA was used to examine the association between the pattern of use and recovery.

The results revealed five patterns of use: (1) Overall middle level with emphasis on work, (2) independent living plus occupational rehabilitation, (3) independent living plus vocational rehabilitation, (4) overall low-level of use, and (5) overall high-level of use. The differences among the five groups of participants in each kind of rehabilitation service were significant (Eta2=19.2%). The recovery status of overall high users was significantly better than middle-level and low users. The recovery status of low-level users was significantly worse than the other four groups.

The findings imply that greater rehabilitation service use is conducive to recovery. Comprehensive use of various types of service or the combination of independent living and other types seem to facilitate recovery.

None Declared

Mental health problems increase the risk for unstable career paths and often lead to early transition to disability pensions. Individual Placement and Support (IPS) is an evidence-based program integrated into psychiatric care helping individuals with serious mental illness to find competitive employment. It comprises personalized job search as well as individual in-work support for both the employee and the employer.

The Finnish Individual Placement and Support Evaluation Study (2020-2023) aims at investigating the implementation, feasibility as well as perceived benefits and outcomes of the IPS program implemented for the first time broadly in Finland. The present study focuses on the changes observed among program participants in employment status and psychosocial well-being during the 6- and 12-months follow-ups.

Both quantitative and qualitative data from different stakeholders have been and will be collected. The data collection will be finished at the end of 2022. The presentation focuses on findings from interviews (n=31) and from questionnaire data collected among program participants at baseline and at 6- and 12-months follow-ups. The total sample will comprise approximately 300 program participants (18−64 years of age) diagnosed with a severe mental illness.

Findings on changes in employment status as well as in psychosocial well-being (self-rated health and work ability, mental distress, positive mental health, self-esteem, satisfaction with life, social inclusion, and perceived social support) will be discussed at the congress. The preliminary findings of the study show that about half of the program participants have succeeded in getting employed at least once during the follow-up. However, becoming employed does not always result in increased psychosocial well-being. Work-related stress, meaningless or unsuitable job, problems at the workplace community or fear of being stigmatized may contribute toward decreased psychosocial well-being.

Meaningful work can play an important role in the process of recovery from mental illness. However, individuals with severe mental health problems need support with the working life related concerns and stress especially at the beginning of employment.

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Despite international and national guidelines advocating psychoeducation for caregivers (PEC) as one of the most effective treatments for patients living with a severe mental disorder (SMD), such programs remain scarce. Only 3% of the 4.5 million French caregivers in psychiatry have benefited from PEC and less than 10% know family associations (i.e., peer-led organizations supporting family members, caregivers, and loved ones of individuals living with a SMD). Worryingly, PEC is provided on average 10 years after the disease onset in France. Recognizing this major shortage in mental health organization, Rey et al. together with the Unafam family association created a short psychoeducational program called “BREF”. BREF means “brief” in French and can be provided early and systematically to caregivers of individuals with a SMD.

The aim of the present study was to assess the impact of the BREF program on depressive symptoms and burden of caregivers who benefited from the program.

This is a retrospective, multicenter, open, uncontrolled study. 303 caregivers of persons living with a SMD benefited from the BREF program and were included in the present study. Depressive symptoms (assessed using the Center for Epidemiologic Studies Depression Scale, CES-D) and caregiver burden (assessed using the Zarit Burden Interview, ZBI) were measured before the BREF program, after the third session and during the 3‑month telephone callback. Quantitative data on caregivers’ satisfaction were collected at the 3‑month telephone callback.

The 303 caregivers included belonged to 216 families. Caregivers were mostly female (65.9%), they were mainly parents (66.8%) and spouses (17.3%). 20% of the included caregivers didn’t know the diagnosis of their relative and 69% had been caring for their relative for less than 5 years. As compared to baseline, we report a significant reduction in depressive symptoms and caregiver’s burden after the third session of the BREF program (p<0.001) and at the 3‑month telephone callback (p<0.05) (Fig. 1-2). The proportion of caregivers with a probable depression (CES-D≥20) was significantly lower after the third session of the BREF program (p=0.02) (Fig. 3). At 3 months, high levels of satisfaction were observed, with 98.4% of caregivers being satisfied or very satisfied with the BREF program. Caregivers deemed that the BREF program was very useful with a mean score of 9/10 (±1.5). 73% of the included caregivers attended the 3 sessions of the BREF program.

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The BREF program is associated with a therapeutic benefit for caregivers. In addition, BREF demonstrates a high level of caregiver satisfaction which is critical for a program intended to be provided early and systematically. The BREF program could reduce the French shortage in PEC provision. These results strongly support the national dissemination of the BREF program.

None Declared

The National School of Rehabilitation, Integration and Recovery in Mental Health was established in 2011 at Ono Academic College. Its operation is supervised and funded by the Department of Rehabilitation in the Mental Health Division of the Israel Ministry of Health. The School offers courses for a broad variety of mental health professionals and others involved in the mental health field (service users and family members) to promote professional competencies, social cohesion, learning from experience, and to advance mental health rehabilitation. In recent years, the School has become increasingly involved in multiculturalism, providing special courses and workshops for both the Palestinian-Arab and ultra-Orthodox Jewish sectors in Israel. The School is based on the belief in the ability of service users to recover, integrate, and live meaningful lives in the community. This belief is consistent with values of the recovery approach (Slade et al., 2017). The School is constantly in dialogue with the community, and provides training for interventions that promote recovery, as well as social cohesion in the field of psychiatric rehabilitation.

To describe the process of foundation, implementation, and outcomes of the unique model of the School; to discuss the multicultural and social opportunities and challenges; to portray major elements of the school methodology and practice.

Work model presentation through qualitative analyses of social and academical processes, alongside quantitative descriptive data.

Every year, 700 students from various helping professions in the field of psychiatric rehabilitation study at the School, as well as service users. The school operates as a bridge between academy and the field and encourages learner and staff diversity, joint learning, and discourse. Over 30 courses are conducted annually including evidence-based intervention courses such as IMR, and training courses such as knowledge by experience, supervision, rehabilitation coordinators, etc. In addition, unique courses are given, such as eating disorders, DBT, and social cognitive intervention training with multicultural adaptations. Lastly, the school offers consultation in implementing interventions within services.

The working model of the School operates under the framework and values of recovery, social integration and cohesion, and multiculturalism. To this day, the School offers courses, symposiums, conferences, and professional publications, to educate for values of recovery and community inclusion, alongside improving the quality of services.

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According to the gender paradox,in suicidology an important sex difference has been reported with a preponderance of females in nonfatal suicidal behavior and a preponderance of males in completed suicide.The lethality of suicidal behavior in females is lower most likely because males choose more violent suicide methods.Furthermore,women more frequently present traditional risk factors for suicide than do men,including depression,childhood sexual abuse, and prior suicidal ideation and attempts.

The purpose of this study was to explore possible clinical differences between male and female psychiatric inpatients who had recently attempted suicide.We hypothesized that clinical characteristics such as psychiatric diagnosis,the methods and lethality of the suicide attempt,the history of suicide attempts,age at onset of psychiatric illness,the presence of substance or alcohol use and the length of stay differ between male and female suicide attempters.

The study included 177 adult inpatients at the University Psychiatric Clinic, Sant’Andrea Hospital, Sapienza University of Rome hospitalized following a suicide attempt, between January 2018 and May 2022.Clinical features assessed included psychiatric diagnosis, method and lethality of suicide attempts using the Risk-Rescue Rating Scale, the history of suicide attempts, age at onset of psychiatric illness, the presence of substance or alcohol use, and the length of stay.All statistical analyses were performed with the Statistical Package for Social Sciences(SPSS 27.0).

Males and females differed according to the method used for suicide attempt(x23=10.96,p<0.05),the scores for risk and rescue(t175=2.55,p<0.05;t146.6=-1.99,p<0.05,respectively),and the length of stay(U= 3084.5,p<0.05).Females were more likely to use drug/poisoning ingestion as method for suicide attempt than were males(72.8% vs.51.4%),whereas males were more likely to use hanging than were females(20.3% vs. 6.8%).The risk score was higher for males(3.76±0.68)than for females(3.49±0.72),and the rescue score was higher for females than for males(2.79±1.09 vs. 2.43±1.22).Finally,the length of stay was longer for males than for females(10.66±8.09 vs. 8.25±6.48).These results confirm the role of difference in suicide methods used by males and females for explaining the “gender paradox.”

The present study illustrates the usefulness of the Risk-Rescue Rating Scale which is a descriptive and quantitative method of assessing the lethality of suicide attempts.Identifying sex related characteristics of suicide risk in patients is important for implementing specific suicide prevention strategies to reduce suicidal intent, psychological pain and rehospitalization in patients with psychiatric disorders.Men and women may need different strategies for the prevention of future suicidal behavior.

None Declared

Adolescence is, arguably, the most vulnerable period of a person’s development when the susceptibility to emotional-affective and behavioural disorders is at its height and conflict situations can result in self-injuries and suicide attempts, some with lethal outcomes (Woycex W., Сlinical Suicidology, 2007.-280p). Research indicates that conflict with family is associated with suicide attempts in adolescents (Elise P. JAD, 2018; 241:499-504). There is a small body of research on the risk factors for suicide attempts in Armenian adolescents. However, there is a lack of research on understanding what role conflict can play in developing suicidal thoughts and behaviour.

The present research aims to understand the role of conflict in suicide attempts among Armenian adolescents.

The researcher conducted a qualitative analysis of 39 patient histories of adolescents hospitalised after a suicide attempt using the documentary method. The patient histories included, among others, the results of psychiatric tests using Hamilton’s Rating Scale for Depression (HAM-D), Hamilton’s Rating Scale for Anxiety (HAM-A), Columbia Suicide Severity Rating Scale (C-SSRS), and the records of psychiatric consultation.

The psychiatric tests showed that all adolescents suffered either mild, moderate or severe levels of depression and anxiety. They also exhibited mild, moderate or severe suicide risk, based on C-SSRS. The results revealed that before the suicide attempt, adolescents were exposed to continuous distress and traumatic events at home that lasted for months, sometimes years. They often witnessed domestic abuse and attempted to protect one of the parents (usually their mother) from being physically and psychologically abused. In some cases, the distress was the result of parents trying to end the adolescent’s relationship with their boyfriend. During psychiatric consultation, adolescents disclosed reoccurring suicidal thoughts and suicidal ideation when exposed to continuous trauma and distress at home. In most cases, conflict with parents was the trigger that made adolescents act. The conflict was the last straw that pushed them to attempt suicide.

Suicide attempt in Armenian adolescents remains one of the least investigated areas. Domestic abuse is often silenced and almost never reported to authorities. This usually leaves adolescents one-on-one with their struggles. The needs of adolescent witnesses of domestic abuse and those suffering controlling behaviour and developing suicidal thoughts, some of them eventually attempting suicide - remain largely unaddressed. More research is needed to understand factors associated with suicidal behaviour in Armenian adolescents. Research studies can hopefully become a basis for a future centralised mental health strategy aimed at helping adolescents find a way out and not resort to suicidal attempts.

None Declared

Suicidal behavior is a global public health problem. Among the most investigated theories for the explanation of suicide there is the interpersonal-psychological theory of suicide (IPTS) by Thomas E. Joiner. IPTS focuses on 3 variables related to lethal suicide attempt: thwarted belongingness, perceived burdensomeness and acquired capability for suicide.

We aimed to understand which variables were mostly related to suicidal ideation (SI) and suicide attempts (SA) in a sample of psychiatric patients.

A sample of 80 psychiatric patients including inpatients (n=18), outpatients (n=21) and patients from various Italian rehabilitative psychiatric communities (n=41) was recruited between June 7th, 2021 and September 12th, 2022. We administered a battery of various scales, including State-Trait Anxiety Inventory, STAI, Beck Depression Inventory, BDI, Reasons For Living Inventory, RFLI, Acquired Capability for Suicide Scale-Fearlessness About Death, ACSS-FAD, Rosenberg self-esteem scale, RSES, Mental pain questionnaire, MPQ, Interpersonal Needs Questionnaire, INQ. For each scale we compared a) patients with and without lifetime SI; b) patients with and without history of SA. Then, we performed two logistic regression models (stepwise backward method), one for SI and one for SA.

Both patients with SI and SA have higher anxiety (STAI), depression (BDI), mental pain (MPQ), perceived burdensomeness (INQ), thwarted belongingness (INQ), fearlessness about death (ACSS_FAD) and lower self-esteem (RSES), beliefs about coping strategies (RFLI) and moral objections (RFLI). Depression (BDI) and beliefs about coping strategies (RFLI) were the variables most strongly associated with SI; higher fearlessness about death (ACSS-FAD) and low self-esteem levels (RSES) were the variables most strongly associated with history of SA. The SI model was able to predict 84% of ideation cases; the SA model was able to predict 74% of the attempts.

The results supported that improving the ability to cope with suicidal thoughts is a key component of therapeutic work with suicidal patients. In addition, according to the IPTS, the history of SA has been particularly explained by fearlessness about death. Hence it may be important to focus on these aspects in suicide prevention.

None Declared

Suicide is a leading cause of death among young people and most deaths by suicide occur in low and middle-income countries. School is the best place where we can identify and respond to youth suicide risk. School-based interventions for suicide prevention in young people have been successful across US, Europe and Australia, but require adaptations to be acceptable and feasible in Pakistan.

To develop and test culturally adapted preventative interventions for suicidal behaviours among pupils in secondary schools in Pakistan. The qualitative component aimed at exploring the views of students, parents, teachers and general practitioners on cultural adaptation, experience of participation, areas of improvement and suggestions for scale-up of the school-based suicide prevention program (SEPAK).

A clustered randomised controlled trial. The four culturally modified interventions 1) Linking Education and Awareness of Depression and Suicide Awareness (LEADS) Training for pupils (students=260) 2) the Question, Persuade, and Refer (QPR) for teachers (students=203) 3) QPR for parents (students=445); 4) Screening by Professionals (Profscreen) (students=260) were compared against control intervention (educational posters) (students=227). Structured questionnaires were administered at baseline and 1-month post-intervention to assess suicidal behaviours, psychological well-being and quality of life. A total of 8 focus groups (FGs) were conducted at pre and post intervention stage with each stakeholders.

Patient and public involvement and Engagement (PPIE) was strongly embedded in the project to ensure meaningful benefits for participants. A total of 40 schools were recruited from 8 cities across Pakistan. A total of 243 students attended LEADS intervention, 92 teachers and 304 parents completed QPR training, and 9 general practitioners were trained in ProfScreen. The retention rate at follow-up was 99% that shows feasibility of delivering intervention package in Pakistan. All participants marked SEPAK as effective in identifying risk of and preventing self-harm and suicide in young people and in improving pathways to treatment. Interventions were perceived as helpful in improving knowledge about mental health, impact of mental health difficulties on functioning, reducing stigma, equipping stakeholders to identify and signpost at-risk people. Improvement in clinical and teaching practice as well as understanding others behaviors were also reported.

This study suggest feasibility of integrating a suicide prevention program in existing educational system and highlights positive role of creating awareness about suicide in youth, introduction of school-based mental health programs, parental counseling and strengthening of the health system by training general practitioners in early identification of suicide risk and promoting suicide prevention strategies

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Depression and treatment-resistant depression (RD) are associated with suicidal behavior (SB) at a higher rate.

1) determination prevalence of RD in district outpatient psychiatric сlinics (i.e., dispensaries) and the socio-demographic characteristics of RD patients with SB.

In this multicenter (3 sites), retrospective, observational epidemiological study, patients (n=148) with diagnoses F 30-39 (ICD-10) were recruited in 2020. Patients (n=22) were assessed for RD, defined as failure to respond to ≥ two antidepressant medications of adequate dose and duration for at least three months.

The prevalence of depression is ≤ 2% of the outpatient population. RD prevalence ˜15%. SB (i.e., suicidal attempts) was noted in every fifth (n=5) for the index year. SB patients differed in the following typical features: a woman (82%) mean age, 46.8 years with long-term (≥ 10 years) depression and annual hospitalizations for three years (61.4 days per patient), and with suicidal attempts (repeated within the last two years) through (80%) self-poisoning with psychotropic drugs. Nobоdy worked, and everyone was divorced.

On the background of ubiquitous underdiagnosis of depressive disorders in routine practice, RD patients with SP represent a high-resource users group with combined clinical and social problems requiring pharmacotherapy and target psychosocial rehabilitation.

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More than 700,000 people die by suicide in 2019 globally (World Health Organitation 2021). Mental health problems constitute a risk factor for suicidal behavior and death by suicide (Hoertel et al. Mol Psychiatry 2015; 20 718–726). Different mental disorders have been related to different forms of suicidal ideation and behavior (Conejero et al. Curr Psychiatry Rep 2018; 20, 33) (Quevedo et al. Compr Psychiatry 2020; 102 152194). However, little is known on comorbidity profiles among suicide attempters.

The aim of our work was to identify the psychiatric comorbidity profiles of individuals who were admitted a hospital emergency department due to a suicide attempt. Moreover, it intended to know their clinical characteristics according to comorbidity profile.

A sample of 683 attempters (71.30% female; M age= 40.85, SD= 15.48) from the SURVIVE study was used. Patients were assessed within the 15 days after emergency department admission. Sociodemographic (i.e., sex, age, marital status and employment status) and clinical data were collected. The International Neuropsychiatric Interview (MINI) was used to assess DSM-V Axis 1 mental health diagnoses and the Columbia Suicide Rating Scale (C-SSRS) to assess suicidal ideation and behavior. The Acquired Capacity for Suicide-Fear of Death Scale (ACSS-FAD), the Patient Health Questionnaire (PHQ-9) to assess the frequency of depressive symptoms during the past 2 weeks, and the General Anxiety Disorder-7 (GAD-7) scale to assess symptoms of worry and anxiety were also conducted. For the identification of comorbidity profiles, latent class analysis framework was followed considering diagnosis to each individual disorder as clustering variables. On the other hand, binary logistic regression was used to study the relationship between comorbidity profile membership and clinical factors.

Two classes were found (Class I= mild symptomatology class, mainly featured by emotional disorder endorsement; and Class II= high comorbidity class, featured by a wide amount of endorsed diagnoses) (see figure 1). Individuals from the High comorbidity class were more likely to be female (OR= 0.98, p<.05), younger in age (OR= 0.52, p< .01), with more depressive symptoms (OR=1.09, p<.001) and have greater impulsivity (OR= 1.01, p<.05).

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We found two profiles of people with suicidal behavior based on the presence of mental disorders. Each of the suicidal subtypes had different associated risk factors. They also had a different profile of suicidal behavior.

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