Little is known about the epidemiology of suicide in young people exposed to the youth justice system (YJS).

We aimed to estimate the suicide rate in a large cohort of young people exposed to the YJS in Australia, and to identify the demographic/criminogenic risk factors associated with these deaths.

Data relating to all young people who had any contact with the YJS in Queensland between January 1993 and December 2014 (N=49,228) were linked to Australia’s National Death Index. We calculated the incidence rate of suicide within the cohort, stratified by sex and Indigenous status. Poisson regression was used to assess the change in suicide rates over time. Crude mortality rates (CMRs) were calculated for all-suicide and method-specific suicides, both overall and within subgroups.

Of the 48,228 participants, 1452 (3%) died during the follow-up period. For 31% (458) of decedents, the cause of death was suicide. The proportion of deaths due to suicide was highest for Indigenous females (37.9% of all deaths), followed by Indigenous males (36.8%), non-Indigenous males (30.1%) and non-Indigenous females (25.8%). Hanging was the most common method of suicide (83%).

The disproportionately high incidence of suicide following contact with the YJS is a cause for concern. There is a pressing need to better understand the trajectories of young people after discharge from the YJS. This missing epidemiological knowledge would inform targeted, preventive interventions to be implemented during the window of opportunity when these vulnerable young people are under the care of the YJS.

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The increasing global suicide rates pose a considerable strain on healthcare professionals. Subsequently, their attitudes toward suicide prevention may influence suicide risk and management, affecting the quality of care.

To investigate the attitudes of Pakistani medical students toward suicide and its comparison with different sociodemographic factors.

A total of 1392 undergraduate medical students belonging to all five years took part in the cross-sectional study conducted in September 2022. In addition to socio-demographic factors, participants were asked about their attitudes toward suicide on a 5-point Likert scale using the ATTS (Attitudes towards suicide) questionnaire. Questions explored competence, religion, experience, and views on suicidal behavior and its treatment. Data were analyzed by using SPSS 26.

The majority of respondents had no prior experience of looking after patients with suicide attempts (88.9%), the experience of having known someone who died by suicide (67.1%), or participation in suicide workshops (94.3%). Statistically significant items showed that males believed more strongly that suicide could be used to end suffering and would consider the possibility of doing it, revenge is the major driving factor, talking about suicide lessens its incidence, and people should have the right to take their own lives. Females more strongly believed that loneliness is the major driving factor, and that suicide is preventable. Preclinical students more strongly believed thought suicide was less justified, especially among young people, not a solution to end incurable illnesses, and that people should not have the right to take their own lives. 996 (71.6%) of respondents expressed their willingness to participate in workshops regarding suicide.

Our study suggests that medical students have little experience in handling suicidal patients and vastly differ in their attitudes. There is a need for suicide management training and further study data to support these findings.

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Research exploring the mental health impact of the early stages of the pandemic among parents has found that 1 in 4 parents experienced increased psychological distress and reported more than one negative mental health symptom, especially quarantined parents. Ongoing stressors for parents related to the Covid-19 pandemic abound, yet the long-term impact of the pandemic on parental mental health remains largely unexplored, limiting the development and effectiveness of prevention and intervention efforts.

This study aims to fill this gap and explore the implications of the pandemic on parental mental health post-lockdown periods.

The Covid Care Calls Program (CCC) was designed to address developing needs in response to the pandemic in highly marginalized communities across Guatemala. For the baseline study at the onset of the pandemic, 330 individuals participated. Convenience sampling was used. Callers administered a semi-structured interview to elicited information regarding health and mental health status, household composition, and nature of parenting and offspring functioning. For the current study, the same procedure of telephone surveying was used. A random sample of 100 baseline participants was included. Calls were administered between June 2021 and August 2021, 6-months post lifting of lockdown restrictions. Paired t-tests were used to examine differences in mental health impairment (anxiety, depression, stress, burnout) from immediately post-lifting of lockdown restrictions to 6-months following lifting of lockdown measures. Multiple linear regressions were used to examine predictors of mental health impairment.

We found that 6-months post lifting of stringent mitigation measures, parents reported engaging in increased negative parenting behaviors; observed increased negative behaviors from their children; reported increased anxiety, depression, and stress; and, reported increased burnout, especially mothers.

Our findings regarding increased parental stress and burnout well after quarantine and lockdown periods are cause for concern. In addition to their own stress, children are likely to experience a negative downstream effect from their parents’ mental health impairment. Increased negative responses from children further exacerbate parental maladjustment which in turn increases negative child behaviors, and thus the cycle begins, resulting in an often conflictual, harsh, or disengaged home environment and dysfunctional parent-child relationships. This type of parental strain (has been noted to confer risk of psychopathology across generation. Family level intervention and increased access to community-based supports for parents are key to mitigating this persistent impairment.

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Differences in psychiatry training vary substantially across Europe. Such organisations as the European Federation of Psychiatry Trainees (EFPT), the European College of Neuropsychopharmacology, and the European Psychiatry Association, have committed to offer international experiences based on the premise that it could foster international collaboration, aid early career professionals to progress professionally and spark discussion regarding different practices across Europe.

To date, there are no studies that focus on the exchange experience in mental health professionals.

We present the synthesis of the first seven years answers from 2012 to 2019 to the post-exchange online evaluation form, which trainees had to fill in in order to receive an attendance certificate.

The present study analysed the answers of 182 psychiatry trainees or recent graduates who took part in the EFPT exchange program during 2012 and 2019 and filled in the internet-based evaluation form. The inclusion criteria were currently in training or recently finished training as a psychiatrist in Europe and filling in the questionnaire. The exclusion criterion was participation in the EFPT exchange program for the second or subsequent time.

All trainees were systemically asked to complete the online evaluation form after the exchange period. The form includes sociodemographic, training in host country-related, and exchange experience-related questions. Experience measures were evaluated using the 4-point Likert scale. Data was anonymized before the analysis. The study followed the principles of the Declaration of Helsinki.

From the 198 individuals who filled the questionnaire, 182 were involved in final analyses. The majority of participants were females in the second half of their training. The average age was 29 years. The largest number of applicants were from Turkey, whereas the United Kingdom hosted the most participants. One-third of the participants had previous international exchange experience.

Most trainees were exposed to both outpatient and inpatient treatment settings and were involved in educational or research activities. 96.7% of participants indicated that they were satisfied or very satisfied with the experience, 95.6% said that the exchange was useful or very useful, and 98.9% were likely or very likely to recommend exchange to colleagues. A description of trainees and exchange placements is presented in a table (couldn’t be uploaded).

To our knowledge, this study is the first to assess the experience of psychiatry trainees who went on exchange during their professional training. Vast majority of trainees were satisfied with their exchange, thought it would be useful for their clinical practice and would recommend it to their colleagues. These findings are in line with other studies that examined medical exchange experiences .

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Simulation-based training is a practical medical education tool to develop health professionals’ knowledge and experience in a low risk, realistic clinical setting. It trains clinicians to recognise and manage rare and complex clinical scenarios without compromising patient safety. Despite an evidence base demonstrating simulation to be an effective medical education tool, it is not commonly used in postgraduate psychiatry training as it is in other medical specialties.

This project outlines the development and effectiveness of a hybrid-virtual simulation-based workshop designed to improve patient care by improving clinical skills of non-consultant hospital doctors (NCHDs) in detecting and managing rare and complex psychiatric emergencies.

Three clinical vignettes based on near-miss clinical scenarios in psychiatry were developed by a multidisciplinary team of doctors and nurses in psychiatry, and experts in simulation-based medical education. The workshop, ‘SafePsych’ was delivered in a simulation laboratory, while being captured on camera and broadcasted via Zoom video-conferencing platform to observers. Debriefing followed each clinical scenario. Participants completed pre- and post-workshop questionnaires to evaluate clinical knowledge of the scenarios in the training programme.

The workshop was attended by consultants (n=12), NCHDs in psychiatry and emergency medicine (n=19), and psychiatric nurses (n=5). In the psychiatry NCHD group, test scores significantly improved following the workshop (p<0.001). There were significant improvements in the test scores with a mean difference of 2.56 (SD 1.58, p<0.001). Feedback from participants and observers was positive, with constructive appraisals to improve the virtual element of the workshop.

Simulation-based training is effective in teaching high risk, rare complex psychiatric cases to psychiatry NCHDs. Further exploration of the learning needs of nursing staff is required. Future workshop delivery is feasible in the COVID-19 environment and beyond, using a virtual element to meet social distancing requirements while enhancing the reach of the training.

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Burnout is prevalent in residents and coping is one of the important modifying factors.

This study aimed to investigate coping strategies, burnout, and their relationship among residents.

A cross-sectional descriptive study was conducted among residents from October 2019 to April 2020 in Thailand. The Brief COPE Inventory Thai version and The Maslach Burnout Inventory Thai version were used, and the associations between coping strategies and burnout were examined.

The number of 280 residents replied the questionnaire (response rate 41.5%). The most favored copings were self-distraction and acceptance and the least common were denial and substance use. Most residents had high level of emotional exhaustion (n = 113, 40.4%) and moderate level of reduced personal accomplishment (n = 99, 35.4%). However, low degree of depersonalization was reported predominantly (n = 164, 58.6%). The coping of venting, behavioral disengagement and self-blame independently predicted emotional exhaustion and depersonalization. Behavioral disengagement was the only predictor of burnout in all dimensions, whereas positive reframing is the only strategy that had independent and protective effect against burnout in all dimensions.Table 1

Multivariate analysis of factors associated with emotional exhaustion

A large number of residents had emotional exhaustion. Behavioral disengagement and positive reframing were the most influential coping strategies related to burnout. This study might inform residency training program of some specific approaches for burnout prevention.

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Mental health conditions are rising globally, and COVID-19 has exacerbated the situation. We often think that massive money investments and training of specialized mental health providers, such as psychiatrists, will help alleviate the demand-supply challenge. But the reality is different. Despite all efforts over the last years, the mental health treatment gap, the percentage difference between the number of people needing treatment for mental illness and the number of people receiving treatment, is still 50+% in countries like Germany. The investment of money and the training of specialized mental health providers alone will not be sudcient to decrease this number.

We need to learn from and with partners from low- and middle-income countries (LMIC), in which a shortage of resources has prevented a signihcant investment in mental health but also has inspired the innovation and implementation of novel approaches to decrease the mental health treatment gap. This reshaped approach allows us to move from Northern Ventriloquism (high-income countries teach LMIC what to do) to honest cross-cultural bidirectional learning. Furthermore, it will hll the “how” gap.

We know WHY we should act in the (global) mental health field. We also know WHAT we should do. The main question remaining is HOW we can implement any of the activities. To fill this “how” gap, the Dresden-based NGO On The Move e.V. designed an annual 8-week program funded by the European Union, which centers around a global mental health and social innovation curriculum and aims to create spaces of empowerment towards mentally healthier communities. Our participants come from four higher education institutions in Germany, Ghana, and Kenya.

The program, which was recently awarded the TU Dresden internationalization award in the category “Innovative International Research Cooperation,” encourages participants to learn from and with each other. To enable an holistic approach to mental health and diversify the pool of mental health champions, the program includes participants from all fields. Since the start of the program, hundreds of culturally sensitive mental health-related Youtube videos have been recorded and distributed widely in the communities of the participants. The number of participant-led advocacy events has also increased.

Contextually, we will discuss core concepts, such as human-centered and community-based approaches, and how they relate to filling the “how” gap in our presentation. We might not have a blueprint of solutions in terms of decreasing the mental health treatment gap; however, our recommendations can support innovative and customized solutions. From a process perspective, we will compare existing global mental health training curricula with our curriculum and highlight transcultural learning opportunities; we will also discuss the elements of our program that empower our trainees.

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Resident physicians compared to the general public are exposed to a more rigorous schedule. Burnout as described by the World Health Organization is a phenomenon occurring in an occupational setting. It consists of three domains: feelings of exhaustion, reduced professional efficacy, increased mental distance from one’s own job. Research shows that increased working hours are associated with higher levels of burnout in resident physicians.

Through literature review we will explore whether this burnout contributes to an increased suicidal risk in the resident physician population.

Various studies assessing training of residents globally were analyzed and compared. A study in Japan distributed a survey to 4306 resident physicians. Suicidal ideation was noted in 5.6% of these physicians but when working more than 100 hours in the hospital the rate increased to 7.8%. In Australia it was found that once doctors in training worked more than 55 hours per week there was was an increase of 50% in suicidal ideation. It was also found that 12.3% of the people surveyed in the Australian study had reported suicidal ideation within the past 12 months of the survey. A study observing 5126 Dutch residents found 12% of residents having suicidal ideation but double in the group with burnout vs the group without burnout.

The studies listed show that increased work hours and burnout was associated with increased suicidal ideation in medical residents. A study observing 1354 physicians in the US found that higher measurements of burnout were associated with suicidal ideation similar to previous studies. However once adjusted for depression, it was noted that there was an association with depression and suicidal ideation but not with burnout. Depression may be a confounding variable that may have not been adjusted for when determining the association of burnout with suicidal ideation. In addition further research looking at the leading cause of death among a total of 381,614 US medical residents between the years 2000 to 2014 found suicide as the second most common cause of death. It was however found when looking at resident physicians between the age of 25-34.9 there was 4.07 suicides per 100,000 person years while in the general public there was 13.07 suicides per 100,000 years.

The rate of suicide was found to be lower in resident physicians compared to the general public. Suicidal ideation may be more closely associated with depression versus burnout itself and should be accounted for when assessing suicidal ideation in the resident physician population. Suicide rates being lower in resident physicians compared to the general public bring up the possibility that burnout in resident physicians does not have to be directly correlated with increased risk of suicide.

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Despite the scientific requirements and restrictive recommendations, there is a significant disparity between theory and practice in the prescription of benzodiazepine(BZD). Long-term prescribing, defined by a duration exceeding six months has been commonly reported worldwide, some authors explained this by physician’s perceptions.

This study aimed to evaluate the perception of general practitioners practicing in Tunis, in the private or public sector, concerning the prescription of BZDs.

A cross-sectional study was conducted among general practitioners in the private and public sectors practicing in Tunis during the study period (September and October 2021). It is based on the response to a questionnaire, which focused on the perception of prescribing BZD, via google forms distributed to members of the regional committee of the order of physicians.

A total of 75 physicians participated in the study. The mean age was 47.75± 12,2 years, with 17,28 ± 11,8 years of clinical experience. Among the 75 participating physicians, 83% considered that patients on BZD patients had a better quality of sleep and 58% assert that patients on BZDs had restful sleep. 83% of participants agreed that BZDs were associated with fewer nocturnal awakenings 83% and 85% with a decrease in the feeling of irritability. 18% of the doctors think that the easiest way to manage a patient’s anxiety is to prescribe a BZD. 24 doctors believe that chronic use of BZDs is essential to control anxiety. patients’ anxiety. The number of years of practice is inversely correlated with the perception that the patient wakes up less at night (p= 0.059). Male gender correlates with the perception that it is acceptable to continue prescribing beyond the recommended duration as long as they are well tolerated (p=0.035).

BZD prescription decision in general medicine is complex. This study participates in increasing our level of understanding of the reasons behind the long-term prescription of this molecule.

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The COVID-19 pandemic disrupted specialist training across Australia and New Zealand particularly in the area of assessments. Large-scale face-to-face exams were especially vulnerable to disruptions including lockdowns, travel and density restriction and required the Royal Australian and New Zealand College of Psychiatrists (RANZCP) to introduce alternatives.

Following several small-scale Objective Structured Clinical Exams (OSCEs) in late 2020 and 2021 (both AV and multi-site), the RANZCP introduced an Alternative Assessment Pathway (AAP) after an exam cancellation in November 2021.

To discuss the introduction of an Alternative Assessment Pathway at the RANZCP and share progress regarding the broader changes to assessment models under consideration.

The AAP was co-designed with trainees and Specialist International Medical Graduates and introduced in December 2021 as an interim measure to assess clinical competence in the absence of an OSCE. It comprises a portfolio review of completed end-of-rotation forms and, if required, a case-based discussion held via Zoom.

The AAP has been held over two rounds (December 2021 and March 2022) with 97% and 90% pass rates respectively (data correct as at 6 October 2022). An evaluation into the pathway is currently underway.

In July 2022, the RANZCP introduced the Clinical Competency Assessment as a continuation of the AAP (with some modifications) for the remainder of 2022 and 2023.

While the pandemic has become a catalyst for change, the RANZCP has been considering broader changes to the theory and practice of its assessments for some time. The presentation will provide an overview of its short-term clinical assessment model and share progress regarding change to the long-term assessment strategy.

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While the role of benzodiazepines (BZDs) has been well established for anxiety and related disorders, there are significant concerns about BZD dependence, withdrawal, and tolerance. There is a lot of ambiguity regarding the potential long-term effects of BZDs on mental health. However, the risk of developing subsequent other substance use disorders is in question.

In this electronic medical record (EMR) based retrospective cohort study, the study cohort was defined as patients between the ages of 18 and 65 with anxiety disorders (ICD-10-CM: F40-F48) prescribed with at least one BZD; the control cohort was defined as patients between the ages of 18 and 65 with anxiety disorders (ICD-10-CM: F40-F48) with no BZD prescription during the five-year timeframe examined. We excluded patients with pre-existing substance use disorders (ICD-10-CM: F10-F19), et al.

We collected data from TriNetX Research database, a real-time international EMR network, from September 2017 to September 2022. Patients in the two cohorts were matched by gender, age, race, ethnicity, and common medical conditions at a 1:1 ratio by propensity scoring and then underwent Kaplan–Meier analysis and association analysis.

A total of 626,754 patients were identified and matched for analysis. Patients in the study cohort were more likely to be female (67.6% vs. 66.7%, p < 0.001), non-Hispanic (65.8% vs. 62.5%, p < 0.001) and white (72.8% vs. 69.1%, p < 0.001). Kaplan–Meier analysis showed the survival probability at the end of the time window was 94.1% for the control cohort and 89.5% for the study cohort (Hazard ratio, 2.20; 95% CI, 2.16-2.25; P < 0.001) in all type of substance use disorders. (Table 1)Table 1.Hazard ratio of substance use disorders difference in BZD cohort versus the control cohort.

Patients with an anxiety disorder who were prescribed BZDs are at higher risk of not only BZD dependence but all types of substance use disorders than a matched cohort not prescribed BZDs. Given this notable association, clinicians should be cautious while prescribing BZDs and inform the patient about the risks associated with their utilization.

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Hallmarks of alcohol use disorder (AUD) are disturbances of circadian rhythms and everyday structures. While circadian rhythms dictate the timing of daily recurring activities such as sleep, activity, and meals, conversely, these activities represent time cues, so called Zeitgebers, that the circadian system uses to synchronize with the environment. We have developed a novel therapy approach for AUD patients (DAILY), in which we take advantage of this mutual influence and stabilize and strengthen their circadian system by creating strict schedules for daily Zeitgeber activities (Hühne et al. Front Psychiatry 2021). Since every person has a circadian system with its own characteristics and is subject to social obligations, the daily plans are personalized for each test person.

We investigated whether the DAILY intervention can serve to increase the success of standard psychotherapy service and reduce alcohol use and relapse in AUD patients who are currently undergoing qualitative detoxification or post-detoxification therapy and are highly vulnerable to relapse at this stage. In addition, we investigated whether possible depressive symptomatology, sleep quality, and physical recovery of the participants are improved.

In a 6-week controlled, randomized, single-blinded, parallel-group intervention study, we used detailed, 14-day diary entries to determine the optimal eating and sleeping times for each participant individually and used these to create personalized daily structure plans. Intervention participants were encouraged to adhere strictly to this plan for the following four weeks, with compliance verifiable by continuing the diary. Relapses and dropouts were documented, and questionnaires on mood state and sleep quality were completed at the beginning and end of the intervention. The control group received a sham treatment with no effect on their daily structure.

Our data show that DAILY therapy significantly improves meal and sleep time regularity and significantly reduces relapse rates, with 60% relapse rate in the control group and 11% in the intervention group (Figure 1A). In addition, the data show that among the few intervention participants who had relapses, these occurred on significantly fewer days during the study period than among relapsing control participants (Figure 1B). While depressive symptoms were unaffected by the DAILY therapy, sleep quality improved significantly (Figure 2).

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Our data show that increasing the regularity of individual eating and sleeping times with DAILY is an effective tool to substantially promote abstinence during a period when AUD patients are particularly vulnerable to alcohol use and relapse, and in addition, to improve their sleep quality and accelerate physical recovery during therapy.

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Alcohol consumption is part of the global youth culture and represents a dimension of young people’s social identity. Even if at-risk drinking in the young population is lower in Italy compared to other countries, the increasing complexity and changes in global values may influence risky behaviours, which therefore require attention and preventive strategies.

The intervention followed a pilot named The Vineyard Project, which engaged a group of young mental health service users in local practices of hand-harvesting grape. The initiative was hosted in the wine-producing area of Langhe (Italy), which shows lower rates of at-risk drinking also due to the protective role played by the cultural dimension of winemaking craft. The pilot inspired a peer led-intervention in a local high school, acknowledging the crucial role that educational settings play in the lives of young people and the relevance of peer influence on adolescents’ behaviours.

Semi-structured interviews with young people participating in the Vineyard Project have been conducted, audio-recorded and shared with high school students (n=80) to become the object of dedicated workshops. Interviews explored participants’ experience in the vineyard, the relationship they developed with the vines and with professional vine growers, their role in the winemaking process, and the emotional and sensorial contents of their immersion in the viticultural landscape.

The peer-led intervention showed promising results in producing benefits beyond the group of young people directly involved in the vineyard activities. By narrating their experiences through the interviews, participants acted as cultural mediators with the students who subsequently listened to their stories. Their narratives represent unusual accounts of the world of wine and its production, drawing on the perspective of non-expert, young people that are not familiar with the viticultural landscape. The embodied knowledge they could learn from professional vine growers, concerning the harvest as well as other activities of care for the vines, contribute to portray wine as a cultural product, which is the result of traditions handed down from generation to generation, hard work, competent interventions on the vines and the other living beings of the vineyard. This unusual perspective on wine was perceived as particularly surprising for students who lived in the area, who became so acquainted with the viticultural landscape and the discourses around its products to the point of taking it for granted in a non-reflexive attitude.

Findings suggest that peer-led interventions concerning wine and other drinking products, narrated in their cultural dimension (e.g. their story, identity, local traditions, practices and the tacit knowledge implied in their production), may encourage a limited and competent consumption among young people.

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Alcohol Use Disorders (AUDs) are highly prevalent psychiatric disorders with often a poor treatment outcome in terms of high dropout rates and relapses. A vulnerability to disinhibition or a lack of self-regulation/low Effortful Control (EC) seems to be a core risk factor associated with both the initiation and continuation of AUDs. EC is the regulative dimension of temperament that involves attentional control, inhibitory control and activation control, and reflects self-regulation abilities that develop later in life parallel with the maturation of the prefrontal cortex.

In this study we want to investigate whether EC, operationalised in terms of self-report and in terms of behavioral measures, can predict relapse. When a low EC indeed turns out to be a significant contributor to relapse, treatment interventions aiming at strengthening EC could result in better treatment outcomes and less relapse in AUD patients.

The sample consisted of 75 adult patients with AUD (68.9% males, mean age 47,4y) admitted at a specialized, inpatient treatment unit for addiction. To assess the regulative temperament dimension, we used the Effortful Control Scale (ECS) from the Adult Temperament Questionnaire Short-Form), a self-report questionnaire as well as five behavioral/neuropsychological tasks using the Cambridge Neuropsychological Test Automated Battery: Cambridge Gambling Task (CGT), Stop-Signal Task (SST), Intra-Extradimensional Set Shift (IED), Spatial Working Memory (SWM) and Spatial Span (SSP).

We performed binary logistic regression analyses with EC/CANTAB measures as predictors and relapse/no relapse (during treatment and after 3 months follow up) as dependent variable. According to these analyses, the self-report measure of EC nor the behavioral tasks CGT, SST, SWM and SSP (CANTAB) were able to significantly predict relapse neither during treatment nor after 3 months follow-up. Only the IED (outcome measure stages completed) was significant in predicting relapse (p<0.05) during follow-up.

In our study we investigated whether self-regulation as measured by self-report questionnaires and behavioral tasks could predict relapse during treatment and after 3 months follow-up in a sample of inpatients with AUD. In contrast to some findings in literature, in our sample most of the used measures were not able to predict relapse. One hypothesis for these findings is that our sample of inpatients at a specialized addiction treatment unit is too homogeneous, all presenting lower levels of self-regulation. Future research should thus focus on larger samples and less homogeneous population. Only the IEC (outcome measure stages completed) was able to predict relapse during follow-up.

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Cocaine use is a worldwide health problem with psychiatric, somatic, and socioeconomic complications, being the second most widely used illicit drug in the world. Despite several structural neuroimaging studies, the alterations in cortical morphology associated with cocaine use and addiction are still poorly understood. Interestingly, findings from human studies and animal models examined how impulsivity is a risk factor for the emergence of substance use disorders.

In this study we aimed at investigating the complexity of cortical folding (CCF) in patients with cocaine addiction using fractal dimension (FD). Since the frontal, parietal, temporal and insular cortices have been shown to play an important role in decision making and impulsivity, we hypothesized that CCF in the brain of patients would be altered in these regions. Furthermore, we predicted the association between CCF changes and 1) the duration of cocaine use for its widespread neurotoxic effects and 2) impulsivity characteristics in those regions implicated in the predisposition to addiction.

We compared the CCF between patients with cocaine addiction (n=52) and controls (n=36) and correlated it with characteristics of addiction and impulsivity. Demographic data, history, and current substance use were collected. Furthermore, the Barratt Impulsivity Scale (BIS-11) was administered.

We found that patients with cocaine addiction had greater attentional impulsivity compared to HC. In addition, they showed reduced CCF in a cluster that encompassed the left insula and the supramarginal gyrus (SMG) and in one in the left medial orbitofrontal cortex. Moreover, the CCF in the left medial orbitofrontal cortex was correlated with the age of onset of cocaine addiction and with attentional impulsivity.

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Overall, our findings suggest that chronic cocaine use is associated with changes in the cortical surface in the fronto-parieto-limbic regions that underlie emotional and attentional regulation, and these changes are associated with prolonged cocaine use. Future longitudinal studies are warranted to unveil the association of these changes with the diathesis for the disorder or with the chronic use of this substance.

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The use/abuse of Information and Communication Technologies (ICT) has become a topic of great interest in recent years. With advances in technology, today’s population spends a great deal of screen time (ST) making watching television (TV), using computers, smartphones, or playing video games a central component of their daily lives. These studies have analyzed the psychological impact of technological exposure or abuse, such as aggressive behaviors, anxiety, depression and other mental problems.

The main objective of this study is to explore the differences between men and women and the abusive use of social networks, technologies, pathological gambling and other addiction problems in primary care.

This study is an observational study conducted within the framework of primary care in the Spanish region of Aragon. The population of the study were participants of 35-74 years old, had been receiving care from the Aragon Health Service. Recruitment is shown at figure 1. Sociodemographic, quality of life, personal factors on health behaviour, social support, lifestyle patterns and chronic comorbid pathology variables were collected during the period 2021–2023. The project was approved by the Clinical Research Ethics Committee of Aragon Nº PI20/302. The comparisons by sex were carried out using a Student T-test or chi squared test to analyse differences.

There are significant differences in the abuse of new technologies between men and women. 25.20% of men (CI 95% 18.26-33.25) compared to 13.41% of women (CI 95% 8.85-19.25) make abusive use of the Internet, with statistically significant differences. In the same way, men present greater abuse of video games (6.25% of men (CI 95% 3.0-11.45) compared to 3.05% of women (CI 95% 1.17-6.55).

Analysing the differences by sex in dependence if it is an urban or rural population. Significant differences in the abuse of new technologies between men and women are present in the urban population, while in the rural population these differences are not observed

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Gender modifies the ways in which technologies are used, so that men have a more problematic use of video games and the Internet than women. On the other hand, in relation to emotional symptoms, it was observed that women presented more anxiety and less satisfaction with life than men. The evaluation of abuse of new technologies cts should be incorporated into health services to improve people’s ability their self-care, the level of knowledge of managing their disease and their physical, mental and social health.

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The neurobiology of gambling disorder (GD) is not yet fully understood. Although dysfunctional signalling involved in energy homeostasis has been studied in substance use disorders, it should be examined in detail in GD.

To compare different endocrine and neuropsychological factors between individuals with GD and healthy controls (HC), and to explore endocrine interactions with neuropsychological and clinical variables.

A case-control design was performed in 297 individuals with GD and 41 HC, assessed through a semi-structured clinical interview and a psychometric battery, adding 38 HC in the evaluation of endocrine and anthropometric variables.

Individuals with GD presented higher fasting plasma ghrelin (p<.001) and lower LEAP2 and adiponectin concentrations (p<.001) than HC adjusting for body mass index (BMI). The GD group reported higher cognitive impairment regarding cognitive flexibility and decision-making strategies, a worse psychological state, higher impulsivity levels, and a more dysfunctional personality profile. Despite failing to find significant associations between endocrine factors and either neuropsychological or clinical aspects in GD, some impaired cognitive dimensions and lower LEAP2 concentrations significantly predicted GD presence.

This study suggests distinctive neuropsychological and endocrine dysfunctions may operate in individuals with GD, predicting GD presence. Further exploration of endophenotypic vulnerability pathways in GD appear warranted, especially with respect to etiological and therapeutic potentials.

F. Fernandez-Aranda Consultant of: Novo Nordisk , Employee of: editorial honoraria as EIC from Wiley, I. Baenas: None Declared, M. Etxandi : None Declared, B. Mora-Maltas: None Declared, R. Granero : None Declared, S. Tovar : None Declared, C. Diéguez: None Declared, M. Potenza Grant / Research support from: Mohegan Sun Casino and Connecticut Council on Problem Gambling, Consultant of: Opiant Pharmaceuticals, Idorsia Pharmaceuticals, Baria-Tek, AXA, Game Day Data and the Addiction Policy Forum; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse control disorders or other health topics; and has consulted for law offices and gambling entities on issues related to impulse control or addictive disorders, Employee of: patent application in Yale University and Novartis, S. Jiménez-Murcia: None Declared.

Elimination disorders (ED) include enuresis, defined as wetting from 5 years, and encopresis, defined as soiling from 4 years onwards after organic causes are excluded. They are highly prevalent in childhood and often associated with clinically relevant comorbid psychological disorders. However, no systematic review or meta-analysis examines their co-occurrence with internalizing and externalizing problems in children.

The aim of this study is to determine if, and to what extent, children with ED show higher internalizing and externalizing problems than their healthy peers.

A multistep literature search was performed from database inception until May 1st, 2022. PRISMA/MOOSE-compliant systematic review (PROSPERO: CRD42022303555) were used to identify studies reporting on internalizing and/or externalizing symptoms in children with an ED and a healthy control (HC) group. First, a systematic review was provided. Second, where data allowed for it, a quantitative meta-analysis using random effects model was conducted to analyze the differences between the ED and the HC groups for internalizing and externalizing symptoms. Effect size was standardized mean difference. Meta-regression analyses were conducted to examine the effect of sex, age, and study quality. Funnel plots were used to detect a publication bias. Where found, the trim and fill method was used to correct it.

36 articles were included, 32 of them reporting on enuresis (n=3244; mean age=9.4; SD=3.4; 43.84% female) and 7 of them on encopresis (n=214; mean age=8.6; SD=2.3; 36.24% female) [Image 1]. The ED group presented significantly lower self-concept (ES:0.42; 95%CI: [0.08;9.76]; p=0.017) and higher symptom scores for thought problems (ES:-0.26; 95%CI: [-0.43;-0.09]; p=0.003), externalizing symptoms (ES:-0.20; 95%CI: [-0.37;-0.03]; p=0.020), attention problems (ES:-0.37; 95%CI: [-0.51;-0.22]; p=0.0001), aggressive behaviour (ES:-0.33; 95%CI: [-0.62;-0.04]; p=0.025) and social problems (ES: 0.39; 95%CI: [-0.58;-0.21]; p=0.0001) [Image 2]. Significant publication biases were found across several of the studied domains [Image 3]. No significant effect of sex, age or quality of the study score was found.

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Children with an elimination disorder may have significant internalizing and externalizing problems, as well as impaired self-concept. It is recommendable to screen for them in children with ED and provide interventions as appropriate.

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Depression is highly prevalent and causes a heavy burden in adolescent life. Being praised for prosocial behavior might be a preventive factor because both being praised and prosocial behavior are protective against depression. However, no study has investigated the association between experiences of being praised for prosocial behavior and depressive symptoms in adolescents.

Here, we investigated the longitudinal relationship between being praised for prosocial behavior and depressive symptoms in adolescents.

In Tokyo Teen Cohort study (TTC), an ongoing prospective population-based cohort study, we collected 3,171 adolescents’ data on self-reported experiences of being praised for prosocial behavior, depressive symptoms, and caregiver-evaluated prosocial behavior. Ten-year-old children were asked to freely describe answers to the question “What are you praised for?”. Only children who clearly answered that they were praised for their prosocial behavior were designated the “prosocial praise group.” The degree of depression at ages 10 and 12 was measured with the Short Mood and Feelings Questionnaire (SMFQ), a self-report questionnaire about depression. Objective prosocial behavior of the 10 year-old children was assessed by the Strength and Difficulty Questionnaire (SDQ). Multiple linear regression analysis was performed using the SMFQ score at age 12 as the objective variable and being praised for prosocial behavior as the main explanatory variable, and the SMFQ score at age 10 and the objective prosocial behavior at age 10 were included as confounders.

3,007 pairs of child and their primary caregiver participated in the second data collection at the age of 12 years (follow-up rate was 94.8%). Regarding the question “What are you praised for?”, 845 (28.1%) children answered that they were praised for prosocial behavior. Depressive symptoms (SMFQ scores) in the “prosocial praise group” were significantly lower than those in the other group both at age 10 (4.3 ± 4.4 vs. 4.9 ± 4.6, p < 0.001) and at age 12 (3.4 ± 4.2 vs. 4.0 ± 4.6, p < 0.01). In the single regression analysis, the children who reported being praised for prosocial behavior at age 10 had significantly lower depressive symptoms at age 12 (partial regression variable: −0.57, 95% confidence interval (CI) [−0.96, −0.17]). This association remained significant after adjusting for confounders, including baseline depressive symptoms (partial regression variable: −0.44, 95% CI [−0.80, −0.08]). Prosocial behavior alone was not associated with depressive symptoms.

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Being praised for prosocial behavior rather than objective prosocial behavior at 10 years of age predicted lower depressive symptoms 2 years later. Praise for adolescents’ prosocial behavior can be encouraged to prevent depression.

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Children with Autism Spectrum Disorder (ASD) have a qualitative deficit in social interaction that can be manifested by two of the following characteristics: a) deficits in the use of non-verbal behaviors, such as eye contact, facial expressions, body postures and gestures used to regulate the social interaction; b) inability to develop peer relationships in an adequate manner compatible with their level of development; c) absence of the spontaneous tendency to share emotions, interests and objects; d) lack of social and emotional reciprocity. Among these characteristics, we can mention the difficulty in establishing and maintaining eye contact as one of the points that make it more difficult to develop important skills for learning in general.

The present study aims to investigate the impacts of visual neurorehabilitation on autistic children.

The online questionnaire based on the emotional and functional development scale (FEDQ) of the DIR/Floortime model was distributed to parents and professionals as of October 15, 2022. To date, the Visual Contact Protocol has been applied to 34 children.

The protocol has been applied to 34 children so far.The collection suggests that when we favor the visual contact of the autistic, the motor, cognitive, linguistic, emotional and especially social learning prove to be facilitated

Discussion

Vision is the master of all the senses. When the child is born, his visual ability is very limited. As she grows functional visual skills (HVF) develop. When we talk about the autistic child, these abilities may not be well defined.The collection suggests that when we favor the visual contact of the autistic, the motor, cognitive, linguistic, emotional and especially social learning prove to be facilitated. When observing the children in speech therapy, a better engagement was verified during the execution of the activities suggested by the therapist. Vision is a learned process that adds meaning to what is seen. There is still a lot of research to be done, but by providing the possibility of visual screening to the autistic child, we give them the opportunity to explore the world, get to know and recognize the environments that surround them and consequently improve their learning.Keywords: autism, visual neurorehabilitation.

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