The EXPERIENCE project aims to enable the creation and sharing of extended-personal realities in virtual reality (VR). Currently, software and hardware technology are under development, that will automatically generate VR environments based on neurophysiological, psychological, cognitive, and behavioral data to support not only the recording of personal experiences but the transmission as well to another user. Potential use cases include enhanced treatment and the assessment of symptom severity of affective disorders.

The objective is to design and create a virtual reality environment that enables the identification of between-group differences in behavioral measures when comparing depressed and healthy-control participants.

We conducted a literature review to identify measures that can be implemented in VR and have the potential to show differences between depressed and healthy-control participants. PubMed and ResearchGate databases were screened to identify potential cognitive tasks. A selection protocol was developed considering effect size, homogeneity of results, risk for cybersickness, cognitive demand, domain heterogeneity, and VR compatibility to choose 4 out of the 47 initial tasks. In addition to the cognitive tasks, behavior measures were considered as well and a virtual environment has been equipped to assess (1) exploratory behavior; (2) engagement with emotionally valenced stimuli (via eye-tracking); (3) metacognitive sensitivity, (4) persistence/grit, and (5) possible effects of mood induction.

Based on the above review, a virtual environment has been developed which is composed of four rooms and a hallway where the starting point is. After an initial tutorial on how the environment/controllers work participants are free to explore and instructions are only provided for the specific cognitive tasks which have to be solved to open the doors and move between rooms. The rooms are equipped with numerous interactive objects and images with varying emotional valence. The engagement with the environment and general activity are continuously recorded and can be retrieved for analyses after participants exit the environment.

If the controlled VR environment will be proven effective for the assessment of depressive symptoms in future studies, the EXPERIENCE system could incorporate direct and objective behavioral measures into the assessment depressive symptoms. Consequently, the system has the potential to support the clinical diagnosis of affective disorders.

The EXPERIENCE project is funded by the European Commission H2020 Framework Program with the Grant No. 101017727.

None Declared

Dementia has a significant psychological and emotional impact on families, especially for caregivers of people living with dementia. In this perspective, the World Health Organization has developed iSupport for Dementia, an online training and skills program to prevent and/or reduce mental health problems associated with the provision of care and improve the quality of life of caregivers. It is being translated and adapted in different countries and as of August 2022, 31 adaptations using 27 different languages were in progress. However, the availability of the program should only be carried out after evaluating its effects on caregivers’ mental health outcomes (such as burden, depressive and anxious symptoms, quality of life, among others).

To analyze randomized clinical trial protocols to assess the effects of the iSupport program in different countries.

This is a data survey carried out in October 2022 on clinical trial registry platforms Clinical Trials, The Brazilian Registry of Clinical Trials, Cochrane Central Register of Controlled Trials, Netherlands Trial Register and Australian New Zealand Clinical Trials Registry by two independent researchers. Descriptive analyzis were performed for sample size, primary outcomes, secondary outcomes and intervention design.

Seven clinical trial registries were identified, conducted in Australia/China, Brazil, Great Britain, the Netherlands, India, Japan and Portugal, published in English, from 2018 to 2022. The sample size ranged from 184 to 390 participants. Regarding the primary outcomes linked to the effect of using iSupport, five countries will analyze burden, anxiety and depression. Only in Australia/China and the Netherlands, the primary outcome will be quality of life and stress, respectively. Secondary outcomes vary between studies, with measures of quality of life (n=6), self-efficacy (n=4), program usability (n=4), cognition and problematic behaviors (n=3), attitudes (n=3), quality of support (n=3), positive aspects of care (n=2), knowledge, competence, resilience and informal costs of care (n=1). Most studies will carry out assessments at baseline, 3 and 6 months after the intervention, with the exception of Japan that will perform at baseline and at 1 and 3 months after the intervention and 6 months.

Analysis of the effectiveness of iSupport is one of the World Health Organization guidelines for countries that are culturally adapting this program. Brazil is the only country in Latin America with a clinical trial registration so far. Burden, anxiety and depression are outcomes considered by most countries. The results could provide evidence to strengthen and expand the possibilities for collaboration between researchers, as internet-based interventions have shown promising results on the mental health and well-being.

None Declared

Patients with severe somatic conditions frequently develop depressive symptoms, with a reduction in quality of life, sleep disturbances and suicide as some of the most serious consequences. However, there is a lack of evidence-based interventions to reduce this comorbidity. The NEVERMIND system aims to address this issue by collecting biomedical and psychometric data through a smart shirt and questionnaires, which are used to predict patients’ depressive symptoms. Based on the predictions, patients are offered personalised feedback to self-manage their mental health symptoms in the form of lifestyle behavioural advice, mindfulness-based therapy, and cognitive behavioural therapy.

The primary objective was to assess the effectiveness of the NEVERMIND system in reducing depressive symptoms in patients with somatic conditions in comparison to treatment as usual. Some of the secondary objectives were to examine the NEVERMIND system’s effectiveness in preventing new depressive symptoms, sustaining the effects of the intervention at 24 weeks post-baseline, and reducing suicide ideation.

For this pragmatic randomised controlled trial, 425 patients diagnosed with myocardial infarction, breast or prostate cancer, kidney failure, or lower limb amputation were recruited from hospitals in Turin, Pisa and Lisbon. Data from clinical interviews and structured questionnaires was collected at baseline, 12 weeks, and 24 weeks. The primary outcome was depressive symptoms at week 12 as measured by the Beck Depression Inventory II (BDI-II), while secondary outcomes included prevention of depressive symptoms, suicide ideation, self-reported general interest, satisfaction with daily life, illness perception, self-compassion, and the sustainability of the system’s effect at 24 weeks post-baseline. The intention-to-treat analyses included all patients, while the per-protocol analyses included 333 patients.

The intervention group included 213 and the control group 212 patients, with the sample’s mean age being 59.41 (SD=10.70). Those who used the system had statistically significant lower depressive symptoms at 12 weeks (mean difference=-3.05, p=0.004; 95%CI -5.12 to -0.99) compared to controls, with a clinically relevant effect size (Cohen’s d=0.41). Notable significant reductions included suicide ideation (mean difference =-0.61, p=0.020; 95%CI -1.13 to -0.10) and incidence of depressive symptoms at week 12 (OR=0.43, p=0.019; 95%CI 0.22 to 0.87). The improvements in depressive symptoms were sustained at week 24 (mean difference =-1.34, p=0.015; 95%CI -2.41 to -0.26). No significant differences were observed for other secondary outcomes.

The NEVERMIND system was shown to be superior to standard care in reducing and preventing depressive symptoms among the studied sample.

None Declared

Motivation is an important factor in therapy and potentially even more so in an online setting. Earlier research shows that more autonomously motivated patients have better outcomes and completion rates than more controlled motivated patients´. However, little is known about how motivation type influences treatment effect in an online setting and in patients with binge eating disorder specifically.

This study set out to investigate how motivation type as per the Self-Determination Theory would affect treatment adherence and effect in a sample of 148 patients, undergoing an Internet-based Cognitive Behavioral Therapy (iCBT) for BED.

The study was mixed-methods. A sample of 148 patients gave two written qualitative statements regarding their motivation for seeking treatment and reasons for choosing online therapy

The statements were transformed into quantitative units via the condensation method. The themes were categorized according to the model by Ryan and Deci based on level of autonomy and perceived locus of causality.

This was compared with completion rate and outcomes on eating disorder symptomatology. Completion was designated into three groups. Low adherers - less than six sessions (n=54), high adherers – between 7 and 10 sessions (n =56) and full adherers - 10 session plus follow up (n=37).

The effect of the treatment was measured via the Eating Disorder Examination Questionnaire (EDEQ) and Binge Eating Disorder Questionnaire (BEDQ).

Table 1shows the distribution of patients’ motivational types regarding therapy aims

Perceived locus of causality and level of autonomy, did not affect level of adherence or outcome of treatment in either setting. This unexpected result may suggest that internet-based therapy is less dependent on motivation types, when comparing with face-to-face treatment.

None Declared

Personal access to digital technologies proved to be an important measure to curb the desertion of students at a public university in the Colombian Caribbean during the COVID-19 pandemic; however, there are no studies that explore the relationship between the use of new information and communication technologies, resilience, anxiety and depression during physical isolation derived from the public health situation, in this geographic area.

Analyze adaptability to the use of technologies and its relationship with resilience, anxiety and depression in university students and professors in the midst of isolation by Covid-19.

The sample consisted of 328 subjects, aged between 18 and 69 years (30.6±12.21), 39% men and 61% women; 67.4% young students and 32.6% professors. The study was quantitative, exploratory, by convenience, online. The instruments were registered on the Web and were provided through WhatsApp, Facebook and personal mail by means of a Snowball type sample selection. It was developed during the period of mandatory physical isolation, decreed in the first quarter of 2020 by the Colombian State due to the COVID-19 Pandemic. The analysis was performed using descriptive, correlational and inferential statistics. The Kolmogorov-Smirnov (KS) normality test was applied, confirming a non-normal distribution of the sample. A correlational analysis was performed using Kendall’s Tau-b correlation coefficient and for the subsequent analysis of variance (segmented by age), Kruskal-Wallis Chi-square (X2) was used, verifying the variances by post hoc. In the case of the analysis of variance segmented by occupation (professors and students) and by sex, the Mann-Whitney U X2 test was used.

Of the total sample, 86.3% showed maladaptability to the use of ICTs, with no significant difference between professors and students (p=0.48). Resilience is higher in professors than in students (p<0.01); anxiety and depressive symptoms are higher in students (p<0.01). Adaptability was inversely associated with Resilience and directly with Anxiety and Depressive Symptoms (p<0.01); the highest risk group are students under 22 years old. A future publication will expand on the details of the results.

It is concluded that maladaptability to the use of ICTs may be associated with contextual elements not studied in the present study, however, the mental impact remains high mainly in the younger student population, especially in times of general social crisis. Credit is given to the project BPIN 2020000100758: Development of an Integrated Technological System for the promotion of mental health, psychosocial and socioemotional problems and prevention of gender violence, caused by the COVID19 pandemic in the Magdalena region, which allowed the deepening for the analysis of the results. Likewise, to Universidad del Magdalena for its support in installed capacity.

None Declared

Cognitive dysfunction affects the development, treatment compliance, significantly worsens the quality of life and social functioning of the patients with epilepsy.

146 patients with epilepsy aged 18 to 65 participated in the study (М-40.7±2.42) were diagnosed with focal, idiopathic epilepsy and epileptic syndromes (G40.1, G40.2, G40).

Clinical-anamnestic, social-demographic, clinical-psychopathological, psycho-diagnostic and statistical.

The study of the attention selectivity was carried out using the Munsterberg test. Only 9 examined patients (6.16%) of the total group had sufficient indices, 35 (23.97%) patients refused from the test, while the rest – 102 (69.87%) had low test results. The overall treatment group score was 7.72, which is by 13.28 lower than in the control group, where the attention selectivity index was 21 (р<0,001), which shows a considerable attention selectivity decrease in patients with epilepsy compared to the healthy persons. According to the МоСА test results, the first treatment group patients showed better cognitive functions (1.4, р<0.001), higher attention selectivity under the Munsterberg test (0.63, р<0.001), lower anxiety level under HARS (1.45, р<0.001), lower depression level under HDRS (1.7, р<0.001) and higher subjective assessment of the life quality (2.77, р<0.05). According to the МоСА test results, the second treatment group patients showed better cognitive functions (0.73, р<0.001), higher attention selectivity under the Munsterberg test (0.27, р<0,05), lower anxiety level under HARS (4.27, р<0.05), lower depression level under HDRS (2.32, р<0.05) and higher subjective assessment of the life quality (1.21, р<0.05). According to the МоСА test results, the comparison group patients demonstrated lower cognitive functions (0.22, р<0.05), higher attention selectivity under the Munsterberg test (0.15, р<0.05), lower anxiety level under HARS (2.61, р<0.001), lower depression level under HDRS (2.49, р<0.001) and higher subjective assessment of the life quality (1.0, р<0.05). The cognitive training showed its effectiveness in healthy persons of the control group: according to the МоСА test results, cognitive functions improved (0.79, р<0.001), compared to the treatment group 2 patients (0.73, р<0.001).

According to the follow-up study data 12 months after the cognitive training and psychoeducation, follow-up study showed better values under depression and anxiety scales, and improved life quality levels in the patients of treatment groups. Patients with epilepsy show a reliable cognitive functioning improvement after a 3-month computerized cognitive training. The study results indicate a more significant cognitive functioning improvement in the patients provided the combined use of the methods of psychoeducation and cognitive training, compared to the use of a cognitive training only.

None Declared

Burnout (BO) is a syndrome combining psychological and somatic symptoms caused by exposure to several years of chronic stress at work. Far from being a theoretical problem, it is a real social problem that has become globalized as societies change. Anesthesiology is among the most stressful medical disciplines which expose to BO in Tunisia and around the world.

Identify associated factors to BO among anesthesia technicians.

We conducted a cross-sectional study during two months, from October 1st, 2015 to December 31th, 2015, among anesthesia technicians affected in the different operating rooms of the Farhat Hached teaching Hospital in Sousse. Data collection was based on a self-administered questionnaire with validated tools assessing BO (Maslach Burnout Inventory) and stress (Siegrist and Karasek)..

Forty-six senior anaesthesia technicians was included in the study. The mean age of our population was 43.76 ±7.74 years with a female predominance (89.1%). According to the Karasek model, 59% of the workers were in job strain, and according to the Siegrist model 23.9% of the participants had an imbalance between high effort and low reward. The BO rate among anaesthesia technicians at the Farhat Hached University Hospital was 39.1%. The results showed a statistically significant association between working at the gynaecology-obstetrics department (p=0.001), the seniority in the department superior or equal to 20 years (p=0.006), the absence of break time at work (p=0.003) and the risk of the occurrence of BO. Furthermore, the last 2 consecutive day rest dates back to more than 15 days (p=0.001), the number of free weekends during the last 3 months less than four (p=0.044) were also significant associated to BO.

Our study confirms that BO is a tangible reality in our country especially among anesthesia technicians, so it must be addressed by adopting effective preventive strategies.

None Declared

People with mental disorders (MD) may experience social stigma in various spheres of their lives. This phenomenon is based on negative social beliefs and hostile perceptions about mental disorders. Stigma may lead to social exclusion and discrimination (unjust treatment compared to people without MD). It may also result in resistance to using professional medical help (psychiatrist, psychotherapist) by people who experience symptoms of MD.

The study aims to analyze the attitude of Polish society toward people with mental disorders and the attitude toward psychiatric treatment. The study investigates the correlation between the abovementioned attitudes and socioeconomic parameters of the respondents.

The study was conducted on a group of 1,230 respondents with the anonymous, authorial questionnaire disseminated by the CAWI technique. The questionnaire consisted of 10 single-choice questions concerned with the socioeconomic parameters of the respondents (age, place of residence, education, gender) and their attitudes toward mental health problems. The chi-square test and Kendall’s tau-b correlation coefficient (τb) were used to analyze the correlations between the above parameters (with p<0,05).

Over 33% of respondents believes that people with MD are more aggressive than people who do not present this type of disorder. In turn, 16.4% of respondents admitted that they would feel uncomfortable in the presence of a person with mental disorders. There was no statistically significant correlation between the above beliefs and any socioeconomic parameter. Every tenth respondent would not hire a person with MD. Resistance to employment increased with the respondents’ age and level of education, whereas it decreased with the population of respondents’ domiciles. More than 17% of respondents would feel resistance to contacting with psychiatrist, and 4.1% of them already hide the fact of treatment from their family. The resistance to using psychiatric help was higher in villages and smaller towns than in bigger centers.

The study shows negative attitudes towards people with MD are still relatively frequent in Polish society. The stereotypical perception of this group of entities is generally not dependent on any analyzed socioeconomic parameter. Such correlations exist only in some areas (employment). Because of the negative perception of MD, some people who struggle with these problems do not use a psychiatrist’s professional help. In effect, these entities remain undiagnosed and untreated. Treatment delay may lead to exacerbating symptoms, prolong treatment time (including the necessity of hospitalization), and increase its cost. Reducing the stigma is necessary for counteracting discrimination against people with mental disorders and improving the mental health condition of Polish society. It requires educational activities and appropriate legal regulations.

None Declared

Healthcare workers (HCW) have been at the forefront of providing care since the COVID-19 pandemic. In addition to physical demands, HCW are also vulnerable to mental health conditions due to the nature of their work. As a result, absenteeism among HCW is inevitable. In Canada, mental disorders caused by a stressor at work results in a work-related claim provided it meets the criteria of a governing worker’s compensation agency. While the literature points to varying prevalence rates of mental health illnesses among HCW, it remains unknown how the COVID-19 pandemic affected the number of work-related mental health claims in this population.

To help fill this gap in knowledge, we will conduct this study that aims to determine the impact of the COVID-19 pandemic on the number of work-related mental health claims among HCW.

We will utilize deidentified individual data from a worker’s compensation agency in all of British Columbia. Mental health claims will be identified using an indicator for mental health. Diagnoses for mental health conditions in these claims are ascertained by a psychologist or psychiatrist. Differences in the number of mental health claims between HCW and non-HCW before (January - February 2020) and after (March 2020 - December 2021) the pandemic will be estimated using interrupted time series analysis.

The findings will inform disability case managers, healthcare providers, and employers the importance of identifying appropriate work accommodations, return to work programs and additional mental health supports for HCW under mental health claims. Healthcare unions in British Columbia can use the findings to advocate for better work accommodations and mental health support for HCW.

Further understanding the complications of long-term effects of COVID-19 on mental health of HCW will inform workforce planning and patient care.

None Declared

Over the years, several studies have shown the high rate of discrimination experienced in particular by mental health service users. Stigma is composed of three elements: knowledge, behaviors, and attitudes. Although behaviors are the core of discrimination, this element has often been overlooked or intertwined with the other components.

Our study aimed to assess Tunisian students’ behavior toward people with mental illness

This was a cross-sectional study conducted on 2501 Tunisian students who anonymously completed a form circulated online through social network groups and pages related to each academic institution. We have used the validated Arabic version of the “Reported and Intended Behaviour Scale” (RIBS) which assesses self-reported mental health behaviors and future intentions.

The median RIBS score was 15 out of 20, ranging from 4 to 20. Among the participants, 40% were living or have lived with someone with a mental health problem and 49.7% would be willing to live with someone with a mental health problem. Moreover, 24% were working or have worked with a person with a mental health problem and 53.4% would be willing to work with him or her. In addition, 34% were having or have had a neighbor with a mental illness and 58% would be willing to have a neighbor with a mental illness. Finally, 51% were having or have had a close friend with a mental health problem and 83.7% answered that they would be able to maintain a relationship with a friend who had developed a mental health problem.

The assessment of behavior toward people with mental illness is fundamental as it has the most impact on individuals. However, behavior may be mediated by knowledge. Thus, it would be interesting to evaluate mental health knowledge to study the relationships between these constructs and optimize anti-stigma interventions.

None Declared

Premature mortality in people with depression is well established. A better understanding of the causes of death and the relative risks of death from each cause may help identify factors that contribute to the health inequalities between people with and without depression.

To describe all-cause and cause-specific mortality of people with a hospital admission record for depression in Scotland, relative to the general population.

We used a linked population-based dataset of all psychiatric hospital admissions in Scotland to the national death dataset to identify 28,837 adults ≥18 years of age who had a hospital admission record of depression between 2000 and 2019. We obtained general population estimates and mortality data from the National Records of Scotland and quantified the relative difference in mortality by calculating the standardised mortality ratio (SMR), using indirect standardisation and stratifying by sex.

During a median follow-up of 8.1 years, 7,931(27.5%) people who were hospitalised for depression died. Circulatory system diseases were the most common causes of death. Standardised all-cause mortality was more than three times higher than would be expected based on death rates in the general Scottish population. SMRs were similar in men and women for all-cause mortality and, in general, for cause-specific death (Table 1). The SMR for the suicide category was markedly higher in women than men, partly explained by the higher suicide mortality in males than females in the general population.Table 1All-cause and cause-specific mortality of people hospitalised for depression in Scotland 2000-19

People hospitalised for depression continue to have higher all-cause mortality than the general population in Scotland, with relative mortality varying by cause of death.

None Declared

Adolescence is the period when many mental disorders have their peaks of onsets. Investigation into adolescent mental health problems and their risk factors is required, but there has been few prospective cohort studies on adolescent mental health.

This study aimed to prospectively reveal the developmental trajectory of physical and mental health in adolescence, and to investigate factors associated with the trajectory.

We launched a prospective cohort study (Tokyo Teen Cohort: TTC) on general population of adolescents at three municipalities in metropolitan area in Tokyo, Japan. Using the resident register, we recruited 10-year-old children from the community between 2012 and 2015. The second, third, and fourth wave of data collection were conducted at 12, 14, 16 years of age, respectively. We collected multidisciplinary data including mental health by self-report questionnaire and home-visit interview. Further, we have launched two subsample studies which focus on biological measures such as brain MRI, EEG, and sex hormones. TTC is based at three research institutes, and ethics approval has been granted by all of the three institutions.

A total of 3171 children participated the TTC. Of those, 3007 children participated in the second wave of data collection (follow-up rate: 94.8). The third and fourth wave of data collection were completed and more than 80% of children continued to participate in TTC. More than 300 children participated in the two subsample studies. More than 30 papers were already published, and many national/international research collaborations have started.

The fifth wave of data collection at 20 years of age is being currently conducted. Further national/international collaborations are expected to examine cultural effects on mental health of adolescents.

None Declared

The Covid 19 pandemic has worsened mental health of teenagers and young adults in particular and highlighted the lack of data for children aged 3 -11 years living in France. To fill this gap, Santé publique France, the national public health agency set up the first nationwide study, Enabee, in 2022.

Enabee (National study on Children wellbeing) aims at monitoring wellbeing and most frequent mental health disorders of children and at understanding associated factors, gathering information from children, parents and teachers. First analyses will be focused on children’ and teachers’ point of view.

Enabee is a nationwide cross sectional study. Elementary and nursery schools were randomly selected in Metropolitan France. Then a maximum of four classes were randomly selected in each school. Elementary school children (from 6 to 11 years old) gave their own assessment of wellbeing and mental health using the following self-administrated questionnaires on tablets: the Kindl and the Dominique Interactive. To get a comprehensive evaluation, parents and teachers also filled the web-administrated Strengths and Difficulties Questionnaire for each child. The parents’ questionnaire also included questions on child’s life habits and global health, parenting attitudes, parent’s mental health, covid 19, major life events and household social situation. A pilot study was launched in January to assess the feasibility and the acceptance before implementing the study at a nationwide level. Key stakeholders of education, family and health participated at the setting up of the study.

706 schools were selected and 399 participated (participation rate 57%). Data were collected from May 2nd to July 31st 2022. In those schools, 1357 classes participated, representing 29 414 children. We collected 15 206 questionnaires filled by children of elementary schools and 21 016 questionnaires filled by teachers for children in nursery and elementary schools. Analysis are ongoing. By March 2023, we will produce weighted estimates of prevalence of children internal and externals disorders based on the children self-assessment and the teachers’ assessment respectively and different dimensions of wellbeing. Prevalences will be presented by sex, age and school levels.

Enabee will provide a representative picture of French children wellbeing and mental health and protective and risks factors. This milestone is essential to guide national policies and build dedicated actions for children in order to promote and improve their wellbeing and mental health. Beyond this edition, Enabee is the first step of a long term monitoring system that will provide regularly updated data and will be completed by ancillary and ad hoc studies.

None Declared

Population surveys often present prevalence estimates of children meeting criteria for psychiatric disorders, which are used to plan services. However, studies have shown that those with ‘subthreshold’ or’ subclinical’ symptoms also experience poorer outcomes, and benefit from identification and support.

This study uses data from the 2017 NHS Digital Mental Health of Children and Young People in England survey (MHCYP-2017), a large probability sample, to examine prevalence of ‘sub-threshold’ difficulties and contact with services.

Secondary analysis of data from MHCYP-2017, using data on 6,718 children aged 5 to 16. The main measures of mental health were the Strengths and Difficulties Questionnaire (SDQ), a validated dimensional measure, and the Development and Wellbeing Assessment (DAWBA), a standardised diagnostic assessment which was clinically-rated to assign diagnoses based on ICD-10 and DSM-V criteria. Parents also reported on mental health related service contacts for their child in the previous year. Descriptive analysis reported the proportion of participants with ‘sub-threshold’ difficulties. This was defined as a high or very high score on the parent-rated SDQ total difficulties score and/or impact score, but not meeting criteria for a DSM-V diagnosis on the DAWBA. Levels of service contact in this group were reported.

According to provisional findings (subject to final weighting strategy), 7.2% (95% CI 6.5-7.8%, n=486) of 5- to 16-year-olds fell into this ‘sub-threshold’ category, 79.1% (95% CI 78.1-80.1%, n=5,295) had no disorder and did not have raised impact or total difficulty scores on the SDQ, and 13.7% (95% CI 12.9, 14.6%, n=937) had a DSM-V diagnosis. Almost half of those with ‘sub-threshold’ difficulties had contact with professional services in the previous year (47.4%, 95% CI 42.8, 52.1%). Teachers were the most commonly reported professional service contact (39.8%, 95% CI 35.3, 44.4%). Contact with child mental health specialist services was reported in 6.5% (95% CI 4.5, 9.1%).

This initial analysis demonstrates that a small but significant (on a population level) proportion of children in this sample had elevated levels of mental health difficulty and/or impact on functioning but did not meet criteria for a disorder. As these data are cross-sectional, it is possible that some children may meet, or have met, diagnostic criteria at an earlier or later point. Almost half of this group had had mental health related contact with a teacher, providing opportunities for early intervention, but only a small proportion had contact with specialist services. These analyses can inform planning and targeting of support for children who may not meet criteria for specialist services.

None Declared

Despite their knowledge about the risks and treatment options for substance abuse disorders, healthcare workers are not immune to them. Meanwhile, a number of studies have shown that health professionals have an increased risk of depression, addictive diseases and burnout due to the occupation-linked mental and physical burden and in particular an increased prevalence of substance-related disorders.

The aim of our present study was to focus on prevalence and the risk factors of addiction behavior and its possible association with burnout among healthcare workers in a moroccan hospital applying a questionnaire-based survey.

Questionnaires were distributed to 250 healthcare workers of CHU IBN ROCHD Casablanca, Morocco. A total of 200 participants completed the survey. Data collected in 2021 were analysed by using descriptive statistics, an independent t test and Pearson’s correlation analysis.

In our sample, the 26-35 year old age group presents 74%, 79% of the participants are women, 38.5% of the participants have freelance status, 62.5% are single, 78.8% of participants have no children, 60% of the participants are residents and 33.2% are nurses. Almost half of the participants have between 1 and 5 years of training or work experience. 37.2% reported a history of an anxiety disorder and 33.1% have a history of a depressive disorder. 90.2% have never used any substance.

45% spend more than 3 hours, 86.6% of the participants used the internet between 6pm and midnight.

In total, 20.5% suffered from mild burnout, 31% moderate burnout and 48.5% severe burnout, according to the Maslach Burnout Inventory. The prevalence of depression was 32%; that of anxiety was 29.5%.

Factors associated with Burn-out in uni-variate study were: age group (p = 0.044) ,marital status (p= 0.001), preferred time of connection (p = 0.019), burnout (p=0.001), depersonalization (p=0.001), personal fulfillment (p=0.001), internet use for work (p = 0.0019), internet use for leisure ( p = 0.002) and also for online games (p = 0.016).

Factors associated with depersonalization were marital status (p=0.001), number of children ( p = 0.042), psychiatric history (p=0.001), substance abuse ( p = 0.012), preferred time of day to use the internet (p = 0.001), use of the internet for social networking (p =0.03), online gaming (p = 0.008).

Factors associated with personal accomplishment were age (p=0.001), number of children (p=0.016), use of the internet for work (p=0.001).

A significant proportion of our healthcare workers suffered from burnout, depression and anxiety disorders, which was associated with substance and internet abuse in univariate analysis. Our study also draws attention to the risk factors of burnout such as age, family status, working type and working hours internet use, substance use. The possible association of burnout and other addiction behaviors merits further investigation.

None Declared

A crisis is defined as a disruption in equilibrium at the failure of own personal resources which results in important distress and functional impairment. Particularly after Covid-19 pandemic we have been attending an increased number of this kind of consultations in the mental health services.

To expose a new mental health program called PAIC (Ambulatory Intensive Community Program) started in March 2019 and addressed to people who are suffering a crises period, and to evaluate its effectiveness. The aim of this program is to reach prior stability, trying to avoid chronicity, clinical status perpetuation and sociofunctional impairment, as well as assessing suicidal risk and perform early prevention interventions.

PAIC is proposed as an early, intensive, focused and psychotherapeutic intervention led by psychiatrist. Consist in an 8-week program of 30 to 60 minute weekly individual sessions. A total of a 205 patients were attended in PAIC during 2021 and 84,6% of the patients completed the program. Mixed-methods, clinical interviews and measurements using validated self-administrated questionnaires were used: CORE-OM pre/post treatment (“Clinical Outcomes in Routine Evaluation-Outcome Measure”), List of Threatening Experiences, LTE and Clinical Global Impression (CGI-I). Changes in CORE-OM Scale were analysed using t-student test and a descriptive analysis was used for CGI-results.

CORE-OM (“Clinical Outcomes in Routine Evaluation-Outcome Measure”) showed improvement in all of four dimensions: subjective well-being (TW), problems/symptoms (PT), general function (TF) and risk (TR).

Perception of clinical improving measured by CGI was 81,6%. There were no cases of clinical worsening.

We conclude that intensive and early programs are effective reducing the intensity of symptoms and the level of disability in people who are experiencing a psychological crisis. Also, it supports primary health care as well as helps to avoid saturation of specialized system.

None Declared

Crisis Resolution Home Treatment Teams (CRHTTs) offer short-term specialist psychiatric input to service users experiencing acute mental illness or crisis in the community. The South Lee CRHTT was setup in 2015.

To evaluate the impact of treatment given by a CRHTT in terms of:

1. Preventing hospital admission,

2. Impact on service user’s symptoms and overall functioning

3. Service user’s satisfaction with the service

To evaluate patient characteristics of those attending the CRHTT, and to assess qualitative data provided by service users using thematic analysis.

All the service users treated by South Lee CRHTT between 2016-2020 were included in this review. Standardized quantitative measures are routinely taken by the South Lee HBTT before and after treatment. The Brief Psychiatric Rating Scale (BPRS) was used to measure symptom reduction, and the Health of the Nation Outcome Scale (HONOS) was used to measure quality of life/health outcomes. The Client Satisfaction Questionnaire- version 8 (CSQ-8) was used to evaluate service user satisfaction quantitatively, and service users were also asked for qualitative data.

1041 service users were treated by the service, between 2016-2020. Treatment by the CRHTT was shown to be effective across all primary outcome measures. Inpatient admissions in the areas served by the CRHTT fell by 38.5% after its introduction. BPRS scores were reduced significantly (p<.001), from a mean score of 32.01 to 24.64 before and after treatment. Mean HoNOS scores were 13.6 before and 9.1 after treatment (p<.001). Of the 1041 service users receiving the CSQ-8, 180 returned it completed (17.3%). Service users’ median responses were “very positive” on a 4 point-Likert scale to all 8 items on the CSQ-8, and qualitative data were thematically analysed.

CRHT was shown to be effective at preventing inpatient admission. CRHT was shown to be an effective option for the treatment of acute mental illness and crisis, using quantitative measures. Feedback gained from service users suggests that overall patient satisfaction with the CRHTT service was high.

None Declared

There has been an increase in the use of new psychoactive substances containing synthetic cannabinoids in recent years. It is also known as K2, spice, or fake weed, and these are popular as recreational drugs [Kourouni I et al. JAMA NetW Open 2020 Jul; 1;3(7): e208516]. CB1 agonists in SCs mimic the effects of cannabis, making users feel happy and relaxed. However, recreational SCs may result in unwanted severe consequences such as acute anxiety and psychosis [Gunderson EW et al. AM J Addict 2012 Jul-Aug; 21(4): 320-6]. Relative to tetra-hydro cannabinol (THC), synthetic cannabinoids (SCs) are more potent and efficacious agonists and may exert deleterious effects on health [Gunderson EW et al. AM J Addict 2012 Jul-Aug; 21(4): 320-6].

Our aim of this review is to focus on the typical presentation of SCs use and help clinicians to better understand and be more vigilant about K2 manifestations

In conducting the literature review, only English language articles were selected from PubMed and PubMed Central (PMC) databases through August 14, 2022, using the search term “Synthetic cannabinoids k2 clinical manifestation”. Three reviewers conducted the initial review of the titles and abstracts of the electronic search, followed by detailed assessments of the relevant studies. Peer-reviewed Case series, case reports, and systematic review studies were included that met the inclusion criteria (articles in the English language, studies on humans, studies on synthetic cannabinoids (SC) or K2 use and its clinical manifestations.

Electronic search results showed a total of 60 articles. Fifty articles were excluded based on title review (36 articles), abstract review (4 articles), and full article review (10 articles). Case series on 30 ICU patients (SC intoxication) showed agitation 33%, bizarre behavior, coma 33%, seizure 20%, Acute respiratory failure 60%, Tracheal intubation 70%, Rhabdomyolysis 26%, Invasive mechanical ventilation 40%, Acute kidney injury 26% and cardiotoxic effect [Kourouni I et al. JAMA NetW Open 2020 Jul; 1; 3(7): e208516]. Cross-sectional study on 50 male cases showed altered perception 68%, including auditory and visual hallucination, dizziness and loss of consciousness, palpitation 76%, chest pain 12%, panic attack, and convulsion [Abdelmoneim WM et al. Middle East Current Psychiatry 2022; 29 (1): 24]. Literature reviews has shown the common psychiatric presentations of SC are acute anxiety, agitation, psychosis, paranoia, disorientation, alteration of mood and perception, hallucination, and delusion [Debruyne D et al. Subst Abuse Rehabil. 2015 Oct 20; 6:113-29, Radhakrishnan R et al. Front Psychiatry 2014 May 22;5:54].

There are limited research related to synthetic cannabinoids in human. Based on our review, SC intoxication can be life-threatening besides psychiatric manifestation. Therefore, clinicians must understand the vast clinical manifestations of SCs.

None Declared

Different mental health care provision models coexist in prisons in Spain. The Ministry of Interior applies a traditional model to secure mental health care to 83% of the country imprisoned population. Three autonomous regions with acquired competencies for health care provision (17% of the imprisoned population) are implementing innovative care models.

To explore the views of healthcare professionals on models of mental health care provision for imprisoned persons with a serious mental illness (SMI) in Spain.

21 healthcare professionals (13 physicians, 5 nurses, 3 pharmacists) working in prisons, penitentiary psychiatric hospitals and a psychiatric in-prison unit took part in 5 online, 2 hours focus groups and one in-deep interview between 31st May and 20th July 2022. The moderator used open-ended questions to research into the characteristics of mental health care models and on the challenges for implementation. Focus groups were audiotape recorded and transcribed. Transcripts were analysed applying thematic analysis.

Healthcare professionals reported that within the traditional model of healthcare provision, the psychiatric care of SMI imprisoners relies on correctional general practitioner physicians (GP). Psychiatrists act as external care providers. There are two psychiatric penitentiary hospitals with a strong correctional character for in-hospital care. Acute psychiatric care happens in prisons or at the local general hospital. Healthcare records remain within the penitentiary organization and outside the accesible healthcare information system. In consequence, there is fragmentation and delocalization of mental health care. An innovative approach consists of a dedicated mental healthcare unit within the prison with continuous psychiatric supervision of imprisoners with SMI and good quality psychiatric care. Schizophrenia and hyperactive attention deficit disorder persons benefit the most. Continued mental health care in the community remains a challenge. Another model of care is centred in the SMI imprisoned person. Acute and rehabilitation psychiatric penitentiary units operate within a network of mental health and social care resources in the community, coordinated by a liaison nurse. Individualised care plans keep SMI persons in their social environment. Costs of implementation are high. Clear definition of roles; investment in dedicated staff and shared information systems are challenges to overcome.

Innovative models of mental health care are needed to benefit imprisoned persons with a SMI in Spain. A decided national and regional will is paramount to overcome challenges.

None Declared

One of the biggest challenges for primary care professionals is to know when it is appropriate to request a consultation with a psychiatrist. A complete medical history should be performed to detect anxious-depressive symptoms, as well as to determine the intensity, the trigger, time of evolution, and the functional repercussion (1). It is also important that the patient is able to express his or her symptoms and ask for help. The concept of “Alexitimia” refers to the difficulty of expressing feelings verbally, and is a frequent symptom in depressive patients (2).

In mild cases and with little repercussion, the physician himself can initiate treatment and follow up (3). However, on other occasions, it will be advisable to request a consultation with psychiatry.

The main objective is to observe the time that elapses from the onset of symptoms until consultation with the Mental Health team is finally requested. Some preliminary results can already be obtained from this data collection.

We have decided to carry out a descriptive study, collecting different variables from patients attending a first Psychiatry consultation.

In a total sample of 208 patients, the majority (67%) were between 31 and 60 years old. Following the DSM-V criteria (4), patients were classified into groups according to their disorder: Adaptive, depressive, or other. These data were cross-referenced (Figure 1).

Subsequently, the time elapsed from the onset of symptoms (referred by the patients) was collected, until the referral to Psychiatry was processed. In order to make a comparison, average time (in days) was calculated for the different groups according to their age and diagnosis.

Those patients under 30 years were referred to psychiatry later. A downward trend was seen as the age range increased. In the “younger than 30” and “between 31 and 60” groups, patients who met criteria for Depressive Disorder took longer to be referred, which was striking considering that they are usually considered as more severe patients (Figure 2). This can be attributed to a greater difficulty in expressing their emotions (alexithymia), as another depressive symptom. Disaggregating these data by gender, the patients who clearly took the longest to be referred were men under 30 years old with a final diagnosis of Depressive Disorder (Figure 3). This gender difference is consistent with the social impact of alexithymia according to some articles (5).

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It is important that primary care physicians know how to take a complete history in those patients with symptoms of anxiety and depression.

In many cases, patients themselves have difficulties expressing their emotions and feelings (alexithymia), which may be another symptom of their discomfort.

This may lead to a delay in the time until referral to a psychiatry is requested, and therefore a worsening of symptoms.

None Declared