Over a quarter of U.S. children have at least one immigrant parent. Mental health disparities in children need to be assessed to better identify disproportionate burdens and promote health equity.

To assess the associations between race, ethnicity, and parent-child nativity, and mental health conditions in the U.S.

Data were from the 2016-2019 National Survey of Children’s Health (n=114,476 children aged 3-17 years), a nationwide, cross-sectional survey. Outcome variables included three mental health conditions (depression, anxiety, and behavior or conduct problems) reported by the parent/guardian. Additional measures included questions about healthcare access and use, demographics, and nine household challenge adverse childhood experiences (ACEs) used to quantify a total ACE score (0-9). Information on nativity was used to define immigrant generation (1st, 2nd, and 3rd+). Weighted logistic regression was used to assess the associations between race/ethnicity (Asian, Black, Hispanic, White, and Other), household generation, and outcome variables, among children who reported access to or utilized health services, adjusting for demographics. Multiple imputation was used to handle missing data.

Asian, Black, Hispanic, and White 3rd+ generation children had increased odds of depression compared to their 1st generation counterparts, same as among White, 2nd generation children. Race/ethnicity was not associated with depression among 1st and 3rd+ generation children, but Asian, Black, and Hispanic children had lower odds of depression compared to White children among 2nd generation children. Asian, Black, Hispanic, and Other-race 3rd+ generation children had increased odds of anxiety compared to their 1st generation counterparts, with similar findings also observed for Black and Other-race 2nd generation children. Being racial/ethnic minorities was generally associated with decreased odds of anxiety among 1st and 2nd generation children compared to White children from the respective generations. Asian, Black, Hispanic, and Other-race 3rd+ generation children had increased odds of behavior/conduct problems compared to their 1st generation counterparts. The observed associations remained significant after adjusting for the modified ACE score.

We found significant differences in several mental health conditions in children by parent-child nativity, race, and ethnicity that could not be explained by demographics, childhood adversity, and healthcare access and use. Lower odds of mental health conditions among minority children could represent differences due to factors such as differential reporting, and higher odds of mental health conditions, including in third- and higher generation children, need further investigation to develop approaches to promote mental health equity.

None Declared

Irish Travellers are recognised as a minority ethnic group in Ireland. While mental health services are available to Travellers, these services are often perceived as inadequate at addressing the mental health needs of this population. Studies have shown that there is a higher prevalence of mental disorders in the Traveller community in Ireland compared to the general Irish public. However, it is unclear if Travellers are at a higher risk of developing personality disorders, particularly borderline personality disorder.

This study will examine the prevalence of borderline personality disorder and other mental disorders in Travellers attending a community mental health service in Tuam, County Galway. This study will also investigate the biopsychosocial interventions delivered to this cohort and the clinical outcome following the interventions.

This is a cross-sectional study. Travellers who were active caseloads on the register of the community mental health service in Tuam were included in this study. Chart reviews were carried out on all samples included in this study.

A total of 59 active patients were included in this study. The Traveller community formed 14.4% (59 out of 410) of the active caseloads of the Tuam mental health service. There were more male than female Travellers who attended the service. Mean age was 36 years old. The most common mental disorder in this study cohort is depressive episode (F32). This is followed by mixed anxiety and depressive disorder (F41.2). A significant minority (9, 15.3%) of the study participants were given a diagnosis of borderline personality disorder. 9 study participants await diagnostic clarification. Nearly one-fifth (18%, n=9) of the study participants with a diagnosis had been given a diagnosis of borderline personality disorder. Over 50% of the study participants were on at least 3 different medications from at least 2 different classes of psychotropics.

This study shows that there is a significant overrepresentation of Travellers attending the community mental health service in Tuam. The findings from this study can be used to plan future service development projects to better meet the needs of this unique population.

None Declared

The evaluation of healthcare pathways must be considered of fundamental importance. The quality of care provided to patients with severe mental disorders (SMD) does not correspond to the standards set by the recommendations. Therefore, measures such as the real coverage rate of psychiatric patients’ needs (contact coverage), by comparing epidemiological prevalence rates and the number of patients receiving adequate care, could be a valuable resource for implementing the transition to community mental health. However, simple assessment and reporting of rates of contact with mental healthcare potentially overestimate the full expected health benefits of services. Therefore, in addition to monitor the coverage rate achieved by the services, the evaluation of the effectiveness of the care provided (effective coverage) [De Silva et al. Int J Epidemiol 2014;43(2):341–53] is also of relevant importance.

To measure the gap between contact and effective coverage of mental healthcare, i.e., the effectiveness of interventions provided by services for the treatment of SMD in preventing an exacerbation of psychiatric symptoms.

Data were retrieved from Healthcare Utilization databases of four Italian Regions (Lombardy, Emilia-Romagna, Lazio, Sicily). 45,761 newly taken-in-care cases of depression, schizophrenia, bipolar, and personality disorder were included. A variant of the self-controlled case series method was used to estimate the incidence rate ratio (IRR) for the relationship between exposure (use of different types of mental healthcare such as pharmacotherapy, generic contacts with the outpatient service, psychosocial interventions, and psychotherapies) and relapse episodes (mental illness emergency hospital admissions).

11,500 relapses occurred. Relapse risk was reduced (Figure) during periods covered by (i) psychotherapy for patients with depression (IRR 0.67; 95% CI, 0.49 to 0.91) and bipolar disorder (0.64; 0.29 to 0.99); (ii) psychosocial interventions for those with depression (0.74; 0.56 to 0.98), schizophrenia (0.83; 0.68 to 0.99) and bipolar disorder (0.55; 0.36 to 0.84), (iii) pharmacotherapy for those with schizophrenia (0.58; 0.49 to 0.69), and bipolar disorder (0.59; 0.44 to 0.78). Coverage with generic mental healthcare, in the absence of psychosocial/psychotherapeutic interventions, did not affect the risk of relapse.

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Psychosocial interventions, psychotherapies and specific pharmacotherapies can be considered particularly effective in treating patients with bipolar, depressive, and schizophrenic disorders. This study ascertained the gap between utilization of mental healthcare and effective coverage, showing that real-world data can represent a useful resource to monitor mental healthcare paths and to assess the effectiveness of a mental health system.

None Declared

The question of preoperative anxiety in an ophthalmological patient and its relief in an outpatient setting is becoming increasingly relevant due to the improvement of the technique and equipment of ophthalmic surgery, when the practice of «one-day surgery» is becoming increasingly common. It could not only affecting the course of the operation, but also a factor limited the availability of this type of medical care to patients. Purpose. To analyze the relationship between the level of anxiety during preoperative preparation and the choice of the optimal approach for the relief of preoperative anxiety in an ophthalmological patient in a «one day» clinic.

89 adult patients of both sexes aged from 20 y.o. referred for outpatient surgery (refractive and cataract surgery) and were included into trials, all of them are divided into main - 45 and control - 44 groups. Clinical psychotherapeutic interviewing, a scale of situational and personal anxiety C.D. Spielberger (adapted by Y.L. Khanin), a questionnaire for analyzing satisfaction with the quality of medical services provided in outpatient settings were used. Statistical: Microsoft Excel spreadsheet editor for Windows; the STATISTICA application software package version 6.1. were taken. The condition for determining statistically significant differences is the value р≤0,05.

Two-stage study by the method of contiuous sampling. Clinical psychotherapeutic interviewing, a scale of situational and personal anxiety C.D. Spielberger (adapted by Y.L. Khanin), a questionnaire for analyzing satisfaction with the quality of medical services provided in outpatient settings were used. Statistical: Microsoft Excel spreadsheet editor for Windows; the STATISTICA application software package version 6.1. were taken. The condition for determining statistically significant differences is the value р≤0,05.

The level of anxiety in patients who received anxiolytics

The study revealed an average and high level of situational anxiety in 66% of patients referred for refractive surgery, in 81% of patients referred for cataract surgery. Into main group, against the background of the performed anxiolytic therapy in the preoperative period, the proportion of people with a high level of reactive anxiety decreased significantly (p≤0.05) (from 24% to 8%), while personal anxiety did not significantly change. Among control group patients show a lower level of satisfaction with the quality of medical services provided in an outpatient setting.

The study showed the possibility of providing better quality medical services in «one-day» eye surgery, which expands the availability of outpatient ophthalmic surgical care to patients with high level of anxiety and anxiety disorders.

None Declared

Most mental disorders, when examined individually, are associated with an increased risk of cardiometabolic complications. However, these associations might be attributed to a general liability toward psychopathology or confounded by unmeasured familial factors.

To examine whether the associations between psychiatric diagnoses and increased risk of cardiometabolic complications are attributable to a general liability toward psychopathology, or confounded by unmeasured familial factors.

We conducted a cohort study in Sweden and identified all individuals and their siblings born in Sweden 1955-1962 with follow-up through 2013. After excluding individuals who died or emigrated before 1987, the final sample consisted 672 823 individuals. We extracted ICD-coded diagnoses (recorded 1973-1987) for ten psychiatric conditions and criminal convictions when participants were aged 18-25 years, and ICD-coded diagnoses (recorded 1987-2013) for five cardiometabolic complications (obesity, hypertensive diseases, hyperlipidemia, type 2 diabetes mellitus, and cardiovascular diseases) when the participants were 51-58 years old. Logistic regression models were used to estimate the bivariate associations between psychiatric conditions or criminal convictions and cardiometabolic complications in individuals. A general factor model was used to identify general, internalizing, externalizing, and psychotic factors based on the psychiatric conditions and criminal convictions. We then regressed the cardiometabolic complications on the latent general factor and three uncorrelated specific factors within a structural equation modeling framework in individuals and across sibling pairs.

Each psychiatric conditions significantly increased the risk of cardiometabolic complications; however, most of these associations were attributable to the general factor of psychopathology, rather than to specific psychiatric conditions. There were no or only small associations between individuals’ general psychopathology and their siblings’ cardiometabolic complications, suggesting that the associations were not attributable to genetic or environmental confounding factors shared within families. The same pattern was evident for the specific internalizing and psychotic factors.

Individuals with mental disorders in early life had an increased long term risk of cardiometabolic complications, which appeared attributable to a general liability toward psychopathology. Sibling analyses suggested that the elevated risk could not be attributed to confounds shared within families.This highlights the importance of transdiagnostic and lifestyle based interventions to reduce the risk of cardiometabolic complications, particularly in patients with several mental disorders.

None Declared

Co-morbid depression is common in people with tuberculosis (TB) but little is known about the course over time.

Our objectives were to determine the level of remission and factors associated with failure to remit in depressive symptom scores in people with TB undergoing treatment in primary care facilities in Ethiopia.

We assessed 648 people with newly diagnosed TB for depressive symptoms using Patient Health Questionnaire (PHQ-9) at the time of starting anti-TB medication, and again at two and six months. Remission was defined as more than 50% reduction in baseline depressive symptom scores. We analyzed factors associated with failure of depressive symptom score to remit at the end of the follow up using multilevel mixed-effects logistic regression by taking individuals as nested within 14 health institutions. Adjustment was made for socio-demographic characteristics, baseline depression score, stigma, type of TB, outcome of TB treatment, perceived severity of TB, substance use, perceived social support, substance use, and HIV status.

Compared to the baseline, the mean PHQ-9 scores declined at two months (Hedge’s G: 0.82; 95%CI: 0.71, 0.94) and six months (Hedge’s G: 1.20; 95%CI: 1.08, 1.33). However, depressive symptom scores failed to remit in 176 (33.1%) of the 532 people with TB who completed the follow up. . Stigma (AOR: 2.23; 95%CI: 1.09, 4.55), older age (AOR: 2.2; 95%CI: 1.13, 4.29), and treatment completion without a bacteriological proof of cure (treatment complete as compared to treatment cure) (AOR: 2.47; 95%CI: 1.37, 4.48) were independent predictors of failure of depressive symptom score to remit. Surprisingly, baseline lower depressive symptom score was more persistent than higher baseline depressive symptom score (AOR: 2.93; 95%CI: 1.56, 5.47).

In one-third of people with newly diagnosed TB, baseline depressive symptom scores did not remit after full course of TB treatment. TB treatment guidelines require in-built mental health component. Studies are required to understand course of depression beyond six months and effective interventions in this population.

None Declared

Depression and coronary artery disease (CAD) are often comorbid conditions. The presence of depression significantly interferes with the recovery after CAD therapy intervention, such as percutaneous coronary intervention (PCI), one of the most common medical procedures in developed countries. Brain derived neurotrophic factor (BDNF) has a major role in angiogenesis and neuromodulation. Its levels were previously shown to be reduced in patients with depression, and latest studies indicate similar in patients with CAD. However, the correlation of BDNF levels and depression after CAD treatment is unknown.

The aim of this preliminary study is to assess the changes in BDNF levels in patients with depressive symptoms during a six-month period upon PCI.

Antidepressant-free participants that underwent PCI with stent placement due to myocardial infarction or angina pectoris were enrolled in the study. Depressive symptoms were evaluated at baseline using the Beck’s Depression Inventory II (BDI-II) with a cut-off score ≥20 indicating moderate depression. Serum BDNF levels were measured from blood samples drawn a day after (baseline) and six-months upon a successful PCI without complications. The t-test for dependent samples was used with marked significant differences at p<0,05.

Altogether, 76 participants were included in the study, of which 25 finished a six-month follow-up. Participants with BDI-II≥20 at baseline had higher serum BDNF levels in the second measurement (M=23,12, SD=6,20; M=32,02, SD=12,26, respectively). No significant difference was found in serum BDNF levels in measurements between participants with and without depressive symptoms (t=0,33, p=0,74; t=-1,40, p=0,18, respectively). Statistically significant difference was found between serum BDNF in the first and second measurement in the overall sample (t=-2,28, p=0,03) and in participants with baseline moderate depressive symptoms (t=-2,46, p= 0,03), but not in those without (t=-0,59, p=0,57).

Serum BDNF levels in participants with baseline moderate depressive symptoms increased after a six-month period upon successful PCI treatment, whereas that trend was not observed in participants without depressive symptoms. This highlights the potential synergistic role of BDNF in comorbid depression and CAD.

None Declared

Prevalence of anxiety disorders in coronary artery disease reaches up to 15% and about half of patients with coronary artery disease have anxiety or depression comorbidity. Prevalence of anxiety in patients undergoing percutaneous coronary intervention ranges from 24% to 72%. Anxiety can be the source of distress and is associated with poor prognosis, impaired health-related quality of life and can cause cardiac dysfunction.

We aimed to determine the prevalence of anxiety and its association to coping strategies and personality traits in non-depressed patients undergoing elective coronary angiography, a diagnostic procedure for coronary artery disease. We also aimed to determine the correlation of state anxiety to elective coronary angiography finding and its expression over time.

This was a single-center, cross-sectional, prospective study. Anxiety was evaluated at four-time points using self-rating questionnaires: 14 days prior to and 2–4h before procedure; 24h after procedure and 6 weeks after discharge. The association between anxiety and psychological variables was assessed by multiple linear regression and by linear mixed effect model.

A total of 259 non-depressed patients were included in the final analysis (median age 65, 32% were female). Prevalence of anxiety was 35% and was higher in patients with avoidance-oriented coping style (p<0.001), meanwhile low neuroticism (p<0.001) and extrovertive personality trait (p=0.032) were protective factors. Patients that had no intervention (p=0.022) or had percutaneous coronary intervention (p=0.010) during elective coronary angiography, had lower anxiety than patients in need for coronary artery bypass graft surgery.

Personality traits emotional stability and extroversion are protective factors against anxiety. More than one third of patients experienced clinically significant anxiety before procedure. Our results suggest that recognising anxiety in patients undergoing elective coronary angiography is important. Further on, application of effective interventions for reducing/treating anxiety before or after procedure is needed.

None Declared

Suicide is considered an important public health problem in contemporary society. Over 800,000 deaths by suicide are estimated each year and the mortality rate is 11.4 per 100,000 people.

In people with cancer, depression is a high-prevalence disorder that affects patients’ ability to cope with illness, decreases treatment acceptance, prolongs hospitalization, reduces quality of life, and increases the risk of suicide. In turn, the diagnosis of cancer is a serious stressor, with many physical and psychological consequences, and is thought to be a risk factor for suicide.

This study aimed to perform a literature review on the incidence and risk factors of suicide in cancer patients

the search for articles was carried out in the electronic scientific databases PubMed, ScienceDirect and Scopus. Variables studied included suicide rate, type of cancer, demographic characteristics, and signs and symptoms associated with suicide using the descriptors “suicide” and “cancer”.

42 articles were selected. As in the general population, the risk of suicide was higher in men with cancer than in women with cancer. Cancer patients aged 65 or older have a higher suicide rate than those under 65. Prostate, lung, pancreatic, bladder and colorectal cancers are the types most at risk for suicide. The first year after diagnosis carries a higher risk of completed suicide. Multiple risk assessment tools have been developed and are effective in identifying patients with depression or hopelessness, factors associated with a higher risk of suicide. However, there are no tools that can sensitively and specifically predict suicide.

The incidence of suicide in a person diagnosed with cancer is approximately double the incidence of suicide in the general population. Early detection of depression in particular cancer populations, such as older male patients, can help identify those most at risk for suicide.

None Declared

Cancer is a major public health problem worldwide and the risk of death from cancer has decreased continuously since 1991, therefore, This translates into an increasing number of cancer survivors (CS) worldwide.

During the survivorship seasons, CS face several short-term, long-term, persistent, and late-emerging health and psychosocial problems, including cancer-related pain, fatigue, menopausal symptoms, anxiety, depression, distress associated with the risk of cancer recurrence, chronic uncertainty, social disruption, alterations of sleep, sexual and cognitive dysfunctions.

Since 2002 that some researchers and clinicians argued that it is important to de-velop and implement rehabilitation programs for cancer patients that integrate both psychosocial and physical rehabilitation.

With the scarcity of studies on the effectiveness of combined interventions in this population, despite the strong recommendation to perform and study it, and aiming to contribute to a greater knowledge on the theme, the present work aims to build, implement, and evaluate a combined intervention program, which integrates psychoeducational intervention with physical exercise to cancer survivors and relatives, through the following indicators: psychopathological symptoms (anxiety and depression), self-concept, coping strategies, personal growth and QoL.

A non-probabilistic convenience sample of 70 cancer survivors was assigned to: control (without intervention: n=32), combined intervention (n=21) and psychoedu-cation intervention (n=17) groups. Both intervention groups were 9 consecutive weeks duration. The combined intervention group benefited from 2 weekly exercise sessions additionally. It was administered before and after intervention the following questionnaires: demographic; Hospital Anxiety and Depression Scale (HADS); Clinical Self-concept Inventory (ICAC); Cancer Coping Questionnaire (CCQ); sub-scale of Personal Growth of the Psychological Well-being Scale (EBEP) and the World Health Organization Quality of Life Questionnaire (WHOQOL-Bref).

It was observed a statistically significant reduction of anxiety and depression symptoms from the beginning to the end of the intervention, as well as a significative improvement of overall and all do-mains of self-concept and personal growth. It was not observed a significative difference on quality of life.

The findings of this study contribute to support of the beneficial effect of combined intervention on psychological functioning of cancer survivors. Positive effects of the psychological program were observed but not into the same extent as in the combined intervention.

None Declared

CAU (Clinical assessment unit) was developed at Croydon University Hospital (CUH) in conjunction with the South London and Maudsley (SLaM) mental health trust in response to the Covid19 pandemic to relieve pressure on services in A&E (Accident and Emergency) and to support the already existing need to provide a more clinically appropriate space for patients presenting to A&E with acute mental health concerns. The clinical model for the unit was developed with input from service users, SLaM, CUH and CCG (Clinical Commissioning Group); and was fully established in October 2021 within a month of conception. CAU is located within close proximity to A&E which is convenient and incurs no transfer cost. Similar units have been developed internationally to address similar concerns (Goldsmith et al 2021, Wiley online library 2021 12849)

To evaluate the financial and clinical impact of the clinical assessment unit after one year in operation

This is a cross sectional study, data was collected from EPJs Reports (SLaM’s patient data reporting system), excel spread sheet collecting data based on referrals to the service over the one-year period from 8/9/2021 – 5/10/2022. This included a trial period from September 2021 – October 2021 where the service was running at half capacity.

CAU is open to capacitous adults aged 18-65 presenting to A&E. Exclusion criteria: individuals conveyed by the police, those under MHA, on-going physical health concerns, diagnosis of learning disability with no primary mental health need, diagnosis of dementia and homelessness

3,322 patients were referred to the Liaison service and of those 402 or 12% of those patients to A&E were transferred to CAU

The 402 service users over the period of one year spent a total of 11, 351 hours in CAU

The main diagnosis of patient admitted to CAU fell into the diagnostic categories F30-39 43.5 %, and F60-69 27%.

The majority of patients were admitted awaiting informal admission and 1/3 of plans for discharge destination were made on CAU. 10 % of patient were discharged on a least restrictive outcome, which has cost benefits for acute mental health trust. This one-year period showed cost saving of £462,112 for 24 hours stay in ED with support staff.

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CAU offers the opportunity to engage and re-assess service users to allow consideration of least restrictive options for on-going care. CAU has financial benefits in way of saving cost on time spent in ED awaiting review and cost for agency staff to provide 1:1 support.

The success of CAU has led to collaboration in the developpment of other acute services in London including that of the Recovery Space which offers community support for service users following discharge from hospital after an acute mental health crisis. Service user feedback has been positive and reflects the importance of the service and its suitability for its target group.

None Declared

Weight gain and metabolic disturbances are frequent in people treated with second generation antipsychotics (SGA).

We aimed to investigate the effect of SGAs on eating behaviors, cognitions and emotions, as a possible contributor to weight gain and metabolic disturbances.

A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Original articles measuring outcomes relating to eating cognitions, behaviours and emotions, during treatment with SGAs were included in this review. A total of 92 papers with 11,274 participants were included from three scientific databases (PubMed, Web of Science and PsycInfo). Results were synthesized descriptively except for the continuous data where meta-analyses were performed and for the binary data where odds ratios were calculated.

Hunger was increased in participants treated with SGAs with an odds ratio for appetite increase of 1.51 (95% CI [1.04, 1.97]; z=6.40; p<0.001)(see Figure 1.). Compared to controls, our results showed that craving for fat and carbohydrates are the highest among other craving subscales. There was a small increase in dietary disinhibition (SMD=0.40) and restrained eating (SMD=0.43) in participants treated with SGAs compared to controls and substantial heterogeneity across studies reporting these eating traits (See figure 2 and 3). There were few studies examining other eating-related outcomes such as food addiction, satiety, fullness, caloric intake and dietary quality and habits.

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Understanding the mechanisms associated with appetite and eating-related psychopathology changes in patients treated with antipsychotics is needed to reliably inform the development of effective preventative strategies.

H. Mutwalli Grant / Research support from: The Saudi Arabian Government Educational Sponsorship for PhD, J. Keeler Grant / Research support from: The Medical Research Council, S. Bektas Grant / Research support from: The Turkish Ministry of National Education for PhD training, N. Dhopatkar Employee of: South London and Maudsley NHS Foundation Trust (SLaM), J. Treasure Grant / Research support from: The National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust (SLaM), Employee of: King’s College London, H. Himmerich Grant / Research support from: The National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust (SLaM), Employee of: King’s College London.

Transsexuality is a form of gender identity, where persons experience a strong dysphoria or dissatisfaction with the original sexual organs and body they are born with, and believe that they belong to the opposite sex -- so many of such persons undertake sex reassignment surgery. Correlates of transsexuality do not suggest causality but they make it possible to better understand transsexuality and its etiology.

It has been shown by previous studies that some signs of transsexuality begin to emerge well before puberty. In our study we wanted to track how transsexual individuals develop from early childhood through adolescence and young adulthood regarding their preferred childhood games and toys, dressing and activities, later sexual partners and social responses to their trans identity.

59 persons participated as volunteers, who have applied to sex-reassignment surgery and the psychiatric evaluation necessary for the surgery, completed a spontaneously written life narrative as an argument for receiving psychiatric approval for the surgery at the Clinique of Psychiatry and Psychotherapy at Semmelweis University, Budapest, Hungary. Narratives were content-analyzed and coded regarding signs of transsexuality occurring in early childhood, elementary school-age, and puberty, conflict with friends, and family, sexual life, and love-life. All participants have signed the informed –consent form, and agreed to the scientific use of their data. The study has been approved by the local ethical committee.

Our results show that there were 24 female-to male, and 35 male-to female transsexual participants in our sample. 45.7% wanted to dress in clothes of the opposite sex in early childhood, whereas only 1.4% said that he/she did not. 41.4% befriended children who were members of the opposite sex, rather than befriending members of the same sex (4.3%), both (7.1%) or none (4.3%). As a young child 55.7% claimed that they preferred toys and games of the opposite sex, whereas 7.1% claimed they did not. The reaction of their families to signs of transsexuality or unusual behavior was supportive, rejecting, indifferent, or mixed in about equal proportion. In elementary school they befriended members of the opposite sex in 37.1% of the time, whereas they befriended members of the same sex in 1.4% of the time, and did not have friends in 22.9%. In elementary school they preferred activities included those of the opposite sex in 45.7%, and they wanted to dress in clothes of the opposite sex in 54.3% of the cases. In adolescence 10% rejected their biological sex, 40% not merely rejected, but desired the body of the opposite sex, and 25.7% was thinking about body/sex alteration procedures.

We can conclude that signs of gender dysphoria emerge in early childhood, and transsexuality may be characterized and anticipated based on such early signs by parents and care takers.

None Declared

The effect of psychotropic drugs on sexuality is difficult to evaluate because psychiatric disorders are frequently accompanied by sexual dysfunction, independently of any drug intake. However, the iatrogenic aspects of psychotropic drugs linked to their side effects should not be underestimated since they are an important cause of treatment discontinuation.

The aim is to show the type of sexual impairment observed according to the different psychotropic drugs used and the means to remedy it. Psychiatric disorders are accompanied by sexual dysfunctions which can be aggravated by psychotropic drugs, and the associated risk factors can be sought or aggravate this undesirable effect.

This is a cross-sectional study, concerning patients followed at ArRazi hospital under antipsychotic treatment. We used the “International Index of Erectile Dysfunction” scale, and the data were analyzed by SPSS software.

68% are men, Age: 71% are between 20 and 50 years old.

Marital status: 43% are single, 24% are married, 34% are divorced.

83% have a low socioeconomic level, 45% have a family history of a psychiatric disorder.

58% of patients have a substance use disorder.

38% of patients consulted for a psychotic syndrome, 23% for a depressive syndrome, 17% for a manic syndrome, 11% for a behavioral disorder, 6% for a suicide attempt.

46% of the medications are antipsychotics, 18% are antidepressants, 15% are mood regulators.

83% of the sexual disorder appeared in the first 5 years.

72% of the patients did not receive information by their doctor about this side effect.

64% of the patients informed their doctor.

32% stopped the treatment, 47% asked to change the treatment.

Careful assessment of sexual function at the initial visit followed by monitoring at subsequent visits is essential. Treatment of adverse sexual effects may be pharmacological, behavioral, complementary and integrative, or a combination of these modalities

None Declared

Understanding the way chemistry influences human communication is important since the reaction to chemosignals has many implications for science and society.

Numerous research points out that human beings are able to identify feelings of fear and happiness through smell. Such emotional information can lead to approach-avoidance behaviors or changes in affective state. Moreover, a heightened sensitivity to social odors has been shown in subjects with social anxiety symptoms. However, more detailed research on the connection between olfaction, affective psychiatric disorders and interpersonal social communication is required.

POTION is an EU funded project within the Horizon2020 initiative that aims at understanding the nature of chemosignals in humans and their sphere of influence on social interaction. Whitin this project, we conducted a preliminary study showing that individuals with social anxiety symptoms benefited from mindfulness training especially when exposed to social chemosignals. A significant reduction in anxiety symptoms was achieved with both the happiness (t(25)=4.37, p=0.029) and the fear (t(25)=4.35, p=0.031) chemosignals. Moreover, individuals exposed to the happiness chemosignal exhibit highier vagal tone compared to subjects exposed to fear chemosignals (p = 0.026), indicating overall increased well-being.

Given the exploratory nature of the preliminary study, an hypothesis driven pilot-RCT with larger sample size and refined design has been conducted. The aim was to further explore the catalyst effect of body odor on anxiety reduction. Notably, if the odor groups (happiness, fear or neutral) differ with the control group (clean air) and if they differ between each other in the outcome measure.

To this end, 96 participants with social anxiety symptoms (women aged between 18 to 35) were randomly allocated to one exposure group (happiness, fear or neutral human body odor or clean air) and followed a mindfulness intervention while being exposed to the odor. Psychological outcomes were measured before and after the intervention through the State-Trait Anxiety Inventory. During the intervention participants’ skin conductance and heart rate was also measured.

Analysis of variance will be performed to assess psychological outcome differences between and within groups, as well as interactions (GroupxTime).

Results of the study will be available and presented at the time of the congress.

This study represents an advancement in the field mental health as it explores the potential impact of using human chemosignals in the clinical setting.

None Declared

Peer support workers (PSW) and text messaging services (TxM) are effective mental health supportive services. Both interventions have positive outcomes, with TxM demonstrating clinical and economic effectiveness and PSW showing its utility within the recovery-oriented model.

To evaluate the effectiveness of combining PSW and TxM together in reducing psychological distress of recently discharged patients receiving psychiatric care.

In a prospective, rater-blinded, pilot-controlled observational design, 181 discharged patients were recruited and randomized into four conditions; TxM only, PSW only, TxM and PSW, and treatment as usual. Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), a standardized measure of mental distress, was examined at four time points: baseline, six weeks, three months, and six months. MANCOVA was used to assess the impact of the interventions on participants’ scores on four CORE-OM subscales across the three follow-up time points.

A total of 63 patients completed assessments at each time point. The interaction between PSW and TxM was predictive of differences in scores on the CORE-OM functioning subscale with a medium effect size (F1,63 = 4.19; p = 0.045; ηp2 = 0.07). The PSW + TxM group consistently achieved higher rates of recovery and clinical and reliable improvement compared to the other study groups. Additionally, the text message group and the PSW + TxM group significantly reduced the prevalence of risk of self/other harm symptoms after six months of intervention, with 27.59% (χ2(1) = 4.42, p = 0.04) and 50% (χ2(1) = 9.03, p < 0.01) prevalence reduction, respectively.

Combining PSW and TxM is effective with positive clinical outcomes for acute care patients. Incorporating the two interventions into routine psychiatric care for patients after discharge is highly recommended.

None Declared

Family caregivers can be a valuable source of knowledge and help in treating persons with mental illness during a psychiatric hospitalization and in ensuring a continuity of service between family caregivers and professionals after the discharge form a psychiatric hospital. Therefore, a family care model has been developed in order to provide professional staff members in psychiatric wards guidelines for how to collaborate with family caregivers during each stage of the hospitalization of their family member with mental illness.

To examine the impact of implementing the Family Care model in psychiatric hospitals in Israel on the family caregivers and on the continuity of care between the hospitalization and the community.

A comparative study was conducted implementing an AB design with an intervention and control groups. Seventy five persons participated in the control group and 93 in the intervention group. Questionnaires were delivered to family caregivers during the hospitalization and after the discharge from hospitalization, about the quality of collaboration of the family caregivers with the professionals during the hospitalization, about the family caregivers health and mental health, about their knowledge and ability to handle situations related to the family member with SMI and about the continuity of services between the hospitalization and the community

The findings indicate that in the intervention group comparing to the control group there was: A lower level of anxiety of the family caregivers after the discharge of their family member from the psychiatric hospital, a higher level of evaluation of the caregivers’ knowledge how to respond to the needs of the family members with mental illness, a higher level of evaluation of the quality of collaboration between the caregivers and the professional staff during the psychiatric hospitalization and a more frequent contact a between the persons with mental illness and the mental health services as well as a greater compliance with treatment after the discharge from the psychiatric hospital.

The Family-Centered care model expands the traditional boundaries of the definition of the patient in psychiatric hospitals to include the family caregivers. This model could help prevent the development of problems for the family caregivers and it could help improve the continuation of services in the community. Therefore, the findings support the implementation of this model in psychiatric hospitals.

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The impact of unhealthy lifestyle behaviors is significant in the general population, being associated with chronic physical conditions, reduced life expectancy and increased healthcare costs. This impact is higher in patients with severe mental disorders (SMD). In fact, SMD patients present higher rates of obesity, metabolic syndrome, diabetes, and cardiovascular diseases compared to the general population. The relationship between physical and mental health is multifactorial and includes side effects of many psychotropic drugs, sedentary behaviors, reduction of physical exercise, smoking, and substance abuse. Finally, illness-related factors, including cognitive impairment, reduced psychosocial functioning, social isolation, and self-stigma, can significantly impact on patients’ physical health.

This study, coordinated by the Department of Psychiatry of the University of Campania “L. Vanvitelli”, aims to test the efficacy of a lifestyle group intervention, compared to a brief psycho-educational intervention, in improving healthy habits in a real-world sample of patients with SMD.

401 patients were recruited and randomly allocated to receive the experimental or the control intervention. Inclusion criteria were age between 18 and 65 years; primary diagnosis of schizophrenia, schizoaffective disorder, delusional disorder, other psychotic disorders, major depressive disorder, or bipolar disorder according to the DSM-5; BMI≥ 25. At baseline and 6 months post-randomization all patients were administered: SCID-5, BPRS, MATRICS, MCCB, IPAQ and a questionnaire on lifestyle behaviors developed by the Italian National Institute of Health.

206 patients were allocated to the experimental group and 195 in the control one, of which 43.3% had a main diagnosis of bipolar disorder, 29.9% of psychosis and 26.9% of major depression. Patients were mainly female (57%), with a mean age of 45.6±11.8 years and with an educational level of 11.7±2.9 years. All patients were treated with at least one psychotropic drug. About 29.4% of patients reported performing physical activity regularly, while only 3.7% performed at least 75 min of vigorous physical activity per week. Patients practicing physical activity report higher levels of perceived satisfaction with the quality of life compared with non-active patients (p < 0.005). A general improvement in dietary patterns from T0 to T1 was found in patients receiving the experimental intervention. We found an increased weekly intake of fish (p < .001), vegetables (p < .05) and fresh fruit (p < .01). Moreover, we also found a reduction of junk food (p <.05) and of weekly consumption of cereals (p < .01).

Our findings show that patients with SMD can improve their lifestyle behaviors with appropriate support. There is the need to implement similar interventions clinical practice to reduce the mortality gap in patients with SMD.

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According to recent studies, there is a relationship between the parent-child attachment style and the child’s externalizing and internalizing problems. However, the parent’s maladaptive schemas were not examined in this relationship before.

We aimed to examine the relationship between parents’ maladaptive schemas, well-being, their attachment to their child, and the parent’s perception of the child’s symptoms.

In our cross-sectional, non-clinical study, 442 parents of children between the ages of 22 and 57 completed the Young Schema Questionnaire (YSQ), Experiences in Close Relationships Questionnaire (ECR), Strength and Difficulties Questionnaire (SDQ) and WHO Well-being Questionnaire (WBI-5). We conducted four mediator analyses. We chose the emotional deprivation schema subscale as the independent variable and attachment anxiety and attachment avoidance subscales as mediators, while the models differed in the dependent variables. We chose the SDQ externalizing symptoms, internalizing symptoms, prosociality subscale, and WHO well-being questionnaire as dependent variables.

The mediation analyses proved to be significant. Emotional deprivation had significant effect on the parent’s attachment anxiety (a1 = 0.01, p < .001), avoidance (a2 = 0.32, p = .002) and on the parent’s well-being (c1 = -0.12 , p < .001), while emotional deprivation was not associated with externalizing symptoms (c2 = 0.002, p = .25), internalizing symptoms (c3 = 0.001, p = .53) and prosociality (c4 = 0.01, p = .26). However, the indirect effects of emotional deprivation through attachment anxiety were significant in case of internalizing symptoms (a1b5 = 0.03 [0.02 – 0.05), prosociality (a1b8 = -0.004 [-0.01 – -0.0002]) and well-being (a1b1 = -0.017 [-0.03 – -0.005]). Furthermore, the indirect effects of emotional deprivation through attachment avoidance were significant in case of internalizing symptoms (a2b6 = 0.009 [0.002 – 0.02]) and prosociality (a2b8 = -0.007 [-0.01 – -0.0002]). While the indirect effects of emotional deprivation through attachment anxiety (a1b3 = 0.007 [-0.001– 0,02]) and avoidance (a2b4 = 0.0001 [-0.006 – 0.006]) on externalizing symptoms were not significant. The indirect effects of emotional deprivation through attachment avoidance on the parent’s well-being were not significant (a2b2 = -0.002 [-0.01 – 0.006]).

Our results - taking into account the limitations - suggest that there is a relationship between the parent’s emotional deprivation schema and the child’s internalizing symptoms, prosociality, and the parent’s well-being through the parent-child attachment pattern. Attachment style and maladaptive schema have no effect on externalizing symptoms. These results may also have practical implications.

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Recent scientific evidence confirms that employability is extremely important in mental health care. Employment promotes a healthy lifestyle and unemployment leads to a global deterioration in health. This principle is transversal to all areas of health, applying equally to people with mental illness, including serious mental illness such as schizophrenia and bipolar affective disorder.

Highlight the importance of employability in the treatment and rehabilitation process of people with mental illness.

PubMed database searched using the terms “supported employment” and “mental health” and “policies”.

Parallel to conventional psychiatric treatments, employment generates self-confidence, promotes social responsibility, a sense of belonging and, consequently, integration in the community. From an economic point of view, it brings financial autonomy to the sick person, allowing the financing of their own accommodation, the payment of proposed treatments and the enjoyment of structures and leisure activities that until then would be impossible. It is also known that patients who are employed are less likely to resort to psychiatric emergency services and have a lower rate of readmissions to psychiatric hospitals, reflecting a better ability to manage the disease. Overall, employability increases the sick person’s quality of life, not only being an effective short-term treatment, but also one of the only interventions that reduce dependence on the health system in the long term.

The treatment plan should aim for more than the suppression of symptoms.

Knowing that employment generates positive outcomes, gets that as fundamental parameter for the treatment and for the rehabilitation of the person with mental illness, and it must therefore become essential that mental health services help patients to find satisfactory jobs and that protect your needs.

Thus, mental health policies should defend a new mental health treatment paradigm and emphasize employment as an imperative measure in the treatment and psychosocial rehabilitation of the sick person, including supported employment as an essential part of treatment.

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