Research has shown that factors related with the migratory process (such as travelling alone, living away from family, and discrimination after arrival) considerably increase the risk of mental health problems in young migrants. Moreover, they are among the most vulnerable migration groups with a high risk of social exclusion.

To identify coping strategies and behavioural changes used to deal with perceived discrimination and its impact on the emotional well-being and mental health of newly arrived young migrants in Spain.

A subsample of 15 audio-recorded in-depth qualitative interviews were analysed from the national action-research Migrasalud project (II IN 190517 EN 162 FA 01). The interviews were transcribed, translated from Arabic to Spanish, and analysed through content analysis.

Most participants were males (93.3%; n=14), ranging from 18 to 20 years, and from Morocco (93.3%; n=14). All participants were from foster care placements in Barcelona and arrived to Spain as minors. Newly arrived young migrants reported that they perceived themselves as being healthy before the migratory process. Adverse experiences during the journey and discrimination after arrival impacted their well-being and mental health. Specifically, they reported perceived discrimination in their daily life due to culture, language, or origin. This negatively impacted their well-being and mental health, increasing their emotional distress response and ‘undervalued or inferior’ and ‘vulnerable’ feelings about themselves. Concerning coping with discrimination, they reported using internalised coping strategies such as ‘ignoring’ or ‘not responding’ for fear of having their legal documents revoked or not obtaining them. Their behavioural changes often occurred when they perceived unfair treatment or prejudice towards their migrant status or their socioeconomics, culture or religion. These changes were motivated by being more accepted by the local community by ‘westernisation or cultural assimilation’ and by ‘creating a good image’ of oneself and its culture.

Findings establish that the cumulative experience of post-migration stressors (such as discrimination) negatively impacts their mental health and well-being in the long term. This suggests the need for specific policies and services to address this population’s effects of post-migration risk factors. Further research is needed to explore the causes and effects of perceived discrimination on mental health more closely and to develop more targeted and effective interventions.

None Declared

Military aggression significantly worsens the mental health of the population due to losses: human, economic-financial, social-psychological, ecological. One of the negative consequences of military aggression is migration, the movement of the population within the country and outside its borders, which disrupts adaptation and leads to the formation of a wide range of psychological and mental disorders.

To study the state of mental health of internally displaced persons (IDPs) and to develop, on this basis, a system of therapy and prevention of mental disorders.

A combination of clinical-psychopathological and psychodiagnostics methods of studying were used to identify peculiarities of the mental state and various forms of mental pathology.

270 IDPs were examined. It was established that the group of IDPs is heterogeneous and includes 3 categories: 1 group of IDPs who do not have signs of mental disorders (conditionally healthy) (34.81%), 2 group of IDPs who have separate symptoms of mental disorders (risk group) (25.19 %) and the 3 group of IDPs with established mental disorders (40.00 %). The assessment of the general condition of the IDPs of the 1 group shows that they have various somato-neurological disorders and the absence of mental disorders. The assessment of the emotional state of the IDPs of the 2 group indicates the presence of various emotional disorders that include asthenic syndrome (41.18 ± 5.97) %, agripnic syndrome (45.59 ± 6.04) %, somato-vegetative syndrom (30.88 ± 5.60) %, anxiety-depressive syndrome (20.59 ± 4.90) %). That separate syndromеs do not meet the criteria of ICD-10 and were subthreshold. The general features of mental disorders in group 3 IDPs are characterized by the predominance of disorders of the anxiety-depressive spectrum and includes adjustment disorders (F43.2) in 35,18%; post-traumatic stress disorder (F43.1) in 17.59%; a moderate depressive episode (F32.1) in 16, 67%; organic affective (depressive) disorder (F06.3) in 14.81%; organic anxiety disorder (F06.4) in 9.28%; recurrent depressive disorder (33.1) in 6.48%.

A system of treatment of mental disorders in IDPs has been developed, which includes pharmacotherapy (the usage of antidepressants, anxiolytics and, if necessary, antipsychotics), cognitive-behavioral and family psychotherapy. For prevention mental disorders among IDPs of groups 1 and 2, a psychoeducational program was created, aimed at forming awareness of clinical manifestations of mental disorders, opportunities to prevent their formation, and necessary actions in conditions of exacerbation of the mental state. Evaluation of the effectiveness of the developed system of therapy and psychoeducation has testified to their effectiveness.

None Declared

The ongoing conflict in Ukraine has resulted in a significant influx of refugees seeking asylum in other countries, including Poland. Among these refugees are individuals who are struggling with mental health issues. Polish psychiatrists have stepped up to provide care for these patients, despite facing a number of challenges in the process.

This presentation aims to shed light on the experiences of Polish psychiatrists treating refugees during the war in Ukraine, highlighting the difficulties they have encountered and the strategies they have employed to provide the best possible care to their patients. The presentation also examines the impact of war on mental health, and the long-term effects on the well-being of refugees.

A questionnaire study was done among Polish Psychiatrists about the forms of support they provided for Ukrainin psychiatric patients they consulted after 24 February 2022. The responses to questionnaires were collected during psychiatric Congresses.

The most commonly reported symptoms were anxiety (44.1%), followed by depression (35.3%), and panic attacks (23.5%). Other symptoms like irritability and sleep disorders were reported by 11.8% and 8.8% of the respondents, respectively. Disturbingly, thoughts of resignation and suicidal ideation were also reported, albeit at lower frequencies (8.8% and 2.9%, respectively). A small percentage (2.9%) reported no new symptoms.

The high prevalence of anxiety and depression suggests that the war has had a profound impact on the mental health of the affected population. The emergence of severe symptoms like psychotic thoughts and suicidal ideation, although less frequent, is alarming and calls for immediate intervention. It is also noteworthy that a small but significant portion of the population reported no new symptoms, which may indicate resilience or other coping mechanisms at play.

The war in Ukraine has led to a range of new psychological symptoms among the affected populations, with anxiety, depression, and panic attacks being the most prevalent. Immediate and long-term psychological interventions are urgently needed to address these emerging mental health issues. Further research is also required to understand the resilience factors among those who reported no new symptoms.

None Declared

The neurocognitive deficit model as a characteristic of patients with borderline personality disorder (BPD) has been the focus of research for the past 20 years. However, no such studies have been performed in Russia.

The aim of the present study was to investigate the neurocognitive profile of patients with BPD.

Fifty patients with BPD (according to DSM-V criteria) in stable mental state (72% women; mean age 22.44±4.32) were examined. BPD symptom severity was assessed using the Borderline Personality Disorder Questionnaire (PBQ-BPD), which was validated in the Russian population (34 points or more indicated a higher probability of BPD diagnosis). The Brief Assessment of Cognition in Schizophrenia (BACS) was used to assess cognitive function (in order to use these data for differential diagnosis with schizophrenia spectrum disorders). The study was approved by the ethical committee of Saint Petersburg State University.

On the PBQ-BPD results, 38% of patients (n=19) scored over 34 points, despite being stable. BACS subscales T-scores (presented as median [Q1; Q3]) were within normal limits (Verbal memory - 49.81 [46.56; 53,06]; Working memory - 43.73 [38.0; 47.50]; Motor function - 44.08 [41.0; 47.25]; Coding - 45.56 [42.50; 48.63]; Verbal fluency - 48.14 [46.0; 52.0]; Tower of London test - 52.33 [47.0; 57.0]). A number of patients had low scores on the BACS subscales (T-score < 40), particularly working memory (33.3%), coding (20.8%), and verbal memory (18.8%). The BACS Composite T Score (46.02 [43.65; 48.39]) correlated with the PBQ-BPD score (32.00 [27.00; 36.00]; r=-0.316; p=0.028). To better characterize the cognitive functioning of patients with BPD, patients were divided into two groups: those who scored less than 34 on the PBQ-BPD (group 1) and those who scored more than 34 on the PBQ-BPD (group 2). Group 2 patients had a lower BACS Composite T-score (42.32 [38.06; 46.58]; 48.45 [45.87; 51.03]; p=0.009) and nominally lower mean scores on all BACS subscales, compared with Group 1 patients. We found significant differences in T-scores values on the Working Memory subscale (Group 1 - 45.0 [41.0; 49.0]; Group 2 - 38.0 [33.0; 43.5], p=0.003), Verbal Fluency (49.0 [47.25; 53.75]; 48.0 [44.0; 49.0]; p=0.047), Tower of London Test (57.0 [52.0; 57.0]; 48.0 [42.0; 57.0]; p=0.036).

Neurocognitive impairment was detected in 33.3% of patients with BPD. The dominant cognitive impairments in the patients were decreased working and verbal memory and information processing speed. The severity of BPD symptoms has been confirmed to correlate with the neurocognitive functioning of these patients.

None Declared

Most treatments for severe mental disorders involve either pharmacotherapy or psychological interventions, which show mild to moderate effectiveness and may not lead to complete remission. Physical activity (PA), effective in enhancing physical health among the general population, emerges as a potential adjunctive treatment option that can address the existing gaps.

Borderline Personality Disorder (BPD) is a severe condition associated with profound psychosocial impairment, a heightened risk of suicide, and considerable burden on informal caregivers and mental health service providers. While there is a lack of approved medications for individuals with BPD, psychosocial interventions demonstrated good efficacy. However, the implementation of these treatments is limited by the demanded extensive training for staff. No studies have investigated the effectiveness of structured PA as an adjunctive treatment for individuals with BPD.

The primary objective of this study is to assess whether the intervention group outperforms the control group in terms of improvement on a standardized assessment scale evaluating BPD psychopathology, the Zanarini Rating Scale for Borderline Disorder. Secondary objective is to assess whether the intervention group can increase and sustain higher levels of PA. We hypothesise that a structured PA program will demonstrate superior results compared to the psychoeducation control group concerning PA levels upon completion of the intervention. Additionally, we hypothesise that the intervention group will exhibit enhanced outcomes in psychopathology, functioning, and sleep.

The PABORD Randomized Controlled Trial is designed for female outpatient individuals diagnosed with BPD aged 18-40 years. This trial will involve two distinct groups: (i) an intervention group (25 participants) that will engage in a 12-week structured PA program under the supervision of a sports medicine physician; (ii) a control group (25 individuals) that will undergo a 12-week psychoeducation program focused on PA and diet.

Patients are assessed at three different time points. Standardized assessments include psychopathology, psychosocial functioning, sleep, menstrual cycle and nutrition data. Measurements are taken on the amount and intensity of PA and sleep patterns using a biosensor device (Actigraph GT9X), dynamometric measures and BMI. Biomarkers and hormonal cycles are examined through the collection of plasma and saliva samples.

The trial is financially supported through donations (5x1000 fund), and has been submitted to the local Ethics Committee for approval. The trial registration process is also currently in progress.

Not yet available.

The study will provide new knowledge which may enhance our treatment options with patients suffering from BPD.

None Declared

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition marked by difficulties in attention, hyperactivity, and impulsivity. Its subtypes—predominantly inattentive, predominantly hyperactive-impulsive, and combined—vary in symptom presentation and impact on daily functioning. Understanding these subtypes is crucial for tailored interventions and support.

Our aim is to clinically characterize the psychopathological aspects of the subtypes of ADHD.

Our study is conducted on patients (>18 years) referred to the adult ADHD outpatient service of the Psychiatric Clinic of Ancona (Università Politecnica delle Marche, Italy). The Diagnostic Interview for ADHD in adults (DIVA 5.0) was used for diagnosing ADHD. The following rating scale were administered: Temperament Evaluation in Memphis, Pisa and San Diego (TEMPS-M), and Temperament and Character Inventory-Revised (TCI-R).

76% (n=170) of all screened patients were diagnosed with ADHD in adulthood. 57.6% (n=98) were diagnosed with ADHD combined subtype, 35.3% (n=60) with ADHD inattentive subtype, and 7.1% (n=12) with ADHD hyperactive subtype. Only 12.9% (n=22) were diagnosed with ADHD in childhood. Based on the results obtained at TEMPS-M, 43.8% (n=32) of patients were found to have cyclothymic temperament. Subjects with ADHD combined subtype scored significantly higher mean on the irritable temperament subscale of the TEMPS-M than those with ADHD inattentive subtype (p=0.016), while patients with ADHD inattentive subtype had a significantly higher mean score on the disorderliness subscale of the TCI-R than those with ADHD hyperactive and combined subtype (p=0.010). Given the logistic regression analyses using the TCI-R, developing an inattentive type of ADHD is negatively predicted by the disorderliness subscale of the TCI-R (exp(B)=0.788, IC95%=0.669-0.929, p=0.005) and positively predicted by the extravagance subscale of the TCI-R (exp(B)=1.104, IC95%=1.009-1.208, p=0.031), the hyperactive subtype of ADHD is negatively predicted by the fatigability subscale of the TCI-R (exp(B)=0.775, IC95%=0.597-1.005, p=0.055) and the combined subtype that is positively predicted by the disorderliness subscale of the TCI-R (exp(B)=1.140, IC95%=1.011-1.287, p=0.033). Regarding temperament, through a logistic regression analysis, the inattentive subtype of ADHD is negatively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=0.904, IC95%=8.39-0.974, p=0.008), while for the combined subtype of ADHD it is positively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=1.088, IC95%=1.014-1.167, p=0.019).

The results show that irritable temperament is a predictor for the inattentive and combined subtype, but with different polarities. In addition, how different patterns of personality are specific to the various subtypes of ADHD are highlighted.

None Declared

Borderline personality disorder is a severe mental disorder characterized by generalized instability of emotional regulation of interpersonal relationships and self-image, and marked impulsivity. Several features of this disorder are likely to be associated with problematic sexual health, such as impulsivity (impulsive sexual behavior), identity disorders (unstable sexual identity) and unstable and intense interpersonal relationships. In addition, childhood sexual abuse and violence are common in people’s histories.

Assessing sexuality in patients followed for borderline personality disorder at Arrazi Salé psychiatric hospital.

This is a descriptive cross-sectional study using a questionnaire including socio-demographic criteria with a questionnaire on sexual behavior in female patients followed for borderline personality disorder at the Arrazi Salé psychiatric hospital. Inclusion criteria: women over 18 years of age diagnosed with borderline personality disorder. Exclusion criteria: psychosis, intellectual disability.

We collected 45 patients with borderline personality disorder. The average age was 22, 80% were single, 58% unemployed, 46% had dropped out of high school. The majority of participants were using psychoactive substances. 25% had attempted suicide. 83% were victims of childhood sexual abuse. The majority were significantly more likely to engage in sexual activity at a younger age than their peers. Over 60% had never used contraception 10% had their first pregnancy at a younger age, with termination. 15% have had genital infections. 53% were attracted to both sexes, and over 66% had more than one sexual partner. Over 73% did not experience sexual satisfaction (sexual satisfaction scale less than 10).

The results indicate that sexuality in patients with borderline personality disorder is present early in the course of the disorder, often at a young age, with significant physical, mental and social consequences. Primary care mental health, sexual health and sexual assault services need to be attentive to the clinical diagnosis of this personality disorder, as the nature of the disorder represents both a risk factor and a health threat.

None Declared

Borderline Personality Disorder (BPD) is a chronic personality disorder characterized by emotional and interpersonal instability, difficulty in mentalization, impulsivity with functional impairment and increased rates of comorbid mental disorders. Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in premenopausal women, with important impact on quality of life and mental health. Studies have begun to explore the eventual relationship between these two pathologies.

The authors aim to describe the existing evidence exploring the relationship between BPD and PCOS as well as explore eventual common causal pathways and the forms which one might influence the other.

The authors describe a clinical case of a 31 year old female patient with history of borderline personality disorder and polycystic ovary syndrome presenting with hyperandrogenism and hirsutism as well as menstrual irregularities. As a compliment to the case, the authors conducted a brief non-structured literature review using articles published in the Medline/Pubmed, ScienceDirect and Google Scholar databases. The keywords used during the research, alone or in combination, included: Polycystic ovary syndrome and Borderline Personality Disorder. The studies consulted in this work included: cross-sectional studies, cohort studies, literature reviews and clinical case reports. Of these, those that were written in the English language and deemed most pertinent to the explored theme were chosen for review in this work.

The results demonstrate a paucity in the literature with only 10 articles having been published between 2009 and 2023 having dedicated studies and research to the relationship between the pathologies. One study reports that those with PCOS show relevant psychiatric disorders in comparison to controls, including personality disorders, such as is demonstrated in the described clinical case. Of the few case studies available, these found that BPD was associated with PCOS with the latter having most frequently been diagnosed previously to the personality disorder. Altered androgen metabolism has been described in both these pathologies, thus further strengthening the relationship between these.

Hormonal fluctuation has been classically associated with psychopathological symptoms, including unstable mood and impulsivity. The alterations demonstrated in PCOS might serve as an exacerbating factor in the genesis of the emotional instability and other symptoms present in BPD. The literature on this topic is still in an embryonic phase with a clear lacuna existing which merits attention and further study so as to fully comprehend the potential of these comorbid states. Clinicians should remain attentive to this comorbidity and the influence that PCOS might have on the psychopathology of BPD so as to better quality of life and global functioning which is impacted in both.

None Declared

Non-suicidal self-injury (NSSI) is defined as any deliberate destruction of one’s body tissue, engaged in for reasons that are non-suicidal. Online platforms, notably social media, witness a surge in NSSI-related content, amplified by the COVID-19 pandemic. Young individuals increase video and post uploads, prompting scholarly inquiry into the impact on vulnerable demographics in the online environment. Despite potential benefits, concerns surface regarding content reinforcing self-injurious behavior. The Blue Whale phenomenon exemplifies serious consequences in this digital landscape.

The present study aims at screening the prevalence of NSSIs on SNS among Italian young people.

An observational cross-sectional study was conducted by recruiting 373 Italian young people (aged 18-25). Bergen Social Media Addiction Scale (BSMAS), Fear Of Missing Out Scale (FOMO), Inventory of Statements About Self-Injury (ISAS) were administered to investigate the relationship between NSSIs, social media use and frequency and underpinned motivations.

Overall, 99.7 % (n=372) of participants declared to have used at least one social network. Around 92.5 % (n=345) declared to know Blue Whale Challenge and more than half of the sample (51.5%) referred to have looked for NSSI contents on SNS, mostly (28.7 % (n=107)) have sought for curiosity, 17.7 % (n=66) have sought for help/support. 53.4 % (n=199) of the sample was found to have problematic social media use (PSMU) according to BSMAS. 85 % (n=317) have committed self-injurious gestures in the past, 66.2 % (n=247) practice NSSI currently, most subjects practice them to vent 51.7% (n=193), calm themselves 41.6% (n=155), and punish themselves 30% (n=112). The mean age of transgender and nonbinary subjects (30 % n=112)) who sought/saw content pertaining to NSSIs appears to be lower (p=0.033) than cisgender subjects. Those who searched for content inherent to NSSIs scored higher mean scores on the FOMO (p=0.022) and BSMAS (p=0.013) scales. Those who follow social pages inherent to NSSIs scored higher on the FOMO scale (p=0.035). Subjects who practice NSSIs at their present state, on average, have higher scores on the FOMO and BSMAS scales (p=<.001). Linear regression analysis was conducted showing an association between BSMAS and FOMO (R²=0.199, B=0.260; F(1.371)=92.334; p=<.001). Logistic regression analyses were conducted to define the effects of FOMO, PMSU, sex, and NSSI search on the development of self-injurious conduct. The logistic regression model was statistically significant, χ2 (1)=3.909; p=0.048.

The study examines NSSI behaviors among young Italian college students on digital platforms, particularly social networks. It stresses the critical need for targeted interventions, addressing concerns like social media addiction, to provide essential mental health support and foster a safer online environment for this population.

None Declared

BPD is a common and severe mental health condition. Longitudinal studies related to BPD show a reduction of symptoms related to the disorder but very little improvement in functionality. The betterment of executive functions of people with BPD after psychotherapy is very limited. The efficacy of those treatments on functionality appears to be mild with a small effect size. Based on previous studies, transcranial direct current stimulation (tDCS) can be used to improve impulsivity and emotional instability in patients with BPD. Moreover, cognitive remediation focuses on reducing neuropsychological alterations by re-educating patients and apply specific strategies to aid them long term on certain daily functions like developing healthy habits, executive functions, problem solving, attention, working memory and cognition.

Our objective is to assess the feasibility and efficacy of the tDCS and cognitive remediation on BPD symptoms and functioning.

The open study includes 10 daily sessions of tDCS for 2 weeks and 8 weekly group meetings for the cognitive remediation. Based on studies conducted on people with BPD, the settings for the tDCS are as follows; 20 minutes of continuous current at the intensity of 2mA and the electrodes are placed on specific stimulation sites related to impulsivity. To verify the effectiveness of the combination on the symptoms and evaluate the cognition and functionality of the patients, questionnaires at neuropsychological texts are conducted at the beginning of the study, after the tDCS, after the cognitive remediation and 3 months after the end of the study. The expected results of this study are that the combination of the two treatments will reduce the symptoms of BPD and improve executive functions compared to the treatment as usual or tDCS alone. This study would allow the implementation of an efficient and low-cost first-line treatment and a better functional progression of BPD patients.

The expected results of this study are that the combination of the two treatments will reduce the symptoms of BPD and improve executive functions compared to the treatment as usual or tDCS alone. This study would allow the implementation of an efficient and low-cost first-line treatment and a better functional progression of BPD patients.

This study would allow the implementation of an efficient and low-cost first-line treatment and a better functional progression of BPD patients.

None Declared

The Personality Inventory for DSM-5 (PID-5) is an instrument that aims to assess pathological personality traits according to the alternative model proposed by the DSM-5. To validate the comparison of an instrument’s scores between different groups, it is necessary that the measure’s invariance be attested, in order to guarantee that the same underlying constructions are being evaluated between the groups. Differences between sex in relation to the predominance of adaptive personality traits were portrayed in previous studies, a fact that seems to be related to culture.

This study aims to assess whether the PID-5 presents structural equivalence between sex (sex measuremet invariance) and whether there are differences between pathological personality traits in Brazilian men and women.

A community sample of 1110 subjects was assessed (71.2% women, mean age 34.6 (±15.8) years, 68.8% higher education). They were recruited through advertisements in different media and by the “snowball” method. Participants responded to the PID-5 in person. The cross-culturally adapted version into Brazilian Portuguese was used

The PID-5 showed that its structure was invariant for sex at the configural level (CFI= 1.000; TLI=1.007; RMSEA<0.001), metric (ΔCFI=0.01; ΔTLI= 0.02; ΔRMSEA=0.02) and scalar (ΔCFI=0.006) ; ΔTLI= 0.006; ΔRMSEA=0.004), allowing comparisons. Regarding the domains evaluated by the PID-5, men showed more traits of Distancing, Antagonism, Disinhibition and Psychoticism (p<0.002), while for Negative Affectivity there were no differences between genders (p=0.06). In terms of facets, women showed higher indicators of lability, anxiety and impulsivity (p<0.01), while men showed perseverance, withdrawal, restricted affectivity, manipulation, dishonesty, grandiosity, attention seeking, insensitivity, irresponsibility, exposure to risks, unusual beliefs and eccentricity (p<0.04).

The findings reinforce the validity evidence of the DSM-5 trait model, which, through the PID-5, similarly evaluates such aspects between sex. Differences between genders were observed in relation to pathological personality traits, which bear similarities with differences observed in terms of adaptive personality traits. Specificities are observed at the cultural level, when, for example, the findings are compared with a Japanese university sample, reinforcing the role of culture at this level

None Declared

Negative symptoms are a key aspect of schizophrenia, significantly impacting a patient’s functioning and quality of life. These symptoms are deemed predominant when they dominate the clinical picture and positive symptoms are only minimally present. As articulated in the most recent guidance by the European Psychiatric Association, including self-report measures is encouraged in negative symptom studies as they can further complement the observer-rated scales when assessing negative symptoms of schizophrenia.

The objective of the poster is to compare the views of patients vs. doctors regarding predominant negative symptoms during a 1-year observational study.

This was a 1-year-long, prospective, multicentric cohort study with three visits after baseline at 3, 6 and 12 months. Adult outpatients with a schizophrenia diagnosis according to the International Classification of Diseases 10th edition who exhibited predominant negative symptoms according to clinical judgement were included. Patients received pharmacological and some non-pharmacological treatment as usual.

The primary outcome measure was the modified Short Assessment of Negative Domains (m-SAND), an anamnesis-based scale that is composed of 7 items: two positive items (delusions and hallucinations) which make the m-SAND Positive sub-scale (m-SAND-P) and five negative items (anhedonia, alogia, avolition, asociality and affective flattening) which make the m-SAND Negative sub-scale (m-SAND-N) Each item is rated from 0 to 5 (not observed; mild; moderate; moderately severe; severe; and extreme). Other measurements included the Self-evaluation of Negative Symptoms (SNS), a validated scale that provides meaningful information regarding the patients’ own perception of their negative symptoms.

Least squares (LS) means were calculated for the change from baseline to final visit using a mixed model for repeated measures (MMRM).

188 patients were included in the study. The mean age was 39.8 years and 65% of patients were men. The mean duration of illness was 12 years. At baseline, patients rated alogia and apathy (mean SNS score: 5.7) to be the most severe and then asociality (5.5). In contrast, doctors found affective blunting (mean m-SAND total score: 4.3), apathy (4.2) and anhedonia (4.0) to be the most severe.

After the end of the observational period all negative symptom sub-domains improved significantly according to both the patients’ and doctors’ views. The latter group reported -1.9 LS mean change from baseline in apathy, -1.8 in anhedonia, and -1.7 in asociality (all p-value <0.0001). Patients felt most change in alogia and asociality (-2.7), and apathy and anhedonia (-2.4).

In summary, both patients and doctors reported significant improvement in predominant negative symptoms. Nonetheless, there were some differences how they perceived severity and change in the specific domains.

J. Dragasek: None Declared, Z. Dombi Employee of: Gedeon Richter Plc., K. Acsai: None Declared, V. Dzurilla Employee of: Gedeon Richter Plc., Á. Barabássy Employee of: Gedeon Richter Plc.

A clinical case is presented of an 18-year-old woman diagnosed with Dandy-Walker malformation, who is admitted to an Acute Inpatient Psychiatry Unit due to atypical psychotic symptoms, pseudology and aggressive behaviour. After several medication trials, there is a partial response observed with low doses of clozapine, consolidating the improvement afterwards, being referred to an open-door community mental health center because of poor family and social network.

Review clinical information about Dandy-Walker malformation and the development of psychiatric disorders, specifically psychotic symptoms, pointing out the peculiarities regarding clinical presentation and treatment management.

Search in the medical database PUBMED, MEDSCAPE and UPTODATE. Keywords: “Dandy-Walker Syndrome”,” Psychotic Disorders”.

The Dandy-Walker syndrome consists on a cystic dilatation of the fourth ventricle, an abnormally high tentorium and the agenesis of the cerebellar vermis. Cerebellar structures are involved in cognitive, emotional and behavioural processes. This syndrome is related to the development of psychotic and affective disorders, as well as obsessive-compulsive disorder. The clinical presentation is usually atypical, being characterised by an early onset, a family history of psychosis and a high prevalence of cognitive deficit and borderline intelligence. There are no specific drugs recommended for the treatment of these patients, which present a high rate of refractoriness to antipsychotic treatments, together with a greater sensitivity to its side effects. Depending on the clinical presentation it is advisable to focus on the most relevant symptoms to be treated and potential side effects in order to reduce polypharmacy.

Image:

• - The Dandy-Walker syndrome is related to a higher risk of psychiatric disorders

• - Clinical presentation is usually atypical and in early stages

• - There is a high rate of refractoriness and greater sensitivity to treatments

• - A specific pharmacological treatment is not recommended and it is recommended to avoid polypharmacy

None Declared

In Italy, it was recently estimated that the total economic burden for schizophrenia is € 2.7 billions, of which around 50% is derived from direct costs and 81% of these are due to hospitalization, residential facilities and semi-residential facilities, whereas only 10% of direct costs is derived from pharmacotherapy (Marcellusi et al. BMJ Open 2018; 8, e018359). Considered the high economic burden that schizophrenia has on healthcare systems (estimated to be between 1.4 % and 3 % of the total), a better characterization of the clinical variables that mostly influence the costs represent a topic of great clinical interest (Altamura et al. 2014 Official Journal of the Italian Society of Psychopathology 2014; 20, 223–243).

The aim of this study was to analyze whether duration of illness has an impact on the costs derived from the use of services (which account for the majority of the direct costs) in a cohort of subjects living with schizophrenia spectrum disorders (SSD).

A total of 496 subjects receiving treatment from the Community Mental Health Centers (CMHC) of Brescia (Italy) were included in the study: for each patient demographic data, data regarding the duration of illness (in months), and data related to the use of service between January 1st, 2022 and December 31st, 2022 were derived from the regional database of mental health (“SIPRL”). Data on the use of service were then converted to costs using the regional rate tables for outpatient services, residential and semi-residential facilities, and the Diagnosis-Related Groups (DRG)-driven rate tables for hospitalization data. Partial correlations analyses were performed between duration of illness, corrected for age, and cost-related variables. All analyses were performed through SPSS v28 and p values <0.05 were considered significant.

A higher duration of illness was correlated with higher costs for outpatient non-pharmacological interventions (p=0.010), for residential facilities (p=0.025) and total costs, both including and excluding hospital admissions (p=0.005 and p=0.007, respectively), but not with hospitalization costs (p=0.773).

The total expenditure for people living with SSD is higher for people with a longer duration of illness. These findings raise an important issue, which is that the mental health system in Italy invests more in subjects with a longer history of disease: this is in contrast with the international guidelines which prompt to intervene early in the course of the disease in patients living with SSD with outpatient rehabilitation interventions.

None Declared

There are studies showing that the systemic inflammation response in patients diagnosed with schizophrenia is different from healty controls. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (TLR), monocyte-lymphocyte ratio (MLR), monocyte-HDL ratio (MHO) and systemic immune inflammation index (SII) have recently been used as inflammation indicators.

NLR, TLR, MLR, MHO and SII have been evaluated in many studies in schizophrenia patients. The aim of our study is to evaluate the relationship between NLR, TLR, MLR, MHO, SII values and antipsychotic treatments of patients diagnosed with schizophrenia.

203 individuals diagnosed with schizophrenia who were followed up in the psychotic disorders outpatient clinic of Selçuk University Faculty of Medicine were included in the study. Neutrophil, lymphocyte, platelet and monocyte counts and HDL values were obtained retrospectively from blood tests. NLR, TLR, MLO, MHO and SII were calculated. The study approved by the ethics committee of Selçuk University Faculty of Medicine.

45.3% of the patients were female (n = 92); the mean age was 45.8±14.0. The average number of hospitalizations was 3.0±2.7 years; the mean disease duration was 17.0±9.6 years. 56.7% (n=115) use long-acting antipsychotic treatment, 21% (n=43) use monthly paliperidone long-acting (PP1M) treatment, and 14.8% (n=30) use 3-month paliperidone long-acting (PP3M) treatment. No significant difference was observed in NLR, TLR, MLR, MHO and SII values between individuals using and not using long-acting antipsychotics. However, a significant difference in NLR value was observed between PP1M and PP3M treatment (p = 0.039). Oral antipsychotic use was 71% (n=137), 19% (n=38) used clozapine monotherapy, and 25% (n=51) used non-clozapine oral monotherapy. No significant difference was detected in inflammatory markers between clozapine monotherapy and other oral monotherapies.

According to our findings, NLR levels in patients diagnosed with schizophrenia were found to be significantly higher in those using PP1M treatment compared to those using PP3M. This finding can be interpreted in favor of the fact that PP3M contributes to the reduction of inflammation due to its longer duration of action compared to PP1M. It is thought that schizophrenia progresses through inflammatory processes and antipsychotic treatments play a role in anti-inflammation. It is envisaged that future studies may be helpful in evaluating the onset, exacerbation and remission periods of the disease, including treatment doses and durations, and revealing the relationship between inflammatory markers and schizophrenia disease and the effects of antipsychotic treatments on inflammatory markers such as NLR, TLR, MLR, MHO and SII.

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Schizophrenia is affecting multiple functions such as cognition, perception, emotion, and social behaviors, and it has also been shown to influence artistic works created by patients. Among the deviations observed in the art works are distinct characteristics like delusional themes, disordered shorter lines, and unique creativity. Such features, along with altered pictorial perceptions and possibly altered motoric function, suggest that it might be possible to differentiate art made by schizophrenic patients from that of healthy individuals. Given the shortcomings of existing diagnostic methods being very long and with a 25% error rate, we proposed a novel neural network model that leverages these artistic markers for classification to support diagnosis.

To develop and train a neural network model leveraging unique artistic markers for the classification and support of diagnosing schizophrenia.

Our study involved 764 participants, 45% diagnosed with schizophrenia, while the others were either healthy or diagnosed with other mental disorders. The average age of the participants was 38.25 years (SD=13.43), and 43.88% of the participants were females. All participants were instructed to draw eight drawings of human faces. These drawings were digitized and categorized based on participants’ schizophrenia status to form the initial training dataset for our model. This data was processed using Python and converted into a NumPy array, which served as input for our model developed using the Keras library. The structure of the model is presented (Image 1).

We used area under curve (AUC), specificity, and sensitivity as key evaluation metrics for our model. The model achieved an AUC of 0.90 on a test dataset that was new to the model and was not used in the preceding training phase. It exhibited a sensitivity of 0.84 and a specificity of 0.85, indicating its capacity to identify schizophrenic and non-schizophrenic individuals, respectively (Image 2).

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The application of machine learning and AI tools to analyze art created by schizophrenia patients, can offer a promising methodology for exploring the differences between schizophrenic and healthy individuals, as well as a possible support for current diagnostic methods. This approach has the potential to provide an additional fast and more accurate diagnosis, enhancing individualized patient care. Future research will focus on refining and validating the model across diverse populations and various art forms.

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The Athens Multifamily Group Therapy Project (A- MFGT) aims to provide systemic multifamily therapy to youths who experienced a first psychotic episode and their families.

Family interventions have been shown to reduce the likelihood of relapse for individuals across the spectrum of psychosis and are recommended in practice guidelines for psychosis internationally (Mc Farlane, 2016).

A group of 22 young adults who presented a first psychotic episode participated with their families to multi-family group systemic therapy, after discharged from in-patient treatment. Sessions were conducted by three therapists twice a month, for nine months and supervision meetings were provided once a month. Six groups of families have been conducted since 2017. Clinical outcome was assessed through PANSS at baseline, one month later after patient’s discharge from in-patient treatment, and one year after, at the end of the multifamily group treatment. Time intervals till relapse were also assessed. Participants’ clinical findings were compared with findings from a matched group of 42 patients who did not attend the multifamily therapy program and were treated as usual.

Two-way mixed ANOVA was conducted to assess PANSS scores change over time (t1: at base line, t2: at one month and t3: one year), while differences were investigated between the two groups of patients and interactions were checked. Regarding PANSS-positive scale and PANSS-general scale, no differences were found between the two groups in neither of the three time points. Regarding PANSS-negative scale, patients attending MFGT presented statistically significantly lower scores in t3 than patients treated as usual, but not in t1 and in t2 (i.e., prior to therapy). Moreover, both patients’ group showed improvement from t1 to t2, but only patients attending MFGT further improved from t2 to t3. Among patients attending MFGT, two (9.1%) had a relapse compared to nine (22.5%) of the patients treated as usual, however this comparison did not reach statistical significance (p = 0.300).

In term to provide early intervention in psychosis, A-MFGT seems to be a viable way to support the patient as well as the whole system facing psychosis, with the aim of preventing relapse and improved quality of life for all the participants.

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Patients diagnosed with schizophrenia, particularly those with severe negative symptoms (NS) and treatment resistant schizophrenia (TRS), have poorer oral health than the general population, which can have serious consequences beyond oral and dental problems, but remains poorly addressed in psychiatric clinical practice and mental health research.

To investigate the association between oral health-related subjective quality of life (OHR-sQoL) and severity of NS in TRS.

We conducted a cross-sectional study in a tertiary psychiatric clinic in Croatia during 2022-2023. The target population were patients diagnosed with TRS with more pronounced NS. The outcome was the Self-Evaluation of Negative Symptoms (SNS) scale and its five dimensions. Exposure was OHR-sQoL measured by the Oral Health Impact Profile questionnaire (OHR-sQoL). We tested the hypothesis using multivariable linear hierarchical regression analysis.

We enrolled 130 participants with a median (interquartile range) age of 43 (36-51) years, with an equal number of women and men. Total SNS and OHR-sQoL scores were found to be significantly associated in both bivariate and multivariable analysis adjusted for a large number of covariates (R2 increase over the effect of covariates = 0.22; p < 0.001; false discovery rate < 5%). Total SNS score was significantly associated with the functional limitation dimension of the OHIP-49, as well as diminished emotional range with psychological discomfort, physical and psychological disability, and anhedonia with functional limitation.

Figure 1. Scatter plot of the correlation between the total score of the Self-evaluation of Negative Symptoms (SNS) and the Oral Health Impact Profile (OHIP-49); the solid line represents the 80% smoothed local polynomial regression curve; the dashed line represents the linear regression line (n = 130)

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NS of TRS are relatively strongly associated with OHR-sQoL, especially with functional limitations. The robustness of this association was confirmed by controlling for a large number of covariates. If the relationship between NS and OHR-sQoL is bidirectional, which should be verified by future studies, perhaps for further progress in solving the serious problems of NS and TRS it will be necessary to include the comorbidity with oral diseases and oral functional disorders and OHR-sQoL.

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Schizophrenia is a complex psychiatric disorder in which biological sex differences, have been extensively documented and researched. What is less well described, is what motivates these differences. Of the various proposed and explored reasons, estrogen appears to be one that has maintained some interest and promise. An increase in symptoms of schizophrenia has been observed to correspond with decreasing levels of estrogen in menopausal women, this, allied to the later symptom onset, culminated in the interest in this hormone and its role in psychotic illness.

The authors aim to briefly explore the current evidence on the association between estrogen and schizophrenia. Its relevance in symptom onset, protective status and eventual therapeutic applications will also be discussed.

The authors conducted a brief non-structured narrative literature review using articles published in the Medline/Pubmed, ScienceDirect and Google Scholar databases. The keywords used during the research, alone or in combination, included: sex hormones, estrogen, schizophrenia and psychiatry.The studies consulted in this work included: cross-sectional studies, cohort studies, literature reviews and clinical case reports.

The literature exploring the relationship between the sex hormone, estrogen, and schizophrenia is extensive. Various studies confirm that during periods of estrogen withdrawal, women appear more susceptible to psychotic episodes. Results also demonstred that those with low estrogen, respond poorly to anti-psychotic drugs, whereas estrogen increased the efficiency of antipsychotics. In regards to symptoms, estrogen has been demonstrated to reduce the positive and cognitive symptoms of schizophrenia in the short term, thus being proposed as an eventual complementary treatment in those suffering from the disorder. It is known that estrogen regulates important pathophysiological pathways in schizophrenia, including dopamine activity, mitochondrial function, and the stress system.One of the explanations for this beneficial effect has been proposed to be action on cerebral blood flow and glucoce metabilism, as well as sensitizing postsynaptic dopamine receptors, thus serving as a protective agent against schizophrenia.

The research appears to be pointing in the direction that estrogen appears to have an effect on psychosis in women, serving as a protective factor in these conditions as well as playing a significant part of the pathophysiology in schizophrenia. This influence on the pathophysiology, promises clinical pertinence, not only in a possible application so to attenuate positive and cognitive symptoms but also as a method to influence antipsychotic efficacy. Continued study in regards to the effects of sex hormones on the psychotic disorders is merited so as to further expand the tools in the mental health professional’s repertoire in the treatment of these serious mental illnesses.

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Recent research has identified varying levels of burnout among teachers, particularly those in training. This condition is believed to be influenced by a combination of internal factors, such as psychological characteristics, and external factors, such as work-related pressures and the social environment.

We examined the prevalence of burnout syndrome and assessed the potential risk factors associated with this condition. This study investigates the complicated correlation between academic burnout and interpersonal connections among trainee teachers in Morocco.

We used a comprehensive database generated from the Maslach Burnout Inventory-Student Survey (MBI-SS), a questionnaire designed specifically for this study, and validated for this context. We examined various dimensions of academic burnout to unravel the complexity of this connection. Our study analyzed individual, professional, and social factors within a cohort of 732 prospective teachers in Morocco during the 2021/2022 academic year.

The findings revealed an intricate network of interrelated factors that contributed to the occurrence of academic burnout among trainee teachers. Significantly, the study highlighted the impact of interpersonal relationships on academic burnout. Trainee teachers who received support and positive interactions from colleagues and superiors showed significantly lower levels of academic burnout. Interpersonal relationships within the educational community also played a pivotal role in preventing burnout. Moreover, our multivariate analysis showed that certain sociodemographic factors,including age, gender, and prior educational experience, moderated the influence of interpersonal relationships on academic burnout.

This study significantly contributes to the comprehension of academic burnout in trainee teachers by emphasizing the vital role of interpersonal relationships in this context. The findings emphasize the necessity of interventions that enhance interactions within educational institutions to prevent academic burnout and promote a healthy learning environment for trainee teachers.

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