Depression is a pervasive and debilitating mental health disorder that affects millions of individuals worldwide. Despite the availability of various treatment modalities, a significant proportion of patients continue to experience inadequate symptom relief and persistent emotional suffering. Sleep disturbance is a common symptom of depression, and emerging evidence suggests that manipulating sleep patterns through sleep deprivation may hold potential therapeutic benefits. This literature review aims to explore the role of sleep deprivation as an adjunctive treatment for depression, shedding light on its mechanisms and potential outcomes.

To investigate the historical context and theoretical underpinnings of sleep deprivation in depression treatment; to examine the methods and protocols used in studies involving sleep deprivation as a therapeutic intervention for depression; to analyze the empirical evidence regarding the efficacy of sleep deprivation in ameliorating depressive symptoms; to assess the safety and feasibility of implementing sleep deprivation in clinical practice; to discuss the potential mechanisms underlying the antidepressant effects of sleep deprivation.

A systematic review of the literature was conducted.

The review identified a diverse body of literature exploring the potential benefits of sleep deprivation in depression treatment. Preliminary findings suggest that acute sleep deprivation may lead to rapid and transient improvements in mood among individuals with depression. Various protocols, including total and partial sleep deprivation, have been investigated, demonstrating differential effects on depressive symptoms. Additionally, potential mechanisms underlying these effects, such as alterations in neurochemical pathways and circadian rhythms, have been proposed.

Sleep deprivation as an adjunctive treatment for depression is a promising but complex intervention that requires further investigation. While some studies have reported significant improvements in mood following sleep deprivation, the sustainability of these effects and the potential long-term consequences remain uncertain. Moreover, the optimal protocols, safety guidelines, and patient selection criteria need to be established for clinical application. Future research should focus on elucidating the mechanisms involved and conducting well-designed randomized controlled trials to determine the efficacy and safety of sleep deprivation in the context of depression treatment. This review underscores the importance of considering sleep as a modifiable factor in the comprehensive management of depression.

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There is a growing interest in understanding the impact of duty hours and resting times on training outcomes and the well-being of resident physicians. Psychiatry resident’s duty hours in Spain comprise a regular working schedule of 37.5h per week and a minimum of 4 mandatory on-call shifts. The most recent duty hours regulations in Spain were transposed from the European Working Time Directive (EWTD). According to Spanish Law, doctors cannot work for more than 48h per week and need to have resting times per day (at least 12h), per week (at least 36h) as well as annual leave (at least a month). However, there is practically no data on this situation in psychiatry resident physicians.

Our aim is firstly, to describe the number of shifts performed by psychiatry resident physicians in Spain. Secondly, to describe compliance with the daily and weekly rests compared to those set in national and European law. Finally, to analyse the difference by demographic variables (gender and year of residency), in both the number of on-call duty shifts and compliance with rests.

A descriptive cross-sectional study was designed through an online survey adapted from the existing literature. The target population were Spanish psychiatry resident physicians undergoing PGT who started their specialist training during the years 2018–2021. The survey was disseminated through the Spanish regional medical councils to all active psychiatry resident physicians by mail as well as through informal communication channels. The study was authorised by the Spanish Medical Organization’s General Assembly which is the highest ethical and deontological body of physicians in Spain.

55 responses were obtained, of which 61.82% identified as females. The mean number of on-call shifts in the last 3 months was 14.05. This mean was highest in women 14,32 and in the cohort of 2020 15.46 (first year of residency). Among the resident physicians surveyed, 66.07% exceeded the 48h per week limit set by the EWTD and 7% of them did not rest after a 24-h on-call shift. Furthermore, 22% of respondents did not have a day-off after a Saturday on-call shift. The mean working hours when not resting after an on-call-shift were 7 hours. The comparison by gender and year of residency of the main variables can be seen in figures 1 and 2 respectively.

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Image 2:

Psychiatry resident physicians in Spain greatly exceed the established 48 h/week EWTD limit. Likewise, non-compliance with labour regulations regarding mandatory rest after on-call duty and minimum weekly rest periods are observed. Differences can be seen by gender and year of residency. The situation described could potentially create a high-risk situation for the health and psychosocial well-being of resident physicians, hinder learning outcomes and could lead to suboptimal patient care.

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There are differences in clinical presentation with and without insomnia in MDD, and it is expected that there are brain biological differences that contribute to this, but functional MRI studies of MDD with insomnia vs MDD without insomnia are scarce. In particular, few studies have examined resting state functional connectivity (RSFC) seeding the habenula and septal nuclei, which play key roles in both mood and sleep.

The purpose of this study is to determine whether there are differences in habenula and septal nuclei and RSFC in the presence or absence of clinically significant insomnia in patients with MDD.

To identify the effects of insomnia in MDD group, one-way ANCOVA covariate control was used to compare differences of RSFC between MDD_w/INS and MDD_wo/INS group. The potential confounders (i.e., age, sex, education years, and total score of HDRS-17) were adjusted in this analysis. To examine the relationship between RSFC and clinical sleep questionnaires (i.e., ISI and PSQI) in the participants with MDD, Pearson’s partial correlation analysis controlling same potential confounders was performed by using Fisher-transformed correlation coefficients and scores of ISI and PSQI. For comparing the difference of RSFC between MDD and HC, the analysis was also performed with ANCOVA controlling for age, sex, education years.

The analysis in this study included 36 in the MDD_w/INS group, 21 participants in the MDD_wo/INS group, and 38 in the healthy controls (HC) group. The main finding of this study was that MDD with insomnia showed increased RSFC in Habe_L - Rolandic_Oper_R, Habe_L - Cuneus_R, Habe_R - Thal_Pul_R, and decreased RSFC in Septal - Cerebellum_Crus1_R compared to MDD without insomnia. All regions with significant results were significantly correlated with insomnia severity.

Since the RSFC of all pairs of regions that showed significant differences between the two groups in this study were significantly correlated with insomnia severity (i.e., ISI score), the association of these regions with insomnia in MDD is supported. The significance of this study is that there have been studies that have examined the RSFC in fMRI for insomnia, but there are few studies on MDD with insomnia, and since the habenula and septal nuclei play an important role in insomnia, sleep, and mood, it is meaningful to seed fMRI studies on these areas.

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Studies conducted up to date on the subject of deprivation of sleep (DS) primarily focused either on its impact on certain cognitive abilities or mood-enhancing effects in patients with depression. A notable body of evidence suggests that both might be related to alterations in neurotrophin synthesis induced by DS. However, the role of NTs as an interface between DS, mood, and cognitive functions is unclear.

The study aimed to investigate associations between cognitive abilities measured by Trail Making Test (TMT) and Stroop Color and Wort Test (ST), serum protein concentrations of brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), neurotrophin-3 (NT3), neurotrophin-4 (NT4) as well as the expression of their respective genes after a night of sleep deprivation.

Each participant (n=76) underwent a 24-hour DS under the control of actigraphy. Venous blood collection, TMT, and ST were carried out in the morning after DS. Mood was evaluated twice, after DS and in the preceding evening; based on the alleviation of depression symptoms participants were divided into respondents (RE; n=47) and non-respondents (NR; n=29). Serum protein concentration was determined using ELISA kits. Gene expression was evaluated by quantitative real-time polymerase chain reaction with gene-specific probes (reference gene: β-actin). Relative expression was calculated using the Livak formula. TMT is a neuropsychological instrument; Part 1 is thought to evaluate mostly attention, whereas Part 2 executive functions. ST is a 2-part test applied in the assessment of response inhibition and complex attention.

In RE, cognitive abilities were not associated with expression levels of any of the studied proteins or mRNA (all p>0.05). In NR, BDNF and GDNF mRNA expressions negatively correlated with TMT Part 1 (p=0.017, p=0.048, respectively); scores obtained in TMT Part 2 bore a similar relation to BDNF, GDNF, and NT4 mRNA (p=0.034, p=0.041, p=0.026, respectively). In this group, expression of all BDNF, GDNF, NT3, NT4 mRNA correlated negatively with both parts of ST (p<0.001, p=0.009, p=0.042, p=0.009 for Part 1; p<0.001, p=0.003, p=0.031, p=0.014 for Part 2, respectively).

Those results suggest that alterations in the synthesis of NTs might be an element of the molecular milieu characterizing different types of DS response. Negative correlations between test scores and NT mRNA expressions could imply that the reduction of the production of NT proforms might protect against the decline of cognitive functions in the aftermath of DS. Projects using a larger battery of tests as well as analyzing immature forms of NTs would be desirable in order to further investigate mechanisms underlying DS response.

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The Palestine-Israel War has reverberated across borders, transcending boundaries to affect individuals far beyond the conflict zone.

While much attention has been rightfully directed toward the immediate physical and psychological consequences within the war-torn regions, there is a growing need to explore the broader impact on the mental health of populations in neighboring countries including the sleep disorders among the Tunisian population during this war.

To study the sleep disorders in Tunisian people related to the extensive war news broadcasting and to identify the factors associated to it.

It was a cross-sectional, descriptive and analytical study, conducted among Tunisians. Data were collected during October and November 2023, through an anonymous online questionnaire, spread throughout social media (Facebook/Instagram), using the Google Forms® platform. We used a socio-demographic and clinical data sheet and the Insomnia Severity Index (ISI) to measures the severity of insomnia.

A total of 1091 participants completed the questionnaire.The participants’ mean age was 32.7 ± 9.8 years, with a sex ratio (F/M) = 3.5.

The study revealed that 100% of the respondents followed the war, predominantly relying on social media (98.6%) with 55% closely monitoring the war via the media during more than 3 hours per day.

74.1% of the participants were Religious practitioners

According to the (ISI): a significant insomnia was found in 75.2% of participants.

The breakdown of insomnia severity indicated that 47.3% experienced subthreshold insomnia, 25.7% clinical insomnia of moderate severity, and 2.2% clinical insomnia of severe intensity.

The factors significantly associated with severe insomnia were: a male population (p=0.018) and an increase in religious practices (p=0.031).

The impact of the Palestine-Israel war on Tunisian individuals’ sleep patterns, predominantly mediated through increased exposure via social media with using increase in religious practices as a possible coping mechanism.

The study highlights support initiatives to address the psychological repercussions of international conflicts on mental health. This suggests the importance of applying sleep hygiene rules and screening for sleep disorders.

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Evidence regarding the link between insomnia and successful aging (SA) in the older generation remains scarce.

The purpose of this study is to explore the relationship of insomnia with SA within a substantial sample of the community-dwelling Indian population.

Data were drawn from the Longitudinal Ageing Study in India (LASI), Wave 1, conducted during 2017-2018. Older participants aged 60 years and above who completed both the insomnia and SA surveys were included. Insomnia was determined by the presence of at least one of three symptoms: 1) difficulty in initiating sleep; 2) difficulty in maintaining sleep; or 3) early morning awakening, occurring 5 or more times per week. SA was assessed by five components: 1) absence of chronic diseases; 2) low probability of disability; 3) high cognitive functionality; 4) low probability of depression; and 5) active social engagement. The association between insomnia and SA was examined through survey-weighted multivariable logistic regression, with adjustments made for potential covariates. Subgroup analyses were carried out to evaluate interactions with age, sex, alcohol use, and smoking status.

A total of 31362 participants met the eligibility criteria. The overall weighted prevalence was 9.91% for insomnia and 23.94% for SA. In fully adjusted models, insomnia exhibited a negative association with SA (OR 0.70; 95% CI 0.63-0.78, see Table 1) and with each of SA’s components, except for the absence of chronic diseases (OR 0.94; 95% CI 0.85-1.04, see Table 1). Subgroup analyses, stratified by age, sex, alcohol use, or smoking status, did not reveal any significant interactions between insomnia and SA (p for interaction = 0.098, 0.873, 0.704, 0.095, respectively).Table 1.

Relationship between insomnia and successful aging.

Insomnia was negatively linked with SA within the older Indian population. Future prospective studies are warranted to validate these relationships, investigate underlying mechanisms, and enhance the understanding and promotion of SA.

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Internet gaming disorder has been associated with an excessive number of hours spent playing video games, which leads to a detriment of other daily activities and interests. In addition, it is associated with personality traits such as aggression and anger. In Portugal this relations are almost unexplored.

To explore the relationship between video game use, internet gaming disorder and aggression.

This study was applied to a sample of 202 subjects, aged between 18 and 29 years old (M = 22.5, SD = 3.006). Subjects fulfilled a sociodemographic and viodeogame pattern questionnaire, and the Portuguese versions of the Internet Gaming Disorder Scale (short form), and the Buss-Perry Aggressiveness Questionnaire.

In this study 20.3% (n = 27) of the males and 5.8% (n = 4) of the females use excessively videogames, considering the screen time recommended by the American Academy of Pediatrics. However, 81% (n = 70) of the sample have a positive self-perception of their use. 21.4% (n = 45) use videogames during day, 71% (n = 49) during night and 3.8% (n = 8) during dawn. The total score for internet gaming disorder was of 15.17 (SD = 6.006), but only 1 subject (0.5%) presented probable videogame disorder considering the sutt-off points. A positive and significant correlation was found between internet gaming disorder and physical agressiveness (.32**), verbal agressiveness (.28**) and hostility (.45**). Finally, a positive correlation was found between internet gaming disorder and time spent playing video games.

Our results, despite being merely exploratory, show us the relationship that exists between the use of video games, internet gaming disorder and aggressiveness. In that sense it is important to continue to explore internet gaming etiology and consequences.

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In Switzerland, alcohol consumption is even decreasing, with an exception for old people after retirement.35%of them have a heavy or addictive consumption (OFSP, consommation d’alcool en Suisse, fait et chiffres. 01.2023). This is also the case for home residents.

The alcohol consumption by old poeple has negatives consequences on the health (falls, fractures, cognitives disorders).

The autors conduct a crossectionnal enquiry in the homes of Fribourg area to identify addictive behaviour and different existing supports. After a review, the authors present the results of their enquiry

Identify how much home-residents have a problematic or an addictive alcohol problem

Identify if there is existing support

Hinghligthing the training need for the staff

Crossectionnal enquiry was sent in 42 Home of the Fribourg area, with 3 relances

The premliminary result will be completed at the end of 2023:

• - Every home identify at leat 4-5 residents with a problematic alcohol consumption

• - Most of them, the staff have no specific addictive trainig and no needs for it

• - The staff authorise alcohol consumption in the home, to avoid alcohol withdrawal

• - The psychiatric consultant in the home can help the staff to manage the counter-attitudes

Home residents are not eligible for specialized addictive care, whil the generally respond well to motivationnal interviewing or to controlled consumption. The lack of staff training could be an hypothesis. The lack of interest in the neagtives conséquences oh alcool on th health of people at the enf of their lives is anothers hypothesis

Nursing home residents are not eligible for specialized addictive care. The enquiry results are astonishing: no need of specialized training, authorization of continous drinking in the different homes, while the literature points the effectivnesse of motivationnal interviewing or controlled approaches by old people with addictive disorders.

Further studies are needed, ethical consideration on the management of alcohol addiction in the elderly should be proposed.

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A 36-year-old man with a history of cannabis use disorder since age 16, consuming 8-10 units/day, experienced irritability and tremors upon reducing consumption. His psychiatric issues emerged in 2020, marked by anxiety, abdominal pain, and severe vomiting, leading to a dyspepsia diagnosis. Subsequently, he received psychiatric care at CAS Hospitalet, diagnosed with severe cannabis use disorder. No prior inpatient admissions occurred.

Our project aims to show a case report and summarize the available evidence on cannabinoid hyperemesis syndrome (CHS).

In May 2023, he voluntarily sought admission to Barcelona’s “Hospital Sant Pau,” aiming for cannabis detox and treatment of cannabinoid hyperemesis. He’d endured years of intense abdominal pain, nausea, and vomiting, worsening over the last two years, with uncontrollable vomiting hindering daily life. Admission saw reduced cannabis use to 3-4 units/day. Inpatient care revealed anticipatory anxiety, rumination, and somatic anxiety, accompanied by distal tremors and internal restlessness due to abdominal discomfort, partially alleviated by 5-10 mg of diazepam.

Treatment included domperidone 10mg/8h, haloperidol drops (5-10 drops/8h), capsaicin ointment, hot showers, and cryotherapy, resulting in gradual relief from abdominal pain. Moderate cravings for tobacco and cannabis led to acetylcysteine 600mg/12h and gabapentin up to 1200mg/8h. Gastric discomfort with SSRIs led to vortioxetine 10 mg/day, well-tolerated with a positive response. Consultation with the GI department confirmed the treatment’s efficacy, emphasizing cannabis abstinence. Upon discharge, cannabinoid hyperemesis symptoms markedly improved, and the patient was referred to “Hospital de Dia.”

CHS is a cyclic vomiting syndrome, preceded by daily to weekly chronic longstanding use of cannabis that can be difficult to diagnose and treat(1,3,4). It is unique in presentation, because of the cannabis’s biphasic effect as anti-emetic at low doses and pro-emetic at higher doses, and the association with pathological hot water bathing (2). The major characteristics are as follows: history of regular cannabis for any duration of time (100%), cyclic nausea and vomiting (100%), resolution of symptoms after stopping cannabis (96.8%), compulsive hot baths with symptom relief (92.3%), male predominance (72.9%), abdominal pain (85.1%), and at least weekly cannabis use (97.4%)(1). Treatments such as topical capsaicin, haloperidol, benzodiazepines, and propranolol have shown symptom relief (3) whereas opioids should be avoided (4). Cannabis cessation appears to be the best treatment (1,3).

1. 1. Sorensen et al. Journal of Medical Toxicology 13 (2017):71-87.

2. 2. Perisetti et al. Annals of gastroenterology 33.6 (2020):571.

3. 3. Senderovich et al. Medical Principles and Practice 31.1 (2022):29-38.

4. 4. Leu, et al. Journal of Emergency Nursing 47.3 (2021): 483-486

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The abuse of prescription drugs (especially sedatives, hypnotics and opioid analgesics) is a serious and increasingly common phenomenon occurring across addiction clinics. Medications are prescribed for the treatment of chronic pain, sleep difficulties or as mood stabilisers in response to the rush of time and demands of performance. The onset of addiction is often protracted and subtle, but has a major impact on the quality of life and the health, economic or social status of the user. Patients may experience, among other things, cognitive impairment, fatigue, sleep disturbances, irritability, loss of motivation, headaches or impaired coordination of movements. This study is focused on cognitive impairment due to prescription drug dependence and how this impairment affects patients in everyday life.

This poster aims to introduce the audience to the possibilities of occupational therapy intervention in the context of addiction medicine.

Data will be taken using standardized tests and questionnaires dealing with cognitive function. It will be conducted upon the patient’s admission to addiction treatment and again after six months of cognitive rehabilitation following the initial survey. Data are collected at the General University Hospital in Prague, Department of Addictology, Prague, Czech Republic.

Data are being collected.

The case study manifests multidisciplinary approach in care of patients addicted of prescription medicine. The aim is a comprehensive view of all aspects of the patient’s life affected by prescription drug abuse with cognitive impairment.

Grant affiliation: This paper was made possible by the institutional support programme Cooperatio, research area Health Sciences and Grant No. 260632 within the Specific Academic Research.

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In Colombia the traditional treatment model implies the needing of a total cessation of consume to be able to acces an impatientand long stance rehabilitation program. However, literature in other countries expériences had sugested and used a harm reduction program with an otpatien rehabilitation program.

As this programs are more cost-effective and enables the patient to continue his daily life, perpetuate his life style, keep and enhance the psychosocial network, an outpatient comprehensive multimodular program was designed to adapt to a health promotion company (EPS for its spanish acronym) and has been used since 2017.

• - share the expérience aquired in an undeveloped country of latin America

• - The tipification in the main substance consumption in the development group as well as it’s differentiation in gender and age group

Expérience and results

• - The majority of patients are men over women

• - the predominant age group is between 29-59 years old

• - there is a difference between the age group depending on the substance of impact

The experience have shown that up to 30% of the population treated have gotten to a controlled consumption or the total suspension without the needing of an impatient program In général thé patient have shown motivation and adherence to an outpatient program

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Efforts are critically needed to increase the armamentarium of options that clinicians can use to treat patients with alcohol use disorder (AUD). Numerous preclinical studies support the hypothesis that mineralocorticoid receptor (MR) pharmacological antagonism may represent a novel and promising treatment for AUD. Namely, the non-selective MR antagonist spironolactone dose-dependently decreased 1) the intake of alcohol in mice in a model of alcohol binge drinking procedure and 2) alcohol self-administration in dependent and non-dependent rats (Farokhnia, Rentsch, Choung et al., Mol Psychiatry 2022; 27(11):4642-4652). Furthermore, two U.S.-based independent human pharmacoepidemiologic studies utilizing electronic health records data showed that patients treated with spironolactone for any indication reduced their weekly alcohol use in a primary care-type medical setting (Palzes et al., Neuropsychopharmacology 2021; 46(12):2140-2147) and Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) score in a Veterans Affairs medical setting (Farokhnia, Rentsch, Choung et al., 2022; 27(11):4642-4652). In both studies, spironolactone-treated patients were compared to matched ones without spironolactone prescription using propensity score matching.

We are conducting a Phase 1b human study to assess the pharmacokinetics and pharmacodynamics of spironolactone-alcohol co-administration and testing the safety and tolerability of spironolactone, alone and combined with alcohol in individuals with AUD.

Spironolactone in Alcohol Use Disorder (SAUD) is a double-blind, placebo-controlled, randomized, within-subject, ascending dose study with spironolactone (0, 100, 200, 400 mg/day) PO for 5 days to reach steady-state, followed by oral fixed-dose alcohol administration aimed at reaching a blood alcohol level of approximately 0.08 %. Our sample consists of 12 adults diagnosed with AUD.

The primary endpoint is to measure spironolactone and alcohol PK during concomitant administration. Our secondary endpoints are 1) assessment of subjective and cognitive effects of acute alcohol administration during concomitant spironolactone treatment; 2) number and severity of adverse events (AEs) experienced, compared between placebo (0 mg/day) and all three spironolactone doses; 3) PK characteristic of spironolactone active metabolites, canrenone, 7-α-thiomethylspirolactone (TMS) and 6β-hydroxy-7α-thiomethylspirolactone (HTMS), before and after administration of alcohol. Recruitment is underway.

The above-mentioned preclinical and clinical evidence suggest that spironolactone may be repurposed for the treatment of AUD. Our Phase 1b study is a key step before moving to larger efficacy trials.

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Sustained alcohol intake, when combined with incomplete treatment, can result in chronic structural changes in the Central Nervous System, including generalized cortical and cerebellar atrophy, amnesic syndromes like Korsakoff’s syndrome, and white matter disorders such as Central Pontine Myelinolysis and Marchiafava-Bignami syndrome. It is crucial to prevent these complications due to their potential for irreversible and debilitating consequences. For Wernicke-Korsakoff syndrome, early recognition and thiamine administration for prevention are paramount, as it arises from thiamine deficiency due to malnutrition caused by persistent alcohol use. In the case of Central Pontine Myelinolysis, which is caused by abrupt fluctuations in serum osmolality, controlled sodium correction is essential.

Through a clinical case and a review of published literature, this study aims to reflect on the importance of preventing neurological injuries associated with chronic alcohol consumption, specifically Wernicke-Korsakoff Syndrome and Central Pontine Myelinolysis.

A literature review was conducted by searching for articles on PubMed using the terms “Alcohol Use Disorder,” “Wernicke-Korsakoff syndrome,” and “Central pontine myelinolysis.” A clinical case is presented, featuring a 50-year-old patient with alcohol use disorder who developed Wernicke-Korsakoff syndrome and Central Pontine Myelinolysis. Considering this case, we reflect on the primary approaches that could have been beneficial in preventing these complications and propose a straightforward method for doing so.

A 50-year-old patient presented with poor general condition, characterized by low weight, significant loss of strength in the limbs and arms, and incoherent speech with anterograde amnesia and confabulation. This condition had progressed to a point where the patient could no longer walk, perform basic self-care tasks such as bathing, dressing, and eating independently, underscoring the severity of his condition. The diagnoses of Wernicke-Korsakoff syndrome and Central Pontine Myelinolysis were established based on clinical manifestations and the presence of hyperintense lesions observed in the central pons on T2/FLAIR axial MRI scans. This clinical case highlights the importance of proper and precocious prevention of complications in patients with alcohol use disorder. The foremost step in preventing these complications is to treat alcohol dependence effectively, even when faced with patient resistance. It’s vital to remain vigilant about potential complications and implement suitable prophylactic measures.

The devastating effects of complications arising from Alcohol Use Disorder, such as Wernicke-Korsakoff syndrome and Central Pontine Myelinolysis, underscore the importance of enhanced attention that clinicians should provide when approaching these patients at all clinical interactions.

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Many individuals who suffer from one or multiple substance use disorders often also struggle with another co-morbid psychiatric condition, primarily anxiety disorders. As substance dependency develops, the loss of self-control becomes a pivotal issue, leading to challenges in self-esteem and self-respect. These challenges subsequently give rise to problems in interpersonal communication and close relationships. In addition to the biological model of substance use problems and highly manualized approaches, it is crucial to have a systemic understanding of the patient’s situation and appropriate treatment settings. This understanding allows for the proper consideration of individual differences and requirements, ultimately enabling better treatment and prevention strategies.

Our aim is to present a comprehensive case that shows various facets of addiction and introduce a systemic therapy concept of an integrative/systemic day clinic from Germany.

Through a detailed case presentation, we will introduce a systemic-psychotherapeutic day-clinic concept from a psychiatric training hospital in Wunstorf, Germany.

Case: In the case of a 48-year-old female patient initially diagnosed with recurrent depressive disorder, it was later revealed that she also deals with alcohol addiction and its interconnectedness with sex addiction. Shame and a lack of self-esteem in relationships played a central role in her journey. She does not perceive herself to be loved but to be harmed, which led to many violent sexual acts that increased her feelings of shame. Systemic therapeutic approaches like family constellations were applied, helping her to experience her child-ego states. This profound insight propelled her willingness to change. She began prioritizing self-care, learning to like, accept, and eventually love herself. Aromatherapy aided in calming and maintaining focus. The patient learned to redefine her emotions, aligning them with reality, thereby enabling the adaptive fulfillment of her needs.

Our interdisciplinary team at the day clinic employs therapeutic approaches like dynamic, cognitive-behavioral, and systemic therapy to thoroughly understand the patients and their conditions. This case underscores the significance of an individually tailored treatment drawing from diverse therapeutic concepts, especially in patients with addiction. The combination of different therapeutic approaches facilitates a profound engagement with the patient, potentially resulting in more intensive therapeutic work and a higher rate of success which should be evaluated in future studies.

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Drug addiction, also called substance use disorder, is a disease that affects a person’s brain and behavior and leads to an inability to control the use of a legal or illegal drug or medicine. there is a complex interplay of neurobiology, genetics, and the environment --nature and nurture-- that play into the development of addiction, alcohol, and other drug use disorder.Substances such as alcohol, marijuana and nicotine also are considered drugs.

Research has shown that women often use drugs differently, respond to drugs differently, andcan have unique obstacles to effective treatment as simple as not being able to find child care orbeing prescribed treatment that has not been adequately tested on women.

describe the socio-demographic and clinical characteristics of female patients admitted to the addictology department of Arrazi Hospital in Salé

Retrospective study with descriptive and analytical aims on the files of women who were admitted to the addictology service since its opening in 2000, with the aim of specifying the prevalence and the characteristics of addictive behaviors in the female population.

in progress

in progress

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Gaming Disorder (GD) has not been officially recognized as a diagnostic entity in the DSM-5, being listed in the “conditions for further study” section. However, it is described in the ICD-11, and clinically, it is observed that an increasing number of individuals, particularly the younger population with easier access to technology, are affected by this issue. Nefarious consequences include loss of performance at school/work and a potential for failing other responsibilities such as in the familiar and social spheres.

Despite its harm, psychiatrists are generally less familiar with this entity when compared to other psychiatric disorders. Thus, our main goal was to establish a comprehensive and hollistic review of its approach.

A bibliographical research on the topic was conducted from the available scientific literature on the topic, with the utmost priorization of evidence-based sources.

The overall prevalence of Gaming Disorder is challenging to assess precisely, but it is estimated to be around 3%, making it comparable to obsessive-compulsive disorder and some substance use disorders. It is more common than pathological gambling. Clinically, GD is characterized by an excessive preoccupation with gaming that supersedes all aspects of life. It may also involve a compulsion to play and the presence of withdrawal symptoms from periods when there are no gaming activities. The behavior is driven by the ACE triad (anonymity, convenience, and escape). Often, individuals with GD do not seek treatment. Although there are no specific pharmacological agents, antidepressants, mood stabilizers, and naltrexone have shown some success. In psychotherapies, cognitive-behavioral therapy has the strongest evidence.

There is a limited amount of information on GD, and when researching the topic, one primarily encounters information on other substance-related addictive disorders and, in the case of behavioral disorders, gambling. However, as young people are increasingly exposed to screens and video games with potential harmful effects on their development, and in adults, inhibiting them from taking on work and family responsibilities, it is essential to conduct more studies on the subject to prevent these deleterious consequences.

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Alcohol addiction can lead to withdrawal seizures, but most patients do not develop epilesy. In some cases a permanent complication occurs - symptomatic epilepsy. In other cases epilepsy precedes alcohol addiction. Comorbidity may pose serious chalenges to treating clinicians. There are conflicting data regarding relationship between alcohol use, seizures and epilepsy (Scorza CA et al.,CLINICS 2020;75:e1770). Other factors like brain trauma may have impact in genesis of epileptic states as well.

Evaluation of interplay between seizures, epilepsy and brain trauma in patients with alcohol use disorder.

Analysis of a case series in a hospital setting and review of relevant literature.

In our series of cases the number of patients who have suffered epilepsy before the onset of alcohol use is small. In most of the hospitalized patients epilepsy occurred after the development of alcohol use disorder. In this group we observed that head and brain trauma play role in genesis of seizures and epilepsy and in some instances the reverse happens.

Our data indicate the potential role of brain trauma as predisposing and complicating factor in patients who developed seisures and epilepsy. Seizures sometimes increase the risk of brain trauma. Seizures and trauma are important factors in typology of Lesch (Lesch et al. 2011) and a serious evaluation in this direction is improtant, because its diagnostic, therapeutic and prognostic implications. Further clarification in this field is necessary.

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Buddha Blue, or PTC for “Pète Ton Crâne”, is a synthetic drug particularly popular with young people. It is sold as a liquid to be inhaled in electronic cigarettes.

To discuss the clinical manifestations and psychopathology associated with PTC.

We shed light on PTC addiction through clinical vignettes of patients who were hospitalized in pediatrics at the Gonesse hospital.

We received two male patients with manifestations of PTC intoxication or withdrawal. One of the patients presented with an acute delirious flush requiring long-term treatment, while the second presented with somatic manifestations of pain and vomiting, as well as psychiatric manifestations such as hallucinations, without meeting the criteria for a psychiatric disorder. Both cases required addictological follow-up and child psychiatric therapy.

PTC addiction can lead to life-threatening complications, hence the importance of prevention and screening in order to institute early and effective treatment.

None Declared

Smoking among university professionals could influence student smoking behavior, making it important to understand the associated factors to prevent this phenomenon.

To determine the prevalence of smoking among University staff in Sfax, Tunisia, and identify its associated factors.

We conducted a cross-sectional survey using a self-administered questionnaire distributed to 100 university staff. The questionnaire included socio-professional characteristics, assessment of physical workload using the Borg CR-10 scale, and evaluation of nicotine dependence using the Fagerström test.

Our study included 62 participants, with 67.7% of them being women. Active smoking was reported by 50% of male participants. We observed symptoms of severe to very severe depression, anxiety, and stress in 6.4%, 22.5%, and 9.7% of our participants, respectively. Nicotine dependence, as assessed by the Fagerström test, was high to very high in half of the smokers. Bivariate analysis indicated a significant association between smoking and male gender, perceived workload (33.9%), and body mass index.

Smoking among university staff is a prevalent phenomenon, especially among male participants. The association of smoking with perceived workload suggests the need for preventive measures to reduce these physical constraints. It is paramount to take actions to encourage smoking cessation among university staff.

None Declared

In the workplace, a smoke-free environment is crucial to guaranteeing the health of workers and those around them. Understanding the relationship between smoking and work is a prerequisite for implementing effective tobacco control measures.

To assess the prevalence of smoking in an electricity and gas company in Sfax and to determine the relationship between workers’ nicotine dependence and perceived workload.

We conducted a cross-sectional survey evaluating the smoking behavior of 100 employees of an electricity and gas company. The survey was carried out from July to December 2022 using a two-part questionnaire. The first part was completed by the participants, and the second was administered by the interviewer. Nicotine dependence was assessed using the Fagerström test, while perceived workload was evaluated using the raw NASA-TLX questionnaire.

Our study population consisted of 82 male participants. Active smoking was reported by 45.1% of participants. Among smokers, 40.5% had moderate to high nicotine dependence as assessed by the Fagerström test. According to the raw NASA-TLX questionnaire, the mean scores for mental, physical, and temporal demands were 88.8±13.5, 63.6±24.7, and 59.1±28.4, respectively. The mean scores for effort, performance, and frustration were 83.8±14, 85.4±13.1, and 34.5±28.1, respectively. Bivariate analysis indicated an inverse correlation between nicotine dependence and physical demands at work. However, a significant positive correlation was found between nicotine dependence and frustration at work.

Smoking among electricity and gas company workers is a prevalent issue, highlighting the urgent need for smoking cessation interventions. The association of smoking with perceived workload underscores the importance of preventive measures to reduce work-related stress.

None Declared