The European Border and Coast Guard Agency (Frontex) detected 330,000 irregular border crossings last year.Tunisian nationals are among the top three nationalities reported.While there are many reasons for illegal immigration,the social driver is one of the most important to study.

To highlight the role of the social environment in promoting illegal immigration and its impact on the psychosocial well-being of individuals in Tunisia through a clinical case study.

we reported the clinical case of a 32 years old tunisian patient who was diagnosed with severe major depressive disorder and post traumatic stress disorder after an illigale immigration to Europe.

A 32-year-old Tunisian man from Tataouine,a region in southern Tunisia,was the subject of this case study.He was the youngest of four siblings,had a secondary education,and worked as a shepherd.His socio-economic status was moderate,unstable and seasonal.He had already attempted to immigrate to Italy twice illegally,by sea,but had been deported both times.The patient sought consultation for depressive symptoms.In January 2023,he made a third attempt to immigrate to Europe,this time by plane.He traveled with two of his cousins,aged 18 and 20,and paid 22,000 Tunisian dinars for the trip.Both cousins died during the journey,one from hypothermia and the other from police pursuit.The patient was deported again and was diagnosed with post-traumatic stress disorder (PTSD) and a major depressive episode.

Tataouine is konwn as “little Paris” a region in the south-east which,according to the National Institute of Statistics,had 71 emigrants/1000 inhabitants or 7.1% of the population.Where the society promotes youth immigration through societal values.

The social environment in Tataouine,which has a high rate of emigration,promotes the idea that immigration is a way to achieve social status and economic security. This can lead to young people feeling pressured to immigrate, even if they are not prepared for the risks involved.

None Declared

Migration has been present in the evolution of human beings throughout history. Economic inequalities give rise to a permanent flow of people trying to improve their lives. In addition, there are people who are forced to seek asylum or refuge due to wars or political violence. Therefore, the migratory flow, gives rise to a clinical scenario in which, the arrival of immigrant people demands an adaptation of the psychiatric paradigm.

The objective of this paper is to review the international scientific literature published on the impact of the migration process on mental health.

We propose a review of the international scientific literature published in recent years on psychiatry and migration.

We present the case of a 27-year-old male, diagnosed with paranoid schizophrenia, who arrived in the Canary Islands after a 2-year migration process from his country of origin (Senegal).

The limits between normality and pathology of certain types of behavior vary from one culture to another.

In the case of a patient with a mental disorder who has undergone a migration process, an approach based on the cultural formulation of the case should be made, taking into account the process of adaptation to the culture of the host country, as well as the impact of the culture of origin on the patient’s interpretation of his or her psychopathology.

Culture can influence the acceptance or rejection of a diagnosis and treatment, affecting the course of the disease and recovery.

Therefore, understanding the cultural context in which the disease is experienced is essential for a good diagnostic evaluation and effective clinical management.

N. Molina Pérez: None Declared, J. Pereira López: None Declared, M. I. Santana Ortiz: None Declared, P. Rivero Rodríguez: None Declared, A. R. Del Rosario Grant / Research support from: Jansen Pharmaceuticals, Inc., Consultant of: Jansen Pharmaceuticals, Inc.; Lundbeck, Inc., Employee of: Universidad de Las Palmas de Gran Canaria, Speakers bureau of: Jansen Pharmaceuticals, Inc.; Lundbeck, Inc.; Otsuka Pharmaceutical Co.; Pfizer Inc.; Esteve Pharmaceuticals, S.A.; AstraZeneca Pharmaceuticals LP.; Angelini Pharma S.L.U.; Laboratorios Farmacéuticos ROVI SA., M. Grimal: None Declared, V. Acosta Pérez: None Declared

Scrupulosity is an Obsessive Compulsive Disorder in which an individual experiences persistent doubts and fears about committing religious and moral sins. Researchers have extensively used the Penn Inventory of Scrupulosity-Revised (PIOS-R), which has been translated into various languages.

The present study translated and validated the PIOS-R into Urdu.

The PIOS-R was translated using the forward-backwards translation method. A sample of 443 Muslim University students (male 224 and female 119) with an age range of 18 to 33 years (M = 21.56, SD = 2.02) completed the Urdu version of the PIOS-R. Cross-lingual validity was established on a further 60 participants.

Confirmatory factor analysis (CFA) confirmed the two-factor structure of the Urdu version of the PIOS-R. It provided an excellent model fit to the data with chi-square 238.72, CFI = .92, GFI = .93 and RMSEA = .03. The Cronbach’s alpha coefficient of total scale, Fear of God Subscale, and Fear of Sins Subscale was .84, .74, and .78 respectively were satisfactory. The convergent validity of the Urdu version of the PIOS-R was demonstrated with significant positive correlations with measures of anxiety (r = .21, p <.001) and depression (r = .26, p < .001).

The Urdu version of the PIOS-R is recommended for use by researchers and practitioners. The results indicated good reliability and validity information for the Urdu version of the PIOS-R, which supports the measure’s utility across cultures and faiths.

None Declared

Occupational therapy - which also includes art therapy - is an activity/test with a purpose, it involves coordination between the sensory, motor, cognitive, and psychosocial systems of the individual. “Sciences recognize the role of observation in research… All artists who practice art therapy are based on their own artistic activity and present a common recurring feature: they are always in line with “essential pragmatism”. (McNIFF, Shaun, Trust the process: an artist’s guide to letting go. Creative ability. Psychological aspects. Self-actualization (Psychology). Artist-Psychology, Shambhala Publication, Boston, 1998, p. 78)

We seek to find new development solutions through stimulation, creativity, catharsis, and socialization to be authentic, spontaneous, feel fulfilled, emotionally balanced, and transformed, with the aim of fulfilling one’s social role through contact with human and environmental factors. (Emilia Chirilă, ART THERA PY IN EMOTIONAL DISORDERS OF CHILDREN AND ADOLESCENTS, printed edition 2018) ISBN 978-973-0-27683-1)

Through the graphic gesture, the child expresses various issues related to his feelings, like the search for his identity, the generated anxieties, the family and professional environment, and the situations of neglect and abuse. (MALCHIODI, Cathy A, Handbook of Art Therapy, The Guilford Press, New York and London, 2003, p. 157).

The following reactions can be identified: aggression, frustration, dominance tendency, low self-esteem, fraternal rivalry, hopelessness, sadness, compensation mechanisms, self-defense, other significant psycho-traumatic aspects. The disappearance of frustrations and negative feelings due to the disinterest of parents who do not visit the beneficiaries was achieved by gaining authority over the environment and by improving pre-existing skills. emotional disorders of children and adolescents” - Journal of Neurology and Psychiatry of Children and Adolescents from Romania - 2012 - vol. 15 - no. 3- p 121-136 - ISSN (printed): 2068-8040)

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Through the creative process and symbolic communication, associated with narration and imitation, we realize the development of outstanding and hidden abilities, we develop new ways of communication, new ways of self-expression, and new ways of seeing things, to increase the ability to face existential problems.(2018 Emilia Chirilă - Art therapy in emotional disorders of children and adolescents: “Festina lente - Hurry slowly!” Harmonizing the rhythm with those around us ,print edition, ISBN 978-973-0-27683)

None Declared

Psychiatry has historically underserved Indigenous people. Earlier, cross-cultural psychiatry assumed that psychiatric disorders were universal and varied little across cultures. We must acknowledge their different views of mind and mental health.

In our auto-ethnographic approach, we introduce or re-introduce participants to cultural beliefs, values, and methods for treating addictions, including narrative methods (storytelling), which receive greater acceptance by indigenous and marginalized peoples. Indigenous philosophy states that we see the world using the stories we have absorbed or constructed to explain our perceptions. Using substances is a story that is connected to poverty and adverse childhood events.

We create new stories to develop a sense of agency, that one’s actions can make a difference in one’s life. We present our experiences and findings from providing psychiatric and addiction services in rural and remote Indigenous settings in Canada (Saskatchewan and Northern Ontario) and in Maine (USA). We present data on a modified approach to psychiatric evaluations and services that emphasizes Indigenous values and begins with a life story interview that determines positive aspects of the client’s history and problem areas and engages the client in therapy from the beginning of the evaluation.

We will demonstrate how this process changes the process of the psychiatric interview, engages Indigenous clients, and results in better outcomes. We discuss how psychotherapy must change to engage Indigenous clients and to be effective with addictions. She will present data on this area. We present the lessons learned and the results of using this approach with a tribal population in Maine. Some key concepts include (1) reframing the person’s self-story about being addicted within a threat-power-meaning network, (2) working with stories about the spirit of the addiction and the consequences of ingesting spirit-laden substances without knowing their songs and protocols, (3) constructing future-self-narratives that explore right relationships and meaningful conduct, (4) constructing stories about the intergenerational transmission of addictions and exploring the question of “whom will be the recipient of your addiction?” We understood that the client sets their goals and defines what recovery means for them, which is the heart of a harm reduction approach.

Indigenous cultures across the world are different but share some similarities including a highly relational approach to defining the self, a collectivist mindset in which the needs of the group can supersede the needs of the individual, a reliance upon stories for transmission of knowledge and culture, and a commitment to a biopsychosocial and spiritual approach, which is often symbolized by the metaphor of the Four Cardinal Directions.

None Declared

People experience various negative emotions when they encounter stressful events, and these negative emotions contribute to the onset of illnesses. These emotional responses are not limited to just one; a person can experience multiple emotions at once, and the primary emotional reactions can vary depending on the severity and duration of the illness or life events. This is reason why we created a self-report scale to assess short-term emotional responses, focusing on the current emotional state experienced subjectively by patients.

The purpose of this study was to develop an affective response scale (ARS) and examine its validity and reliability.

We established clusters of affective via a literature review and developed preliminary items based on the structure. We conducted expert content validation to converge on the final items, followed by construct validity and reliability analyses.

The research findings indicate that the Affective Response Scale was composed of three main dimensions: anxiety, anger, and depression. Content validity results confirmed the validity of most items. The scale developed in this study was found to be valid in both exploratory and confirmatory factor analyses, and it was identified to be stable and consistent through the analysis of the internal reliability.

These results indicate that the ARS is highly reliable and valid, and that it can be utilized as an effective measure of the patient’s emotion and its severity.

None Declared

Depressive disorder is a common public health problem that significantly impairs quality of life and has a high risk of mortality and morbidity.

The aim of this study was to investigate circadian rhythm differences, stressful life events and coping styles in patients with depression.

The study involved 100 participants, including 50 patients with depression and 50 healthy controls, recruited from the psychiatric clinic of one-university hospital. The participants completed a sociodemographic information form, Beck Depression Inventory (BDI), Life Events Checklist (LEC-5), Coping Inventory for Stressful Situations-Short Form (CISS-21) and Morningness-Eveningness Questionnaire (MEQ).

The mean age of the patients with depression was 31.88±10.6 years, and the control group was 29.84±8.02 years. There were no significant relationships between the variables including gender and some other sociodemographic characteristics except education level. There were significant differences between the depression and control groups in terms of coping styles for stressful life events. Emotional coping was significantly higher in patients with depression compared to the control group, whereas task-oriented coping was significantly lower than the control group (p<0.05). The majority of both depression and the control group consisted of intermediate type. Natural disasters, severe suffering, and other stressful events or experiences were more frequent stressful life events in the depression group. Task-oriented coping scores and emotional coping scores showed significant discrimination with sensitivity and specificity values.

Recognizing stressful life events and the coping strategies used to deal with them is important for identifying future mental problems such as depression and developing treatment and follow-up plans. Longitudinal studies are needed to fully understand how the reporting of mature and dissociative coping methods interacts with depression in recovery from traumatic events.

None Declared

Borderline Personality Disorder (BPD) is the most common personality disorder in psychiatric care. BPD often co-occurs with Major Depressive Disorder (MDD). Both BPD and MDD are associated with various impairments of social functioning. Among these, mentalizing disturbances are the most extensively studied.

The Movie for the Assessment of Social Cognition (MASC) is an ecologically valid video-based test, which is suitable for measuring both hypermentalization and implicit mentalization. Based on the literature, it is sensitive enough to detect mild deficits in mentalization capacities. In this study, we investigated mentalization deficits with a special focus on implicit mentalization and hypermentalization in patients with MDD and MDD+BPD with a set of well-established mentalization tests including MASC.

We examined patients with MDD (n=43) during the depressive episode. A subgroup of these patients was also diagnosed with BPD (MDD+BPD group; n=23), the other group had no comorbid personality disorder (MDD group; n=20). We assessed the patients’ mentalization abilities using the Hungarian version of the Reading the Mind in the Eyes test, the Faux Pas test, and the MASC test. Additionally, symptom scales (measuring the severity of anxiety, and depression), WAIS (Wechsler Adult Intelligence Scale), the Childhood Trauma Scale, as well as scales measuring affect regulation and attachment were used during the assessment.

There were no differences between the two groups in terms of age, IQ, or the severity of depression and anxiety. The MDD+BPD group exhibited significantly poorer performance in the MASC total mentalization score (MW U=118, df=1,41, p< 0,001), as well as in the hypermentalization score (MW U=98,5, df=1,41, p< 0,001). The MDD+BPD group achieved significantly lower results on the emotion recognition and mentalization measures in the RMET test (t=2,883, df=1,41, p< 0,001). The MDD+BPD group performed significantly worse on the Faux Pas test measuring mentalization (MW U=144,5, df=1,41, p< 0,001). In the whole sample, MASC performance correlated with overall IQ.

The MASC, RMET, and Faux Pas tests show a consistent trend and indicate significant differences between the mentalization abilities of MDD+BPD and MDD patients. Our findings are in line with data in the literature: BPD patients’ implicit mentalization with a predominance of hypermentalization is impaired. This impairment is detectable when we compare their performance with MDD patients without BPD. In the future, a larger sample size, additional tests, and the inclusion of a control group are needed to further investigate MDD and MDD+BPD patients’ mentalizing deficits. However, our results emphasize the significance of mentalization-based therapies in the therapy of patients with BPD and depression.

None Declared

Ankylosing spondylitis (AS) is one of the most common inflammatory rheumatisms. It is a chronic, sometimes disabling and it could cause both physical and psychological problems among patients, including depression.

With this in mind, the objective of our work was to study the prevalence of depression among patients with AS and to determine its associated factors.

This was a retrospective descriptive and analytical study, carried out in 2021 over a period of 5 years in southern Tunisia on patients with a confirmed diagnosis of AS established in accordance with the ASAS diagnostic criteria (Assessment of Spondyloarthritis International Society) or the modified New York criteria for AS. Depression was assessed using the Hospital anxiety and Depression (HAD) score. A HAD score>10 means certain depression.

A total of 62 patients were included in our study. The median age was 39 years with an interquartile range (IQR) = [32-50 years]. There were 35 men (56.5%). Inflammatory back pain was noted among 51 patients (82.3%). Extraarticular manifestations were noted among 14 cases (22.6%) and were mainly ocular (11 cases; 78.4%). The diagnosis was confirmed by ASAS criteria in 55 cases (88.7%). AS was treated symptomatically in 58 cases (93.5%), specifically by basic treatment among 17 patients (27.4%) and by additional physical rehabilitation among 15 patients (24.2%). Depression was certain among 30 patients, giving a global prevalence of 48.4%. The factors statistically associated with this disease among patients with AS were having a low level of education (illiterate or primary) (Odds Ratio (OR) = 2.87; p = 0.044), being clinically suffering from severe fatigue (OR= 7.14; p<0.001), have a poor quality of life [Ankylosing spondylitis quality of life questionnaire (Asqol) Score ≥13] (OR=4.52; p=0.007) and have certain anxiety (HAD>10) (OR=19; p<0.001).

In addition to its clinical impact on patients, the psychological impact of AS was considerable in terms of depression. The factors associated with it were individual, clinical, and psychological. Thus, psychological support must be coupled with AS medical management in order to prevent psychological disorders among patients, particularly depression.

None Declared

Alcohol Use Disorder (AUD) and depression are among the most prevalent mental health concerns on a global scale. The co-occurrence of alcohol use disorder (AUD) and depression has been well acknowledged, leading to intricate issues in diagnosis, treatment, and prognosis.

This study aims to analyse the complex correlation between AUD (Alcohol Use Disorder) and depression, with a specific emphasis on examining common underlying causes, reciprocal influences, and potential implications for clinical treatment.

An exhaustive review of literature was undertaken, emphasizing epidemiological studies, neurobiological research, and the efficacy of combined treatment modalities. The review also delved into the potential role of genetics, environmental factors, and psychosocial stressors in co-occurrence.

The available evidence indicates that there exists a reciprocal relationship between depression and alcohol use disorder (AUD), wherein each disease can serve as a triggering factor for the other. This interplay between depression and AUD forms a detrimental cycle that intensifies the severity of both conditions. The comorbidity of various disorders may be attributed to the presence of shared neurochemical pathways, with a particular emphasis on the serotonin system. Furthermore, the co-occurrence of both illnesses frequently leads to heightened symptom severity, reduced treatment efficacy, and a higher risk of suicide.

The complex relationship between alcohol use disorder (AUD) and depression underscores the need for a comprehensive and integrated therapy strategy. The effective management of this comorbidity necessitates the implementation of multidisciplinary collaboration, patient education, and early intervention.

None Declared

Depression in psychosis has been more or less neglected as a field of study, due to its vague nosographic framework. Some studies have nevertheless focused on certain features of depression in psychosis, such as post-psychotic depression. This is a frequent phenomenon with a nosographic and etiopathogenic complexity that can lead to confusion.

To study the characteristics of post-psychotic depression and compare results with those in the literature.

It is a prospective, descriptive, case series study conducted at the Ar-Razi psychiatric hospital in Salé. Inclusion criteria were patients diagnosed with a brief psychotic disorder, schizophreniform disorder or schizophrenia, in remission, who met the criteria for a DSM 5 characterized depressive episode. Data are collected during the psychiatric interview with the patient, using a questionnaire.

Ongoing

Ongoing

None Declared

For many people, January is the most depressing month of the year. “Blue Monday” encompasses the generally accepted belief that Monday is the hardest day of the week compared to Friday and Saturday, which are the most anticipated days of the week. The connection between the color blue and Monday is in the emotional stage, which is presented as emotional anger. The third Monday in January is currently known as the most depressing day of the year. Speaker Cliff Arnall was the first to declare that day in 2014. The theory says that this is the time of the year when respiratory diseases are common, the day is shorter, the weather conditions are worse, and the time when people are burdened with guilt about whether they will achieve their New Year’s resolutions.

The aim of this work was to investigate that on third Monday in January there were more suicide attempts and that there were more depressive disorders in emergency psychiatric admissions.

In the research, we included participants who were examined at the Emergency Psychiatric Admission of the Clinical Hospital Center in Split, in the period from 2019. until 2023. Inclusion criteria were respondents of both sexes, examined in the outpatient clinic on Mondays in January for five years.

There were 198 of them in total. The primary outcome of the research is to determine the occurrence (incidence) of psychological deterioration in patients diagnosed with the anxiety-depressive spectrum. The secondary research outcomes are of a descriptive nature, patient follow-up, examination outcome, and psychiatric heredity.

For now, there are no strong scientific foundations that justify the formula of “the most depressing day” of the year, some scientists believe that it is a marketing trick to achieve higher tourist revenues. However, the post-holiday period can have an impact on individuals.

None Declared

Esketamine, an active Ketamine isomeric form that indirectly inhibits the GABAergic neuronal pathways, has been recently approved to treated severe, resistant depressive disorders. Here, we present the case of a 64 years old woman diagnosed with severe, resistant depression and an initial score of 28 points in the Hamilton Depression Rating Scale who was treated with Esketamine with excellent response and a HDRS of 8 points after 4 months.

To expose our experience with the first patient treated with Esketamine in our Hospital.

Describing the patient’s patobiography and the different treatments lines tried in first place and exposing the experience among Ketamine treatment and the final results.

We present the case of a 64 years old woman, divorced and retired, who lives with her son since the aggravation of the depressive symptomatology, with no medical nor surgical background and no history in Mental Health before her first psychiatric internment in 2020. Between February 2020 and June 2023, 5 different treatments options with supervise intake were tried, including increment of the dose, antidepressant rotation, the combination of Desvenlafaxine + Mirtazapine and adding Topiramate and Lithium, with no improvement. Among this years, 3 psychiatric internments were needed because of the depressive symptoms and 1 more hospitalization in Internal Medicine was required because of the patients severe, malnutritional state. In June 2023 and after two complete analysis, a MR and a score of 28 points in the Hamilton Depression Rating Scale treatment with Esketamine was started with no incidences. She described one dissociative episode during which she assures “she was surrounded by soft, rubbery, yellow bubbles”. After 4 months of treatment the patient has recovered her previous functional rate and has an 8 points score in the HDRS.

In conclusion, we can affirm that Esketamine is an effective and secure option for Resistant Depresion Dissorder. Nevertheless, Before considering a Depressive Episode as “resistant to treatment”, treatment adherence and other medical, surgical and psychiatric comorbidities must be studied.

None Declared

tardive dysphoria is a relatively new term used to describe the phenomenon of clinical worsening of depression after long-term antidepressant use. Most of the theories proposed to explain this talk about antidepressants tachyphylaxis that implies the loss of efficacy with its prolonged use, or even a pro-depressant effect of antidepressants when used for long periods of time.

to explore the concept of tardive dysphoria, potential causes and clinical implications, by making a literature review on the topic. Moreover we pretend to understand the challenges in its diagnosis and treatment.

bibliographical search in PubMed database, using the key-words “long-term antidepressant”, “tardive dysphoria” and “antidepressant tachyphylaxis”, limited to works published in the last twenty years.

from our search resulted 53 articles, 26 were chosen for further analysis.

the concept of tardive dysphoria is controversial, namely doubt persists if it constitutes a clinical entity by itself caused by long-term antidepressant use or if it simply relates to cases of treatment-resistant depression. We conclude that it is necessary further investigation in this area given the significant implications on clinical practice specifically in the psychopharmacological treatment with antidepressants, which is very common in psychiatric and general practices, with antidepressants being used to treat many mental health conditions.

None Declared

Depression and dementia with Lewy bodies (DLB) are two fairly common pathologies in the elderly which can have similar presentations or be associated and therefore pose a diagnostic challenge.

We propose to illustrate, through our case, the diagnostic and therapeutic challenge of these two pathologies.

We present the case of Ms. S. BA aged 67, without organic or psychiatric history, admitted to the psychiatry department for massive anxiety and insomnia. The troubles date back to nineteen months when the patient isolated herself, remained bedridden, lost her appetite and no longer slept. The evolution quickly led to the appearance of an excessive agitation. The patient became distracted, talking and laughing to herself, and ran away from the house. She consulted several free-lance psychiatrists and received several antipsychotic medications without improvement. The admission interview revealed a very anxious patient with a difficult contact. Her speech was centred on well-detailed visual hallucinations with themes of death. The neurological examination was difficult at first. She was started on haloperidol and clonazepam. After 2 days, neurological examination showed a parkinsonian syndrome and a temporal disorientation. Other cognitive functions were difficult to assess. The two diagnoses evoked were DLB and a characterized depressive episode with psychotic features. Standard workup showed mild anaemia and thrombocytopenia. Brain MRI and electroencephalogram and immune tests were normal. However, PET imaging was not available in our hospital. Haloperidol was immediately stopped and the patient was treated with an anticholinergic corrector in combination with quetiapine at 200 mg. The evolution was characterized by a significant reduction in anxiety and visual hallucinations with a marked improvement of the parkinsonian syndrome. Depressive symptoms took the forefront of the clinical presentation; hence we associated sertraline with quetiapine. The subsequent evolution showed a clear improvement in the depressive symptoms with total resolution of the parkinsonian symptoms and a normal cognitive evaluation.

In our case, the clinical evolution constituted a key element in the diagnostic orientation. So far, it is unlikely that our patient has DLB and the diagnosis retained was a characterized depressive episode with psychotic and melancholic features. Depression in the elderly can have atypical presentations, and raise the possibly of other differential diagnoses. Diagnostic uncertainty should not delay the implementation of treatment.

The choice of molecules must take into account the associated somatic symptoms for a better tolerance. In the absence of a biological or iconographic examination with good sensitivity and specificity, the therapeutic test remains the only way to decide.

None Declared

Depression represents a significant challenge in terms of disability among the elderly population and its responsiveness to conventional treatment approaches tends to diminish in this population group. Esketamine has shown both effectiveness and safety in addressing treatment-resistant depression in older patients.

Currently, there is a lack of available literature regarding the use of esketamine in the treatment of patients experiencing both cognitive decline and treatment-resistant depression (TRD). We administered esketamine to a 79-year- old patient to evaluate the effectiveness and tolerance of the medication.

We recruited a 79 year old female referred to the outpatient clinics of Pavia suffering from TRD with current Severe Depressive Episode (scoring 42 on the MADRS) with cognitive impairment (MMSE 16/30). The patient was on a fourth-line treatment. First-line treatment was started with paroxetine 40 mg from september 2021 to May 2022, switched to sertraline 50 mg. Second-line treatment with quetiapine 150 mg from June 2022 to December 2022 failed, despite optimal compliance for both lines of treatment. Then third line treatment with fluoxetine 20 mg, olanzapine 10 mg was initiated from December 2022 to May 2023. Study duration was 12 weeks. Anamnestic data and psychometric (MADRS, HAMD-21, HAM-A) and cognitive (MMSE and MoCA TEST) assessment were collected from medical records at baseline (T0), one month (T1) and three month (T2) follow-ups.

MADRS, HAM-A and HAM-D values decreased significantly at T1 and T2 follow-ups. T0: MADRS 42, HAM-D 33, HAM-A 54; T1: MADRS 18, HAM-D 12, HAM-A 15; T2: MADRS 4, HAM-D 5, HAM-A 10. We also observed an improvement in cognitive test: T0: MMSE 16/30, MoCA test 4/30; T1: MMSE 18/30, MoCA test 6/30; T2: MMSE 20/30, MoCA test 8/30. The patient reported one episode of hypertension treated with clonidine after two moth of treatment, and mild prolonged motor slowing lasting about two hours after esketamine in the first month.

This case documented a successful treatment using intranasal esketamine in combination with an SSRI (Fluoxetine) for an older individual with cognitive impairment and a persistent anxiety-depressive syndrome. This approach was employed as a therapeutic intervention after multiple unsuccessful attempts with other antidepressant medications. Our findings confirmed the safety and tolerability of esketamine in an elderly female with cognitive impairment. Although a minor improvement in cognitive abilities has been noted, secondary dysfunction attributable to vascular-based cognitive decline remained. In terms of cognitive tolerance, derivatives of ketamine could potentially serve as an alternative to electroconvulsive therapy in cases of treatment-resistant depression, potentially improving short-term cognitive outcomes.

None Declared

Depression is one of the most prevalent and incapacitating disease in current times and depressive symptoms have important global functioning implications.

The serotonergic and glutamatergic systems are involved in the pathophysiology and treatment of depression. Ketamine is an N-methyl-d-aspartic acid (NMDA) receptor antagonist that has demonstrated an important role on depressive symptoms, but its use is restricted due to its dissociative effects and other possible adverse effects.

Memantine is a noncompetitive antagonist of the NMDA receptor that modulates glutamate transmission. Memantine is used for the treatment of moderate to severe Alzheimer’s disease.

In this review, we aim to investigate, organize and synthetize the current data about the use of memantine for depressive symptoms.

Our literature research focused on some of the most significative articles published in the last decade, including meta-analysis and systematic reviews.

Most of the relevant literature suggests that memantine may effectively reduce depressive symptoms in patients with mood disorders.

The literature also supports that memantine’s glutamatergic mechanism of action could reduce apathy and treat depression comorbid with alcohol abuse.

Memantine affects brain-derived neurotrophic factor(BDNF) production suggesting that glutamate assumes an essential role in the pathology and etiology of depression. Also, the relationship between depression and the NMDA receptor is further supported by the fact that people with major depressive disorder demonstrate higher glutamate levels in the brain and blood.

Moreover, current studies demonstrate that treatment with memantine as adjunct to selective serotonin reuptake inhibitors (namely sertraline) manifested a favourable safety and efficacy profile in patients with major depressive disorder.

Memantine may have a wide therapeutic use beyond its utility in neurodegenerative diseases.

More studies should be performed, especially larger controlled studies of longer duration focusing on long-term safety and efficacy.

None Declared

Depression, particularly in early adulthood, presents a significant mental health challenge with far-reaching implications. Innovative approaches to address and alleviate depressive symptoms are of paramount importance in this context. One such approach involves the utilization of technology, specifically chatbot-based programs, to target specific cognitive biases associated with depression.

The central objective is to empirically examine whether this program can effectively influence depressive mood and negative cognition in individuals grappling with depressive symptoms.

To ascertain the program’s efficacy, participants were divided into two groups: the CBM-I group (n=20), which underwent interpretation bias modification training, and the Mood Check group(n=20), which served as a control and engaged in a simple mood-checking exercise. A battery of psychological measures was employed, including assessments of depression, interpretation bias, suicidal ideation, resilience, and attention control.

Analysis results showed that the CBM-I group had a significant reduction in depression (PHQ-9, CES-D) compared to the Mood Check group in the post-measurement. Moreover, resilience (CD-RISC) and attention control (ACQ) significantly improved in the CBM-I group.

This research serves as a stepping stone towards a deeper understanding of how chatbot-based interventions can contribute to the management of early adulthood depression, offering new perspectives and possibilities in the realm of mental health support and treatment.

None Declared

This review aimed to identify common pathophysiological mechanisms that exist between depression and obesity, as well as pharmacological strategies used in clinical trials and animal models. It is necessary to carry out larger studies that integrate the multiple neurobiological processes of these phenomena and the search for therapeutic targets that affect these pathways.

Conduct a literature review on the common neurobiological aspects that exist between depression and obesity. Compare pharmacological and therapeutic strategies in the management of depressive patients by means of common neurobiological mechanisms.

We used the Pubmed search engine to search for the keywords: ((depression and obesity) OR (common pathways for depression and obesity) OR (therapeutic targets for depression and obesity) OR (neurobiology of depression and obesity) OR (treatments for depression and obesity))Once the predefined screening was carried out, 68 studies were identified. 54 articles were left for review and analysis. At the end of the review, 25 studies were discarded, including 29 studies with relevance to the objectives described in the study. These articles were selected when they provided information with adequate, concrete and specific reasoning towards the scientific and methodological elements of the review.

Table 1: Findings related to the NEGR1 gene and its involvement in processes associated with alterations associated with depression and obesity.

Table 2: Findings of inflammation associated with depression and obesity in clinical trials and animal models.

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Alterations in the NEGR1 gene, inflammatory markers, HPA axis and microbiota demonstrate multiple pathophysiological mechanisms in the clinical pictures associated with obesity and depression.

Infliximab, pioglitazone, ondansentron, BVT.2733 and palmitoylethanolamide showed anti-inflammatory regulatory effects with reduction in depressive symptoms and multiple anti-inflammatory markers.

Animal models for obesity and depression present ample and reliable evidence regarding the use of drugs that direct their therapeutic profile towards the pathophysiological mechanisms involved in pathologies involving depressive and metabolic disorders.

None Declared

Major depressive disorder (MDD) is defined as a mental disorder of multifactorial etiology, which presents with mood disturbance, mainly sadness associated with loss of interest or pleasure. Light therapy (LT) is a therapeutic intervention consisting of daily exposure to a light source. This study aims to evaluate the effects of LT on anxious-depressive symptomatology and sleep in a sample of patients diagnosed with depression.

This study aims to evaluate the effects of LT on anxious-depressive symptomatology and sleep in a sample of patients diagnosed with depression.

Prospective case-control study, in which the cases are outpatients diagnosed with MDD and the controls are healthy individuals. Both groups underwent LT sessions and were assessed by means of validated scales, anxiety and depression symptoms before and after LT sessions, as well as changes in sleep patterns through a sleep measuring device.

11 cases and 18 controls were included in the study. Of the participants, 62.1% were female and 37.9% were male. The mean age of the sample was 54.03 □ 11.55 years. There were significant case differences in the pre and post LT scores of the depression scale. There were no significant differences in the changes in superficial, deep and total sleep and in the anxiety scale scores.

In the sample analysed, LT has significant effects on the cases at the level of the depression scale.

None Declared