Intranasal esketamine has recently been approved for the treatment of treatment-resistant depression in adults, with different studies showing its efficacy and tolerability. However, the real-world tolerability of this treatment is still unclear.

Evaluate the tolerability of intranasal esketamine in a case series of 15 patients.

Our case series includes 15 patients, who received treatment with intranasal esketamine during 2022-2023. In order to evaluate the tolerability of intranasal esketamine, patients were asked to complete the TSQM and a side effect questionnaire on different moments of the treatment (one week, six weeks and six months after the beginning of the treatment).

The most common adverse effects were dissociation, dizziness, and somnolence, which resolved within the hours following the administration. All of them were mild or moderate in severity, having a minor impact on the patient, so none of the patients discontinued the treatment due to adverse effects. Other adverse effects noticed were: transitory increment of blood pressure in several patients, and worsening of obsessions in a patient with previous obsessive-compulsive symptoms.

Our data suggests that intranasal esketamine is well tolerated, with transient and mild adverse effects. In all cases the risk-benefit ratio must be evaluated, but until more studies are done, it seems to be a safe treatment for treatment-resistant depression.

None Declared

Depression is a widespread problem that affects individuals of all ages. This study looks at the use of omega-3 polyunsaturated fatty acids (PUFAs) as an additional therapy for depression in people of different ages. Depression has an impact on everyone, from youth to the elderly, causing therapeutic concerns such as treatment resistance and recurrence. Omega-3 PUFAs, which may be found in fish and flaxseed, are important because of their impact on neurochemistry, inflammation, and neuroprotection. While pharmacotherapy, including antidepressants, has proven beneficial for many, the likelihood of remission and recurrence remains substantial. In recent years, there has been a growing interest in the potential role of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in mitigating depressive symptoms. The primary constituents of n-3 PUFAs are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Understanding the potential of omega-3 PUFAs across the lifespan can help address the multifaceted challenges posed by depression and improve mental health outcomes for diverse age groups.

This review aims to assess the role of omega-3 fatty acids in depression treatment across different age groups: children and adolescents, adults (18–60), and the elderly (60+). It investigates the effectiveness and potential differences in omega-3 supplementation among these age cohorts.

A comprehensive literature search was conducted from 2003 to 2023 using PubMed, Google Scholar, and EMBASE, using specific keywords. Studies with inadequate age group information or Omega-3 intervention were excluded.

In children and adolescents, several studies indicate a positive association between omega-3 supplementation and improved depressive symptoms. In adults, results are mixed, with some studies showing benefits while others do not. In the elderly, omega-3 PUFAs appear to have a more consistent positive effect on depression. In contrast, a consistent positive association was observed in the geriatric population, suggesting that Omega-3 PUFAs may hold particular promise in the treatment of depression among older adults. However, variations in methodology, dosage, and study populations contribute to these mixed findings.

Omega-3 PUFAs show promise as an adjunct therapy for depression across different age groups. Further research with standardized methodologies and larger sample sizes is needed to clarify their role and establish optimal dosage guidelines. Omega-3 PUFAs should be considered as a potential complement to conventional depression treatments, emphasizing the need for personalized approaches in depression management.

None Declared

Vortioxetine is mainly prescribed as oral tablets, usually starting at 5-10 mg per day, and is well tolerated by most patients. However, some patients may experience side effects, the most common of which is nausea, which occurs in 20.9-31.2% of people treated with doses of 5-20 mg/day (Baldwin et al, J Psychopharmacol. 2016;30:242-52). In some countries, vortioxetine is also available as an oral solution (1 drop = 1 mg), which allows a very slow titration schedule that may improve tolerability.

To evaluate whether vortioxetine oral drop solution, started with 1-2 drops (1-2 mg per day) and increased by 1-2 drops per day to 10-20 drops (10-20 mg), is associated with better tolerability and a lower risk of nausea than that observed with oral tablets started with 5-10 mg per day, while maintaining efficacy. To provide pilot data for the design of a multicentre, prospective study.

Retrospective, single-centre, observational study. Participants were 58 consecutive patients (mean age 45 + 17 years, 55.2% female) treated with vortioxetine for a depressive episode. Vortioxetine was initiated and titrated up to 1 drop (1 mg) per day in 58.6% of subjects, and initiated and titrated up to 2 drops in 41.4% of subjects. Tolerability was assessed at all visits. CGI and MADRAS scores were recorded at the following time points: T0-baseline, T1=week 1, T2=week 2, T3=week 4, T4=week 8). Comparisons were made using repeated measures ANOVA with Bonferroni correction.

Nausea was reported by 8 subjects (13.8%) at T1, 4 subjects (6.9%) at T2, 1 subject at T3 (1.7%) and none at T4. Other adverse reactions (mainly dizziness, pruritus/itching, vomiting, diarrhoea, and xerostomia) were reported by a total of 6 subjects (10.3%) at T1, none at T2 and T3, and 1 subject (1.7%) at T4. The maximum dose administered was 20 mg in 75.9% of patients. No patients discontinued vortioxetine due to adverse events, but vortioxetine was discontinued prior to T4 (8 weeks of treatment) in 2 subjects due to lack of efficacy. The mean CGI at baseline was 4.3 ±0.8. The mean value decreased to 3.9±0.7 at week 1 and to 3.4±0.6, 2.7±0.6, 1.9±0.5 at weeks 2, 4 and 8, respectively. All differences were statistically significant (p<0.001) compared to baseline. Also from week 2, all scores were statistically significant compared to all previous assessments. The total MADRS score decreased from 28.3±4.6 at baseline to 24.9±4.2, 20.9±4, 16.3±3.6 and 10.9±3 at weeks 2, 4 and 8, respectively. A significant decrease in MADRS total score was observed at each time point (p<0.001) compared to baseline and previous assessments.

Slow titration with vortioxetine oral drop solution was associated with a very low percentage of patients reporting side effects in general, and nausea in particular, and with a relatively rapid improvement in depressive symptoms.

None Declared

Cognitive symptoms are the main factor of discomfort in depressed patients, persisting even during clinical remission (Conradi et al. Psychol Med 2011;41:1165-74) and inevitably compromising their quality of life (Fehnel et al. CNS Spectr 2013;25:1-10). Several studies have suggested the neuroprotective role of vitamin D, both through actions on the genome and rapid non-genomic mechanisms; so, low serum vitamin D levels are related to poorer cognitive performance (Goodwill et al. JAGS 2017;2:1-8), depressive disorders (Kjærgaard et al. Psyc Res 2011;190:221-225) and suicide risk (Umhau et al. PLoS One 2013;8:e51543).

to investigate relationships between serum vitamin D levels, depressive symptoms and cognitive performance in unipolar and bipolar depressed adults hospitalized for Major Depressive Episode (MDE).

80 patients (34 M and 46 F; average age 48,96±14,17 years; 40% with bipolar depression) were examined. Depression was investigated using Hamilton Rating Scale for Depression (HAM-D), while cognitive functions were explored by: Rey Auditory Verbal Learning Test (RAVLT) and Rey-Osterrieth Complex Figure (ROCF) to assess verbal and visuospatial memory, respectively; Trail Making Test (TMT) and Stroop Color and Word Test to assess attention, spatial planning and cognitive flexibility. Venous blood sampling was used to determine serum Vitamin D levels (average level 15,67 ± 8,7 ng/ml).

At first, the serum level of vitamin D was found to be inversely correlated with HAM-D scores (p=0,0079), so that lower concentrations of vitamin D is related to greater severity of depression. In addiction, there were strongly significative positive correlations between low vitamin D levels and poorer RAVLT and ROCF scores and strongly significative negative correlations between vitamin serum level and higher scores in TMT and STROOP test, so that calcidiol deficit is associated with poor cognitive performance. Similarly, patients with higher HAM-D scores were found to have a greater cognitive impairment (lower RAVLT e ROCF scores and higher TMT e STROOP scores).

In accordance with previous works, our study supports the close relationship between serum vitamin D levels and depressive morbidity. During MDE hypovitaminosis D is related to worse disease indices, such as severity of affective symptoms and cognitive impairment, without substantial differences between clinical manifestations of unipolar and bipolar depression, both in terms of affective and cognitive symptoms and disease severity. Considering that cognitive deficits are truly disabling because they may resist to common antidepressant treatments and, as a result, persist during stages of clinical remission, vitamin d supplementation, by minimizing cognitive dysfunction, could be a good strategy to reduce the risk of relapses and to improve patients’ functioning and quality of life.

None Declared

Public safety personnel (PSP) encounter traumatic events in their workplace, elevating the likelihood of mental health issues. Delivering efficient, evidence-backed interventions, like supportive SMS text messaging programs, can significantly enhance PSPs’ mental well-being, garnering high user satisfaction rates.

This study evaluates users’ satisfaction, receptiveness, and perceptions of the supportive SMS text messaging intervention (Text4PTSI).

Participants enrolled in the Text4PTSI program and received one-way cognitive behavioural–based supportive text messages for six months. They participated in a web-based survey delivered through SMS text messages at enrollment, six weeks, three months, and six months after enrollment. The participants’ perceptions and receptiveness of the program were evaluated through a 5-point Likert scale. Data were represented as categorical variables, and overall satisfaction with the Text4PTSI program was assessed on a scale ranging from 0 to 100.

Of the 131 Text4PTSI program subscribers, 81 participants responded to the survey, yielding 100 responses across the three follow-up time points. The average satisfaction score was 85.12 (SD 13.35). A significant portion of respondents, constituting 79%, agreed or strongly agreed that Text4PTSI helped them manage anxiety. Additionally, 72% reported relief from depressive symptoms, and 54% (54 out of 100 responses) felt less lonely. Moreover, the majority (84%) of participants expressed that Text4PTSI connected them to a support system, improving their mental well-being, felt more hopeful about managing concerns about their mental health or substance use (82%), and helped enhance their overall quality of life (77%). The data also revealed that most participants consistently read the supportive text messages (84 out of 100 responses, 84%), took time to contemplate each message (75 out of 100 responses, 75%), and revisited the messages more than once (76 out of 100 responses, 76%).

PSP participating in the 6-month Text4PTSI intervention expressed significant satisfaction and gratitude in the follow-up surveys. Their positive feedback indicates a promising path towards increased service utilization, potentially enhancing its effectiveness and impact on end users.

None Declared

The transition phase from late adolescence to early adulthood, which corresponds with the period of university life, is a time that offers important opportunities for personal growth. However, this developmental phase also concurs with the peak period of risk for the onset of mental health disorders. For this reason, the literature clearly identifies university students as a vulnerable population group for psychogical distress and mental problems. Digital psychological interventions and e-mental health solutions are emerging as a promising solution for university students, particularly appealing due to their anonymity, portability and ease of access. Hence, the World Health Organisation has developed several psychosocial e-mental health tools including Doing What Matters in Times of Stress (DWM), which has been consistently shown effective in various vulnerable populations. These data provide the framework for the CAMPUS study that is intended for students attending the University of Verona.

The main objective of this project is to adapt the WHO psychological intervention called “Doing What Matters in Times of Stress” (DWM) to this target population and to evaluate the effectiveness, feasibility, and acceptability of WHO’s DWM as a psychological strategy for effective mental health prevention and promotion, and for reducing psychological symptoms and distress in university students. Secondary objectives of the project include to evaluate the fidelity of DWM, to assess factors associated with its implementation and effectiveness and to co-create the necessary local conditions for implementation and up-scaling of DWM.

The CAMPUS study is a prospective non-randomized follow-up study. The target population is composed by university students of University of Verona, Italy. The online assessments, which are collected pre and post intervention, consist of an ad-hoc sociodemographic information page, and four self-administered questionnaires assessing psychological distress, depression and anxiety symptoms, and psychological well-being. In addition, implementation checklists will be administered to assess the acceptability, appropriateness and feasibility of the intervention.

Preliminary results on a sample of 300 students attending University of Verona show that the adapted DWM intervention promote students’ psychological well-being and reduce the level of psychological distress as well as the risk for the later development of a psychopathology. Moreover we expect that future results would include data on the effectiveness, feasibility, and acceptability of the adapted DWM intervention among university students

These results provide valuable information for mental health promotion and support programs for university students, as well as insights into factors influencing its implementation and suggestions for future scaling of the intervention.

None Declared

Ageing populations with increased needs, rising costs of traditional services, and new technologies are some factors driving the use of e-health services. A Norwegian study with data from 2015-2016 found that 13.5% had used apps, 7.3% had used social media, and 5% had used video services for health purposes. Little is known about the effects of many online health services, but in general they seem to increase knowledge and make most people feel reassured, although some users feel more anxious or confused after using such tools. Recent technological developments have resulted in new online health services, including AI-based technologies. More updated knowledge regarding the population’s use of e-health services in general and e-mental health services in particular, is needed.

The objective here is to provide information about an upcoming large population-based epidemiological study and how it addresses e-health and e-mental health.

We introduce the upcoming 8th version of the epidemiological Tromsø Study and discuss its importance to the field of e-mental health.

The Tromsø epidemiological study has since 1974 taken place in the Norwegian municipality of Tromsø. It contains information on a range of topics within health and illness, including topics from many medical specialities, psychiatry and substance use. In the upcoming 8th version of the study (2025-2026), more than 33,000 people aged above 40 will be invited to participate. The main questionnaire will include questions relating to a wide variety of topics, including on e-health use. We suspect the importance of e-health and e-mental health have increased lately, and we will examine how the use of e-health may impact mental health.

Community-based studies, such as the Tromsø Study, allow researchers to study associations between many different variables, including mental health and e-health. The upcoming Tromsø 8 study will enable us to study e-health use and its relationship to mental health in a large sample representative of the Norwegian population.

None Declared

The sudden emergence of the COVID-19 pandemic resulted in a compulsory shift to distance learning due to school closures. Consequently, all educational courses were delivered virtually. To facilitate this transition for students and educators, the Ministry of Education implemented digital learning platforms, such as Taalim.ma and TelmidTice. Furthermore, the Broadcasting and Television National Company reorganized its television channels to maintain continuity throughout the academic year. As a result, trainee teachers have effectively shifted to distance learning, using resources such as e-Takwine, MOOC classes, and digital classrooms.

This study examines the factors that cause discomfort among trainee teachers and evaluates their influence on satisfaction with distance learning during the COVID-19 pandemic.

We conducted a descriptive study with 370 Moroccan trainee teachers, with a mean age of 28.30 ± 5.99 years. We collected data using a self-administered questionnaire that was divided into three sections. The initial section examined sociodemographic and professional factors, including gender, age, marital status, academic level, and training cycle. The subsequent section focuses on discomfort-inducing factors, including living arrangements during lockdown, digital skills, material availability, network connectivity, and training schedules. Finally, the concluding section analyzes the trainees’ satisfaction and perceptions within their learning community.

The study indicated that 75% of trainee teachers lived in homes with four to seven residents, leading to confined living arrangements. Furthermore, 55% of the participants did not have a designated workspace for studying, focusing, or engaging with instructors. Participants identified various obstacles to online learning, including 80% lacking digital skills, 60% having insufficient equipment, 73.33% experiencing connection and network issues, 78.33% being unfamiliar with online learning, and 68.33% facing an unsuitable training schedule. The study indicates a positive correlation between trainee satisfaction and engagement (r = 0.422, p< 0.001).

The COVID-19 pandemic has necessitated online education as a crucial resource for ensuring the continuity of education. This study highlights the paramount significance of developing effective e-training policies to direct novice teachers toward successful online learning by alleviating their discomfort factors.

None Declared

The digital age has transformed mental health support in Tunisia. This study explores how individuals seek assistance for mental health concerns online, considering their comfort levels, preferences, and decision-making factors.

This study aims to: Investigate the comfort levels of Tunisians when discussing mental health concerns online Identify preferred online sources for mental health support Explore factors influencing the choice between online sources and mental health professionals

To unearth these insights, an exhaustive online survey was meticulously conducted. This survey was posted online on different social media platforms and cast a wide net, drawing responses from an eclectic cross-section of Tunisian society. The survey methodically gathered data on participants’ demographics, their inclinations towards online avenues for seeking assistance, and the multifaceted factors that sway their choices in this digital age.

Intriguingly, the results of this study illuminate several key findings:

Comfort Levels: A striking 47% of respondents expressed their unease about discussing their mental health concerns online. This statistic vividly underscores the intricate interplay between digital platforms and the persistent social stigma surrounding mental health issues.

Preferences for Online Sources: The study notably revealed that mental health apps and online counseling websites are emerging as the favored choices among those seeking support. This underscores the surging significance of digital mental health solutions tailored to individual needs.

Factors Influencing Preferences: An array of factors sways the preference for online sources. Among them, the allure of anonymity, the appeal of convenience, and the perception of limited access to in-person mental health professionals were prevalent. Additionally, financial constraints emerged as a notable consideration in the decision-making process.

Trust in Online Information: In contrast, individuals who leaned toward seeking assistance from mental health professionals stressed the pivotal importance of professional expertise, personalized guidance, and a comprehensive understanding of their concerns. Importantly, 38% expressed reservations about the reliability of online mental health information, underscoring the critical role of trust in the process.

This study sheds light on the nuanced process of seeking mental health assistance in the digital age. It emphasizes the need to address mental health stigma and improve online resource credibility. The findings highlight the importance of comprehensive mental health strategies that integrate digital solutions and traditional professional care, catering to diverse preferences and needs in Tunisia.

None Declared

In the digital age, the landscape of mental health information dissemination and consumption in Tunisia has experienced a profound transformation. As the digital revolution continues to reshape our lives, understanding how individuals seek and interact with mental health information online has become increasingly critical.

The primary objectives of this study are as follows:

• - To comprehensively investigate the digital mental health literacy of individuals in Tunisia by administering an insightful online questionnaire.

• - To delve into the multifaceted aspects of how Tunisians engage with mental health content on digital platforms, unveiling their comfort levels, preferences, and decision-making factors.

This study conducted an online survey comprising three sections. The first gathered demographic information to profile our diverse participants. The second explored internet usage patterns, unveiling their digital activities. The third delved into perceptions of mental health information on social media, revealing preferences. Our survey reached participants of various ages and locations in Tunisia.

The findings of this study cast a revealing spotlight on the digital mental health landscape in Tunisia. A significant proportion of our respondents frequently engaged with various social media platforms. Notably, Instagram emerged as the favored platform for 80% of our participants, while 72% chose Facebook as their preferred digital sanctuary. Intriguingly, 57% of our respondents actively embarked on quests for mental health information on YouTube, with a distinct preference for video-based content.

In the labyrinth of online mental health information, our participants exhibited a discerning eye. They assigned paramount importance to source credentials, references to reputable sources, and unwavering adherence to established medical guidelines. However, beneath this discernment, a noteworthy 65% harbored doubts regarding the accuracy of online information, reflecting the inherent challenges and complexities of navigating the digital information ecosystem.

Furthermore, our study unearthed areas where social media platforms may still grapple with shortcomings in addressing the multifaceted needs of mental health consumers. Participants eloquently expressed concerns about the accuracy of information, the availability of reliable platforms, and the crucial need for a diverse array of perspectives in mental health content on social media.

This study offers key insights into Tunisia’s digital mental health landscape. It highlights prevalent digital information consumption and preferences. Emphasizing the need for credible and diverse mental health information on social media is vital. This sample lays the foundation for enhancing available content, better supporting mental well-being in Tunisia.

None Declared

The concept of digital psychiatry, encompassing technologies such as mental health apps, Virtual Reality (VR), Artificial Intelligence (AI), and telepsychiatry, emerges as a potential solution to bridge the existing gaps in the mental health system of Pakistan. However, one of the major barriers to the implementation of these technologies is hesitancy to adopt digital tools by psychiatrists.

This study aims to explore the current understanding of digital psychiatry, the barriers faced by psychiatrists in its’ widespread implementation, and their willingness to adopt these services in clinical practice.

This cross-sectional study surveyed psychiatrists’ knowledge, attitudes, and practices on digital psychiatry from 39 public hospitals across Pakistan using an online validated questionnaire from January to July 2023. Participants included psychiatry residents, fellows, and consultants practicing in Pakistan. Responses were analyzed with Raosoft software, Quirkos, and SPSS 26 using thematic analysis and correlation.

A total of 200 participants responded to the questionnaire, primarily in the age range of 20-30 years (56%). The gender distribution was 55% male (N = 111) and 45% female (N = 89). Among the professional roles, 23% were consultants, 7% were registrars, 54% were psychiatry residents, and 17% were medical officers. Respondents came from both rural (N = 148, 74%) and urban (N = 52, 26%) practice settings. Regarding telepsychiatry, 46% strongly agreed that they are familiar with telepsychiatry, while 58% agreed that telepsychiatry can save time and money. Additionally, 22% strongly agreed that it’s a viable approach for patient care. Concerning perspectives on Artificial Intelligence (AI) in digital psychiatry readiness, only 40% of participants had received AI training. However, 55% expressed interest in collaborating with international centers on AI-related projects. In terms of mental health apps, 62% of respondents reported limited familiarity with them. Nevertheless, 65% believed that these apps could potentially save time and money for psychiatric health systems. Lastly, concerning Virtual Reality (VR) in psychiatric care, 57% of participants were familiar with VR technology, but only 43% were acquainted with its applications in psychiatry. Notably, 71% did not view VR as a viable replacement for in-person psychiatric management.

This is the first study conducted on understanding digital psychiatry in Pakistan’s healthcare system, which revealed multiple challenges to digital health competency among psychiatrists. This emphasizes on the need for formal training and funding towards resources to overcome obstacles in utilizing mental health technologies.

None Declared

Internet Addiction Disorder, a concept introduced for the first time by Ivan Goldberg in 1995, is one of the most recently identified forms of addiction, but already considered a real psychosocial phenomenon, capable of having a profound impact on different aspects of social and psychological life of individuals. One of its most recently identified manifestations is Nomophobia, a neologism formed from the combination of terms such as “no mobile”, “phone” and “phobia”, which can be understood as the fear of feeling disconnected. It is today considered a situational phobia, characteristic of contemporary times. The most common symptoms include excessive cell phone use and constant anxiety at the thought of losing the internet connection. Others are, for example, “Ringxiety”, ringing anxiety, or the “phantom vibration syndrome”.

This study aims to examine the spread of Nomophobia in the Italian population, evaluating psychopathological correlations that can explain its diffusion.

Between January and May 2023, an anonymous online questionnaire was randomly sent to the general population. Alongside with tests to evaluate psycho-social features, the instrument used to study Nomophobia was the Nomophobia Questionnaire (NMP-Q) (Yildrim et al. Comput Hum Behav. 2015; 49:130–7), in its Italian version (Adawi et al. JMIR MHealth UHealth. 2018;6:e24).

The sample consists of 308 people (189 F, 119 M), with an average age of 32 years (sd 14). In our sample, 100% of the subjects tested positive for Nomophobia. Values indicating a state of severe Nomophobia are found in 12.3% of the sample (F 15.9%, M 6.7%). The young population, between 18 and 25 years old, represents 54% of the affected population, but more than 60% of severe cases (95% confidence interval 50-65%). The severe cases correlate positively (p<0,05) with findings of high impulsiveness. There are no other studies that investigate the psychopathological correlates of Nomophobia among Italians.

Despite possible biases, the data obtained are an alarming sign of the spread of internet addiction that characterizes our times, of which the excessive use of cell phones in the form of Nomophobia is an expression. Despite their now undisputed usefulness, mobile devices are capable of causing the onset of serious health problems, starting from exposure to radiation capable of causing dermatitis, tumors, and infertility. Furthermore, they dramatically interfere with driving safety, becoming a major cause of road accidents. Considering these consequences, it appears to be extremely important to characterize the phenomenon, as well as its psychosocial determinants, in order to proceed with its better definition and prevention.

None Declared

Empathy plays an important role in everyday human relationships. It is the ability to put oneself in the place of others, to represent what they think and feel. In healthcare settings, several studies have highlighted its positive effects on patients in terms of physical and psychological well-being.

Evaluate empathy among caregivers.

This is a cross-sectional study, conducted over a 1- month -period and enrolling nursing staff working at Farhat Hached Academic hospital. Empathy was assessed using the Jefferson Scale of physician’s empathy (JSPE) scale.

A total of 92 caregivers were enrolled in this study. The average age was 40.41 years with a sex ratio of 0.95. The most represented category was nurses (64.1%) with an average seniority of 17.2 years. The average empathy score was 98.4. Scores above half were reported in 69.5% of cases. The presence of empathy was significantly associated with female gender (p=0.002).

Empathy is a key point in the patient-caregiver relationship. Thus, the nursing staff must be aware of this concept in order to improve the quality of care.

None Declared

Many with mental illness do not seek treatment, often due to stigma; be it public, self, or institutional type. To improve outcomes, stigma needs addressing.

Understand the opportunity for e-mental health to help overcome stigma and, to provide an expert opinion to foster its adoption.

We conducted literature searches using the terms ((mental health) AND ((stigma) OR (discrimination))) AND (((((digital tools) OR (digital services)) OR (healthcare apps)) OR (digital solutions)) OR (digital technology)), limited to 2007 – 2023, identifying 223 citations, 9 of which were relevant for this evaluation, including 4 systematic reviews (Table 1).

Literature reports suggest that e-mental health may be useful for addressing stigma and reducing the treatment gap. While it was not consistently as good as face-to-face services, e-mental health tools were frequently shown to be effective in reducing stigma, improving mental health literacy, and increasing help-seeking behaviors. Tools included web-based breathing, meditation, and CBT; suicide prevention apps; and online videos and games. Experts from a 2022 global Think Tank session convened by eMHIC, opined and emphasised that embracing e-mental health must not leave people behind nor reinforce inequality and that structural barriers must first be acknowledged and overcome. Creating a shared understanding of the challenge and of terminology is essential, as is codesigning any solution together with people with lived experience.Table 1.

Systematic literature reviews

Published data suggest that e-mental health is promising to reduce stigma and discrimination, with the potential to foster help-seeking and treatment engagement. Adoption requires attention to derailers and must foster inclusivity. There is an imperative to adopt e-mental health, especially evidence-based solutions.

K. Subramaniam Employee of: Employee of Viatris, A. Greenshaw: None Declared, A. Thapliyal: None Declared

The literature has emphasized the importance of implementing evidence-based occupational therapy teleinterventions to enhance work participation in adults with attention-deficit/hyperactivity disorder (ADHD).

This study aimed to evaluate the efficacy of an innovative metacognitive self-tailored teleintervention for adults with ADHD performance at work enhancement (Work-MAP). The outcome measures were efficacy of and satisfaction with the performance of self-selected work goals (Canadian Occupational Performance Measure), executive functions (Behavior Rating Inventory of Executive Function-Adult), and quality of life (Adult ADHD Quality of Life Questionnaire).

In this randomized controlled trial, participants were 46 adults with ADHD. Group A (n = 31) received the synchronous, hybrid-telehealth intervention in 11 weekly 1-hour individual sessions, while Group B (n = 15) completed the same intervention after a waiting phase.

Following the intervention, participants demonstrated and maintained significant improvements in all outcome measures (strong-to-moderate significant effects) to the 3-month follow-up.

Work-MAP seems to be effective intervention for enhancing work participation (i.e., performance at work), executive functions, and quality of life of adults with ADHD. Future studies with larger samples and additional objective measures are needed to further validate these findings.

None Declared

Over the past few years, Psychiatry has undergone a significant transformation with the integration of Artificial Intelligence (AI). This shift has been driven by the increasing demand for mental health services, as well as advances in AI technology. AI analyzes extensive datasets, including text, voice, and behavioral data, aiding in mental health diagnosis and treatment. Consequently, a range of AI-based interventions has been developed, including chatbots, virtual therapists and apps featuring cognitive-behavioral therapy (CBT) modules. Notably, chatbots, as conversational agents, have emerged as valuable tools, assisting users in monitoring emotions and providing evidence-based resources, well-being support, psychoeducation and adaptive coping strategies.

This study aims to investigate the impact of AI chatbots on improving mental health, evaluate their strengths and weaknesses and explore their potential for early detection and intervention in mental health issues.

A literature review was conducted through PubMed and Google Scholar databases, using keywords ‘artificial intelligence’, ‘chatbot’ and ‘mental health’. The selection focused on the most relevant articles published between January 2021 and September 2023.

Mental health chatbots are highly personalized, with a primary focus on addressing issues such as depression or anxiety within specific clinical population groups. Through the integration of Natural Language Processing (NLP) techniques and rule-based AI algorithms, these chatbots closely simulate human interactions and effectively instruct users in therapeutic techniques. While chatbots integrating CBT principles have gained widespread use and extensive research attention, some also incorporate alternative therapeutic approaches, including dialectical behavior therapy, motivational interviewing, acceptance and commitment therapy, positive psychology or mindfulness-based stress reduction. AI chatbots provide substantial advantages in terms of accessibility, cost-effectiveness and improved access to mental health support services. Nonetheless, they also exhibit limitations, including the absence of human connection, limited expertise, potential for misdiagnosis, privacy concerns, risk of bias and limitations in risk assessment accuracy.

AI-based chatbots hold the potential to enhance patient outcomes by enabling early detection and intervention in mental health issues. However, their implementation in mental health should be approached with caution. Further studies are essential to thoroughly evaluate their effectiveness and safety.

None Declared

University students often face challenges to their well-being and up to a third develop mental health problems. Given high rates of smartphone use among this group, app-based digital mental health interventions may play a role in preventing these problems. Previously demonstrated to improve well-being and mental health outcomes in young people aged 16-25, ‘Whitu: seven ways in seven days’ is a well-being app based on positive psychology, cognitive behaviour therapy (CBT) and psychoeducation principles.

This randomised controlled trial was undertaken to evaluate the efficacy, usability and acceptability of Whitu with first year university students.

Ninety first year university students were recruited via a social media advertising campaign to take part in a prospective randomised controlled trial of Whitu against a standard university self-help website, with 45 participants in each arm. Primary outcomes were changes in well-being on the World Health Organisation 5-item well-being index (WHO-5) and short Warwick-Edinburgh mental well-being escale (SWEMWBS). Secondary outcomes were changes in depression on the Centre for Epidemiological Studies Depression Scale (CES-D), anxiety on the Generalised Anxiety Disorder seven item scale (GAD-7), self-compassion on the Self Compassion Scale- Short Form (SCS-SF), stress on the 10-item Perceived Stress Scale (PSS-10), sleep on the single-item Sleep Quality Scale (SQS), and self-reported acceptability of the app. Outcomes were evaluated at baseline, four weeks (primary study endpoint) and three months.

At 4 weeks, participants in the intervention group experienced significantly higher mental well-being and significantly lower depression compared to controls. Emotional well-being among the Whitu group was greater in the intervention group at 3 months. Other outcomes did not differ between groups. User feedback was positive, with 88% of those who provided feedback saying they would recommend the app to a friend.

Our findings provide preliminary evidence that Whitu is an acceptable and more effective, scalable and multi-modal means of improving some aspects of well-being and mental health among university students than direction to a self-help website.

None Declared

Increasing popularity of Generative AI systems such as GPT provides us with new dilemmas concerning the future of diagnosis and novel tools to improve daily psychiatrits’s work.

The aim of the study was to assess the abilities of generative AI to diagnose and propose treatment in comparison with real psychiatrists and performing a Turing test.

We examined the ability to diagnose and propose treatment of various Generative AI versions (CHatGPT/CHATGPTpro etc.) and then compare the results with 10 clinicians performing the same task. Then a group of 10 psychiatry specialists not involved in the first evaluation assessed wether the diagnose and treatment were established by Generative AI or a clinician.

The reults showed that the generative AI systems were able to provide valid diagnosis in most of the cases with favour to newer and most proficient version of CHATGPT. Proposed treatment results were less accurate. The comparison between human and AI group was hard to accurately acces, with tendency to favouring psychiatrists group assesment as the right decision.

There is huge need to further explore the possibilites and limitations of Generative AI use in psychiatry.

There is huge need to further explore the possibilites and limitations of Generative AI use in psychiatry.

None Declared

Nonsuicidal self-injury (NSSI), the deliberate and direct destruction of one’s own body tissue without suicidal intent, has represented a significant public health concern among adolescents and young adults worldwide, yet they have limited access to evidence-based interventions. App-based digital therapy, with its advantages of high cost-effectiveness, accessibility, and user receptivity, could be an effective intervention for NSSI. We expected that the use of an app-based brief cognitive-behavioral therapy (CBT) would improve depressive symptoms and emotion dysregulation, the most prevalent symptoms among individuals with NSSI.

This study aimed to evaluate the efficacy of a 3-week app-based brief CBT program focusing on cognitive distortion correction for individuals with NSSI.

A total of 34 participants who engaged in NSSI were included in the final analysis, with 18 individuals assigned to the ‘app group’ and 16 to the ‘waitlist group.’ The brief CBT program consisted of three quizzes designed to prompt the users to identify cognitive distortions embedded in a series of short scenarios, develop more realistic perspectives, and imagine advising to significant others. The app group was instructed to complete three quizzes per day for three weeks, while the waitlist group received no intervention.

Baseline and follow-up assessments of depression and emotion regulation were conducted. After the 3-week program, the app group showed a significant reduction in depressive symptoms (F = 8.30, P = .007) compared to the waitlist group. There was no group difference regarding emotion regulation.

Depression is a prominent symptom in individuals with NSSI. Our findings suggest that an app-based brief CBT intervention targeting cognitive distortions can effectively alleviate depression in individuals with NSSI. The results also highlight the need for digital interventions that are tailored and designed to improve emotion regulation in this population.

None Declared

Public safety personnel (PSPs) often suffer from mental health issues due to the challenging and intricate nature of their work. Various barriers may prevent them from seeking necessary support and treatment. Therefore, implementing innovative and cost-effective interventions can potentially enhance the mental well-being of PSPs.

The study sought to assess the influence of the Text4PTSI program on symptoms of depression, anxiety, trauma, and stress, as well as the resilience of public safety personnel after six months of receiving supportive text message intervention.

PSP subscribed to the Text4PTSI program and received daily supportive l SMS text messages for six months. Participants were invited to complete standardized self-rated web-based questionnaires to assess depression, anxiety, posttraumatic stress disorder (PTSD), and resilience symptoms measured on the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 scale (GAD-7), Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), and the Brief Resilience Scale (BRS), respectively. The assessment of mental health conditions was conducted at enrolment, six weeks, three months, and six months after enrollment.

One hundred and thirty-one subscribers participated in the Text4PTSI program. A total of 31 participants completed the baseline survey, and 107 total surveys were recorded at all follow-up time points. The baseline prevalence of likely major depressive disorder (MDD) was 47.1%, likely generalized anxiety disorder (GAD) was 37.5%, low resilience was 22.2%, and likely PTSD was 13.3%. At six months post-intervention, the prevalence of psychological conditions. There was a decrease in the mean scores on the PHQ-9, GAD-7, PCL-C, and the BRS from baseline to post-intervention by 25.8%, 24.7%, 9.5%, and 0.3%, respectively. However, the decrease was only statistically significant for the mean change in GAD-7 scores with a low effect size (t (15) = 2.73, p = 0.02).

The results of this study suggest a reduction in the prevalence of likely MDD as well as the severity of anxiety symptoms from baseline to post-intervention for subscribers of the Text4PTSI program. The program has the potential to complement existing services, aiding in mental health support for public safety personnel.

None Declared