Postpartum period is defined as the 12 weeks following the birth of a child as per ACOG guidelines. This period is crucial for women to physically and emotionally adapt to major changes in their lives. If concerns are not addressed properly it can result in fatal outcomes such as filicide and suicide in context of untreated mental illness with postpartum onset. Postpartum psychosis is considered a psychiatric emergency and literature shows that up to 4.5% of patients with depressive symptoms with psychosis commit filicide. However, postpartum psychosis is not recognized as a formal psychiatric disorder in DSM-5, leading to a delay in identification and treatment of the condition in a timely fashion.

The primary purpose of the case report is to inform the clinical picture and the legal implications associated with postpartum psychosis, a poorly understood and underdiagnosed psychiatric illness and to emphasize the importance of considering other psychiatric illnesses with peripartum onset that affect maternal and pediatric population wellbeing.

A comprehensive review of literature using databases, such as PubMed and Google Scholar as well as observation of the patient in the Emergency Department by the psychiatry team.

We present the case of a female in her 20s, mother of two toddlers, with a history of PTSD and postpartum depression, who was brought to our Emergency Department for stabbing her children in the context of a psychotic episode. The patient endorsed persecutory delusions and religious preoccupation, stating that she was experiencing “demonic energy inside” and that demons were speaking through her sons. Upon further assessment, it was noted that symptom onset was during the peripartum period, initially with depressed mood, and later with psychotic features. Organic causes of psychosis were ruled out with an extensive workup. Patient was transferred to an inpatient forensic unit for further stabilization. From a legal perspective, literature review shows that mothers may face the death penalty in the US in contrast with other countries such as England for instance. In the context of the current case, the plausible diagnoses are MDD with psychotic features or the first psychotic episode with peripartum onset that was left untreated resulting in a fatal health and legal outcome.

As postpartum psychosis is not currently recognized as an independent diagnosis under the DSM-5, further attention is warranted for such critical psychiatric condition that afflicts the lives and well-being of the maternal and pediatric populations globally. Postpartum psychosis affects mothers despite their past psychiatric history, socioeconomic status, educational level, and supportive network. Thus, it is essential to target proper and timely identification of symptoms and address those to prevent filicide and maternal suicide.

None Declared

Background: Maternal mental health is increasingly becoming a public health concern in developing countries because of predominant health and socio-economic inequalities. Mental well-being is essential for a woman to cope with daily life stresses and contribute positively to her community. Initiatives that empower women can enhance their well-being and improve the health of their families. However, limited evidence shows how women’s empowerment affects maternal well-being in a rural setting.

This paper explores the perspective of women’s economic empowerment in a rural Kenyan community and its effect on women’s mental well-being.

We purposively sampled women and men from the rural community who met the eligibility criteria (women who were pregnant and or with a child less than two years old and married men and residents in the community. We conducted two focus group discussions with the men and women separately, 11 key informant interviews with community stakeholders, and a four-month participant observation of 20 women participants who were pregnant and or with a child less than one year old.

The study found that economically empowered women had greater decision-making power and self-efficacy. However, cultural expectations and barriers that dictated the role of women prevented them from accessing and controlling resources and participating in important decisions such as land and property ownership. Women faced domestic violence (physical, verbal, and denial of basic needs) and inadequate support (emotional, physical, and financial) from spouses and other family members. These challenges and barriers increased their mental stress. To cope, women engaged in economic activities individually or in groups to meet the basic needs of their families.

Women’s economic empowerment can positively and negatively affect their overall well-being. Positively, women gain greater access to resources, improved decision-making, and the ability to plan and achieve their goals. Negatively, empowerment can lead to reduced spousal and kin support and an increased risk of domestic violence. Furthermore, these negative consequences can also affect women’s mental well-being. To ensure the well-being of mothers, it is crucial to engage men in empowerment programs and raise awareness in communities to address socio-cultural norms that impede women’s economic empowerment and negatively affect the well-being of women. Additionally, mental health support should be incorporated into these empowerment programs to mitigate the negative effects of women’s empowerment and improve resilience.

None Declared

Affective temperaments can play a significant role in the development, progression and outcome of various somatic diseases, as well as in the effectiveness of their treatment. Although infertility is influenced by both physical and psychological factors, the relationship between affective temperaments and infertility treatment success remains unexplored.

The aim of this retrospective cohort study was to assess how dominant affective temperaments influence the outcome of infertility treatments.

Data was collected from a cohort of infertile women who underwent infertility treatment at an Assisted Reproduction Center in Budapest, Hungary. The study recorded treatment success defined as clinical pregnancy, detailed medical history, demographic parameters, and administered the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). TEMPS-A scores then were classified into nondominant and dominant temperaments for each scale, based on their score being above or below the mean+2 standard deviation for the given temperament. The predictive value of dominant temperaments on assisted reproduction outcomes were analyzed by multivariate logistic regression models, using age, BMI and previous miscarriage as covariates.

In the cohort of 578 women who underwent infertility treatment, besides age, BMI, and previous miscarriage, dominant depressive, anxious and cyclothymic temperament decreased the odds of achieving clinical pregnancy by 85% (p=0.01), 64% (p=0.03), and 60% (p=0.050), respectively).

The findings of this study suggest that dominant affective temperaments have a significant impact on the outcomes of infertility treatments. As a clinical consequence, creening for affective temperaments, Identifying dominant affective temperaments, stratifying high-risk patient groups, and offering personalized treatment options may enhance the likelihood of successful pregnancy and live birth for women undergoing in vitro fertilization treatment.

None Declared

Infants born preterm usually show a Preterm Behavioural Phenotype, which includes mixed symptomatology characterized by lack of attention, anxiety and social difficulties, with a 3-4 times greater risk of disorders in further childhood. Critically, this behavioural pattern is also observed in infants born after a threated preterm labour (TPL), regardless of the presence of prematurity. It is known that the course of this Preterm Behavioural Phenotype shows high variability. Nevertheless, the predictors of this Preterm Behavioural Phenotype prognosis remain unknown.

This study aimed to explore the predictors of change of Preterm Behavioural Phenotype symptomatology during preschool ages in order to improve prognosis.

In this prospective cohort study, 117 mother–child pairs who experienced TPL were recruited. Preterm Behavioural Phenotype symptoms were assessed at age 2 and 6 using Child Behaviour Checklist. Gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress were included as predictors in a regression model.

Whereas increased internalizing problems were associated with a previous trauma history (p = .003), increased externalizing symptoms were linked to prenatal and postnatal maternal anxiety (p = .004 and p = .018, respectively).

Identifying modifiable risk factors, such as the history of maternal traumas and anxiety at TPL diagnosis and postpartum is recommendable to enhance better prognosis of Preterm Behavioural Phenotype in the offspring.

None Declared

Threatened preterm labor (TPL) represents an adverse prenatal event that can impact maternal mental health in the long term. Additionally, this prenatal event can disrupt fetal neurodevelopment, primarily during the third trimester of pregnancy when neuronal connections in the fetus are established. Indeed, infants born following TPL exhibit delayed communication and socio-individual skills at 6 months of age, regardless of prematurity. Furthermore, maternal mental health during the postpartum period can also influence the offspring’s psychomotor development.

The aim of this study is to examine the impact of maternal psychopathology on psychomotor development trajectories in infants born after a TPL from 6 to 30 months of age.

This prospective cohort study recruited 117 mother–child pairs who suffered from a TPL. Psychomotor assessment was performed at 6 and 30 months of age using the communication and socio-individual subscales of Ages & Stages Questionnaires for psychomotor development. A regression model was carried out, including gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress as predictors.

Increased communication delays were associated with higher maternal anxiety levels (p < 0.001), elevated maternal depression scores (p= .0003), and increased cortisol levels (p = .004) during postpartum. Similarly, elevated cortisol levels after 6 months postpartum were predictive of increased Personal-Social delays (p = .0018).

Maternal postpartum psychopathology was the main determinant of the course of psychomotor developmental disturbances. Therefore, infants born after TPL, whose mothers display postpartum psychopathology, should be identified and considered for psychological treatment to improve psychomotor delays in infants.

None Declared

Threatened preterm labour (TPL) is associated with long-lasting neurodevelopmental challenges, independent of prematurity. For instance, it is known that infants born a TPL show delayed communication and socio-individual skills, regardless of the gestational age at birth. Furthermore, TPL constitutes an adverse prenatal event that can induce maternal anxiety or depression, even during postpartum period, which can produce a deleterious effect of the prognosis of infant’s psychomotor development.

This study aimed to explore the influence of maternal psychopathology as well as other peripartum variables on the course of psychomotor development in children born after a TPL between the ages of 2 and 6.

In this prospective cohort study, 117 mother–child pairs who experienced TPL were recruited. Psychomotor development was assessed using the Ages & Stages Questionnaires-Third edition at age 2 and 6. A regression model was carried out, including gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress as predictors.

Low gestational week at birth emerged as the most relevant factor in the course of increased communication delay (p < 0.001). However, parental psychopathology during prenatal or postnatal stages was not a relevant factor in the prognosis of Communication skills or Socio-Individual development.

Gestation age at birth rather than parental psychopathology during peripartum period was the most relevant predictor of the course of psychomotor development between 2 to 6 years of age. Further studies should examine other potential modifiable predictors to moderate the impact of gestational age on psychomotor development.

None Declared

Psychotic disorders are strongly linked to a higher risk of mandatory hospitalization, often affecting men more, though some studies report the opposite. Recent investigations also show a higher rate of involuntary admissions in younger individuals. Knowledge in this area is still limited despite extensive research.

Analyze whether there is an association between sex and age with involuntary admissions of individuals with psychotic disorders.

Retrospectively, 254 people with psychotic disorders admitted between 2018-2023 to the adult psychiatric inpatient unit at Hospital Universitari Germans Trias i Pujol were selected, collecting their nature of admission, sex, age, and discharge diagnosis. Comparisons between voluntary and involuntary admissions, with respect to sex and age variables, were conducted using independent sample t-tests, Mann-Whitney U tests, Fisher’s exact test, and chi-square tests. A logistic regression model was used to identify variables significantly associated with mandatory admission.

In both the male and female groups, there were no statistically significant differences in terms of the mean age at admission (p = 0.162) or the nature of admission (p = 0.586) (Table 1). When analyzing the voluntary nature of admission based on age and sex, statistically significant differences were only found in the female group (p = 0.01), resulting in a 9.18 year age difference among those admitted voluntarily (Table 2). The model that best predicted the probability of involuntary admission in individuals with psychotic disorders included the sex variable (OR = 4.88) and the interaction between sex and age (OR = 0.97) (Table 3).Table 1:

Differences between sex regarding voluntariness of patients with psychotic disorders.

Young women with psychotic disorders face a higher risk of involuntary admissions, emphasizing the need for gender-specific strategies to improve care of these patients.

None Declared

Recently, the pros and cons have been debating in Korea even before the approval of use of medical marijuana with very strict limitations. And the next controversial topic is psychedelics. In 1890, when mescaline was first isolated from peyote cactus, clinical researches began, but due to its harmful effects, it was thereafter legally prohibited in 1970 in USA. However, a pernicious debate over the medical efficacy of psychedelic drugs has begun again with the release of a study that uses psychedelic mushrooms to be effective against treatment-resistant depression, alcohol dependence, and depression and anxiety in terminal cancer patient.

To make a consensus on the medical use of these, we reviewed wild mushrooms containing hallucinogenic ingredients living in Korea.

To make a consensus on the medical use of these, we reviewed wild mushrooms containing hallucinogenic ingredients living in Korea.

Mushrooms have long been popular as a food ingredient in Korea. Psilocybin, a classical psychedelic, can be obtained from magic mushroom (Psilocybe cubensis). The psilocybin on the CNS and causes hallucinations. Intoxication symptoms include pleasant or nervousness, sudden laughter, hallucinations, visual impairment, tachycardia and hypertension, reflexes, agitation, cognitive impairment, confusion, and aggressive behavior. These symptoms last for 2-4 hours after ingestion, and most disappear within six hours.

Among 114 species of Psilocybe containing psilocybin around the world, only five wild mushrooms found in Korea that cause nervous system hallucinations are as follows: P. argentipes, P. coprophila, P. perdaria, and P. subcarulipes.

In Korea, there is acute poisoning case suffering with GI symptoms caused by mushrooms, but it is difficult to find records of abuse or dependences case caused by psychedelic mushrooms. In addition, although oriental medicine treatment is relatively active, it is not used as an herbal medicine.

Currently, the Korean government classifies psychedelic mushroom-derived substances, Psilocybin and Psilocin, as psychotropic drugs by law. If researcher intends to clinical trial with eve very small amount of it for academic purpose, it is only possible after obtaining approval from Korean FDA. In order to determine the usefulness of psychedelics, many clinical studies are needed in Korea.

None Declared

It is important to prevent school dropout and to help students who have dropped out re-enroll in school. Dropping out of school is associated with an increased risk of unemployment, low salaries, and receiving social security or disability benefits. In this study, we interviewed participants in ‘Guttas Campus’ (The Boys’ Camp), which is a group-based intervention that aims to support disengaged boys from the 9th grade and through their transition to high school. The intervention consists of a two-week learning camp. The students subsequently participate in mentoring groups, with teachers and other camp participants, for a period of 18 months.

We present a study of a school dropout prevention program.

16 students were interviewed qualitatively. The interview data were analysed by drawing on the method of Grounded Theory.

When the students who have completed the learning camp were asked what they believed were the most important and useful parts of the intervention, some common themes emerged: 1) The learning camp community provided a safe environment and helped give the participants learning and coping experiences that increased their self-confidence. 2) The students brought up the method of teaching, which they described as more persistent, adaptive and encouraging than they had been used to from regular school. 3) The students also mentioned the intervention’s focus on character strengths such as willpower, self-control and optimism as central to increasing their motivation to learn.

The students that were interviewed were generally positive to the intervention, as mentioned several factors that they believed were useful in increasing their motivation and ability to learn.

None Declared

Adjustment disorder is characterized by an emotional or behavioral response to a stressful event or change in life. This condition can impact a student’s academic performance, social life, and overall well-being. Adjustment disorder with the stressor is a psychological response to identifiable stressors that result in the development of emotional or behavioral symptoms. These symptoms cause significant impairment in various areas of functioning, such as social, occupational, or academic performance.

Students with adjustment disorder may experience a range of symptoms, including feelings of sadness, anxiety, hopelessness, and a lack of concentration. They may also have trouble sleeping, feel overwhelmed, and struggle to cope with daily responsibilities. These symptoms can be triggered by various factors such as academic pressure, relationships, family issues, or cultural adjustments.

This study aims to determine the prevalence of adjustment disorder among undergraduate students and investigate the potential risk factors of stress that can lead to adjustment difficulties.

Recognize the signs of adjustment disorder, how to access support, and how to create a supportive environment, therefore, students can effectively manage this condition and thrive in their academic and personal lives.

To prioritize mental health and provide the necessary resources for students to navigate the challenges of adjustment disorder effectively.

Adjustment Disorder‑New Model 20 (ADNM‑20) was used to assess prevalence of adjustment disorder among undergraduate students. It is a diagnostic tool used to assess adjustment disorder in individuals experiencing significant life stressors. The ADNM 20 is specifically designed to capture the nuanced manifestations of adjustment disorder with the stressor, enabling clinicians to make accurate assessments and develop targeted treatment plans.

Adjustment disorder is a real and impactful challenge and a common mental health condition among undergraduate students at Prince Mohammad Bin Fahd University, Al Khobar, Saudi Arabia.

Adjustment disorder can significantly affect a student’s academic performance. The inability to focus, persistent feelings of distress, and a lack of motivation can lead to a decline in grades and overall achievement. By recognizing the signs, accessing support, and creating a supportive environment, students can effectively manage this condition and thrive in their academic and personal lives. It’s crucial to prioritize mental health and provide the necessary resources for students to navigate the challenges of adjustment disorder effectively.

None Declared

Conversion disorder is characterised by symptoms that can impact sensory or motor function. The average incidence of conversion disorder is between 4 -12 per 100,000 per year. Conversion disorder has a wide variety of somatic and neurological differential diagnoses.

A 22-year-old woman was admitted to the hospital due to COVID-19 pneumonia. During the hospitalisation period, she developed progressive weakness, due to which she couldn’t move, eat or take care of herself. In terms of history, she is healthy, married and gave birth to her first child almost 9 months ago. Two days postpartum, the patient experienced an inability to connect with the child and provide care, as well as a decline in her mood. The husband reports episodes in which the patient had difficulties holding the child while being able to perform house chores, which required more physical strength. Two years prior to hospitalization, during stressful situations she experienced similar episodes and difficulty swallowing. While hospitalized, extensive testing was done, including an acetylcholine receptor antibody test, which was negative at first. Because of of the initially negative testing results a psychiatrist was called. On the first visit, the patient remained in a supine position and reported a lack of strength in both arms and legs, occasionally experiencing difficulty raising her head, however managed to stand up from the bed, walk independently for 5–6 meters, turn around, and, as soon as she reached the bed, descend into it. The staff reported her inability to walk earlier in the day. On the second visit, she notes that she feels tired but now can feed and take care of herself; however, some weakness persists in the proximal muscle groups. In between visits she received treatment with corticosteroids because of the COVID infection. After repeating the acetylcholine receptor antibody test, there was a positive result, and a diagnosis was established.

This case report demonstrates how a somatic disorder can mimic a psychiatric one because of the overlapping symptoms and initial negative test results. While receiving symptomatic therapy with glucocorticoids due to the COVID infection, the patient’s condition improved; she began to eat and walk on her own.

From the psychiatric aspect, it was associated with separation from the child— a relieving of the stress factor, due to which dissociative symptoms decreased.

Before considering a diagnosis of a dissociative disorder, a patient should be examined by other specialists according to their symptoms. A thorough neurologic and physical examination, as well as diagnostic tests, should be performed to exclude a physical pathology. Myasthenia gravis has a comorbidity with a number of psychiatric conditions and can also be very similar to a dissociative disorder, especially due to stress aggravating the symptoms of myasthenia gravis.

None Declared

Psychological trauma is a significant public health concern with long-lasting effects on physical and mental well-being. Trauma-informed care is an approach to providing support and services that acknowledges and integrates an understanding of the pervasive impact of trauma on individuals. This review delves into the critical imperative of trauma-informed care within the realm of health services. Recognizing the pervasive impact of trauma on individuals’ physical and mental well-being, this REVIEW aims to explore existing literature, identify key objectives, and propose effective methods for implementing trauma-informed strategies in health services.

To Review Existing Literature on Trauma: Conduct an review of the literature to comprehend the varied dimensions and consequences of trauma on individuals’ health; To Identify Key Principles of Trauma-Informed Care: Explore established principles of trauma-informed care, highlighting their relevance and applicability within health service settings; To Propose Implementation Strategies: Develop practical strategies for integrating trauma-informed care into health services, ensuring a comprehensive and sensitive approach to patient care.

A review of published articles, books, and reports related to trauma and trauma-informed care to establish a foundational understanding.

Psychological trauma can have profound and multifaceted impacts on individuals, affecting their mental, emotional, and even physical well-being. The consequences of psychological trauma can vary widely based on the nature, severity, and duration of the traumatic experience, as well as individual factors such as resilience and support systems. Trauma-informed care aims to create an environment that is sensitive to the needs of those who have experienced trauma, and it is based on six key principles: safety, trustworthiness, peer support, collaboration, empowerment, and cultural competence. Healthcare providers need to understand trauma beyond the personal and acknowledge the cultural, historical, social, political, and structural trauma that impact individuals and communities across generations. This approach recognizes that there is a risk of retraumatization in social and health services, especially for minority communities.

This review underscores the pressing need for health services to adopt trauma-informed care strategies. By acknowledging the prevalence and impact of trauma on health outcomes, the healthcare sector can transition towards a more patient-centered and empathetic approach.

None Declared

It is well known that emotions guide decision-making processes in risk contexts. Several studies in the literature have showed the influence of emotions on risk-taking using the Balloon Analogue Risk Task (BART).

The aim this research was to investigate the influence of emotional intelligence (EI) levels on the impact of emotions in risk-taking propensity assessed by the BART.

To this end, we developed a variant of the BART in wich each balloon displayed a face with an emotional expression: happiness, fear, or neutral. EI was assessed from the performance-based ability model by the MSCEIT. The sample consisted of 120 participants (Mage = 21.52; 80% women).

A repeated measures ANOVA revealed a higher tendency to take risks when happy faces were presented, compared to the fear and neutral conditions. Moreover, participants with higher levels of EI showed a lower tendency to take risks across all emotional conditions. This relationship was particularly strong in the fear faces.

Our findings support the effect of incidental emotions on risk-taking and suggest the role of EI as a protective factor for risk engagement.

None Declared

In the medical field, work addiction is a double-edged phenomenon. It can be regarded as a positive addiction leading to high motivation to work, but it can also have adverse mental, physical, and social consequences.

To assess the relationship between work addiction and perfectionism in trainee doctors.

We conducted a cross-sectional descriptive and analytical study among trainee doctors. We used the “Work Addiction Risk Test” (WART), and “The Big Three perfectionism scale short form”.

A total of 99 doctors were included. The mean age of participants was 27.6 years, with a sex ratio (M/F) of 0.33. The doctors in our study worked 5.39±1.6 hours a day and were on call 3.84±2.87 times a month. Their average number of hours of sleep was less than 7 hours in 43.4 % of participants. The mean score of the WART was 61.2±14.83. Among the trainee doctors surveyed 39% were considered at high risk of workaholism. The mean WART score was significantly higher among female physicians and those who slept less than 7 hours per day on average. In addition, the average score on the WART scale was significantly associated with the number of calls per month. We found a statistically significant association between perfectionism scores and work addiction scores.

Our study showed that work addiction is common among doctors in training and is favored by high levels of perfectionism. It is therefore essential to explore and define preventive measures to help them find a balance allowing them to aim for high standards and be able to progress, without setting unrealistic expectations, which can lead to work addiction.

None Declared

Perfectionism is often seen as a beneficial trait for trainee doctors since it means they have high standards and a drive for success. However, it demands a flawless level of performance regardless of one’s physical or mental health and well-being. Consequently, perfectionism is now viewed from a different perspective.

We aimed to study the impact of perfectionism among doctors in training on their self-esteem.

We conducted a cross-sectional descriptive and analytical study among trainee doctors. The following psychometric instruments were used: The “Work Addiction Risk Test” and the “Rosenberg Self-Esteem Scale”.

We included 99 doctors in training. Their mean age was 27.6± 2.2 years. The sex ratio (♂/♀) was 0.33. Most participants were single (63.6%) and of middle socioeconomic level (86%). Tobacco use was reported in 6.1% of cases, and alcohol use in 4.1% of cases. Among all participants, 58 % had low or very low self-esteem. The mean score of Rosenberg Self-Esteem Scale was 30±5.13 and the mean score of the big three perfectionism scale short form was 41.11±13. Higher self-esteem scores was significantly associated with lower self-critical perfectionism scores.

Our results point to the negative impact of self-critical perfectionism on self-esteem. In fact, perfectionism can hold you back, both personally and professionally. Perfectionists see their own self-worth as tied to what they achieve, and they believe that others judge them on this as well. They can never live up to the standards they set for themselves, and this can lead to a downward spiral of self-criticism and blame.

None Declared

Psychiatric care is unique in its scope and complexity, as it involves the assessment and treatment of a wide variety of pathologies and, as these patients seek treatment, it is imperative to understand who accompanies them in clinical consultations and how the presence of these companions influences the treatment path. The dynamics between psychiatric patients and their companions in consultation, is extremely important as it can have significant implications for the effectiveness of treatment and the well-being of the patient.. Therefore, the presence of companions can take different forms, varying according to the diagnosis and needs of each person.

Thus, the authors intend, through carrying out a research study, to fill a critical gap in the understanding of presence of companions in psychiatric consultations, exploring the diversity of companions and their profiles in relation to patients psychiatric patients with specific diagnoses. Furthermore, they intend to understand how their presence impacts the process of adherence to the treatment.

To achieve this, they defined a two-year follow-up period, where they examined in detail the composition of companions in psychiatric consultations, including who they are, their relationship with the patient and how this relationship varies according to different psychiatric diagnoses.

The presence of companions in psychiatric consultations is expected to prove to be a significant facet in the field of mental health, providing valuable insights into the dynamics of consultations and the treatment of patients with different psychiatric diagnoses. In this study we highlight how the presence of companions varied in relation to psychiatric diagnoses and how this influenced the process therapeutic. One of the main results was the identification of the different types of companions who were present at the consultations psychiatric disorders, reflecting the diversity of available social support and highlighting the importance of understanding the available support networks. A notable variation in the presence of companions in relation to psychiatric diagnoses was also observed, emphasizing the variations monitoring needs according to the nature of psychiatric disorders, suggesting the need for management strategies personalized treatment. This study also highlighted the influence of the presence of companions on doctor-patient communication and on adherence to treatment, in which the presence of family members often facilitated communication, allowing for a better understanding comprehensive history of the patient.

In conclusion, this study contributes to a more holistic understanding of mental health care provision, highlighting the importance to consider not only the patient, but also the support context in which they are inserted

None Declared

The advent of digital innovations in psychiatry has ushered in a new era in mental healthcare. These innovations offer the potential for enhanced diagnosis, treatment, and patient care. Establishing scientifically backed, dynamic, and adaptive business models is necessary to launch sustainable innovations onto the healthcare market.

This poster aims to provide a comprehensive understanding of the complex business-related challenges posed by digital innovations in psychiatry and to offer insights into potential strategies to address these challenges. The objectives include illuminating the dynamic landscape of digital psychiatric care from a business perspective.

A systematic review of the current literature was conducted, encompassing scholarly articles, industry reports, and expert perspectives. This method enabled the synthesis of insights regarding how digital innovations are reshaping the business models of psychiatric medical markets and the unique challenges.

Digital innovations in psychiatry are catalyzing a transformation of business models in the field. Telepsychiatry, Digital platforms, VR technologies, and AI-driven diagnostic tools have expanded the reach of psychiatric services, potentially attracting new patient populations and offering innovative payment models. The opportunities presented by these technologies are promising. However, substantial challenges exist in parallel. Safeguarding data privacy and security is paramount, given the sensitive nature of patient information. Navigating the evolving regulatory, managing the costs associated with the adoption and maintenance of these technologies pose significant hurdles. Complex pricing structures and reimbursement models further add to the complexity of the challenges, necessitating adaptability and innovative strategies.

This poster underscores the dynamic and multifaceted nature of business models in the market of psychiatric innovations. While these innovations offer expanded service reach, improved patient engagement, potential for innovative payment models, addressing the business-related challenges is of utmost importance. Compliance with data privacy regulations, cost management, adaptability in pricing and reimbursement strategies are fundamental for psychiatric innovators. Proactive measures are pivotal as the mental healthcare field continues to embrace digital innovations. By addressing these challenges, the mental health industry can fully harness the transformative potential of these innovations to enhance patient care, improve access to services, and ensure the sustainability of high-quality psychiatric care. The evolving business models in psychiatry require astute management and innovation to thrive in this digital era.

None Declared

Fahr’s Disease, also known as Fahr’s Syndrome, is a rare genetically dominant disease, characterized by the abnormal accumulation of calcium deposits, or calcifications, in various areas of the brain, particularly the basal ganglia. These calcifications, which are typically bilateral and symmetrical, can lead to a wide range of neurological and psychiatric symptoms, making diagnosis and management challenging. It usually manifests between the ages of 40 and 60, primarily after the age of 30.

To contribute to the medical literature by sharing this rare case, thereby increasing awareness and knowledge about Fahr’s Disease among healthcare professionals.

Non systematic review of the literature and access to the medical history of the patient.

We present a case of a 42 year old woman, who came to our hospital with behavior changes, with increasing confusion and new mystical beliefs, insomnia and agitation.

According to the patient’s husband, the patient sounded confused and inappropriate in her speech. The patient was admitted for evaluation of altered mental status. The patient was alert and oriented to person, place, time, and situation in the emergency department, with shudder while neurologically intact. The patient was unpolite, agitated.

Psychiatry was consulted for evaluation. We decided to admit the patient and did a posterior study with a CT scan and MRI. The MRI, as well as CT scan revealed “dense calcification of the dentate nuclei and the basal ganglia”, highly suggestive of Fahr’s syndrome. The patient’s phosphorus level was 3.5 mg/dl (normal level: 2.5-4.5 mg/dl). Parathyroid hormone (PTH) intact was 53 pg/ml (normal level: 15-65 pg/ml), and calcium level was 10,3 mg/dl (normal level: 8.4-10.5 mg/dl). The vitamin D 25-hydroxy concentration was 43,5 ng/ml (normal level: 30-60 ng/ml).

In conclusion, Fahr’s Disease is a rare and complex neurological disorder characterized by idiopathic calcification of the bilateral basal ganglia, resulting in a diverse range of neurological and psychiatric symptoms. Diagnosis involves clinical evaluation and neuroimaging, while treatment is primarily symptomatic. Further research is needed to better understand the underlying genetic and biochemical mechanisms driving calcification in the brain and to develop more effective therapeutic strategies for this challenging condition.

None Declared

Despite vulnerability being a poorly understood concept is a key concept in health and social care disparities. Typically, vulnerable groups include individuals with physical and/or mental disabilities, children, the elderly, members of the lower social classes, and refugees. In Portugal, the pandemic was responsible for worsening inequalities in access to health and social care for the most vulnerable. To the best of our knowledge, there is a dearth of qualitative research on vulnerability from the viewpoint of those who are vulnerable or work with the most vulnerable.

As expressions of vulnerability are strongly influenced by cultural factors, this study aims to examine issues of vulnerability among people who attend and work in a Portuguese community-based association.

Secondary analysis of qualitative data from twelve vulnerable people and fifteen professionals who attended these people. The manifestations of the vulnerability reported by participants included being homeless, being a migrant, having an infectious disease, being drug dependent, living with socioeconomic difficulties (unemployment), and experiencing a process of loss and grief. They also reported having a mental or physical health problem, or both. Depression and anxiety were the most often reported mental health disorders. Regarding the academic background of professionals, most of them (n = 12) are from social sciences (e.g., social workers, social mediators, and psychologists).

Three main themes emerged from the study: (1) meanings of human vulnerability; (2) barriers to vulnerability mitigation; and (3) approaches to addressing vulnerability. Our findings revealed that vulnerability is a very dynamic process of openness to conditions that impact individual outcomes. However, there is a conceptual gap: being vulnerable is perceived as something negative, but vulnerability also has the potential to change priorities in life for the better. Some participants emphasized the importance of self-care to avoid becoming vulnerable themselves, particularly in terms of mental health.

Understanding the social determinants of vulnerability is necessary to achieve satisfactory care for human groups. Practitioners need to be aware of these larger societal dynamics, understand them, and make sure their services are responsive to cultural differences. In order to develop interventions that promote social and health outcomes, practitioners should be encouraged to share knowledge on best practices.

None Declared

ADHD is a diagnosis almost always made in childhood or adolescence and oftent difficult to make it new in adults because it is not thought of in the differential diagnosis process and for the lack of experience from adult devices.

• - ADHD in adults is characterized by symptoms of executive dysfunction, inattention, emotional dysregulation. The symptoms of impulsivity and hyperactivity tend to be less evident.

• - Frequently, the adult patient with ADHD comes to the consultation with a secondary symptom and the primary pathology is hidden and often not evident at first glance.

• - A 20-year-old woman, university student, with no relevant medical or psychiatric history, without toxic habits, who attended her first consultation referred by her primary care physician for long-standing insomnia, restless legs and anxiety.

• - The patient’s underlying complaint and her bigger concern is her poor academic performance. It is striking that she has just started her third year at the university, the first year she did not pass any subjects, the second year she changed majors and only passed two, now she is repeating the course.

• - The examination did not reveal overt affective symptoms, nor psychotic symptoms or other notable psychopathology. The patient’s speech tended towards superficiality, inconcretion, it was salty, it was difficult for her to express herself, even suggesting a certain intellectual disability.

• - In the first consultation sleep study is requested. And referral to clinical psychology consultation for psychometric study.

• - She is administered Clinical interview and WAIS IV (Adult Intelligence Scale), Trail Making Test, d2 and Stroop, Diagnostic Interview for ADHD in adults (inattention items).

• - The WAIS-IV demonstrated global cognitive abilities within normality, although with significantly lower scores in the IMT and IVP indices which involve the functions of attention, concentration, mental control and short-term visual memory). Trail Making Test, d2, Stroop and Diagnostic Interview of ADHD in adults (inattention items) yielded profile results highly suggestive of Attention Deficit Disorder without Hyperactivity.

• - The insomnia subsided with a regimen of 7.5 mg of mirtazapine per day. Subsequently, after starting treatment with low-dose methylphenidate (20 mg/day), the patient improved very significantly, both academic performance and social functioning and mood, self-esteem and subjective well-being.

• - We must always include ADHD in the differential diagnosis of a young adult patient when faced with a wide variety of consultation symptoms, especially if they report some type of deterioration or dysfunction in their social, family or academic life.

• - An adequate clinical evaluation supported, if possible, by psychometric tests is essential to reach the diagnosis, which allows establishing an effective treatment that modifies the patient’s overall prognosis.

None Declared