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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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

Adolescents with depression have distinct affective reactions to daily events, but current research is controversial. The emotional context insensitivity theory suggests blunted reactivity in depression, whereas the hypotheses of negative potentiation and mood brightening effect suggest otherwise. While nonlinear associations between depression severity and affective reactivity have been observed, studies with a separate subclinical group remain rare. Subthreshold depression (SD), defined by two to four symptoms lasting for two weeks or more, provides a dimensional view to the underpinnings of affective reactivity. In this study, we compared positive affect (PA) and negative affect (NA) reactivity to positive and negative daily events (uplifts and stress) among adolescents with Major Depressive Disorder (MDD), SD and healthy controls (HC) using experience sampling methods (ESM).

We hypothesized a stepped difference in affective reactivity along the depression spectrum: the MDD group will have the strongest reactivity of PA and NA to uplifts and stress, followed by SD and HC.

Three groups (MDD, SD, and HC) of adolescents were recruited from an epidemiologic sample entitled ‘Hong Kong Child and Adolescent Psychiatric Epidemiologic Survey: Age 6 to 17’. Group status was determined by the Diagnostic Interview Schedule for Children Version 5. They completed an experience sampling diary on smartphone for 14 consecutive days, with 5-10 entries per day. Momentary levels of PA (happy, relaxed, contented), NA (irritated, low, nervous), uplifts and stress experienced before the entry were measured on a 1-7 Likert scale.

The sample consisted of 19 adolescents with MDD, 30 with SD, and 59 HC. The M:F ratio was 17:19. The age range was 12-18 with a mean of 14.8. The overall ESM completion rate was 46%. The MDD group had the highest levels of stress and NA, and the lowest levels of uplifts and PA, followed by the SD and HC groups respectively (p<0.01). Across groups, levels of PA were positively associated with uplifts and negatively associated with stress, whereas levels of NA were positively associated with stress and negatively associated with uplifts. The Group x Uplift interaction effect on PA was significant, with greater PA reactivity in SD (p<0.01) and MDD (p=0.07) when compared with HC. The Group x Uplift interaction effect on NA was significant, with greater NA reactivity in SD than HC (p<0.01). The Group x Stress interaction effect on PA was significant, with greater PA reactivity in SD than HC (p<0.01) and MDD (p<0.01). The Group x Stress interaction effect with NA is non-significant.

Contrary to our hypothesis, adolescents with SD experienced strongest PA and NA reactivity in uplifts and PA reactivity in stress. It provides evidence towards a nonlinear relationship between severity of depression and affective reactivity.

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The mental health of flight crews is of paramount importance. Due to the demanding nature of their work, crew members are subject to various stress factors such as irregular working hours, time differences, operational demands and high passenger safety responsibilities.

We aimed to evaluate the mental health of Tunisian flight crews working for a private airline.

This is an exhaustive cross-sectional study which included all flight crews working for a private airline in Tunisia who consulted the occupational medicine and pathology department at the Farhad Hached University Hospital in Sousse as part of their periodic check-up. Data collection was based on a pre-established questionnaire which included socio-demographic data, lifestyle habits and professional data. The DASS21 questionnaire was used to assess depression, anxiety and stress.

Our study included 160 participants. The median age was 42 years with a female predominance. More than half were smokers (58.8%). Alcohol was consumed by 41.3% of flight crews. The vast majority drank coffee (84.4%). With regard to professional data, 71.3% were flight attendants. The median length of service was 15 years. The majority of participants had operated a medium-haul flight (< 5 hours) during the last month (65%). The majority of participants (85.6%) had a normal depression score. Almost a third of the participants (28.5%) had anxiety scores ranging from mild in 24 to extremely severe in one patient. The majority of flight crews had a normal stress score (90%). After multivariate analysis, unmarried marital status, working more than 2 days a week and stress were factors independently associated with anxiety.

Work-related psychosocial risks can have a major impact on workers’ mental health. It is therefore essential to take these risks into account and put in place preventive measures to protect workers’ mental health and promote their well-being at work.

None Declared

Depression in the elderly represents a multifaceted and critical area of study within the realm of geriatric mental health. As the global population continues to age, the prevalence and impact of depression among older adults have garnered increased attention from researchers and clinicians.

This abstract delves into the comprehensive exploration of the clinical and psychometric characteristics of depression in the elderly population. This study aims to contribute to a deeper understanding of depression’s manifestation in the third age, providing invaluable insights that can inform tailored interventions, improve diagnostic accuracy, and enhance the overall quality of life for older adults.

A cross-sectional study was conducted that gathered 80 patients. Their common characteristics were the signing of the consent, their admission to the Psychiatry Clinic in Timișoara and their main diagnosis with one of the ICD-10 codes F32.x, F33.x or F06.8.

This selection resulted in three groups: patients younger than 65 years old, patients older than 65 years in whom depression began before this age, and patients older than 65 years in whom depression began after 65 years of age. Anamnestic data, paraclinical, socio-demographic data, psychometric scales that measured the level of depression as well as personality scales were collected. The data that was obtained was compared and examined to find significant correlations between the 3 batches.

The results show that there are no significant differences between patients with depression from rural or urban areas, showing the universality of the occurrence of this disorder among the population, regardless their environment. Depression in the third age is most often found in the elderly who have only finished secondary school, education levels playing a role in depression prevalence suggest the significance of socio-economic factors, warranting targeted outreach and education efforts in vulnerable populations. Correlations were also found between the level of depression and certain blood parameters. The integration of these findings for an understanding of the etiology of depression can pave the way for new therapeutic approaches. Certain personality traits were correlated more with certain items on the scales that evaluated depression, thus in those with a neurotic personality it is very strongly correlated with the appearance of guilt as a symptom, agreeableness with psychomotor slowness, paranoid with insomnia, and anankastic and dependent personalities were correlated much more with social isolation.

By recognizing the distinct clinical features and implications of depression in older adults, we can pave the way for improved mental health care and better quality of life for this growing population. This study reinforces the importance of continuous research and collaboration in the field of geriatric mental health.

None Declared

The results of the study of psychological factors of hostility in depression are presented. The topicality of the study is due to hostility considered, on the one hand, as a property of depression, and on the other hand, as a risk factor, associated with the likelihood of auto-aggressive behavior.

The aim of the study was to analyze the relationship between hostility and attachment disorders in endogenous depression.

The study involved 49 patients with depressive disorder (mean age 19,8±4,5). All patients were assessed using the Hamilton Depression Rating Scale (HDRS-17 mean 21,03±6,02). All completed the following methods: Revised Experiences in Close Relationships (ECR-R); Symptom Check List-90-Revised (SCL-90R); Aggression Questionnaire by Buss and Perry (BPAQ); I-structural test by G. Ammon (ISTA). According to the “depression” parameter of the SCL-90R, the group was divided into subgroups with high and medium severity of depression. Analysis of variance (ANOVA) or Mann-Whitney test were. Correlation analysis (Spearman) and stepwise multiple regression analysis were also used.

At high levels of depression, the indicators of “hostility”, “destructive” and “deficit aggression” are statistically significantly higher. The severity of depression significantly correlates with the severity of “anxiety” in attachment (close relationships), as well as with pathological “narcissism”, “destructive external self-delimitation”, “deficient internal self-delimitation”.

For the measure of depression, regression analysis showed that the regression model explained more than 76% of the variance, with the measures of “interpersonal sensitivity”, “deficit narcissism”, and “avoidance” in attachment making significant contributions. For the “hostility” the regression model explains about 62% of the variance, while a significant contribution is made, as in the analysis of “depression”, by the indicators of “interpersonal sensitivity” and “avoidance”, however, unlike “depression”, the contribution of the “destructive narcissism” is noted in contrast to the “deficit narcissism”.

With severe depressive symptoms, indicators of hostility are increased. Hostility in depression is associated with factors caused by a violation of early interpersonal relationships (anxious attachment), which causes increased sensitivity in relations with others, “building a barrier” between oneself and the external environment perceived as hostile in the narcissistic pathology, problems in emotional regulation. One of the targets of psychotherapeutic work may be the ambivalence between desire for symbiotic dependence and the experienced hostility.

None Declared

Chronic exposure to damaging noise can lead to hearing loss . People suffering from hearing problems find it increasingly difficult to communicate and become withdrawn. This lack of contact can lead to the onset of anxiodepressive disorders .

To study the epidemiological and clinical particularities of hearing loss in patients with psychoaffective disorders.

To study the impact of this association on the medical aptitude for work.

Retrospective descriptive study of depressive patients with hearing loss who consulted the Occupational Medicine Department at Charles Nicolle Hospital over a six-year period from January 2016 to November 2022.

Out of 150 patients with hearing loss who consulted our service, 10 patients had an axio-dépressive disorder . Seven were men and three were women. The mean age was 43 ± 5 years and the mean job seniority was 11 years [3-20]. they belonged to the telecommunications (n=6), industry (n=2), printing(n=1), and transport sectors (n=1) . The job positions were : teleconsultant (n=6), operator machine (n=3) and driver (n=1)  the symptoms presented by the patients were hearing loss (n=4), otalgia (n=1) , diziness (n=1), tinnitus(n=1) . The average time to onset of symptoms was 13±8 years [1-35] . The hearing deficits presented by the patients were: sensorineural hearing loss (n=7), mixed hearing loss (n=1) and conductive hearing loss (n=2). The mean of Hearing loss were 34±9 dB in the right ear and 34±6 dB in the left ear . A declaration of the deafness as an occupational disease was indicated in two of the cases. the univariate statistical study showed that anxiety-depressive disorders were associated with tinnitus (p=0,036,OR=4,2[0,99-17,659]) and the position of teleconsultant (p=0,009,OR=5,622[1,338-23,627] . Eviction from exposition to noise was indicated in seven cases

According to our study, hearing loss in patients with anxio-depressice disordes is associated with tinnitus and teleconsultant job position . Early screening early screening of people at risk is recommended.

None Declared

Major depressive disorder is a common psychiatric condition affecting around 264 million people worldwide (WHO: Depression Fact Sheet. [Apr;2021]). Despite pharmacological advances, many patients still do not respond to antidepressant treatment or do so partially.

It is estimated that only 50-70% of patients respond to the initial antidepressant treatment according to the STAR-D study. 15% percent of cases do not respond significantly to various pharmacological and psychotherapeutic attempts (Rush AJ et. STAR*D report. al Am J Psychiatry). The current consensus places resistant depression for a practical approach in one that has been treated with two different antidepressant strategies in adequate doses and time and has not been remitted (Souery D et el, Treatment-resistant depression. J Clin Psychiatry 2006). We present a clinical case of a patient with Major Depressive Disorder, resistant to several therapeutic lines, in which intranasal esketamine was initiated.

The main objective is to report the result of treatment with esketamine in a clinical case.

This work analyze the clinical evolution and reponse of a 62-year-old patient after initiating intranasal esketamine.

This is a patient with a single depressive episode, with no personal psychiatric history of interest that, after exhausting several options of pharmacological and non-pharmacological treatment.

Regulated psychotherapy based on cognitive behavioral therapy was carried out along with different pharmacological strategies according to the recommendations of the main clinical guidelines: antidepressant dose increase, antidepressant change, combination of several antidepressants and potentiation with another drug. We measured clinical changes with MADRS Scale (Montgomery-Asberg Depression Rating Scale) at diferent times.

From the fifth administration of esketamine the patient presented a clear improvement. At three months, the score on the MADRS scale improved markedly and at 6 months, the patient reported euthymia.

Score MADRS:

• - Basal 46

• - 3 Months 14

• - 6 Months 1

As for the adverse effects, the patient presented in all administrations very mild dizziness.

The use of esketamine is a new therapeutic approach, being fast, safe and well tolerated in patients with depression who do not respond to other treatments (Sapkota A et al. Efficacy and Safety of Intranasal Esketamine in Treatment-Resistant Depression in Adults: A Systematic Review. Cureus.2021 Aug 21;13(8)). In our patient has proven to be effective and fast.

None Declared

We present the case of a 56-year-old patient with two depressive episodes with psychotic symptomatology in a period of three years, who began with mania and developed Alzheimer’s disease.

The case is presented with the aim of providing a brief review of psychiatric symptomatology as a prodrome of Alzheimer’s disease.

A 56-year-old patient, with no psychiatric antecedents of interest, who presented a depressive episode with psychotic symptoms, requiring admission to a short hospitalisation unit, as well as antidepressant treatment with sertraline at 200mg daily and olanzapine 20mg. He remained stable for two years and was able to withdraw treatment progressively. However, after remaining euthymic without pharmacological treatment for six months, he had another episode with psychotic symptoms. In this last episode, he did not require hospital admission, but he did require a change in antidepressant treatment, given that he did not tolerate treatment with sertraline. Treatment was therefore started with duloxetine 120mg, aripiprazole 20mg and as no clear improvement was observed, months later it was decided to use lamotrigine 100mg as a stabiliser.

In this last episode, despite the significant affective improvement and maintaining psychopathological stability, without presenting psychotic symptoms, the patient presented marked dysfunction in day-to-day life due to a striking attention deficit, lack of concentration and reduced short-term memory. At the same time, he also exhibits mannerisms which are observed in the consultation room, in the form of repetitive hand movements.

For these reasons, it was decided to request MRI and SPECT, obtaining results compatible with possible incipient cognitive deterioration.

It seems that up to 40% of patients with dementia have depressive symptoms. It seems that depression at an advanced age may in fact be a prodromal symptom of dementia.

None Declared

Sexual dysfunction is a common side effect of antidepressants and can have significant impact on the person’s quality of life, relationships, mental health, and recovery. The reported incidence of sexual dysfunction associated with antidepressant medication varies considerably between studies, making it difficult to estimate the exact incidence or prevalence.

The focus of this e-poster is to explore the incidence, pathophysiology, and treatment of depression disorder and antidepressant iatrogenic sexual dysfunction.

A bibliopgraphical review was performed using PubMed platform. All relevant articles were found using the keywords: depression, sexual disfunction, antidepressant.

Sexual dysfunction is a common symptom of depression. Although decreased libido is most often reported, difficulties with arousal, resulting in vaginal dryness in women and erectile dysfunction in men, and absent or delayed orgasm are also prevalent. Sexual dysfunction is also a frequent adverse effect of treatment with most antidepressants and is one of the predominant reasons for premature drug discontinuation. Selective serotonin reuptake inhibitors are the most widely prescribed antidepressants and have significant effects on arousal and orgasm compared with antidepressants that target norepinephrine, dopamine, and melatonin systems. The availability of an antidepressant that does not cause or exacerbate sexual dysfunction represents an advance in pharmacotherapy for mood disorders and should reduce treatment noncompliance and decrease the need for switching antidepressants.

The sexual problems reported range from decreased sexual desire, decreased sexual excitement, diminished or delayed orgasm, to erection or delayed ejaculation problems. There are a number of case reports of sexual side effects, such as priapism, painful ejaculation, penile anesthesia, loss of sensation in the vagina and nipples, persistent genital arousal and nonpuerperal lactation in women.

None Declared