Basing on our previous findings of significant additional gain obtained from usage of adjunctive antioxidant medicine added to antipsychotic+antidepressant therapy in late-onset schizophrenia-like psychoses (LOP), the group often suffering of comorbid pathologies and experiencing substantial side-effects of drugs, we spred our approach to try “metabolic” medicines as adjunctives in LOP.

To reveal biochemical parameters of the blood cells which might be used for distinguishing subgroups of patients suffering with LOP for whom various adjunctive therapy (antioxidant, metabolic) would be advantageous.

The study included 59 patients 50-89 years old, with LOP (onset after 40 years), and 38 healthy peoples 51 – 84 years old. The activities of glutamate dehydrogenase (GDH), glutathione reductase (GR), and glutathione S-transferase (GST) were determined spectrophotometrically in erythrocytes and platelets. Scores by PANSS were evaluated twice: before and on the 28-th day of antipsychotic treatment.

Samples from control group were used for determination of the control ranges for levels of studied enzymatic activities. Enzymatic activity levels were analyzed in three groups of patients: group Gr1 (n=16) treated without adjunctive therapy, and two other groups (Gr2 and Gr3) treated with adjunctive medicines: antioxidant 2-ethyl-6-methyl-3-hydroxypyridine succinate (Gr2, n=20), or “metabolic” medicines citicoline/cerebrolysin/cortexin/actovegin/gliatilin (Gr3, n=23).

As compared with controls, activity of erythrocyte GR was decreased at baseline and after the treatment course in all patients’ groups (p<0.01); in Gr2 significant decreases in baseline platelet GDH and GST activities were observed (p=0.005). Different significant links between biochemical parameters and scores by clinical scales before treatment were observed: in Gr1, erythrocyte GST activity positively correlated with scores by PANSS-Neg (R=0.61, p=0.012), by PANSS-Psy (R=0.54, p=0.032), and by PANSS (R=0.62, p=0.010), in Gr2, erythrocyte GST activity positively correlated with scores by PANSS-Pos (R=0.53, p=0.016), by PANSS-Psy (R=0.52, p=0.015), and by PANSS (R=0.60, p=0.005), in Gr3, platelet GR activity positively correlated with PANSS-Pos (R=0.50, p=0.014).

We have confirmed the additional favor (decrease in side-effect severity) obtained by distinct patient groups when treated with adjunctive antioxidant or “metabolic” therapy. Moreover, correlations revealed in the patient subgroups between enzymatic activities and scores by psychometric scales enable revealing those biochemical markers measurement of which facilitate differentiating the patients for whom the adjunctive medicines to antipsychotic+antioxidant treatment can positively influence the treatment outcome.

None Declared

Patient care suffers when practitioners do not understand the patient’s experience of the illness. This is especially true in psychiatry relative to patients having learned the jargon and studying the diagnostic criteria for various mental disorders using internet search engines, especially Google. Patients more commonly present with a list of symptoms that match the checklist for their self-diagnosis. Their experience may be quite different from the words they use to present their symptoms to medical personnel. More than ever, psychiatric providers need to unpack the words their patients use to discover the actual experience. K. Toombs has written exquisitely about clinical phenomenology in the context of her diagnosis of multiple sclerosis and her negotiation of a medical system that largely ignored her lived experience. This algorithmic, checklist approach to human suffering derives from an understanding of clinical practice in which the practitioner applies scientific knowledge of the bodily processes of diseases, recognizing those diseases by inquiring about the presence of symptoms characterizing those diseases and then rendering treatments based upon statistical studies (preferably randomized, controlled trials) of large groups of individuals. Within this approach, little need exists to encounter the person with the disease as an actual human being, an Other in the sense of Levinas. This approach suffers because even history-taking requires an encounter with an Other in which the internal, private experience of this Other must be heard and made part of the clinical process. This approach can ignore the role of the doctor-patient relationship and the clinical encounter in symptom relief.

To describe an educational program in clinical phenomenology that was well received by trainees who rated that it improved their practice.

In this presentation, we will describe our efforts at teaching clinical phenomenology and psychiatry within a residency training program, in which we encourage trainees to develop deeper listening skills through conducting life story interviews, motivational interviewing techniques, and narrative approaches in which they search for the metaphors underlying the patients’ illness. We will describe factors influencing trainees’ acceptance or rejection of these approaches and the change in the culture of our training program and clinic that have arisen from their implementation.

One hundred and twenty residents have taken this course. Eighty-eight percent reported improved clinical skills and ability to relate to patients.

The practice of medicine does not exist independently from the relationships in which medicine is practiced and a thorough understanding of the lived experience and experience of the patient is necessary for accurate diagnosis, psychiatric or medical, and for discovery of a treatment approach with the patient.

None Declared

Philosophy of mind grapples with fundamental questions concerning the Consciousness, the Mind-body problem, the Identity, and Free will (as opposed to Determinism). In the context of psychiatry, this philosophical groundwork provides a conceptual framework for comprehending the intricate workings of the human psyche.

We aim to discuss how the philosophical investigation of the mind influence and enhance psychiatrists understanding of psychiatric disorders and patient-centered care.

Review of the literature.

Philosophy of mind explores what it means to be conscious and the nature of subjective experience. This includes questions about the “hard problem” of consciousness, that refers to the difficulty of explaining why and how physical processes in the brain give rise to subjective, first-person experiences (or qualia). The “hard problem” posits that even if we knew everything about the brain’s physical processes and how they relate to cognitive functions, we would still lack an explanation for why these processes give rise to subjective consciousness. Psychiatry often deals with individuals who experience disturbances in their subjective conscious experiences, so the “hard problem” perspective allows psychiatrists to appreciate the diversity of conscious experiences and to empathize with their patients’ unique mental worlds.

Related with the previous topic is the mind-body problem. The elucidation of this problem highlights the challenge of reconciling mental phenomena with neurobiological processes. Integrating philosophical notions of dualism, materialism, and emergentism into psychiatric practice is essential for addressing the holistic nature of mental health.

Concerning to philosophical perspectives on personal identity, questions about the continuity of identity, selfhood, and the role of narrative in shaping one’s sense of self contribute to a deeper understanding of disorders like dissociative identity disorder, borderline personality disorder and even psychosis.

Furthermore, philosophical discussions on free will and determinism are pertinent to psychiatric ethics and the treatment of individuals with behavioral disorders, informing the ethical considerations surrounding involuntary psychiatric hospitalization, medication administration, and the delicate balance between autonomy and paternalism in psychiatric care.

Philosophy of mind provides psychiatry with a rich conceptual landscape, offering insights into the nature of mental phenomena. As our understanding of the brain and consciousness continues to evolve, the philosophy of mind remains an evolving area of philosophical inquiry.

None Declared

The 10-item Montgomery–Åsberg Depression Rating Scale (MADRS) measures different dimensions of depression symptomatology. Digital traits may generate deeper understanding of the MADRS subscales and provide insights about depression symptomatology.

To identify digital traits that predict specific MADRS subscales and ascertain which digital traits are important for which MADRS subscales.

During a Phase II decentralised clinical trial in major depressive disorder (MDD), patients completed the MADRS and used AiCure (LLC, New York, NY, USA), a smartphone application, to complete image description tasks at baseline. Digital measurements identified from the literature as relevant to MDD symptomatology were conducted using audio and video data derived from the image description tasks. Digital measurements included speech (rate, sentiment and first-person singular pronouns), vocal acoustics (intensity, pause fraction and fundamental frequency), facial expressivity (regional facial movement) and head pose (Euclidean and angular head movement). Digital traits analysis involved data pre-processing followed by machine learning (ML) using Elastic Net, Decision Tree, and Random Forest models; model performance was evaluated using 5-fold cross-validation and mean absolute error (MAE). Important digital traits were calculated by percentage change in MAE after permuting a specific variable. Important digital traits for the MADRS Apparent Sadness subscale score were mapped to defined, interpretable domains.

The ML model predictions varied for different MADRS subscales (Table). Overall, Elastic Net and Random Forest models outperformed Decision Tree across all subscales scores other than suicidal thoughts. Half of the literature-based digital traits contributed to the prediction of ≥1 MADRS sadness sub-scale score. The important digital traits for the Apparent Sadness subscale score could be mapped to 4 domains (Figure); this aligned with findings from the literature.

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Digital traits collected from patients with MDD were able to predict certain MADRS subscales better than others.

Boehringer Ingelheim.

Z. Zhu Employee of: Boehringer Ingelheim Pharmaceuticals, Inc., Y. Wu Employee of: Boehringer Ingelheim Pharmaceuticals, Inc., J. Seidel Employee of: Boehringer Ingelheim International GmbH, D. Roy Employee of: Boehringer Ingelheim Pharmaceuticals, Inc., E. Salzmann Employee of: Boehringer Ingelheim International GmbH

Medication adherence was defined by the WHO as “the extent to which a person’s behavior coincides with the medical advice given” (WHO, 2003). Existing literature indicates that approximately 49% of patients with major psychiatric disorders do not fully adhere to their prescribed psychopharmacological therapy (Colom et al, 2002). Non-adherence can lead to partial therapeutic responses or treatment resistance, increased risk of relapse, re-hospitalization, elevated suicide risk, and overall poorer functioning, thereby compromising the patient-doctor therapeutic relationship (Garcìa et al, 2016).

The aim of the present study was to assess potential differences in terms of clinical features related to adherence to treatment in a large cohort of psychiatric patients of an Italian psychiatric department.

The study included 307 psychiatric patients, of any gender or age, diagnosed with unipolar depression (UD), bipolar depression (BD), anxiety disorders (AD), schizophrenic spectrum disorders (SS) or a primary diagnosis of personality disorders (PD), based on DSM-5 criteria. Patients were consecutively recruited from the Department of Psychiatry at Luigi Sacco University Hospital, in Milan. The patient’s adherence to treatment was evaluated using the Clinician Rating Scale (CRS), with a cut-off of ≥ 5 defining adherence subgroups (A+: score ≥ 5; A-: score < 5). Comparative and predictive analysis were performed for the whole sample and the two adherence subgroups.

Overall, nearly one-third of the whole sample reported suboptimal medication adherence. Specifically, rates were approximately 35.3% and 32.7% for BD and SS, respectively, followed by 30.8% for PD, 28% for AD and, 20.3% for UD (see Figure 1). Patients with A- showed significantly higher current substance abuse (17.8% vs 4.5%, p<.001), along with a higher rate of lifetime substance abuse, although with a trend towards significance (31.5% vs 20.5%; p=.057). Moreover, the A- group had a significantly higher number of lifetime hospitalizations (1.35 ± 1.8 vs 0.73 ± 1.11; p<.001) and higher rate of previous psychotropic treatment dropouts compared to the A+ group (90% vs. 36.2%; p<.001, see Figure 2).

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Approximately one-third of the whole sample reported a suboptimal medication adherence, with varying rates across different diagnoses. Current and lifetime substance abuse appears to be an unfavorable transdiagnostic factor. Additionally, severe outcomes such as increased hospitalizations and a more acute disease presentation are linked to poorer adherence. Recognizing the characteristics of adherence patterns within specific diagnostic categories is crucial for designing precise interventions to enhance patient outcomes and optimize the overall effectiveness of treatment.

N. Girone: None Declared, B. Benatti Speakers bureau of: Angelini, Lundbeck, Janssen, Rovi., M. Cocchi: None Declared, F. Achilli: None Declared, C. Viganò: None Declared, M. Vismara: None Declared, B. Dell’Osso Grant / Research support from: Angelini, Lundbeck, Janssen, Pfizer, Otzuka, Neuraxpharm, and Livanova, Speakers bureau of: Angelini, Lundbeck, Janssen, Pfizer, Otzuka, Neuraxpharm, and Livanova

The literature on Values-Based Practice often neglects the significance of love in therapeutic interactions, sometimes treating it as taboo or crossing professional boundaries.

This systematic review investigates the role of humanitarian love in the lives of healthcare professionals and its psychosocial impact, aiming to establish it as a core value in values-based practice.

We conducted a PRISMA 2020-compliant systematic review, searching databases (CINAHL, PubMed, Scopus) from inception to April 3, 2023, using PEO elements: health professionals (P), love (E), psychosocial impact (O). Two independent reviewers conducted screening, data extraction, and bias assessment. A narrative synthesis of the data was applied. The selection process is presented in Figure 1.

Eight articles met the inclusion criteria, comprising 1,948 participants (median age: 28.55). Humanitarian love encompassed compassionate love, self-compassion, and affection. Humanitarian love showed a negative correlation with burnout, compassion fatigue, self-judgment, and secure attachment, while positively correlating with professional well-being, professional commitment, self-care, patience, diversity acceptance, spirituality, self-kindness, and ethical values. Humanitarian love significantly influenced healthcare professionals’ psychosocial well-being. The main outcomes are presented in Figure 2.

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This review highlights humanitarian love’s potential to enhance the psychosocial well-being of healthcare professionals and emphasizes its significance as a core value in values-based practice. Cultivating humanitarian love among healthcare professionals through research and interventions could bolster their resilience, job satisfaction, and overall fulfillment in their roles.

None Declared

Psychiatric drugs, including antipsychotics and antidepressants, are widely prescribed, even in young and adolescent populations at early or subthreshold disease stages. However, their impact on brain structure remains elusive. Elucidating the relationship between psychotropic medication and structural brain changes could enhance the understanding of the potential benefits and risks associated with such treatment.

Investigation of the associations between psychiatric drug intake and longitudinal grey matter volume (GMV) changes in a transdiagnostic sample of young individuals at early stages of psychosis or depression using an unbiased data-driven approach.

The study sample comprised 247 participants (mean [SD] age = 25.06 [6.13] years, 50.61% male), consisting of young, minimally medicated individuals at clinical high-risk states for psychosis, individuals with recent-onset depression or psychosis, and healthy control individuals. Structural magnetic resonance imaging was used to obtain whole-brain voxel-wise GMV for all participants at two timepoints (mean [SD] time between scans = 11.15 [4.93] months). The multivariate sparse partial least squares (SPLS) algorithm (Monteiro et al. JNMEDT 2016; 271:182-194) was embedded in a nested cross-validation framework to identify parsimonious associations between the cumulative intake of psychiatric drugs, including commonly prescribed antipsychotics and antidepressants, and change in GMV between both timepoints, while additionally factoring in age, sex, and diagnosis. Furthermore, we correlated the retrieved SPLS results to personality domains (NEO-FFI) and childhood trauma (CTQ).

SPLS analysis revealed significant associations between the antipsychotic classes of benzamides, butyrophenones and thioxanthenes and longitudinal GMV decreases in cortical regions including the insula, posterior superior temporal sulcus as well as cingulate, postcentral, precentral, orbital and frontal gyri (Figure 1A-C). These brain regions corresponded most closely to the dorsal and ventral attention, somatomotor, salience and default network (Figure 1D). Furthermore, the medication signature was negatively associated with the personality domains extraversion, agreeableness and conscientiousness and positively associated with the CTQ domains emotional and physical neglect.

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Psychiatric drug intake over a period of one year was linked to distinct GMV reductions in key cortical hubs. These patterns were already visible in young individuals at early or subthreshold stages of mental illness and were further linked to childhood neglect and personality traits. Hence, a better and more in-depth understanding of the structural brain implications of medicating young and adolescent individuals might lead to more cautious, sustainable and targeted treatment strategies.

None Declared

The clinical high-risk state for psychosis (CHR) is associated with alterations in grey matter volume (GMV) in various regions such as the hippocampus (Vissink et al. BP:GOS 2022; 2(2) 147-152). Within the scope of the North American Prodrome Longitudinal Study (NAPLS-2; Cannon et al. AM J Psychiatry 2016; 173(10), 980-988), a publicly available risk calculator based on clinical variables was developed to assess the likelihood of individuals to transition to psychosis within a 2-year period.

In the current study, we aim to examine the association between GMV and NAPLS-2 risk scores calculated for individuals with CHR and recent-onset depression (ROD), taking a transdiagnostic approach on the transition to psychosis.

The sample consisted of 315 CHR (M = 23.85, SD = ± 5.64; female: 164) and 295 ROD (M = 25.11, SD = ± 6.21; female: 144) patients from the multi-site Personalised Prognostic Tools for Early Psychosis Management (PRONIA) Study (Koutsouleris et al. JAMA Psychiatry 2018; 57(11), 1156-1172). Risk scores were calculated using the six clinical and neurocognitive variables included in the NAPLS-2 risk calculator that were significant for predicting psychosis. Further, we derived smoothed GMV maps from T1-weighted structural magnetic resonance imaging using a full width at half maximum kernel size of 8 mm. We employed a multiple regression design in SPM12 to examine associations between risk scores and GMV. On the whole-brain level, we calculated permutation-based threshold-free cluster enhancement (TFCE) contrasts using the TFCE toolbox. Additionally, we calculated t-contrasts within a region-of-interest (ROI) analysis encompassing the hippocampus. All results were thresholded at p < 0.05 with family wise error correction to address multiple comparisons.

Our analysis revealed that linear GMV increases in the right middle and superior frontal gyrus (kE= 2726 voxels) were significantly associated with higher risk for psychosis transition within two years (see figure 1, highlighted in blue). In the ROI analysis, we found a significant negative linear association between GMV decreases in the left hippocampus (kE = 353 voxels) and higher risk for psychosis transition (see figure 1, highlighted in red).

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GMV reductions in the hippocampus have frequently been observed in CHR and psychosis patients (Vissink et al. BP:GOS 2022; 2(2) 147-152), therefore our results further highlight the crucial role of this region in the progression of the disease. There is limited evidence on GMV increases in CHR patients. However, the GMV increase we found in the frontal pole may reflect compensatory mechanisms of the brain in the development of psychosis. In addition, we were able to provide biological validation of the NAPLS-2 risk calculator and its assessment of risk for transition to psychosis.

None Declared

Mental pain is a transdiagnostic symptom, predictive of suicide and reported as a critical outcome by patients. A previous systematic review of epidemiological and clinical research has shown a lack of consensual definition of mental pain in clinical research and high heterogeneity across the different measurement instruments of mental pain. Up today there is no systematic review synthetizing all published biological investigations on mental pain.

This study aims to map the field of biological investigations of mental pain in human to identify what and how biomarkers are investigated with a meta-research approach, by providing a critical appraisal of the terms and definitions of mental pain, the studies’ hypotheses, the experimental paradigms used to induce or mimic mental pain and the measurement instruments used to measure mental pain.

We conducted a systematic review (compliant with PRISMA guidelines) of all primary research reporting to investigate candidate biomarkers of mental pain in human subjects as stated by the authors. We searched from inception to June 23rd, 2022, the 3 databases MEDLINE, Web of Science and EMBASE. We extracted the study characteristics (e.g., year of publication, population, etc.), the terms used for meaning mental pain, the definition of mental pain, the method to induce mental pain and its rational, the hypotheses and aims, the measurement instruments of mental pain, the candidate biomarkers, and their method of investigation. We performed descriptive statistics of the sample’s characteristics and the extracted data, a qualitative analysis of the definitions, hypothesis, aims and experimental paradigms, and a data visualization linking candidate biomarkers, experimental paradigms, and their investigation methods.

The search retrieved 5685 papers of which we included 72 primary research publications constituting 78 distinct research studies. Only 37.5% of studies reported a definition of mental pain. 11.5% of studies did not show a measurement instrument of mental pain. The Cyberball (a social exclusion paradigm) was the most frequently used paradigm in experimental studies (62.7%). The cingulate cortex was the most frequently investigated biomarker category (15.3% of all candidate biomarkers), with fMRI as the most frequent investigation method (53.7% of all investigation methods).

The field of biological investigations on mental pain shows a marked heterogeneity of definitions, terms, hypotheses, experimental paradigms, and measurement instruments, with an over-representation of the construct of social pain and the Cyberball. These could compromise the comparison and combination of studies results in evidence synthesis and their translation into clinical practice.

None Declared

Even though depression is a severe health issue among older adults, few studies have explored their knowledge of geriatric depression.

This study aimed to explore older adults’ knowledge of geriatric depression and its related factors.

A cross-sectional survey was conducted. Older adults were recruited by convenience from outpatient clinics of three hospitals in Taiwan.

A total of 327 older adults participated in this study. Their mean score of knowledge was 7.73 (SD=2.12, Range=2-12) on an 18-item knowledge scale, indicating poor knowledge of geriatric depression. Females had significantly higher geriatric depression knowledge scores than males (t=2.50, p=0.01). Junior and senior high school graduates had significantly higher geriatric depression knowledge scores than illiterate and primary school graduates (F=10.23, p<0.01). In addition, their geriatric depression knowledge scores also differed by religious belief (F=4.91, p<0.01), living status (F=8.64, p<0.01), and perceived health condition (F=8.81, p<0.01). Buddhists had significantly higher geriatric depression knowledge scores than Taoists. Living with partners and perceiving their health status as fair and good tended to have higher geriatric knowledge scores than their counterparts. However, their geriatric depression knowledge scores did not significantly correlate with their mean scores of social distance toward older adults with depression.

Older adults tended to have poor geriatric depression knowledge. Improving their knowledge shall be an urgent task. Our results may serve as references for developing further depression prevention.

None Declared

In South Korea, all men at the age of 18 or older are required to serve at military for a certain period as an obligation. These recruits should be able to withstand psychological stress and pressures of rapid adaptation of the unique and new environment in military. The number of military recruits facing adaptation issues has been on the rise, necessitating an evaluation for active service. In our previous study (Park et al., in press 2023), we classified the military recruits with mental issues according to latent profile analysis (LPA) and examined the treatment response during six months.

In this study, we further examined clinical characteristics over the next six months.

Ninety-two participants were analyzed with LPA using MMPI-2 clinical profiles in the previous study. The three classes were identified: mild maladjustment (Class 1, n=14), neurotic depression and anxiety (Class 2, n=36), high vulnerability and hypervigilance (Class 3, n=42). At 12 months, Clinical Global Impression-Severity and Global Assessment of Functioning were assessed to test their long-term changes.

While Class 1 and 2 significantly improved over 6 months, Class 3 showed little or no improvement even with more medications in our previous study. During the 6-month follow-up period, 50% of Class 1, 38.9% of Class 2, and 41.5% of Class 3 were dropped. It was during this period that their level of military service was decided. Class 1 and 2 which showed marked improvement up to initial 6 months, did not demonstrate substantial further improvement during follow-up period with a considerable portion stopped visiting hospital. Subjects in Class 3, who showed little or no improvement during initial 6 months, demonstrated continued improvement in this study, although their symptoms still appeared relatively severe.

This study suggests clinical implications for treatment plan and intervention of each subgroup classified based on MMPI-2 clinical profiles of military recruits who might show maladjustment to serve. The long-term continuous treatment for Class 3 patients will be needed, even after exemption from active duty.

None Declared

Heart failure is a progressive and unpredictable heart disease. How to work with these patients to decrease their psychological distress and promote their self-care behaviors is important. Transition care is the continuity of medical care for heart failure patients returning home from the hospital. Intervention through transition care may improve the continuity of medical care for patients with heart failure but it has not been examined in clinical settings in Taiwan.

The aims of this study were to explore the effects of a newly developed transition care program on depression, self-efficacy, and self-care behavior of heart failure patients.

Using an experimental research design and block randomization, participants were divided into the experimental group (received transition care and routine care) and the control group (received routine care only). The Patient Health Questionnaire-9 (PHQ-9), the General Self-Efficacy Scale (GSES), and the Self-Care of Heart Failure Index (SCHFI version 6.2) were used to collect data before discharge and the first month after discharge.

A total of 20 patients with heart failure were recruited. No significant differences were found between the experimental (n=10) and control groups (n=10) in the degree of depression (Z=-.077, p=.938), self-efficacy (Z=-1.214, p=.225), and three self-care behaviors subscales (self-care maintenance Z= -1.214, p=.225; self-care management Z= -.401, p=.689; self-care confidence Z=-.436, p=.663) at discharge. After the one-month posttest, only self-efficacy (Z=-2.545, p=.011) and three self-care behaviors subscales (self-care maintenance Z=-3.097, p=.002; self-care management Z= -2.595, p=.009; self-care confidence Z=-3.671, p<.001) reached a statistical difference between the two groups.

Based on the preliminary results, heart failure patients can improve their self-care behavior and self-efficacy but not depression through transitional care intervention.

None Declared

According to the World Health Organization, around 2 billion people worldwide are estimated to drink. Alcohol intake results in 25% of the 3.8% of worldwide fatalities and 4.6% of global disability-adjusted life years that may be attributed to alcohol

This review seeks to synthesize data on psychological and pharmacological treatments for Alcohol Use Disorder (AUD) available in the inpatient setting.

A comprehensive and narrative review of studies and research on psychological and pharmacological interventions for patients with alcohol use disorders in inpatient treatment units was performed. Data was extracted from electronic bibliographic databases, including Medline, EMBASE, PsycINFO, Global Health, HealthSTAR, and Cumulative Index for Nursing and Allied Health Literature (CINAHL) via EBSCOhost. This review included both qualitative and quantitative studies

Overall, after an initial title, abstract screening, and subsequent full-text screening, seven out of 1245 extracted studies met the eligibility criteria and were included in the review. This review suggests that a combination of pharmacological interventions such as naltrexone, nalmefene, acamprosate and brief psychological interventions were effective in treating AUD.

This review suggests that pharmacological and psychological approaches, when used together, are efficacious in treating AUD. There is a need to adopt both pharmacological and psychological interventions in the treatment of AUD.

None Declared

The postpartum period poses a risk of both onset and relapse of mental health disorders in mothers, which can impact maternal-child relationships and development of children. Timely intervention is crucial, especially considering that majority of at-risk women do not seek professional help.

This study aims to evaluate the effectiveness of Mom Supports Mom, a remote peer support intervention, in improving the mental health of postpartum women.

A randomized controlled trial with 488 Czech postpartum women with depressive symptoms (Edinburgh Postnatal Depression Scale, EPDS score ≥ 10 shortly after giving birth) assessed the impact of Mom Supports Mom on depressive and anxiety symptoms (EPDS and Perinatal Anxiety Screening Scale, PASS) and health-related quality of life (Assessment of Quality of Life, AQoL-8D) at 6 weeks postpartum. The Mini-International Neuropsychiatric Interview 5 (MINI) was used to assess psychiatric diagnoses.

The intervention significantly reduced depressive (Cohen’s d = 0.30; p = 0.003) and anxiety symptoms (Cohen’s d = 0.29; p = 0.003) and improved health-related quality of life (Cohen’s d = 0.27; p = 0.008) at 6 weeks postpartum. No significant difference was observed in psychiatric diagnoses between the intervention and the control group.

Mom Supports Mom intervention reduces postpartum depressive and anxiety symptoms and enhances health-related quality of life. These findings support the integration of peer support into perinatal mental health care, addressing barriers that women face in seeking help.

None Declared

The war in Gaza is a stressful life event. Due to its significant human and financial losses, it affected the mental health of people around the world including the middle east citizens.

To study the coping strategies of Tunisian people toward Palestine-Israel war in its first month and the factors associated with them.

It was a cross-sectional, descriptive and analytical study, conducted among Tunisians. Data were collected during October and November 2023, through an anonymous online questionnaire, spread throughout social media (Facebook/Instagram), using the Google Forms® platform. We used a socio-demographic and clinical data sheet and the “Brief-COPE” to assess coping strategies.

A total of 1091 participants completed the questionnaire. Their mean age was 32,7± 9.8 years, with a sex-ratio (F/M) of 3.5. Among participants, 46,1% are married, 42,5% have children and 19,5% have a psychiatric follow history. Sport’s practitioners represent 23,3% of the participants and 10,6% increased their use of sports after the war news.

In terms of coping strategies: problem focused coping was the most used strategy (mean= 2,02) followed by emotional focused coping (mean= 1,98) and avoidant coping (mean= 1,63). Tunisians rely the most on religion, accepting reality and planning as coping mechanisms (score= 2,85; 2,4 and 2,23 respectively). Substance use was the last resort option (score= 1,11).

Our survey revealed significant associations between coping mechanisms and several factors: Venting, humor and behavioral disengagement were significantly correlated with sex gender (p=0,000 ; 0,000 ; 0,000 respectively); Substance use coping mechanism was significantly correlated with participants having a psychiatric follow history (p=0,001); Avoidant coping subscale was significantly correlated with having children (p=0,000); Self distraction was significantly correlated with the increase use of sport among Tunisians (p=0,000).

These findings underscore the need for healthcare and productive coping strategies for Tunisians and middle east people during the Palestine-Israel war.

None Declared

In England, a national Mental Health Act (MHA) review was carried out, providing recommendation for policy and practice changes. One of these recommendations was to provide support to family members (FMs) of patients who have been involuntarily hospitalised. In response to this review, the National Institute for Health and Care Research (NIHR) provided funding for research to address policy questions, for example what support may be most relevant to FMs during their patients’ treatment. The study presented here was funded as part of this initiative and has explored what support FMs wish to receive.

To explore FMs’ experiences and views around support they would have liked during their patients’ involuntary hospitalisation and wider stakeholder views on what a family support programme in England should involve. This information can be used to develop a support programme for FMs.

One-to-one interviews were conducted online as part of two work packages. The first work package explored FMs’ experiences and views of support. The second work package explored views on what should be included in a family support programme in England from FMs, patients and professionals. Interviews took place at three sites across England. Audio recordings of the interviews were transcribed, and data were analysed using thematic analysis.

22 FMs were recruited to the first work package, where four key themes were identified: (1) heterogeneity in the current support for families; (2) information about mental health and mental health services; (3) continuous support; and (4) peer support and guidance. FMs reported receiving support from professionals, peers and relatives, but the extent of this support varied. FMs consistently reported wanting a named contact to provide information and personal continuity of support. 5 FMs, 4 patients and 10 professionals took part in the second work package, where four main themes were also identified: (1) development of a support programme; (2) delivery of a support programme; (3) factors limiting accessibility or engagement; and (4) benefits of a support programme. Information about the MHA and strategies to promote effective communication between FMs and professionals were identified as important to include in the programme and its delivery should include a combination of face-to-face, written and online methods. Potential benefits of the programme include improved FM knowledge and wellbeing.

FMs of involuntarily hospitalised patients should receive information around the MHA and strategies to promote effective communication with professionals. FMs should also be allocated a named contact person to offer information and personal continuity of support through various methods, for example through online, face-to-face or written contact.

None Declared

The high level of psycho-emotional stress today significantly increases the moral burden on the mental health of medical workers. One of the most vulnerable groups of medical specialists in Ukraine are foreign resident doctors. Since in Ukraine this contingent of doctors is faced with extraordinary problems of high psycho-emotional stress, such as COVID-19 around the world and the russian war against Ukraine. Raising the issue of resident doctors, the main issue becomes not only their professional identity, but also the formation of the necessary stress resistance in different conditions of professional activity.

To study the level of tolerance to stress and uncertainty among foreign resident doctors in unusual conditions of performing professional duties.

The examination included the use of clinical-psychological, psychodiagnostic and psychometric research methods.

As of the beginning of 2020, 395 foreigners were studying. During the first phase of the pandemic, 118 foreigners left Ukraine. By the beginning of 2022 (before the full-scale war), 302 medical residents were trained. As of the beginning of 2023, 167 doctors are studying, of which only 61 people are on the territory of Ukraine.

The primary analysis of the clinical-psychological study showed that the most common complaints among foreign resident doctors are: increased levels of feelings of tension (in 75,4%), decreased motivation for activity (73,2%), anxious (72,7%) and depressive symptoms (69,3%), frequent headaches (68.6%), constant feelings of irritation (65,4%), manifestations of aggression in relation to colleagues (63,9%) and patients(61,4%), a feeling of fear for the future (60,1%), conflicts in the family (59,5%).

The study of factors that influence the increase in the level of stress among foreign resident doctors were sorted according to the principle of ordinary and extraordinary. Ordinary stress factors include: the nature of the specialty, the conditions of professional activity, a foreign country, relationships in the team. Extraordinary factors include new working conditions (professional challenges of COVID-19, war on the territory of Ukraine), increased risks of responsibility for the patient’s life (search for a treatment solution against the background of COVID-19), nature of assistance (providing assistance due to combat injuries).

At the end of the study, a comprehensive program will be created for the early detection of signs of adaptation disorder, which will be aimed at reducing emotional distress, tension in the learning process, support in the first years of training for medical residents.

None Declared

Pregnancy,postpartum and breastfeeding is a very challenging period in the women’s life. Many shared false beliefs and perceptions about this period can influence a pregnant woman’s sexual life and couple.

to explore sexual satisfaction, misconceptions and beliefs about sexuality during pregnancy and postpartum in women.

It was a cross-sectional study established over a period of 3 months from the June 1st, 2023 to August 31, 2023. This study focused on a population of pregnant postpartum and breastfeeding women recruited from outpatient consultations and inpatient of the obstetric gynecology department at the university hospital of Gabes, Tunisia. We used a pre-established sheet exploring socio-demographic data, medical and gyneco-obstetric history, informations concerning the marital relationship and the woman’s sexual activity and eight questions (yes or no / choosing an option) to explore the beliefs and perceptions about sexuality during pregnancy and postpartum. We administered the validated Arabic version of the Arizona Sexual Experiences Scale (ASEX) to assess sexual functioning.

Fifty-eight women were included. The average age was 35.6±5.5 years, they had a university level in 40% and they were unemployed in 74.2%. They were from an urban origin in 75%. They were pregnant in the first, second and third trimester in (15.6%, 15.6% and 25% respectively). They were in postpartum in 43.8% of cases with a cesarean delivery in 73.3% and breastfeeding in 56%. All women reported being on good terms with their spouses and satisfied with their sexuality. The usual frequency of sexual relations (SR) was (1/day: 22.6%, 1/week: 74.2%, 1/month: 3.2%). Only 3.4% masturbated and 5.17% had sexual fantasies. Among women, 55.1% believed that RS is not allowed in the first trimester, and 67.8% believed that it can harm the baby. Only 25% of women believed that RS is permitted throughout pregnancy. 58.1% believed that RS in the third trimester could induce early delivery, and 30% believed that it could harm the baby. They all believed that post-partum SR is only authorized after 40 days. Among the sample 22.6% believed that SR is not allowed during breastfeeding, and that it can harm the baby in 13% of cases. The mean ASEX score was 13 ± 4.3 and 47% had sexual dysfunction. Regarding the frenquency of SR, 25% reported wanting to reduce the frequency, 3.4% wanting to increase the frequency and 71.6% were neutral.

A better understanding of the misconceptions and beliefs about sexuality during pregnancy and the post-partum period is needed to reduce restriction imposed on sexual activity during a normal pregnancy and to enhance marital harmony and the sexual life of the couple.

None Declared

Koro, also known in Cantonese as Shook Yang, which literally translates to “shrinking penis”, has its roots in a cultural belief that a mythological figure would steal the penis of his victims. Predominantly reported in Southeast Asia, it involves an acute fear of genital retraction, often accompanied by the belief that this retraction may lead to death. Over the last two centuries, Koro has undergone several attempts to establish its definition and classification, without a true consensus having been reached.

This study aims to explore the cultural nuances surrounding Koro and reflect on the various conceptualizations that modulated its definition and nosological classification, from Ancient China until the present.

A non-systematic literature review with the keywords “koro” and “culture” was conducted.

Koro was only introduced to the Western world during colonial expansion, drawing the attention of several psychiatrists who, in Asian territory, reported numerous cases in natives, making the very first attempts at a nosological classification, whether as an anxiety neurosis, or as an obsessive-compulsive disorder. The literature reveals significant cultural variations in the manifestation of Koro, challenging the traditional psychiatric understanding rooted in Western diagnostic categories. Cultural factors, including societal beliefs, religious practices, and regional variations, emerged as influential contributors to the prevalence and presentation of Koro. Additionally, the study identified instances of Koro evolving in response to cultural shifts and globalization, emphasizing the dynamic nature of this syndrome.

This review underscores the need for a comprehensive understanding of Koro that acknowledges its diverse conceptualizations across cultures. Its occurrence, not only in multiple parts of the world, but also in close relation with various comorbidities, has contributed to the dissolution of its primary identity as a culture-bound syndrome, turning Koro into a moving target.

None Declared

Negative countertransference in psychiatry refers to the therapist’s unfavorable emotional reactions to the patient, such as anger and frustration, which can hinder the therapeutic relationship and the client’s progress. This is why it is imperative to study the causes of this negative counter-transference, such as cultural causes, to ensure effective treatment, appropriate care and better comfort for psychiatry residents during their professional practice.

To study the cultural causes of negative countertransference among psychiatric residents in Tunisia and their coping behavior.

This cross-sectional study was carried out among Tunisian residents working in psychiatric departments, using a questionnaire deployed via Google Forms.

The study involved 26 residents with 23 females. The average age was 27.57 years with extremes ranging from 26 to 32. The participants were family doctors practicing in psychiatric wards (26.9%), first year psychiatry residents (15.4%), second year psychiatry residents (23.1%), third year psychiatry residents (19.2%), fourth year psychiatry residents (11.5%) and child psychiatry residents (3.8%). The majority of residents admitted having had a negative transference towards a patient (88.5%). The level of frustration felt by residents during this counter-transference on a scale of 100 varied from 1 to 100 with an average of 61.9. Substance abuse was the primary cause in 52.17% of cases. The second cause was the patient’s ideology, with a percentage equal to 43.47%. The same percentage of 17.39% was for traditions, socio-economic level and membership of a particular political group. In 82.6% of cases, residents tried to analyze this counter-transference and 65.2% of them managed to deal with their frustration. The feeling of guilt was experienced by 56.52% of practitioners and the same number of residents tried to avoid the patient. Among the participants, 43.47% discussed this difficulty with their supervising physician and only 4 residents asked to change patients.

In conclusion, our study identified the cultural causes of negative countertransference in Tunisian psychiatry residents, including substance abuse, ideology, traditions, socio-economic level and politics. Understanding these causes is essential to resident training but also to the delivery of quality care in psychiatry. By integrating this knowledge into training, we can help residents recognize and manage negative countertransference, in order to improve the quality of care they provide to their patients.

None Declared