Esketamine intranasal spray has been approved in both the USA and EU as a novel treatment in patients with treatment-resistant major depression (TRD) and for the management of acute depressive emergencies during the course of major depressive disorder (MDD). Real-world data on the effectiveness and safety of esketamine nasal spray in clinical use are limited.

To investigate the clinical effects and safety of esketamine nasal spray on depression severity and suicidal ideation during inpatient treatment in n=76 patients in a German university hospital.

In this retrospective chart review, we analyzed the change in depression severity and safety after a treatment series with esketamine nasal spray combined with treatment-as-usual in patients with treatment-resistant depression (TRD) in inpatient treatment setting of a University Hospital. Depression severity has been rated with the Montgomery–Åsberg Depression Rating Scale (MADRS) as well as with the BDI-II (Beck Depression Inventory-Second Edition) before and after the treatment series. The intensity of suicidal ideation has been evaluated using MADRS item 10 on suicidal thoughts.

A total of 76 patients have been included (women 55.3, n=42) in this analysis. Mean BDI-II pre-treatment was 37.6 and mean MADRS was 33.6 corresponding to severe depression. Mean score on item-10 pre-treatment was 2.4 (median 2.0). On average patients received 10.9 sessions (standard deviation 4.2, median 11.0) of esketamine nasal spray (min 1, max. 19 sessions). There was clear improvement after the treatment series in both the BDI-II (mean change -10.1, p < 0.001) as well as in MADRS score (mean reduction -10.0, p < 0.001). Suicidal ideation on item-10 also decreased significantly (-0.9, p < 0.001). The effect sizes were large for all three measures: Cohen’s d 1.050 for BDI-II; 0.986 for MADRS and 0.742 for changes in suicidal ideation. Overall, esketamine treatment was well tolerated. In five cases esketamine treatment has been terminated early (after a mean of 3.4 sessions) due to dissociations (n=4; 5.3%) or due to non-response (n=1).

Esketamine nasal spray is a novel effective and safe treatment option, which leads to significant decrease in depression severity as well as in suicidal ideation. More data from real-world patients are needed to position esketamine in the algorithm of depression treatment. Rate of treatment discontinuation due to side-effects in this study was comparable to those in other esketamine studies (4.2% in Reif et al, NEJM, 2023).

None Declared

Hundreds of fires have been burning from coast to coast across the country since March 2023, putting Canada on track to experience the worst wildfire season ever. From East to West, provinces such as Quebec, Ontario, Nova Scotia, Alberta, and British Columbia have been particularly affected by large and uncontrollable wildfires.

This study aimed to determine the prevalence and predictors of depression symptoms among residents of Alberta and Nova Scotia during the Canadian wildfires of 2023.

This study conducted a cross-sectional quantitative survey for data collection. In the period between 14th May and 23rd June 2023, an online survey was administered using REDCap. Through the Text4Hope program, participants subscribe to receive supportive SMS messages daily. After the first message, participants were invited to complete an online questionnaire, containing demographic information, wildfire-related information, and responses to the Patient Health Questionnaire-9 (PHQ-9) for depression assessment. SPSS version 25 was used to analyze the data. Descriptive, univariate, and multivariate regression analyses were employed.

A total of 298 respondents completed the online survey out of 1802 who accessed it, resulting in a response rate of 16.54 %. Most of the respondents were females (85.2%, 253), below 40 years of age (28.3%, 84), employed (63.6%, 189), and in a relationship (56.4%, 167). A historical depression diagnosis (OR = 3.15; 95% CI: 1.39–7.14) was a significant predictor of moderate to severe MDD in our study. While employment status did not significantly predict MDD, unemployed individuals were two times more likely to report moderate-to-severe symptoms of MDD than employed individuals (OR = 2.46; 95% CI: 1.06–5.67). Among the total sample population, the moderate to severe MDD prevalence was 50.4%, whereas it was 56.1% among those living in wildfire-affected areas.

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As a result of our study, the development of moderate to severe MDD symptoms during wildfire disasters was significantly associated with a history of depression diagnosis. Although employment status did not significantly predict MDD, unemployed individuals had a greater likelihood of experiencing moderate-to-severe symptoms than employed individuals. Further research is necessary to ascertain reliable predictors of mental health issues among those who have experienced disasters, as well as to offer appropriate interventions and treatment options to the communities and individuals who are most vulnerable.

None Declared

Today, the most vulnerable group of Ukrainians are children. Their physical and mental health has been tested since 2020, from COVID-19 to 2022, the start of a full-scale-russia’s war against Ukraine. The children of Ukraine were the first to feel the changes, since a complete change in life and the principles of acquiring primary adaptive skills of social interaction were distorted by COVID-19. Subsequently, new challenges in the form of war deformed the idea of life, happiness and the future.

Studying the level of adaptation potential in children and adolescents living in the front-line zone in Ukraine.

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

The study in 2021 involved 217 children and adolescents with signs of maladjustment. In 2022, 378 children and adolescents with signs of maladjustment, of which 285 children are still in the frontline zone of Ukraine, 93 children, at the time of 2022, were taken abroad and returned to Kharkov in 2023.

During the initial analysis of the results, it was revealed that children with low adaptive resources are more susceptible to showing signs of maladjustment. One of the main factors of an adaptation resource is interaction with others (direct communication). It was this criterion that became the primary frustrating factor for children in the first months of the war. External isolation has led to a lack of communication between children and everyone in Ukraine, who during COVID-19 have adapted to a way of communicating while staying at home in physical isolation. War is a powerful independent psychogenic factor for the formation of maladaptation, but in today’s realities it has also become an additional trigger for a previous psychogenic event in the life of Ukrainians.

Parents, for their part, note a sharp deterioration in the well-being of their children, frequent complaints of headaches (89.4%), overwork, aggressiveness (81,5%), closed-mindedness (78,6%), health complaints (74,5%), which is why they have to often consult a doctor and endlessly carry out diagnostics in search of reasons for deterioration (72,3%), weight loss (64,5%). The data indicate the frustration of being in the front-line zone, which aggravates mental health and triggers the process of disruption of adaptation and mental health of children and adolescents.

The study is aimed at developing a psychorehabilitation program for children and adolescents with a low level of adaptive resource.

None Declared

Sexual exploitation is a human rights violation that has a detrimental impact on the psychological-, physical- and social well-being of victims. Sexually exploited male youth are prevalent, yet underrepresented in clinical practice, policy and research. There are multiple barriers that often prevent male youth to disclose and to seek or receive support, such as gender norms, limited awareness of victimization and feelings of guilt and shame.

By gaining more insight into the background and clinical characteristics of male victims and their care and support needs, this study aims to raise awareness and to better inform policymakers, care- and educational professionals on adequate prevention and intervention efforts.

Twenty-six male youth at high-risk or victims of sexual exploitation participated in this qualitative study. By means of semi-structured interviews and case-file analyses, data was collected by to identify risk and protective factors in their life-course and care and support needs.

Results indicate that several vulnerabilities (e.g. previous experiences of abuse and neglect, mental health problems, household dysfunction, social rejection, running away, substance use) and a lack of positive and supportive relationships led male youth into high-risk situations. Among these were involvement in pay dates, survival sex and criminality, which contributed to victimization. Experiences of stigmatization were often a barrier to express vulnerabilities and to disclose victimization. There was a wide variety in care and support needs, including peer-to-peer support, therapy, support with day-to-day practices and anonymous support.

These results will contribute to adequate prevention and intervention strategies and meet the unique needs of male youth at risk for, or victim of sexual exploitation.

G. Mercera Grant / Research support from: This research was funded by the Dutch Ministry of Health, Welfare and Sports (grant number: 328604)., S. Leijdesdorff: None Declared, E. Heynen: None Declared, T. van Amelsvoort: None Declared

One of the principles of healthcare is preventive focus, that is, the implementation of measures to improve the hygienic education of the population and maintain a healthy lifestyle. The scientific rationale for carrying out primary prevention activities is based on an analysis of morbidity and prevalence rates and their dynamics.

to conduct a comparative analysis of the primary incidence and prevalence of mental pathology in children and adolescents (0-17 years) in the Kyrgyz Republic for 2005-2020 .

statistical data from the Republican Center for Electronic Health and the National Statistical Committee of the Kyrgyz Republic were used  (http://www.stat.kg/ru/rss/), (http://cez.med.kg/).

primary incidence of mental pathology among children and adolescents in 2005, 2010, 2015 and 2020 amounted to 66.2, 44.1, 44.8, 51.1 respectively (based on 100,000 the child population). The prevalence of mental pathology for 2005-2020 was 418.4, 317.0, 312.5, 400.0 respectively (based on 100,000 the child population). That is, morbidity and prevalence rates show higher numbers in 2005 and in 2020 (Diagram №1). In the gender aspect, morbidity rates were higher in males 40.0, 28.0, 31.3, 31.0 compared to females 26.3, 16.1, 17.1, 20.1 (based on 100,000 the child population; (Diagram №2).

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the variability of the obtained indicators of morbidity and prevalence of mental pathology in children and adolescents is due to difficulties in providing specialized psychiatric care to the child population due to the lack of child psychiatrists in the regions of the country, the processes of population migration, and the phenomenon of stigmatization. In this regard, measures and educational programs are needed to improve the provision of psychiatric care to the child population at the level of primary medical and social care.

None Declared

Majority of international guidelines for bipolar disorders are based on evidences from clinical trials. In contrast, the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was developed to adopt an expert-consensus paradigm which was more practical and specific to the atmosphere in Korea.

In this study, preferred medication strategies for acute mania over six consecutively published KMAP-BP (2002, 2006, 2010, 2014, 2018, and 2022) were investigated.

A written survey using a nine-point scale was asked to Korean experts about the appropriateness of various treatment strategies and treatment agents. A written survey asked about the appropriateness of various treatment strategies and treatment agents commonly used by clinicians as the first-line.

The most preferred option for the initial treatment of mania was a combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP) in every edition. Preference for combined treatment for euphoric mania increased, peaked in KMAP-BP 2010, and declined slightly. Either MS or AAP monotherapy was also considered a first-line strategy for mania, but not for all types of episodes, including mixed/psychotic mania. Among MSs, lithium and valproate are almost equally preferred except in the mixed subtype where valproate is the most recommended MS. The preference of valproate showed reverse U-shaped curve. This preference change of valproate may indicate the concern about teratotoxicity in women. Quetiapine, aripiprazole, and olanzapine were the preferred AAP for acute mania since 2014. This change might depend on the recent evidences and safety profile. In cases of unsatisfactory response to initial medications, switching or adding another first-line agent was recommended. The most notable changes over time included the increasing preference for AAPs.

The Korean experts have been increasingly convinced of the effectiveness of a combination therapy for acute mania. There have been evident preference changes: increased for AAP and decreased for carbamazepine.

None Declared

Predicting acute affective episodes in individuals with Bipolar Disorder (BD) remains a clinical challenge. Specific environmental stressors, including air pollution, noise, and temperature variations might worsen affective symptoms or sleep in the general population, but their role in BD relapses is often overlooked. Indeed, they might exacerbate BD by perturbing circadian rhythms – fundamental aspects of BD.

We thereby present the protocol of this pilot study and future preliminary data. We aim to longitudinally assess sleep alterations, mood fluctuations, and environmental exposure to several factors (air pollutants, climate, noise, artificial light-at-night, green space access) in patients with BD and to check the association of these variables with BD relapses.

In this pilot study, we will recruit 40 patients with BD in a 6-month prospective study. Patients were assessed during baseline, at 3 and 6 months. Data recollected will consist of a subjective (questionnaires) and objective (through meteorological stations) evaluation of physical environmental factors around the home residence; clinical assessment of mood and circadian rhythms, and continuous tracking of sleep-wake patterns, energy, and movement using actigraphy.

Expected results will show that exposure to a worse environment (higher pollution, noise, light exposure, climate) will be associated with worse BD outcomes (i.e., relapse, mood symptoms, sleep alterations).

We will be sharing preliminary data from our ongoing study, offering insights into early patterns and findings that shed light on our objectives.

None Declared

This study investigated source-level cortical functional networks using resting-state electroencephalography (EEG) in patients with Bipolar disorder and Major depressive disorder, comparing the neuropathology of these disorders.

This study investigated source-level cortical functional networks using resting-state electroencephalography (EEG) in patients with Bipolar disorder and Major depressive disorder, comparing the neuropathology of these disorders.

A total of 116 participants (35 patients diagnosed with bipolar disorder(BD), 39 patients diagnosed with Major depressive disorder(MDD), and 42 people who are healthy-control groups(HC)) were enrolled for this study. Depression and anxiety were evaluated with using State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). Graph theory‑based source‑level weighted functional networks were assessed via strength, clustering coefficient (CC), and path length (PL) in six frequency bands.

At the global level, patients with BD and MDD showed higher strength (p = 0.001) and CC (p = 0.001), and lower PL (p < 0.001) in the high beta band, compared to HCs. At the nodal level, compared to HCs, patients with BD showed higher high beta band nodal CCs in the right precuneus(p < 0.001), left isthmus cingulate(p < 0.001), bilateral paracentral(p < 0.001), and left superior frontal(p < 0.001); however, patients with MDD showed higher nodal CC only in the right precuneus(p < 0.001) compared to HCs. Although both MDD and BD patients had similar global level network changes, they had different nodal level network changes compared to HCs.

This study suggest that both patients have similar network changes at the global level, but they have different network changes at the nodal level. Also, the higher nodal CCs in the high beta band might indicate the regions became more connected with their neighbors in accordance with the severity of depressive and anxious states. This study found a significant correlation between cortical network state and anxiety-related psychological measure in BD patients. Our source-level cortical network indices might contribute to the understanding of the neuropathological mechanisms in these two disorders.

None Declared

Emotional dysregulation is central to the problem of the overlap between attention‐deficit/hyperactivity disorder (ADHD) and cyclothymia.

We aimed to compare clinical characteristics, psychiatric comorbidity, affective temperament, and emotional dysregulation among subjects with attention-deficit/hyperactivity disorder (ADHD) and cyclothymia.

In this cross-sectional study, 187 participants were consecutively recruited between January 2018 and December 2019 at the outpatient clinic of the 2nd Psychiatry Unit of the University Hospital of Pisa. Eighty-one subjects were diagnosed with ADHD, 62 with cyclothymic disorder, and 44 with both conditions. Participating psychiatrists collected socio-demographic and clinical data, psychiatric comorbidities according to DSM-5 criteria, familiarity for psychiatric disorders, and any previous responses to antidepressant drug therapy. To study the temperamental characteristics of the participants, the short version of the Memphis, Pisa, Paris and San Diego Temperament Assessment (Brief-TEMPS-M) was administered, while emotional dysregulation was measured through the Reactivity, Intensity, Polarity, Stability questionnaire (RIPoSt-40).

Cyclothymic subjects, both with and without ADHD, were more often female (p<0.001) than subjects with ADHD. Participants with ADHD showed significantly lower educational attainment than subjects without ADHD (p<0.001). In addition, participants with ADHD alone showed comorbid substance use disorder more frequently (p<0.001) than subjects with cyclothymia alone. On the other hand, the latter showed higher rates of eating disorders (p=0.033) and familiarity for major depressive disorder (p=0.009) and panic disorder (p=0.029). Depressive and anxious temperament was significantly more represented in cyclothymic subjects without ADHD, as was negative emotionality, while hyperthymic temperament showed an opposite trend. No significant differences were observed between groups for cyclothymic temperament and overall negative emotional dysregulation, but patients comorbid with both conditions had the highest scores in these subscales.

ADHD and cyclothymia show high and overall similar levels of emotional dysregulation. However, cyclothymic patients may be more prone to negative emotionality (“dark cyclothymia”). It is possible that individuals with “sunny” cyclothymic features may escape clinical attention if ADHD is not present in comorbidity.

None Declared

The increase in cortisol can be exogenous or endogenous. As etiologies of endogenous increase we find: Cushing’s disease, 68% of cases, generally due to an ACTH-producing pituitary tumor; Adrenal Cushing syndrome (17%); Ectopic Cushing syndrome (15%) due to lung tumor most frequently. It is relevant since among its symptoms one of the most notable are the psychiatric alterations it produces, among them mood disorders, depression being the most common, as well as psychotic symptoms, delirium and anxiety disorder.

To carry out a correct differential diagnosis of the pathologies that could present with symptoms of a manic episode.

Clinical case description of a 52-year-old woman, who presented with manic symptoms in 2020, requiring hospitalization. Upon discharge from the acute care unit, she consulted with the endocrinologist due to weight gain, revealing an increase in abdominal diameter, hyperpigmentation, a moon-like face, and a hump. Free cortisol was measured in 24-hour urine, with a high result, followed by brain MRI, and pituitary microadenoma was confirmed.

The patient underwent surgical resection of the microadenoma, which was partially effective, so she maintained high cortisol levels, even despite oral retreatment. In 2023 she had a new manic episode, with a cortisol value of approximately 300 nmol/day.

The importance lies in the correct diagnosis to provide appropriate treatment and avoid the chronicity of the disease and the patient psychiatrization. In this case and as in many other diseases, which present with psychiatric symptoms, it is important to differentiate whether it is a primary psychiatric disorder or are component symptoms of another disease that, upon receiving treatment, would resolve the psychiatric symptoms.

None Declared

Lithium is an important treatment option for individuals with mood disorders, but its use has been linked to the development of chronic kidney disease (CKD). Existing studies on this association have reported conflicting results.

The aim of this study was to examine the risk of developing CKD with lithium use adjusting for common comorbidities.

This was a retrospective cohort study that included all individuals in Iceland receiving lithium therapy between 2008 and 2018. Lithium use was defined as at least one dispensed prescription for Lithium or at least one serum lithium concentration above the detection limit. Patients with affective disorders (ICD-10 codes F30-F39) attending the outpatient clinics of Landspitali–The National University Hospital Mental Health Services in 2014-2016, without lithium exposure, served as controls. CKD stages 3-5 were defined according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines for CKD as estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2. The eGFR was calculated using the serum creatinine (SCr) based on the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Acute kidney injury (AKI) was defined according to the SCr component of the KDIGO criteria for AKI, and other comorbid diseases were defined based on ICD-9 and ICD-10 codes. Individuals with fewer than 2 SCr measurements during the study period and those with CKD stages 3-5 prior to 2008 were excluded. Cox regression analysis with time dependent variables was performed to assess the risk of CKD.

The study included 2046 individuals exposed to lithium, of whom 221 (10.9%) developed CKD in the study period. Among the 1220 control subjects, 39 (3.2%) developed CKD. Lithium use was associated with CKD (hazard ratio [HR] 1.93, 95% confidence interval [CI] 1.37–2.74) after adjusting for sex, age, and comorbid diseases. Other significant risk factors were age (per year, HR 1.03, 95% CI 1.02–1.04), initial eGFR (per mL/min/1.73 m2, HR 0.92-0.96, 95% CI 0.90–0.99), presence of diabetes (HR 1.73, 95% CI 1.15–2.48) and history of AKI (HR 1.89, 95% CI 1.32–2.70). When compared to the control group not exposed to lithium, the risk (HR) of CKD was 1.24 (95% CI 0.81–1.89), 2.88 (95% CI 1.97–4.20) and 5.23 (95% CI 3.31-8.26) for groups with a mean lithium concentration of 0.3-0.59, 0.6-0.79 and 0.8-0.99 mmol/L, respectively.

Long-term lithium therapy seems to increase the risk of CKD in a concentration-dependent manner in individuals with bipolar and unipolar mood disorders. To mitigate this risk, it is essential to monitor blood levels carefully and use doses of lithium as low as possible for adequate mood stabilization and treatment.

None Declared

Bipolar disorder (BD) is characterised by heterogeneous phenotypic manifestations that may affect the achievement of a timely diagnosis delaying its therapeutic management. Increased circulating levels of pro-inflammatory cytokines and cortisol (CORT) have been observed in BD patients in addition to decreased levels of Brain-Derived-Neurotrophic Factor (BDNF) suggesting that the interaction among these mediators may play a role in the occurrence of affective episodes overall disrupting brain plasticity. However, knowledge on BD etiopathogenesis is still limited, including the causal relationship with inflammatory and neuroendocrine markers.

To assess whether variations in peripheral neuroendocrine and inflammatory markers during acute phases of the disease and euthymia might predict the occurrence of affective episodes; to evaluate whether the interplay among these biomarkers might be exploited as a signature of BD.

We are currently recruiting BD patients during depressive or manic/hypomanic phases together with age- and sex-matched healthy controls (CTRLs). Complete blood count, pro-inflammatory, anti-inflammatory cytokines and BDNF will be assessed in serum; salivary cortisol awakening response test will be used to evaluate hypothalamic-pituitary-adrenal axis activity. MADRS, YMRS and HAM-A will be used to assess psychiatric symptoms, PSP and C-SSRS for global functioning and suicidal risk, IPSS and SRRS for stress levels and CIRS to evaluate physical comorbidities. All assessments will be carried out at the time of recruitment (T0) and after 3 (T1) and 6 (T2) months.

Data have been so far collected on 28 BD patients (18 males, 10 females, age: 48.31±11.3) and 26 CTRLs (16 males, 10 females, age: 46.82±10.86). At T0, BD were characterised by a greater total number of white cells (7.83±1.86 BD vs. 6.78±1.87 CTRL, p<0.05), mean number of neutrophils (4.89±1.49 BD vs. 3.92±1.45 CTRL, p<0.05) and neutrophil/lymphocyte ratio (NLR) (2.52±1.1 BD vs. 1.9±0.69 CTRL, p<0.05). Moreover, BD patients showed overall a greater BMI (30.5±6.6 BD vs. 24.45±3.86 CTRL, p<.001). No difference was observed among groups with respect to sex and age.

Although preliminary, these results suggest that the active phases of BD are associated with a low-grade inflammatory state, potentially related to a different metabolic set-point in BD patients. Ultimately, this study will allow us to evaluate whether the presence of affective symptoms is correlated with fluctuations in the levels of inflammatory mediators, salivary cortisol and BDNF and to establish a reliable and highly predictive BD signature.

“Funded by: Bando Ricerca Indipendente ISS 2021-2023 to A. Berry project code ISS20-9286e4091f8e”

None Declared

Buprenorphine/Naloxone (B/N) is a safe and effective treatment for the long-term stabilization of individuals with opioid use disorder (OUD). Patients undergoing opioid maintenance treatment experience reduced mortality rates, decreased substance use, and an overall improvement in their quality of life. Premature discontinuation of maintenance treatment increases the risk of relapse.

Our primary objective was to assess patient compliance with maintenance treatment and to identify potential factors associated with treatment discontinuation and relapse.

The study involved 206 patients with OUD who initially enrolled in a 28-day abstinence-based inpatient program at our hospital. Following their inpatient treatment, they were subsequently admitted as outpatients for B/N maintenance treatment at the Alcohol and Substance Addiction Treatment Center in Trakya University School of Medicine (Edirne, Türkiye). The addiction profiles of patients were assessed using the Addiction Profile Index (API) Clinical Form during the baseline evaluation. Sociodemographic and clinical data were collected from the patients’ records.

After 3 months, 114 patients (55.3%) remained in treatment, and 52 patients (25.2%) were still in treatment at the end of 1 year. Factors associated with a higher likelihood of remaining in treatment for one year included older age (z=-2.257, p=0.024), longer length of education (z=-2.270, p=0.023), later onset of smoking (z=-2.704, p=0.007), later onset of substance use (z=-3.597, p<0.001), and a higher rate of completing the inpatient treatment program (χ²=4.016, p=0.045). Patients in the 1-year retention group had lower scores on the API anxiety (z=2.767, p=0.009), anger management problems (z=2.754, p=0.011), and novelty-seeking behavior (z=2.634, p=0.043) subscales. They also had a lower rate of having a criminal history (χ²=5.349, p=0.021). The duration of treatment retention was positively correlated with age (r=0.160, p=0.021), length of education (r=0.158, p=0.023), age of onset of smoking (r=0.228, p=0.001), and age of onset of substance use (r=0.268, p<0.001). It was negatively correlated with the duration of substance use (r=-0.138, p=0.048), the number of inpatient treatments (r=-0.142, p=0.042), and scores on the API anxiety (r=-0.167, p=0.040), anger management problems (r=-0.173, p=0.033), and novelty-seeking behavior (r=-0.209, p=0.010) subscales.

Identifying the specific factors associated with treatment retention and dropout/relapse can be valuable in developing more effective and personalized treatment plans for individuals with OUD.

None Declared

Social networks (SN) addiction is a serious problem among young adults that requires increased attention.

The aim of the study was to assess the relationships between internet addiction and selected psychological characteristics of university students.

This is a descriptive and analytical study, conducted over the period from November 2022 to January 2023, among students in various fields. SN addiction was measured using the Social Media Addiction Scale-Student Form (SMAS-SF). The Rosenberg scale was used to assess global self-esteem and the Social Self-Esteem Inventory was used to assess social self-esteem. The Big Five Personality-10 (BFI 10) scale was used to assess the 5 personality dimensions.

A total of 116 students, with an average age of 25.49, took part in the study. Most students (91.4%) were over 20 years old. They were female in 78.4% of cases. They enrolled in postgraduate studies in 55.2% of cases. The majority of students (59,5%) studied medicine. According to the SMAS-SF scale, the average score was 75.87. The mean score for social self-esteem score was 122.03. Sixty-four participants (55.2%) had low and very low self-esteem. The dominant personality dimensions were extraversion and neuroticism in 15.5% each. Addiction to SN was significantly associated with very low global self-esteem (p=0.028) and a lower social self-esteem score (p=0.011). Low conscientiousness and neuroticism were significantly associated with increased SN use (p=0.007, p=0.004 respectively).

This study provides a better understanding of the phenomenon of addiction to SN, and enables us to tailor prevention and care more effectively. The psychological factors associated with this behavior need to be more explored in future research.

None Declared

Use of psychoactive substances is a risk factor for mental health. Studying the peculiarities of using psychoactive substances by university students is extremely important for organizing preventive health care

To specify the frequency of smoking and alcohol drinking, as well as the peculiarities of the correlational interconnections, in domestic and foreign university students

The survey covered 546 undergraduate domestic and foreign university students of both genders and different religious backgrounds. As a tool, we used the Sociocultural Health Questionnaire (E. Nikolaev)

It has been revealed that domestic students smoke cigarettes and hookahs surely more often (p=.01) than foreign students (30.49% vs 19.08%). It is obvious that they also more often (p=.01) use electronic cigarettes or vaping drugs (25.24% vs 12.86%) and alcohol (54.42% vs 9.96%). Students in both groups denied using other psychoactive substances. Foreign students reveal positive correlational interconnections between smoking and alcohol drinking (r=.44), while there is no evidence of such interconnections in domestic students. Both groups show valid interconnections between the frequency of smoking and the level of stress (r=.15 и r=.17 correspondingly), the frequency of smoking and monthly financial expenses (r=.21 и r=.22 correspondingly). With domestic students, vaping negatively correlates with exercising in gyms (r=-.12), with foreign students it directly correlates with bodybuilding supplements consumption (r=.15). Those foreign students who drink alcohol more often point to the necessity of having a psychologist in the university (r=.13).

The revealed general and specific factors associated with domestic and foreign students’ use of psychoactive substances call for the necessity of developing culturally differentiated preventive programs

None Declared

Substance use disorders (SUDs) are associated with high rates of comorbid depression. Finding effective treatments for many of the substances of abuse is still an area of developing research. Repetitive transcranial magnetic stimulation (rTMS) is an established treatment for depression, but its effects in SUDs are less conclusive.

Therefore, we aimed to investigate the effect of rTMS in patients with SUDs and comorbid major depressive disorder (MDD).

We conducted a retrospective observational study of 55 patients with SUDs and comorbid MDD who were eligible for rTMS. Craving was measured using the Brief Substance Craving Scale (BSCS). Severity of MDD was measured using the Clinical Global Impression-Severity (CGI-S) scale.

We found a statistically significant difference between baseline and posttreatment scores in patients receiving rTMS on both CGI-S scores and BSCS scores. The number of rTMS sessions significantly predicted increased days of abstinence in the community, even after controlling for confounders.

Patients with SUDs and MDD who received rTMS significantly improved in the areas of severity of depression and craving. The number of rTMS sessions significantly predicted increased abstinence.

None Declared

Schizophrenia, a chronic and complex psychiatric pathology, can be isolated. However, it can be associated with other comorbidities and thus be accompanied by addictive behaviors that complicate their management.

The objectives of our study were to estimate the prevalence and identify the characteristics of addictive behaviors in patients with schizophrenia.

A retrospective study of 151 patients with schizophrenia hospitalized in the psychiatry department of Taher Sfar University Hospital in Mahdia from January 2017 to December 2021.

The mean age of the patients was 39.8 ± 11.23 years, with a predominance of the 36-45 age group (38.4%). All patients were male. Three quarters of the patients (75.5%) were users of psychoactive substances (PAS): nearly three quarters (72.8%) were addicted to tobacco, more than one third (39.7%) were addicted to alcohol, more than one quarter (29.1%) were addicted to cannabis and nearly one quarter (26.5%) were addicted to other PAS. In more than half of the cases (54.4%), the age of onset of substance use was between 16 and 25 years. The use of PAS preceded the onset of schizophrenia in 62.3% of cases. The relationship with the entourage was marked by hetero-aggressiveness in 77.5% of patients, withdrawal from the entourage in 16.6% of patients and conflict in 5.3% of patients. The impact on the relationship with oneself was marked by self-aggressiveness in 18.5% of patients. Concerning the professional impact, three quarters of the patients (76.1%) had to stop working. The majority of patients (84.1%) continued their usual treatment, while 15.2% of patients stopped it. Only one patient required an increase in dose.

Subjects suffering from schizophrenia are particularly vulnerable to addictions, mainly to tobacco and alcohol. They are thus a group more at risk of the deleterious effects of psychoactive substances and of the aggravation of the clinical and psychosocial evolution of their psychiatric disorders. Measures for early detection and treatment of their addictive behaviors even before the onset of schizophrenia should be proposed.

None Declared

The purpose of this study is to investigate the potential relationship between stressful events experienced in childhood and subsequent toxic substance consumption among university students majoring in Social Education at a Spanish university during the academic year 2022-2023.

The primary objective is to analyze whether an association exists between stressful life events in childhood and patterns of substance consumption among university students.

A cross-sectional, observational, and analytical design was employed. The target population encompassed 258 students enrolled in the Social Education program in 2023. The final sample consisted of 161 students. A questionnaire incorporating the Childhood Trauma Questionnaire - Short Form (CTQ-SF) and the Severity of Dependence Scale (SDS) was administered to assess trauma history and substance consumption.

A high percentage (95.03%) of students reported having consumed toxic substances at some point in their lives. The most common substances were alcohol (95.03%) and cannabis (52.8%). A statistically significant correlation was observed between childhood emotional abuse and increased alcohol consumption currently (p = 0.015). Furthermore, a significant relationship was identified between childhood sexual abuse and heightened alcohol consumption (p = 0.015). Moreover, positive correlations were found between sexual abuse and the consumption of specific drugs, such as cocaine and psychopharmaceuticals (p < 0.05).

No statistically significant differences were observed in drug consumption with regard to other forms of childhood maltreatment, such as emotional or physical neglect.

The results underscore the connection between childhood stress experiences and substance consumption among university students. Emotional and sexual abuse in childhood are linked to higher alcohol consumption and, in some cases, specific drugs like cocaine and psychopharmaceuticals. These findings emphasize the importance of considering traumatic experiences when addressing prevention and treatment strategies for substance consumption among young student populations.

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Basic beliefs can be defined as a person’s implicit, global, stable ideas about the world and about himself. The psychological features of people with suicidal ideas can be considered as characteristics of the value sphere of a person who is ready to choose a destructive way of solving problems.

The relationship of basic beliefs regarding the general «Benevolence of the surrounding world», its «Meaningfulness» and «Worthiness of the Self» with the presence of suicidal ideas was investigated.

The study involved 140 people, (117 women). The Janoff-Buhlman World Assumptions Scale (WAS), the short Epstein Rational-Experiential Inventory (REI)), Simptom Check List-90-Revised (SCL-90R), moral dilemmas (proposed by J.D.Green), as well as separate questions about the suicidal ideation, risk tendency were used.

For analysis, the subjects were divided into two subgroups: 98 people without thoughts of suicide; and 42 people answered that they had thoughts of suicide of varying severity. The subgroups did not differ by gender; in the group with suicidal ideation, the average age of the subjects was lower.

In the subgroup with suicidal ideas, almost all indicators of basic assumptions, such as “Benevolence of the World” (average values of 16.10 ± 3.28 and 12.13 ± 4.80 for the control subgroup and the subgroup with suicidal ideas), were lower: “Benevolence of the People “ (15.35±3.07 and 12.42±4.97), “justice” (12.46±3.30 and 10.46±3.60), “value of one’s own self” (16 .21±3.93 and 11.83±5.15), etc., with the exception of the “Self-controllability”, which does not differ between subgroups. Also, in the subgroup with suicidal ideas, the indicators of “randomness” were increased (15.67±3.64 and 18.67±3.96). Indicators on the clinical scale “Hostility” of the SCL-90R questionnaire are also significantly higher in the group with suicidal ideation (average values 0.53±0.5 and 1.29±0.8). In the group with suicidal ideation, there is a higher tendency to take risks. At the level of a statistical trend, the rational method of decision-making in the “Rational - Intuitive” questionnaire is lower (average values 14.3 and 13.0; significance level of differences 0.05). In the “Moral Dilemmas” test, in the subgroup with suicidal ideas, the ratio of choices in personal and impersonal dilemmas is statistically higher (0.67 and 0.93).

It was shown that the presence of suicidal ideas is associated with a reduced indicator of the Worthiness of the Self, the meaningfulness of the world and its benevolence, and with an increased sense of randomness as a principle for distributing ongoing events, which can manifest itself in a propensity for risk, impulsive decisions, devaluation of human life.

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Competency and skill-based education and assessment have become increasingly significant in mental health professional training. The conventional approach of acquiring knowledge is now being supplemented by emphasizing practical skills and implementing best practices that prove effective in the field. This emphasis on competencies is particularly apparent in the instruction regarding suicide risk evaluation and management. Cramer and colleagues have identified ten core competencies essential for working with patients at risk of suicide and developed a training material (Cramer et al. 2013, Train. Educ. Prof. Psychol; 1 1-11).

We aim to tailor Cramer et al.’s training program to the Hungarian setting and assess its efficacy among mental health experts, including psychiatrists, clinical psychologists, and social workers. Additionally, we aim to validate the Suicide Prevention and Assessment - Competency Assessment Form (SCAF-R), which comprises a ten-item survey to measure the ten core competencies’ levels with Likert scales and textual ratings by observers. Through this training program, we aim to offer mental health professionals an educational framework to enhance their skills in evaluating and managing suicide risk. Our goal is to provide a comprehensive approach to suicide risk assessment and better equip professionals to handle this emotionally difficult clinical task.

We have created a Hungarian version of the core competencies training material tailored to the culture. We are assessing changes in attitudes towards suicide behavior and prevention by administering pre- and post-training psychometric measures, such as Willingness to Intervene against Suicide (WISE), Suicide Behavior Attitude Questionnaire (SBAQ), Attitudes Toward Suicide Prevention Scale (ASP), and Suicide Competency Assessment Form - Revised (SCAF-R). A quantitative analysis will be performed on the responses. The research was approved by Péterfy Hospital’s Institutional Review Board (IRB): approval number 07-2023.

The questionnaires’ results will be summarized with standard statistical methods.

Improving mental health education in healthcare with up-to-date knowledge of evidence-based best practices is a top priority. Enhancing skills and knowledge can lower clinicians’ anxiety in this emotionally challenging and burdensome task. There is a high demand for mental health workshop training among healthcare workers in both undergraduate and post-graduate education. We expect positive changes in attitude and self-perceived competencies in participants.

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