Intranasal esketamine has been approved as a treatment for patients with treatment-resistant depression. We analyzed the results of its efficacy in 15 patients.

To evaluate the efficacy of intranasal Esketamine as a treatment in patients with treatment-resistant depression

Case series

For the last 8 months, since the treatment with intranasal esketamine was approved for resistant depression, we have treated 14 patients with this drug. Through this process, we followed a standardized method consisting in the following steps:

On the first esketamine session (DAY 1) the patient has to fill a CGI and a MADRS scale.

On the second esketamine session (DAY 7) the patient has to fill a CGI, a MADRS scale, a form about the level of satisfaction with the drug and a last form in which they can include the secondary effects.

On week 6 since the start of the treatment, the patient has to fill again a CGI, a MADRS scale, a form about the level of satisfaction with the drug and a last form in which they can include the secondary effects.

In the 6th month since the start of the treatment, the patient has to fill again a CGI, a MADRS scale, a form about the level of satisfaction with the drug and a last form in which they can include the secondary effects they have perceived.

We analyzed and compared all of the previous data and obtained the following results:

At day 7: 64% of the patients had a response in the form of improvement, of which 66% were feeling “slightly better” and 33% were feeling “better”.

At week 6: 71% of the patients had a response in the form of improvement, of which 50% were feeling “slightly better” and the other 50% were feeling “better”.

At month 6: only 28% of the patients completed the treatment; of which 100% had a response in the form of improvement: 50% were feeling “slightly better”, 25% were feeling “better” and 25% were feeling “far better”.

Although our data suggests that intranasal esketamine has been effective in short term depressive symptoms, we have yet no information about its medium and long-term efficacy or secondary effects. Nevertheless, other potential factors should be evaluated as they could affect the results in the long-term such as the difficulty in maintaining the treatment for more than 6 weeks.

In addition, the patients who experienced the most improvement according to our data were patients with a TAB diagnosis, so this could be an interesting research focus.

None Declared

Since that the online commerce provides an important shopping environment, it has been argued that traditional buying-shopping disorder may migrate into the online market.

The aims of the current study were to investigate the prevalence of online buying-shopping disorder, and to determine sociodemographic and psychological factors related to this addictive behavior.

A cross-sectional, descriptive and analytical study was conducted among subjects who had already made at least one online shopping. Data was collected using a self-questionnaire published by GOOGLE FORMS. Assessment included the short version of the Internet Addiction Test modified for online shopping sites (s-IATshop). The Hospital Anxiety and Depression Scale (HADS) has been used to assess anxiety and depression.

A total of 137 participants aged 34.62 ± 9.82 years completed the online questionnaire.

Only 4 (2.9%) participants had a probable compulsive buying shopping on line.

The HADS-A score ranged from 0 to 14, with a mean of 6.85 +/- 3.49 and almost half of the participants (44.5%; N=61) had anxiety symptoms.

A high s-IAT shopping score was correlated with secondary or university education (p=0.046). We also found that women, who were younger and had higher incomes, had the highest scores on the s-IAT-shopping scale, without however confirming statistical significance.

Our study has shown the potential vulnerability factors for compulsive online shopping disorder. Thus, this behaviour deserves to be taken into account in behavioural addictions.

None Declared

Chronic consumption of alcohol has clear deleterious effects on the nervous system. Among its less-recognized consequences are subacute and chronic alcohol-induced psychotic disorders. Lasègue, Garnier, Magnan, and Michaux provided exhaustive clinical descriptions of different presentations of subacute alcoholic delusional disorder, while Kraepelin, Allamagny, and Neveu defined the characteristics of chronic alcoholic hallucinatory psychosis. Both conditions are characterized by the occurrence of hallucinations and vivid dream-like content in their delusions, along with potential emotional detachment from the symptoms. Presently, both conditions are categorized under the generic term ‘Alcohol-Induced Psychotic Disorder,’ with limited available scientific literature.

Our goal is to bring attention to the existence of subacute and chronic alcohol-induced psychosis in individuals with long-term alcohol users.

Case report using clinical records and a non-systematic literature review.

A 63-year-old male, with a forty-year history of chronic alcoholism and no other prior mental health issues, was admitted in the emergency department. He conveyed vague delusional notions regarding his roommate and described vivid morning dreams in which he tried to communicate but couldn’t speak. This led him to believe his roommate harboured harmful intentions. Additionally, he mentioned that for the past two months, he had developed a telepathic connection with his sister and his deceased mother, with whom he felt he communicated without speaking. He described feeling strangement and anxiety concerning these experiences, which he firmly believed to be undeniably real. He reported being able to hear the voices of his mother and sister. He also described short-term memory problems dating back two years. He denied any other psychopathology and exhibited probable ideational and emotional impoverishment secondary to chronic alcohol consumption. Confirmation of the patient’s account was provided by his family members. The prescribed treatment included antipsychotic medication and a recommendation for alcohol abstinence.

Descriptions of chronic and subacute alcohol-induced psychoses are found in early psychiatric textbooks but have been omitted from contemporary classifications. While their incidence is low among chronic alcohol users, they represent a severe clinical entity. These disorders are usually distinguished by the presence of delusions and vivid hallucinations characterized by dream-like content. This distinct symptomatology aids in the accurate differentiation from other psychotic disorders and clinicians should be aware of their existence.

None Declared

Existing systematic reviews have suggested mixed effects of the Covid pandemic on the mental health of children and young people. Those with pre-existing mental health and neurodevelopmental conditions have been suggested to be disproportionately affected, but this has not been meta-analysed. Most reviews of studies in clinical populations to date only include cross-sectional studies during the first lockdown or longitudinal cohorts up to early 2021, which limits our understanding of causality and long-term effects. To our knowledge, this is the first systematic review and meta-analysis to examine the longitudinal impact of the pandemic on the mental health of children and young people with pre-existing mental health and neurodevelopmental conditions.

To compare 1) mental health pre versus during Covid, and 2) mental health during Covid.

Medline, Embase, APA PsycInfo, and Global Health databases were searched up to August 2023. Longitudinal studies reporting mental health outcomes in children and young people (≤18 years old) with pre-Covid mental health and/or neurodevelopmental conditions were included. Cohorts were deemed eligible if children and young people were diagnosed using a diagnostic assessment, scored above clinical threshold on validated measures, or attended mental health services pre-Covid. Outcomes included internalising, externalising, and other symptoms. Studies were narratively synthesised by symptom category and meta-analyses performed where number of studies reporting the same outcomes were sufficient (≥5).

6,083 records were identified and 21 studies (N=2,617) were included. These widely differed in country, setting, diagnosis, outcome, and timepoints under study. The narrative synthesis highlighted mixed findings in mental health changes during the pandemic for all three symptom categories showing increases, reductions, and no changes. Only studies reporting changes in internalising symptoms pre- versus during the pandemic were in sufficient number to be amenable to meta-analysis.

Our findings suggest the pandemic’s impact on the mental health of children and young people with pre-existing mental health and neurodevelopmental conditions were complex and varied. We highlight an urgent need for longitudinal Covid research on long-term mental health outcomes in this vulnerable group. Understanding risk factors and longitudinal trajectories is warranted to guide clinical practice and policy.

None Declared

Mobile phone addiction (MPA) has been associated in the literature with various psychiatric comorbidities and psychological risk factors, which indicates the need to screen these patients for multiple disorders. However, a clear protocol for the evaluation of individuals with an MPA does not yet exist, therefore, investigating the most prominent risks for comorbidities is considered necessary from the perspective of developing structured methods of assessment.

The main objective of this review was to determine the available existence able to describe the most common comorbidities in individuals presenting with MPA.

Data regarding MPA were collected from the main medical electronic databases (PubMed, Cochrane, Clarivate/Web of Science), but also from other sources (main engines research and grey literature). All published papers between January 2000 and July 2023 were included in the primary selection, if they corresponded to the paradigm „mobile phone addiction”/”cell phone addiction”/”mobile phone dependence” and „comorbidity”/”dual diagnosis”.

Based on the review of six papers, the most frequently reported comorbidity in MPA patients were substance use disorders (mainly nicotine and cannabis) and other behavioral addictions (especially problematic Internet use). Other symptoms or syndromes reported in the literature as co-occurring with MPA were anxiety, depression, high levels of stress-related pathology, sleep disturbances, emotional instability, and somatization. Overall lower levels of mental health were reported in patients with MPA. A heterogeneity in the results of these epidemiological studies was observed because of the different instruments administered and the populations explored.

The screening for detection of comorbid disorders or psychological problems in patients with MPA is important because the case manager should integrate all this information into a therapeutic strategy.

None Declared

Suicide is the most frequent psychiatric emergency. About 1% of all deaths are due to suicide so around 700,000 people commit suicide each year. Suicide attempt is more frequent in women (3:1) while completed suicide is more frequent in men (4:1). Most suicides occur in the 35-64 age range. The severity of a suicide attempt is assessed in terms of method, potential lethality, rescuability and impulsivity. A previous suicide attempt is the main risk factor for suicide behavior. The majority (more than 90%) of suicide behavior are related to an underlying psychopathology, mainly depression and substance abuse, especially alcohol. However, there are also numerous cases of impulsive attempts in the context of life stressors.

To analyze sociodemographic and clinical characteristics of adult patients with suicidal behavior attended in the emergency department during a one-year period. To study the stability of the data obtained in the following annual period

A retrospective review of the population over 18 years attended in the emergency department during 2022 because of suicidal behavior, was carried out. Data collection for the year 2023 is in progress in order to be able to carry out a comparative study between both annual periods.

562 patients over 18 years were attended in the emergency department of our hospital due to suicide behavior during 2022. 383 of these patients were women (68.1%) and 179 men (31.9%). with an average age of 38.6 and 42.2 years respectively. The age range between 18 and 25 years accounted for 28.5% of the total cases. The most frequent suicidal behavior was medication overdose with a total of 307 (54.6%), being more frequent in women than in men (2.6:1). The second most frequent reason for attention was suicidal ideation without suicide attempt, with a total of 212 patients (37.7%). 371 patients were discharged home from the emergency department (66%) and 191 required a longer observation in hospital environment. We are awaiting to complete data collection for 2023 to establish a comparison with those described above.

According to our study, suicidal behavior in adult population is more frequent in women than in men. The most frequent age range in both genders was between 18 and 25 years old. The method most frequently used was medication overdose and suicidal ideation without a suicide attempt was the second most frequent reason of attention. Our patients mostly presented diagnoses of personality disorder, depression and substance use disorder.

None Declared

Medical students have been under immense pressure throughout their studies, impacting their mental health and academic performance. Stress reduction is a fundamental skill that all students require to manage their studies and lives efficiently. Biofeedback devices providing information about physiological states have been shown to aid stress reduction. Methods to reduce stress should be taught to medical students to help them tackle the challenges of medical school.

Our goal was to teach stress reduction methods such as extracurricular activities and paced breathing aided by biofeedback training and its application in simulated healthcare situations to medical students.

15 medical students who completed medical physiology were recruited for an elective course of 7 sessions on practical techniques in stress management. One credit was offered to those who completed the course requirements consisting of participation in sessions and individual biofeedback training.

Sessions (classes) consisted of presentations on good sleeping and eating patterns, group simulations of stressful hospital environments, visiting a science centre with interactive displays, an orchestra performance, and nature walks. Before biofeedback training, heart and respiration rates were taken individually by a biofeedback device during the first week of the course. Data was processed using a code created in statistical software. Heartbeats per minute and heart rate variability (HRV) for every 10 seconds were calculated and plotted on a graph. Two measurements were taken with each student: a baseline measurement for 10 minutes and another measurement during controlled breathing paced at 6 breaths per minute for 15 minutes, of which the first 10 minutes were used for calculation and plotting. Students provided narrative feedback in an essay submitted after the course was completed.

5 males and 10 females from years 2-5 registered for the elective, and 12 participated in individually scheduled sessions. Heart beats per minute decreased, whereas HRV increased during paced breathing sessions in 83% of them. Most students reported feeling calm and drowsy during the sessions, and 2 students fell asleep by the end.

Feedback from 11 students showed that the music session and the science centre visit were the highlights throughout the elective. Improvements recommended were to have a consistent time slot for all sessions and fewer simulations.

In concert with the literature, biofeedback training seems to be a feasible and effective method for relaxation in medical students. This method could be offered as part of mental health services for students. Data could be used to follow students’ progress and identify those requiring extra support. Providing them with avenues to de-stress while emphasizing activities outside medicine could boost their confidence and improve their coping skills.

None Declared

ADHD is a neurodevelopmental disorder characterised by: inattention, hyperactivity and impulsivity.Diagnosis of ADHD in adults is complex, owing to the need for retrospective evidence that symptoms began in childhood as well as the high rates of comorbid mental health conditions. There are no public specialized clinics for adults with ADHD in Ireland. In their absence, referrals are sent to general adult psychiatry.

An audit of standards of care received by patients with ADHD against those set by the NICE guidelines.

Care received pre and 8 weeks post MDT (multi-disciplinary team) educational session. Inclusion criteria: existing adult community mental health team (CMHT) patients with a diagnosis of ADHD. Recommendations as per NICE guideline used for assessment: Specialist MDT team input, OT/ Psychology input, MDT review of reports, Specialist consultant with training in diagnosis and treatment, Diagnosis based on structured assessment e.g. DIVA, Detailed psychiatric assessment, Physical health monitoring before commencing treatment (e.g. ECG), Ongoing physical health monitoring (BP, HR, weight), Patient regularly attending follow up

There were 7 patients with diagnosed ADHD attending the CMHT, 4 male, 3 female aged 19-42yo. 4 patients were diagnosed privately (average age at diagnosis 31yrs). 2 were diagnosed by CAMHS. And 1 was diagnosed by primary care psychology (age 27). 8 weeks following MDT meeting; 2 patients had been commenced on ADHD medication. Those on the wait list for OT/psychology remained on the wait list.

ADHD is a specialised area which requires a specialist MDT led by a consultant with expertise in diagnosis and treatment. As evidenced by this audit, despite the best efforts of adult psychiatric services, teams are not sufficiently resourced to meet the needs of adults with ADHD and fall short of the expected standards of care.

None Declared

This is a descriptive cross-sectional clinical study with professionals from the Nursing Team (Nursing Assistant, Nursing Technician and Nurse).

To assess the psychological impact of the Covid-19 pandemic on nursing staff professionals.

A descriptive, quantitative, cross-sectional study will be applied to a structured interview aimed at collecting sociodemographic and occupational data, Mental Health Scales evaluating professional exhaustion - Oldenburg Burnout Inventory and Beck’s Anxiety Rating Scale to assess the state of anxiety.

About 13,587 nursing professionals were interviewed, including nurses, technicians and nursing assistants. They were evidenced through the behavior indexes related to insomnia, the desire to cry and appetite variation may be related to the long working hours, the fear of contamination and the consequent absence from work, as well as the fear of getting sick may be related to the fact that the professional stops being a caregiver and starts to be cared for.

the study denotes the importance and need for interventions to promote and prevent mental well-being in health professionals exposed to COVID-19, these need to be implemented immediately, for nursing professionals, as they are on the front line, demanding attention Special. In this sense, the Nursing Council of the State of São Paulo created and implemented some bills such as the Obligation of Rest Rooms in Health Units, the Cuidando de Quem Cuida Program and the Yellow September Campaign in Allusion to actions for Nursing professionals for the prevention and promotion in mental health category.

None Declared

The mental health of immigrants is a significant, yet often overlooked, aspect of public health. This case study highlights the intersection of migration and mental health, focusing on a patient with delusional disorder. It is particularly relevant for psychiatrists due to the unique challenges in diagnosing and treating mental health conditions in migrant populations, who often face cultural, linguistic, and systemic barriers in accessing care.

The primary objective of this case study is to elucidate the diagnostic and clinical challenges encountered in managing delusional disorder in a migrant patient. The case study presented aims to provide insights into how delusional beliefs can precipitate and perpetuate the process of migration.

The case study was developed through comprehensive psychiatric interviews during the patient’s stay in a Psychiatric Inpatient Unit, supplemented by a targeted literature review on PubMed using “delusion disorder” and “immigration” as keywords.

The patient, a 44-year-old Indian male, was a functional young adult until 2007 when he began exhibiting symptoms of delusional disorder. His delusions progressively evolved from local scenarios to national and eventually to a global scale. The initial delusions were focused on personal and professional conspiracies within his home country, leading to his first internal migration. As the condition worsened, his delusions expanded, fueling a belief in a widespread conspiracy that transcended national borders. This escalation of delusional beliefs became the primary motivation for the patient’s international migration. He changed countries four times, each move driven by an attempt to escape the perceived threats and conspiracies associated with his delusional disorder. The patient’s journey through various countries was a direct result of the intensifying nature of his condition.

This case study accentuates the profound impact that a delusional disorder can have as a driver and catalyst of international migration, influencing the individual’s decision-making process and shaping the migratory experiences. It emphasizes the necessity for psychiatrists to consider the unique socio-cultural contexts of migrant patients in diagnosis and treatment. The case study advocates for a comprehensive treatment approach, integrating psychiatric care with a nuanced understanding of the migrant’s experiences and challenges. This multifaceted approach is crucial in addressing the complex needs of patients with delusional disorder in migrant populations.

None Declared

Opioid use disorder (OUD) is a significant public health concern, and understanding the risk factors associated with OUD is crucial for effective prevention and management strategies. However, limited information is available regarding the role of sex differences in OUD risk factors. Women have often been excluded from clinical studies to create more homogeneous samples and simplify the analysis of treatment effects. The underrepresentation of women in clinical trials and the lack of sex stratification, typically limited to binary comparisons without considering gender dynamics, raise concerns about potential sex disparities. Given the emerging evidence suggesting the possibility of sex differences in the likelihood of developing OUD, further research is needed to investigate and understand these potential disparities to optimize the individualized management of OUD.

The primary objective of this study was to examine and identify any sex-related variations in OUD risk variables within the Lebanese community. By pinpointing sociodemographic, psychiatric, and other factors related to sleep and chronotype, we aim to elucidate their impact on the onset and progression of OUD in both males and females.

A cross-sectional study was conducted among 581 Lebanese adults using an online questionnaire that included sociodemographic questions, validated scales for substance use disorders and sleep disorders, and assessments for depression and anxiety. Multivariate analyses were performed to identify associations between risk factors and OUD scores in both male and female populations.

Common risk factors for OUD were identified, including family and personal history of substance use disorder, co-occurrence of sedative and alcohol misuse, and psychiatric illnesses. Sex-specific risk factors were also observed. Among women, the ASSIST-opioids subscore was significantly associated with the Pittsburgh Sleep Quality Index (B=0.143) and Insomnia Severity Index (B=0.286) scores. Men demonstrated a correlation between ORT-OUD and younger age (B=0.882). Waterpipe consumption was negatively correlated with the ORT-OUD score in men (B=-0.018).

Our study emphasizes the importance of examining sex differences in risk factors for OUD, particularly within the Lebanese population. By acknowledging these gender-specific risk factors, interventions can be customized to address the distinct vulnerabilities of each sex. This approach could potentially improve prevention efforts, facilitate early identification, and implement treatment strategies tailored to the specific needs of individuals with OUD. Further research is needed to delve into the underlying mechanisms and develop targeted interventions for enhanced management of OUD.

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

In this research work the sense of resilience was studied, which is an essential factor in reducing the stress of health care workers, it also helps to maintain the sustainability of the work of medical specialists and prevents the burnout syndrome. Aaron Antonovsky’s Sense of Coherence scale was used in this study, which helps to determine how health care professionals are able to preserve their mental and physical health.

This study is aimed to determine the differences in components of Antonovsky’s Sense of Coherence scale for various health care specialists and to describe the factor structure of Coherence scale for health care specialists in Latvia, that forms the sense of resilience for health care specialists.

The questionnaire used in the study is Antonovsky’s Sense of Coherence scale’s (Antonovsky, 1987) Latvian version, that was translated into Latvian and adapted in the research work of A. Veylande, N. Bahmačova (2000). 202 respondents who are representatives of medical professions took part in this study. The obtained data were entered into the MS Excel computer program and were statistically processed using the SPSS 22 computer program.

Looking at the obtained results of this study, it can be stated that Medical Doctors- Specialists have statistically significantly higher Comprehensibility scores than Medical Orderlies (p = 0.01, r = 0.24), while Medical Doctors- Specialists and Medical Doctors- Residents have statistically significantly higher Manageability scores than Medical Orderlies (p= 0.04, r=0.21). Based on the analysis of the results, it has been determined that Doctors-Specialists (p=0.00, r=0.32) and Doctors-Residents (p=0.00, r=0.34) have statistically significantly higher Meaningfulness indicators than Medical Orderlies, as well as Doctors-Specialists (p=0.00, r=0.29) and Doctors-Residents (p=0.00, r=0.31) have statistically significantly higher Meaningfulness scores than Medical Nurses.

Higher scores of the three components of Antonovsky’s scale for Medical Doctors-Specialists and Medical Doctors-Residents compared to Medical Orderlies and Medical Nurses could be explained by a lower overall time that Doctors spend in the department with patients. Higher education helps to overcome stress at work and to become aware of possible strategies for improving the joy of life, ways to reduce stress at work and to relax from work.

None Declared

The association between the intake of antipsychotic drugs and the occurrence of thromboembolic complications is widely described in the literature. The occurrence of this complication may call into question the medical responsibility of the attending physician.

The objective of this work is to describe the physiopathological mechanisms involved in the occurrence of thromboembolic complications in a patient under antipsychotic treatment, whether or not associated with physical restraint and to discuss the forensic implications.

Our study is retrospective on cases of fatal pulmonary embolism, discovered at autopsy, in connection with the taking of antipsychotics. The autopsies were carried out in the Department of Forensic Medicine of the Tahar Sfar University Hospital in Mahdia. The cases were collected over a period of 04 years. A review of the literature was carried out. We only selected articles published until February 2021 and dealing with cases of patients on antipsychotics, diagnosed with pulmonary embolism by performing a chest CT scan or during an autopsy.

915 autopsy cases were performed during the study period. Twenty cases of pulmonary embolism, discovered at autopsy, were collected. Four cases were related to the taking of antipsychotics (incidence 0.004%), including two men and two women, aged between 25 and 52 years. They were all on antipsychotic treatment for at least 5 years, with the exception of one case who was put on 3 antipsychotics, 7 days before his death, with indication of physical restraint. After analysis of the memorial data, the external examination and the autopsy, the results of additional examinations, the death was attributed, in the 4 cases, to a massive fibrino-cruoric pulmonary embolism. A selection of 45 studies regarding thromboembolic complications associated with taking antipsychotics, was included in the final review.

The reported cases provided additional evidence on the involvement of antipsychotics in the occurrence of thromboembolic complications. Psychiatrists should be careful when prescribing these treatments. The establishment of therapeutic guidelines, taking into account the thromboembolic risk factors, becomes essential, in order to avoid the occurrence of a complication which could engage both the vital prognosis of patients and the responsibility of the physician.

None Declared

Suicide is one of the leading causes of death worldwide being the fourth major cause of death among young people 15-29 years old. The reduction of suicide mortality is prioritized by the World Health Organization (WHO, 2019). There is a number of internal and external factors associated with suicidality (Soto-Sanz V et al., 2019; Farbstein et al., 2022.). Special attention is paid to the influence of the social media on suicidality (Cheng A. T. A. et al., 2007; Niederkrotenthaler T. et al., 2020; Sedgwick R. et al., 2019). In the Russian Federation, anime, an animation genre and a media cultural phenomenon, is increasingly popular among young people. Characters who are lonely and lost their meaning of life are common in anime. Romanticization and idealization of such characters may lead to increased attractiveness of death and thus have a negative effect on the mental health of adolescents and young adults due to their incomplete identity development (Liu Y. et al., 2022; Backer, H. A., 2023).

We aimed to study the influence of the anime on the presence of suicidality and depression in adolescents and young adults in the Russian Federation.

We interviewed 304 people living in the Russian Federation and watching anime on the regular basis (244 women, mean age 20.9 ± 3.8 years, range 13-36 years). We collected sociodemographic data and age when a person had started watching anime. We performed Reasons for Living Inventory, RFL (M. Linehan et al., 1983), Beck Depression Inventory, BDI (Aaron Beck, 1961). We divided all participants into three groups according to their age: adolescents (13-19 years), young people (20-24 years), adults (25-36 years). In each group, we compared BDI: level of depressive symptoms, cognitive-affective subscale, subscale of somatic manifestations of depression; RFL scales: Survival coping beliefs, responsibility to family, child related concerns, fear of suicide, fear of social disapproval, moral objections between three subgroups based on the age of the anime watching start (<12 years old, 12-15 years old, ≥16 years old) using Kruskall-Wallis test and post hoc Mann-Whitney U-test for pair comparisons with Bonferroni correction for multiple comparisons. Level of significance p<0.05.

In the adolescents (n=130), we did not find any differences between the three subgroups. In the young people (n=127), participants who had started watching anime in childhood (<12 years old) had higher level of depression (p= 0,014) and higher level of cognitive-affective symptoms (p= 0,006). In the adults (n=47), participants who had started watching anime in childhood had decreased moral attitudes contrary to suicide (p= 0,004). Other scales not found to differ significantly.

Start of the anime watching in childhood (<12 years old) was associated with increased suicidal risk factors and decreased anti-suicidal factors in the young adults.

None Declared

The COVID-19 pandemic has led to a rise in psychological disorders among adolescents and young adults. There is an increase in the prevalence of likely anxiety and likely depression among the subscribers of MoreGoodDays supportive text message program, reflecting the impact of the COVID-19 pandemic on this cohort.

To assess the prevalence, severity, and correlates of likely generalized anxiety disorder (GAD) and likely major depressive disorder (MDD) among subscribers of MoreGoodDays program.

This study used a cross-sectional design. An online survey questionnaire was used to collect sociodemographic and clinical information from subscribers of MoreGoodDays program, a daily supportive text message program co-designed with adolescents and young adults for their peers in Alberta. Validated instruments, the Generalized Anxiety Disorder GAD-7 and Patient Health Questionnaire-9 PHQ-9 were used to collect information on likely GAD and likely major depressive disorder (MDD), respectively. Data was analyzed with SPSS version 25 using chi-squared tests and binary logistic regression analysis.

343 subscribers of MoreGoodDays participated in the survey. Overall, 117 (56.0%) respondents had a likely MDD and 97 (46.6%) had a likely GAD. Participants who would like to receive mental health counselling were 27 times more likely to experience GAD (OR = 27; 95% CI: 3.09–250.00) and 40 times more likely to experience MDD (OR = 40.03; 95% CI: 4.43–361.51) than those who did not. Respondents who had received mental health counselling in the past were 18.5 times more likely to experience MDD compared with those who had not (OR = 18.52; 95% CI: 1.55–200.00). Demographic variables, including age, education, employment, and relationship status, and clinical variables, such as history of anxiety, depression, obsessive-compulsive disorder, ADHD, and adverse childhood experience, did not independently the predict presence of likely GAD or MDD in subscribers of MoreGoodDays.

The prevalence of anxiety and depression was relatively high among subscribers of MoreGoodDays, indicating the long-term effect of the COVID-19 pandemic. This finding has significant implications in the broader context of mental health research and emphasizes the need for more research into innovative mental health support for this cohort. The desire to receive counselling was predictive of both anxiety and depression and is a positive sign of the openness of this cohort to receive psychological intervention. Since this group is mostly adapted to mobile text technology, government agencies and policymakers should prioritize and implement readily accessible interventions such as supportive text messages to support their psychological well-being.

None Declared

Vitamin B12 deficiency gives rise to a wide spectrum of hematological, gastrointestinal, psychiatric, and neurological disorders. Notable among the neuropsychiatric symptoms are mood disturbances, cognitive decline, and psychotic manifestations.

We present a case of a woman with neuropsychiatric symptoms linked to vitamin B12 deficiency to highlight certain organic aetiologies with psychiatric symptoms in the foreground.

We discussed through a clinical case and a literature review, the relationship between neuropsychiatric symptoms and vitamine B12 deficiency in the context of biermer’s disease.

We presented a patient aged 51-years-old without neurological or psychiatric history, she was hospitalised in a psychiatry department for behavioral disturbances, hetero-aggression, and incoherent speech. The psychiatric examination revealed distant contact, inappropriate affects, disorganized speech with persecutory delusions, memory problems, and poor insight. Neurological et physical examinations were normal, and cerebral magnetic resonance imaging (MRI) showed no abnormalities. First, haloperidol 25mg was prescribed, however, there was only partial improvement. Complete blood counts revealed macrocytic anemia (Hemoglobin: 8 g/dL, mean corpuscular volume: 106 fL). Her serum B12 assay was 48.19 pmol/L.Given these results we proceed to a Fundic biopsy, performed by fibroscopy, that revealed fundic atrophy and intestinal metaplasia compatible with Biermer’s disease. Vitamin B12 replacement therapy began with hydroxocobalamin at 1000 μg/day intramuscularly for 15 days, followed by 1000 μg every 15 days for one month. Subsequently, there was a remarkable improvement in psychotic symptoms and cognitive function. Follow-up assessments demonstrated a return to baseline functioning.

This case, coupled with prior studies, emphasizes the importance of considering vitamin B12 deficiency in the differential diagnosis of neuropsychiatric symptoms. Therefore, prompt diagnosis and treatment of vitamin B12 deficiency are imperative in preventing potential irreversible neurological damage.

None Declared

Metabolic syndrome and cardiovascular diseases are a very important cause of morbidity and mortality among patients with schizophrenia who live an average of 10-20 years less than the general population. Second generation antipsychotics are associated with obesity and other components of the metabolic syndrome.

The aim of this paper was to provide complete insight into the existing recent evidence for metabolic risks associated with the use of new antipsychotics, and establish recommendations for monitoring metabolic syndrome and other risks, as well as current options for treatment and prevention of metabolic syndrome.

This review article is based on a literature search. We identified relevant publications and articles by searching the PUBMED database from 1999 to the present day according to the given parameters. The search criteria were the keywords “metabolic syndrome” combined with “schizophrenia” and “new antipsychotics”.

All researches has convincingly shown that patients with schizophrenia tend to be overweight and have a three to four times higher risk of developing diabetes than the general population. There are also more and more evidence in recent literature about the impact of new antipsychotics on the frequency of metabolic syndrome in patients with schizophrenia. The World Health Organization (WHO) defines metabolic syndrome as an elevated insulin level or a fasting glucose concentration of 5.6-6.0 mmol/l in combination with two or more of the following parameters: abdominal or central obesity and dyslipidemia and/or arterial hypertension. The research results systematically showed a 1.5 to 3 times higher frequency of metabolic syndrome in people suffering from schizophrenia compared to the general population. Therefore, regular control of all components of the metabolic syndrome is necessary, from waist circumference, which is the easiest to measure, to all others that can be carried out and done in the general practice doctor’s office.

Metabolic changes in patients with shizophrenia who receive new antipsychotics in addition to their unfavorable lifestyle (improper diet, lack of physical activity, smoking) can lead to the development of metabolic syndrome and increase the risk for diabetes and cardiovascular diseases. It is therefore necessary to establish protocols for monitoring these risks and preventing comorbidities.

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Some studies have shown that late-life depression is related to faster cognitive decline and may increase the risk of dementia.

Identifying risk and protective factors for dementia is essential to develop preventive interventions. Some literature has suggested that mood disorders (namely depression) are potential modifiable risk factors for dementia.

Thus, it is important to know clinical presentation of depression that is associated to dementia, as a manifestation of subclinical dementia or as a risk factor for neurocognitive disorders.

We aim to identify clinical characteristics related to dementia of inpatients admitted for first time due to depressive episode after 55 years old.

Retrospective cohort study of inpatients admitted between January 1st 2010 and March 31st 2022 in a psychiatry inpatient unit of a tertiary hospital. Descriptive analysis of the results was performed using the SPSS software, version 26.0.

Our sample included 57 inpatients, 15,8% (n=9) with the diagnosis of dementia 5,2 (SD 5,6) years after admission. All of these patients presented a depressive episode with psychotic symptoms, namely delusion activity. In those with hallucinatory activity, no one developed dementia.

Interestingly, 33,3% of patients with dementia (n=3) presented with delusion of ruin, 55,6% (n=5) with delusion of prejudice/persecutory delusion and 66,7% (n=6) manifested delusion of ruin and/or prejudice.

We also found that 42,9% (n=3) of patients with dementia manifested Cotard delusion while this type of delusion was observed in 13,6% of patients without dementia (p=0,095).

Our study has several limitations because is based on results of only one hospital, with a small sample size.

However, since depressive symptoms are potentially modifiable risk factors for dementia, future studies are essential to understand the mechanisms that link depression to cognitive decline as well as clinical characteristics that may constitute predictors of dementia.

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The world of the third millennium is witnessing the highest levels of displacement on record. To meet the specific needs of this vulnerable population, a task-shifting approach is developed, where individuals with refugee background and lived experience are trained and supervised my mental health professionals to provide emotional and practical support to members of their communities.

The evaluation of a scalable psychosocial intervention for refugees based on the task-shifting approach.

The intervention consisted of sessions of Problem Management Plus (PM+) and peer case management delivered by a team of community psychosocial workers (trained refugees). The sample consisted of 173 participants, Arabic- and Farsi-speakers male and female, recognized refugees, and asylum seekers. Anxiety, depression, and psychological distress were measured before and after the intervention using the Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire - 9 (PHQ-9), and Psychological Outcome Profiles (Psychlops) scales respectively. Repeated measures analysis of variance (ANOVA) was adopted to evaluate the difference in the degree of change across patients’ characteristics over the follow up period. Statistical significance was set at p<0.05 and analyses were conducted using SPSS statistical software (version 26.0).

Significant decreases were found in all post-test scales, indicating diminution of anxiety, depression symptoms, and psychological distress. Large effects sizes were found in all scales.

The findings support that task-shifting approach incorporating PM+ and case management is effective for the mental health of refugees. Peer support could be included in a stepped care model for refugee mental health and well-being in high-income countries. For future research a randomized controlled trial is proposed as a study protocol.

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