Mental health problems are common in children and young people (CYP) in England, yet evidence suggests high levels of unmet need in this group. Understanding of the determinants of mental health-related service contact is needed to identify gaps in service provision and areas for targeted intervention to improve access.

To determine the relationship between CYP characteristics and mental health-related support and service contact in England.

A secondary analysis of the 2017 NHS Digital Mental Health of Children and Young People (MHCYP-2017) cross-sectional survey dataset was performed. MHCYP-2017 was a national survey investigating the mental health of CYP using a stratified multistage random probability sampling approach, providing the official national statistics for England. Multi-informant data were collected through a combination of questionnaires and interviews. Expert clinical rating took place to formally identify the presence of mental disorders, according to established diagnostic criteria. This secondary analysis describes mental health-related support and service contact amongst 6681 participants aged 5-16 recruited to the MHCYP-2017 study. A range of socio-demographic and clinical characteristics were analysed as explanatory variables and their relationships with different types of support/service contact were examined through multivariable multinomial logistic regression. Analyses were stratified by age group: 5-10- and 11-16-year-olds.

Overall, around 25% of parents reported CYP mental health-related contact with one or more types of support/service in the past 12 months due to concerns regarding CYP “emotions, behaviour, concentration or difficulties in getting along with people”. Age stratified multivariable analyses revealed several statistically significant associations between participant socio-demographic/clinical characteristics and mental health-related support and service contact, independent of CYP mental health status and parental perception of difficulties. These associations were not necessarily consistent across mental health support categories, suggesting that several of the measured characteristics have differential relationships with different types of support and service contact. Whilst there were some differences between the 5-10 and 11-16 age groups, similar associations were seen for many of the explanatory variables. Socioeconomically disadvantaged and black and minority ethnic CYP were less likely to have had professional contact for mental health problems.

There may be higher levels of unmet need in socioeconomically disadvantaged and black and minority ethnic CYP, warranting further investigation and efforts to address inequalities. Further longitudinal studies are needed to elucidate causal associations and mechanisms underlying these observations.

None Declared

The fundamental principle of medical ethics is based on the principle of autonomy, of which consent is part, in addition to the right to information and the free choice of caregiver by the patient. In the psychiatric emergency department, the psychiatrist is confronted in his daily practice with the decisions of outpatient or hospital care, sometimes without the consent of the patients, in particular when the disorders hinder their capacities for self-assessment and judgment or when he there is a vital prognosis involved.

It is therefore important to know certain basic legal rules in order to better manage these emergency situations.

Literature review

Patients requiring care in the emergency department present particular challenges to ensuring valid consent. Patients often present in a crisis situation and their abilities may be altered by, for example, psychoactive substances or impaired judgment. These patients are cared for by clinicians who may have to make urgent decisions based on incomplete information. The emergency department can be a disorienting and frightening environment for patients. The following aspects of consent: autonomy and capacity, are particularly relevant to care in emergency departments.

The interplay between emergent need, presumed incompetence, implied consent, and societal interest, as well as the individual details of each case, are all important in making the right ethical and legal decision in an emergency situation. given, because the emergency situation does not allow any delay in the decision-making process.

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Burnout in the medical profession has garnered a lot of attention over the recent years. While it is reported across all specialties and all stages of medical education; resident physicians in particular are at high risk for burnout throughout their years of training.

This study aimed at evaluating the prevalence and correlates of burnout among resident physicians in Alberta.

Through a descriptive cross-sectional study design, a self-administered questionnaire was used to gather data from resident physicians at two medical schools in Alberta, Canada. Maslach Burnout Inventory was used as an assessment tool. Chi-squared and multivariate binary logistic regression analyses were used.

Overall burnout prevalence among residents was 58.2%. Working more than 80 hours/week (OR= 16.437; 95% CI: 2.059 – 131.225), being dissatisfied (OR= 22.28; 95% CI: 1.75– 283.278) or being neither satisfied nor dissatisfied with a career in medicine [(OR= 23.81; 95% CI: 4.89 – 115.86) were significantly associated with high depersonalization. Dissatisfaction with efficiency and resources (OR= 10.83; CI: 1.66- 70.32) or being neither satisfied nor dissatisfied with a career in medicine (OR= 5.14; CI: 1.33- 19.94)] were significantly associated with high emotional exhaustion. Working more than 80 hours/week (OR= 5.36; CI: 1.08- 26.42) and feeling that the residency program is somewhat having enough strategies aimed at resident well-being in place (OR= 3.70; CI: 1.10- 12.46) were significantly associated with high work exhaustion and interpersonal disengagement. Young age of the residents (≤ 30 years) (OR= 0.044; CI: 0.004- 0.445) was significantly associated with low professional fulfillment.

Burnout is a serious occupational phenomenon that can degenerate to other conditions or disrupts one’s professional performance. Significant correlates were associated with high rates of burnout. Leaders of medical schools and policy makers need to acknowledge, design, and implement various strategies capable of providing continuous effective mental health support to improve the psychological health of the medical resident across Canada.

None Declared

Psychiatry Across Borders working group of the European Federation of Psychiatric Trainees has the mission to improve psychiatric training in transcultural psychiatry and trauma-related topics in Europe. It started conducting a survey in 2016, to assess trainees’ experiences in forcibly displaced people mental health (Frankova et al. Transcult.Psychiatry, in press).

To investigate European psychiatric trainees’ and Early Career Psychiatrists’ (ECPs) training about trauma and refugees’ mental health, focusing on educational and clinical difficulties occurring while assisting war refugees or in Eastern Europe, due to the ongoing conflict.

A new survey for European psychiatric trainees and ECPs was designed. A web questionnaire was shared through various channels, including social media, in September 2022. It included an informed consent form and investigated socio-demographic data, training in trauma and refugees’ mental health, clinical practice in war areas or with war refugees.

As of 16/10/22, 31 were the responders, mainly adult psychiatrists (93.6%). Although the 87.1% worked with forcibly displaced people, only 29% received a specific training, and 53.6% didn’t feel prepared to face war trauma-related disorders. However, 64.3% could reach out to a teamwork member specialized in the topic, and 72.2% to interpreters. The 67.7% worked with actual war refugees, mainly addressed to psychiatric services due to new onset of psychiatric symptoms, especially insomnia (66.7%), often diagnosed with Acute Stress Reaction (66.7%) and treated with psychiatric drugs (83.3%). Two colleagues working in war areas participated in the survey: both lost patients at follow-up and experienced increased workload or lack of means (i.e., drug supply) or support.

This survey can spot educational needs in transcultural psychiatry, helping to program targeted interventions for psychiatric trainees and ECPs, aimed at implementing clinical practice towards the common goal of social cohesion.

None Declared

In the field of health, social networks are increasingly used for research since they have demonstrated multiple uses. Proof of this is that more and more projects financed by public entities use this methodology, as well as scientific publications.

In the symposium, how to do this type of research will be explained in a practical and useful way for the listener. It will be explained with practical examples, and based on successful publications, how this type of work is designed, what type of people should integrate this research team, how to carry out the project, interpret the results and publish them.

We will also address the difficulties encountered and how to overcome them. Attendees will be able to ask all the questions they deem appropriate.

None Declared

Eye Movement Desensitization and Reprocessing (EMDR) is a powerful psychotherapy approach developed by Francine Shapiro in 1987 when she realized that rhythmic eye movements reduce disturbing thoughts. The effectiveness of the therapy has been proven by many studies after its discovery. EMDR, which was initially used only in the treatment of Post Traumatic Stress Disorder, has become a treatment option used in the treatment of psychiatric disorders of more than 2 million people today. EMDR, which is used today, contains elements from many therapy schools andconsists of a phased protocol (Shapiro, 2018). Increasing evidence acknowledging the relationship between trauma and psychosis indicates that EMDR can be a vital addition to the treatment of psychosis (Sin & Spain, 2017; Valiente-Gomez et al., 2017). However, the effect of EMDR on psychosis has not yet been sufficiently clarified. There is alsoIt has not yet been clarified whether the curative effect on the psychotic symptoms or on the anxiety symptoms.For this reason, in our study, the effect of EMDR on these symptoms will be investigated by comparing the case and control groups.

This study aims to evaluate the effect of EMDR therapy on post-traumatic stress symptoms, schizophrenia symptom severity and anxiety level in psychotic patients with at least one traumatic event.

This study is a randomized controlled, prospective follow-up study aiming to evaluate the effect of EMDR therapy on post-traumatic stress symptoms, schizophrenia symptom severity and anxiety level in psychotic patients with at least one traumatic event.Written informed consent to participate in the intervention study will be requested from all patients who meet the inclusion criteria. Consent participants receive pre-treatment (T0) measurements. After T0, participants will be randomized to EMDR or waiting list Participants will be randomly assigned to 26 people in each group. These groups will be made by the independent randomization bureau of the Parnassia Institute of Psychiatry using the scientific randomization program on the Internet (www.randomizer.org).

The effects of EMDR therapy on posttraumatic stress symptoms, schizophrenia symptom severity and anxiety level in psychotic patients were obtained from pretest and posttest measurements.

More studies are needed on the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy.

None Declared

Fear was the primary construct for this study, however, knowing that high levels of anxiety can cause changes in sleep quality, it was considered opportune to study the relationship between these two concepts.

According to Marks (1969), “Fear is a normal response to active or imagined threat in higher animals, and comprises an external behavioral expression, an inner feeling and associated physiological changes”, almost all children experience some degree of fear during its development. Additionally, while these fears vary in frequency, intensity, and duration, they tend to be mild, age-specific, and transient.

According to a simple definition, sleep is a reversible behavioral state of perceptive disconnection and indifference to the environment (Carskadon & Dement, 1989).

Sleep quality perceived by children is inversely correlated with self-perception of fears

Participants

The study sample consists of 121 students from the 1st cycle of basic education, 65 (53.7%) attending the 3rd year of schooling and 56 (46.3%) attending the 4th year of schooling, 66 ( 54.5%) were female and 55 (45.5%) were male, aged between 7 and 10 years old (M=8.5; SD=0.61).

Sleep Self Report-PT (SSR-PT): The SSR-PT is a questionnaire designed to assess children from 7 to 12 years old regarding their self-perception of the quality of their sleep. Fear Survey Schedule for Children-Revised (FSSC-R): T. Ollendick (1978); Translation and adaptation: Pedro Dias & Miguel Gonçalves

The lower the sleep quality perceived by the children, the greater the self-perception of fears of the two factors with very strong significance .000 in both.

The lower the sleep quality perceived by the children, the greater the self-perception of fears of the two factors with very strong significance .000 in both.

None Declared

Feeding plays a very important role in our lives. First of all survival, but in general it has a much wider and important social role. Through feeding, in addition to satisfying life’s needs and basic instincts, we experience a sense of satisfaction through the investment of libido. Anorexia nervosa and obesity as the two extremes of eating disorders can be considered as a disturbed experience of the satisfaction of eating, and in the background there is usually a very weak, fragile personality structure. A fragile personality structure tends to use primitive defense mechanisms, but the use of healthier, neurotic defense mechanisms in people with eating disorders should not be neglected.

To investigate the role of the psychological defense mechanism of displacement in people with obesity and anorexia nervosa.

Search of contemporary professional and scientific literature in the field of psychodynamics of eating disorders.

Displacement is a defense mechanism in which, when faced with a problem, the problem is not solved with the initial object of aggression, but the problem is moved to another object or situation that the individual perceives as less dangerous. Thus, when faced with a stressful situation or sadness, obese people may have a need for emotional eating, which can be interpreted as displacement of the problem, which is temporarily “solved” by satisfying the basic instinct, but later the person becomes overwhelmed by internal and external shame. Equally so, a traumatic upbringing and disturbed interpersonal family dynamics, which are often present in people with anorexia nervosa, can cause anxiety drives that are displaced in the form of the need for a strong restriction of food intake.

In people with obesity and anorexia nervosa, the use of the defense mechanism of displacement is pointed out. Through psychodynamic psychotherapy it can be very useful to recognize and interpert the use of displacement and, thus to enable reaching a neurotic and healthier level of functioning in people with the aforementioned eating disorders.

None Declared

Crisis Resolution Home Treatment Teams (CRHTTs) offer short-term specialist psychiatric input to service users experiencing acute mental illness or crisis in the community. The South Lee CRHTT was setup in 2015.

To evaluate the impact of treatment given by a CRHTT in terms of:

1. Preventing hospital admission,

2. Impact on service user’s symptoms and overall functioning

3. Service user’s satisfaction with the service

To evaluate patient characteristics of those attending the CRHTT, and to assess qualitative data provided by service users using thematic analysis.

All the service users treated by South Lee CRHTT between 2016-2020 were included in this review. Standardized quantitative measures are routinely taken by the South Lee HBTT before and after treatment. The Brief Psychiatric Rating Scale (BPRS) was used to measure symptom reduction, and the Health of the Nation Outcome Scale (HONOS) was used to measure quality of life/health outcomes. The Client Satisfaction Questionnaire- version 8 (CSQ-8) was used to evaluate service user satisfaction quantitatively, and service users were also asked for qualitative data.

1041 service users were treated by the service, between 2016-2020. Treatment by the CRHTT was shown to be effective across all primary outcome measures. Inpatient admissions in the areas served by the CRHTT fell by 38.5% after its introduction. BPRS scores were reduced significantly (p<.001), from a mean score of 32.01 to 24.64 before and after treatment. Mean HoNOS scores were 13.6 before and 9.1 after treatment (p<.001). Of the 1041 service users receiving the CSQ-8, 180 returned it completed (17.3%). Service users’ median responses were “very positive” on a 4 point-Likert scale to all 8 items on the CSQ-8, and qualitative data were thematically analysed.

CRHT was shown to be effective at preventing inpatient admission. CRHT was shown to be an effective option for the treatment of acute mental illness and crisis, using quantitative measures. Feedback gained from service users suggests that overall patient satisfaction with the CRHTT service was high.

None Declared

Preventing psychiatric admissions holds benefits for patients as well as healthcare systems. The Clinical Global Impression-Severity (CGI-S) scale is a 7-point measurement of symptom severity, independent of diagnosis, which has shown capability of predicting risk of hospitalisation in schizophrenia. Due to its routine use in clinical practice and ease of administration, it may have potential as a transdiagnostic predictor of hospitalisation.

To investigate whether early trajectories of CGI-S scores predict risk of hospitalisation over a 6 month-follow-up period.

A retrospective cohort study was conducted, analysing Electronic Health Record (EHR) data from the NeuroBlu Database (Patel et al. BMJ Open 2022;12:e057227). Patients were included if they had a psychiatric diagnosis and at least 5 recorded CGI-S scores within a 2-month period, defined as the ‘index’ period. The relationship between early CGI-S trajectories and risk of hospitalisation was investigated using Cox regression. The analysis was adjusted for age, gender, race, number of years in education, and psychiatric diagnosis. Early CGI-S trajectories were estimated as clinical severity (defined as the mean CGI-S score during the index period) and clinical instability (defined as a generalised Root Mean Squared Subsequent Differences of all CGI-S scores recorded during the index period). The primary outcome was time to psychiatric hospitalisation up to 6 months following the index period. Patients who had been hospitalised before or within the index period were excluded.

A total of 36,914 patients were included (mean [SD] age: 29.7 [17.5] years; 57.3% female). Clinical instability (hazard ratio: 1.09, 95% CI 1.07-1.10, p<0.001) and severity (hazard ratio: 1.11, 95% CI 1.09-1.12, p<0.001) independently predicted risk of hospitalisation. These associations were consistent across all psychiatric diagnoses. Patients in the top 50% of severity and/or instability were at a 45% increased risk of hospitalisation compared to those in the bottom 50% (Figure 1).

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Early CGI-S trajectories reflecting clinical severity and instability independently predict risk of hospitalisation across diagnoses. This risk was compounded when instability and severity were present together. These results have translation potential in predicting individuals who are at high risk of hospitalisation and could benefit from preventative strategies to mitigate this risk.

E. Palmer Employee of: Holmusk, M. Taquet Consultant of: Holmusk, K. Griffiths Employee of: Holmusk, S. Ker Employee of: Holmusk, C. Liman Employee of: Holmusk, S. N. Wee Employee of: Holmusk, S. Kollins Employee of: Holmusk, R. Patel Grant / Research support from: National Institute of Health Research (NIHR301690); Medical Research Council (MR/S003118/1); Academy of Medical Sciences (SGL015/1020); Janssen, Employee of: Holmusk

Postpartum psychosis is a rare psychiatric emergency, occurring days to weeks after 1-2 per 1000 deliveries. Its low prevalence makes it difficult to recruit enough participants to investigate the underlying pathophysiology. It is epidemiologically linked to bipolar disorder, which one study also found it to resemble in genetic susceptibility for psychiatric disorders (Di Florio et al. Lancet Psych 2021; 8: 1045–52).

In this study we aim to investigate polygenic liability for psychiatric disorders in two new Swedish postpartum psychosis cohorts.

Cases with postpartum psychosis, defined as a psychiatric hospitalization within 6 weeks after delivery, and/or receiving a diagnosis of F53.1 (ICD 10) or 294.40 (ICD 8.), parous women with severe mental illness without postpartum psychosis, and healthy parous controls were identified in two Swedish genetic studies: the Swedish bipolar collection (SWEBIC) and Predictors for ECT (PREFECT). Polygenic risk scores (PRS) were calculated from summary statistics from genome wide studies on bipolar disorder (Mullins et al. Nat Genet 2021; 53 817-829), schizophrenia (Trubetskoy et al. Nature 2022; 604 502-508) and major depression (Wray et al. Nat Genet. 2018; 50 668-681). The p-value thresholds best predicting their respective phenotype were used in logistic regression analyses with the first six principal components and genotyping platform as confounders.

We identified 176 patients with postpartum psychosis and genetic information (N(SWEBIC)=126, N(PREFECT)=50). Compared with healthy parous women, patients with postpartum psychosis had significantly higher PRS for bipolar disorder (SWEBIC: odds ratio [OR] 2.6 (95% confidence interval [CI] 1.9-3.5), PREFECT: OR 2.4 (95% CI 1.8-3.2), Figure 1.) and schizophrenia (SWEBIC: OR 1.6 (95% CI 1.2-2.2), PREFECT: OR 1.8 (95%; CI 1.3-2.5)). Patients with postpartum psychosis had significantly higher PRS for bipolar disorder (SWEBIC: OR 1.4 (95% CI 1.2-1.8), PREFECT: OR 1.5 (95% CI 1.1-2)) compared with parous women with severe mental illness without postpartum psychosis. We found no associations with major depression PRS in either cohort.

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We replicated previous findings of significantly higher PRS for bipolar disorder and schizophrenia in postpartum psychosis compared with healthy controls. In contrast to previous research, we find postpartum psychosis cases to have higher PRS for bipolar disorder than bipolar disorder cases. Our findings highlight the genetic influence in postpartum psychosis and support previous genetic and epidemiological evidence that postpartum psychosis lies on the bipolar spectrum.

None Declared

A growing body of literature has documented that obstructive sleep apnea syndrome (OSAS) is associated with an increased risk of depressive disorders.

This study aimed to determine whether depression is associated with OSAS.

This was a descriptive prospective comparative study conducted over two years among patients with OSAS. Excessive daytime sleepiness was assessed by the Epworth Sleepiness Score (SES). The presence and intensity of depressive symptoms were screened using the Patient Health Questionnaire PHQ9. Data were analysed using SPSS software.

A total of 139 patients participated in the survey with an average age of 48.98 ± 9.80 years. According to the SES, the study population was divided into two groups: a group including 70 subjects with normal SES (< 11); and a group including 69 subjects with pathological SES (≥11). The PHQ9 depression score was higher in sleepy subjects with SES ≥ 11 compared to non-sleepless subjects; the difference being very highly significant (PHQ9=11.97 ± 4.99 and 6.54 ± 5.27 respectively; p=0.0000). The frequency of mild to moderate depressive disorders was found to be greater in non-sleepy subjects (94.3% and 78.3% respectively; p=0.007). For moderately severe to severe depression, their frequency was more marked in sleepy subjects (21.7% and 5.7% respectively; p=0.007).

Depressive disorders constitute a major comorbidity in OSAS. Therefore, it is necessary to improve the quality of these patients’ health by the early detection of the symptoms of overlapping OSAS and depression.

None Declared

Intensive home treatment (IHT) for people experiencing a mental health crisis has been progressively established in many western countries as an alternative to in-ward admission. But is this a real alternative? We previously reported that patients treated in our IHT unit only differ from those voluntarily admitted to hospital in suicidal risk and severe behaviour disorders (not in other factors such as clinical severity) (Martín-Blanco et al., Rev Psiquiatr Salud Ment 2022;15:213-5). Now we are interested in disentangle if those patients who used to require inward management can be successfully treated at home.

To describe subsequent treatment trajectories of the first 1000 admissions to our IHT unit and to compare clinical characteristics among the different groups of trajectories.

Retrospective cohort study. Subsequent treatment trajectories were collected from December 2016 to October 2022 and classified: absence, hospital, IHT, and mixed (hospital and IHT). Statistical significance was tested by means of ANOVA or Kruskal-Wallis test for quantitative variables (corrected for multiple comparisons) and chi-square tests for qualitative variables.

Tables 1 shows the characteristics of the whole sample. Of the 1000 IHT admissions, 12.1% needed subsequent hospital admission(s), 12.7% IHT admission(s), and 9.3% mixed admission(s). There were no differences among these groups in median severity at IHT admission, but there were differences in the number of previous admissions (p=0.0001): the group with no subsequent admissions had less previous admissions than the other groups (pBonf<0.0001), and the group with subsequent IHT admissions had less than the group with mixed admissions (pBonf=0.0123). There were differences between groups regarding distribution of diagnoses (p<0.0001) (Fig. 1). When considering subsequent admissions by diagnosis, there were differences in severity at IHT admission (p=0.0068) and in number of previous hospitalizations (p<0.0001) (Fig. 2).Table 1.Clinical characteristics of the whole sample (N=1000)

Image:

Image 2:

Patients that used to require inward management can now be treated at home when suffering an acute episode. Therefore, IHT has changed treatment trajectories for some patients with psychiatric disorders.

None Declared

Attention Deficit/Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD) have several similarities and it is difficult to distinguish these disorders in adolescents.

We aimed to identify the unique correlates of mentalization abilities that may distinguish these two disorders, and to investigate the mentalization abilities of adolescents with ADHD, BPD and ADHD+BPD in an inpatient sample (n=550) to determine the effect of co-morbidity on mentalization abilities.

We have explored the relationship between Child Eye Test (CET) scores, Movie for the Assessment of Social Cognition (MASC) subscales, and ADHD and BPD symptoms in adolescent inpatients. In addition, we compared ADHD, BPD and ADHD+BPD groups in terms of their mentalization abilities.

Correct MASC scores were negatively associated with both ADHD and BPD symptoms in girls, and negatively associated with ADHD symptoms in boys. In addition, hypermentalization scores were associated with BPD symptoms in girls, and hypomentalization and no mentalization scores were associated with ADHD symptoms in girls. CET scores were negatively associated with ADHD symptoms in girls, but no relations with BPD were found. Group comparisons revealed no significant difference among groups.

We found that while ADHD symptoms are related to hypomentalization, BPD symptoms are rather related to hypermentalization. We believe that these findings make significant contributions to literature aimed at understanding the differences between two disorders which have great commonalities in terms of clinical appearance and developmental course.

None Declared

Gender dysphoria (GD) is characterized by a marked incongruence between one’s experienced/expressed gender and gender assigned at birth, associated with clinically significant distress or impairment in important areas of functioning. Persons with GD are a population with specific healthcare needs. In our hospital, psychiatric assessment of these individuals started in 2008.

Characterization of a population of transgender individuals and their perceived negative mental health and life experiences.

Since the beginning of evaluations of transgender individuals in our hospital, from 2008 to 2022, they were asked to freely elaborate their “life story”: a report of the most relevant events in their lives, related to their condition. We retrospectively analyzed the content of the reports that were sent and associated with the clinical files.

We collected the data of 104 individuals. The gender attributed at birth consisted of 74 (71.2%) females and 30 (28.8%) males. As for the gender identity, the sample consisted of 73 (70.2%) males, 28 (26.9%) females, 2 (1.9%) nonbinary and 1 (1%) person didn’t identify with any of the existent denominations. The medium age in October of 2022 was 27.4 (minimum 18, maximum 60, SD 7.3). The age at first evaluation at consult was 23.6 (minimum 15, maximum 56, SD 7.2). 99 (95.2%) individuals mentioned symptoms of gender non-conformity beginning in childhood, and of those who mentioned their adolescence (n=43, 41.3%), all expressed feelings of anguish relating to their changing bodies. The medium age of recognition of their condition was 17.2 (minimum 11, maximum 30, SD 4.3). Of those who recall their first contact with health practitioners regarding their symptoms (n=31, 29.8%), 32.3% admitted they didn’t feel they were helped. Of those who mentioned early relationships with family and carers (n=65, 62,5%), 35.4% reveal dysfunctional relationships and 79% mention gender expectations from their families. Similarly, 42 (40.4%) individuals reveal experiences of victimization and bullying because of their gender nonconformity. 53 (60.2%) described symptoms of a likely comorbid psychiatric illness throughout their life, particularly depressive symptoms, anxious symptoms, suicide attempts and non-suicidal self-injury.

GD has gained more attention in the recent years, and the scientific community has now developed a more accurate set of criteria for the recognition of this condition. The findings in our study are in accordance with these criteria. Unfortunately, much of the suffering this condition entails is also associated with distress related to stigma and societal gender expectations, and that was evident in this investigation.

None Declared

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor and nonmotor symptoms, the latter contributing significantly to morbidity, mortality, nursing home placement and quality of life.

We present a literature review about the impact of psychosis on PD’s prognosis.

A literature review is performed on PUBMED, using the next keywords: "Parkinson’s disease”, “psychosis” and “prognosis”. We focused on data from systematic reviews, clinical trials and meta-analysis published in English on last 10 years.

Psychosis is a common feature of Parkinson’s disease, occurring in up to 30% of PD patients treated chronically with antiparkinsonian drugs. Visual hallucinations are the most common psychotic symptom observed, delusions being considerably less common and affecting only 5% of treated patients.

Positive symptoms in PD vary across its course: early in the disease, passage hallucinations, illusions and presence hallucinations occur; later, complete visual hallucinations, initially with good insight, then without insight.

Psychosis spectrum symptoms in early PD predict a decline in cognitive function at 2 years, especially visual hallucinations. There is an association between visual hallucinations and the subsequent emergence of dementia.

Current evidence highlights the role of PD psychosis as a clinical biomarker of disease stage, distribution and future progression. Early recognition and treatment of psychotic symptoms improves disease’s outcomes.

None Declared

Up to 30% of individuals with obsessive-compulsive disorder (OCD) present with a current or past history of tics. Simultaneously, OCD is one of the most frequent psychiatric comorbidities in patients with primary tic disorders (TD), such as Tourette syndrome.

We present a literature review about the relationship between OCD and movement disorders, including its potential implications.

A literature review is performed on PUBMED, using the next keywords: "obsessive-compulsive disorder”, “comorbidity”, “movement disorders” and “tic disorders” We focused on data from systematic reviews, clinical trials and meta-analysis published in English on last 10 years.

Goal-directed behaviour, such as compulsions, is orchestrated by the basal ganglia, through parallel but interconnected frontal–striatal circuits. Dysfunction of these circuits is known to play a role in the pathogenesis of TD and may also underlie OCD.

The most common movement disorders comorbid with obsessive-compulsive disorder (OCD) are indeed TD, with obsessive-compulsive symptoms (OCS) occurring in up to 90% of Tourette syndrome cases. OCD comorbid with TD associates with higher frequencies of hoarding, counting rituals, intrusive violent and sexual thoughts/images, somatic obsessions and repetitive movement compulsions. It also associates with earlier age of onset, higher frequency of sensory phenomena, higher male prevalence and familial aggregation.

However, OCD and OCS are also highly prevalent in choreatic movement disorders, such as Huntington’s disease and rheumatic fever with Sydenham’s chorea. There is also evidence for a correlation between streptococcal infections, autoimmunity, tic disorders and OCD, as seen in Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS).

Current evidence shows OCD and movement disorders may share dysfunctional brain circuits, resulting in a neuropsychiatric obsessive–compulsive phenotype, which may differ in terms of clinical characteristics and management.

None Declared

The digital revolution is evolving at an unstoppable pace. The dissemination of interconnected networks, the growth and spread of new digital technology across all ages at different levels, has rapidly led to an increasing usage of the Internet, smartphones and digital social networking, particularly among young people. Smartphones, social networking and digital videogaming platforms are currently being used as primary means of online access, source of information and as preferred mode for social communication and peer interaction. However, despite digital world is progressively replacing the ‘physical world’ concerning socialization process and communication modalities, there is poor attention on the ‘digital trauma load’ experienced by individuals belonging to the Z and alpha generations in term of potential impact of digital instruments on mental health.

None Declared

Psychodynamic psychotherapy emphasizes the unique history, subjectivity, and psychological complexity of each individual. The core principles in the psychodynamic treatment of schizophrenia spectrum disorders (SSD) includes a stable (yet flexible) frame; attention to countertransference; and clarification of experiences, emotions, and relationships including giving psychotic symptoms context in internal and external object relationships.

This study has two aims. First, to present the progress of a patient with chronic schizophrenia treated with psychodynamic psychotherapy. Second, to provide a systematic review of comparative trials that have included psychodynamic psychotherapy as treatment for SSD.

The case presentation includes information from the therapist’s notes, video footage, and the electronic health record. The systematic review will be conducted in November and December, 2022, and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The databases of MEDLINE, EMBASE, and PsycInfo will be searched for literature.

L, a 25-year-old woman, was diagnosed with paranoid schizophrenia five years prior to starting psychodynamic psychotherapy at an outpatient unit for SSD. L grew up with a close relationship with her mother, father, and sister. She was bullied in school and clearly remembered being told by her classmates that she was “just L”. When therapy began L had been living with her boyfriend for six months. Voice hallucinations were one of the most interfering symptoms. The most present voice, M, was both her best friend and worst enemy. During psychotic breakdowns M could take control of L’s body. L was incapable of making her own decisions. Small and big decisions were consulted with a family member or the hallucinatory voices. L attended 33 psychotherapy sessions from October, 2020 to November, 2021. In the first six months, sessions were weekly and afterwards biweekly due to L feeling significantly better and she wanted to have more time to study. L benefitted from the structure and clarifying questions from the therapist. Most notably, she broke up with her boyfriend. She started dating and found a new boyfriend. At this point the voice hallucinations and psychotic breakdowns were reduced considerably. In the termination phase the themes were feeling insecure, relationships, and how having been bullied affected her as an adult.

Results from the systematic review are not available at the time of submission.

In the present case, psychodynamic psychotherapy was an effective treatment of psychotic symptoms as well as childhood trauma and interpersonal conflicts for an individual with paranoid schizophrenia. It speaks for a broad application of psychodynamic psychotherapy in the treatment of SSD as the therapy both assesses and treats psychotic and non-psychotic symptoms.

None Declared

ADHD has been studied less extensively in adults than in children over the years, even though the indications of it clearly affect academic attitudes and closely linked to depression and substance abuse.

Exploratory cross-sectional research was conducted to examine the prevalence of subclinical ADHD is among medical students and its correlations with substance abuse. Furthermore, our goal was to find psychological and academic mediating variables, that might be risk or protective factors of its occurrence.

A total of 239 (69 male) medical students were screened by an online questionnaire using Adult Self-Report Scale (ASRS), Depression, Anxiety and Stress Scale-21 (DASS-21), Maslach Burnout Inventory-Student Version (MBI-SS), Utrecht Work Engagement Scale for Students (UWES-S) and CAGE Questionnaire, which included smoking, alcohol, stimulant and sedative use.

Problematic substance use was reported by 48% of medical students for alcohol use, 43% for smoking, 25% for stimulant use and 21% for sedative use. The prevalence of ADHD symptoms is relatively high among medical students (m=36.13). Correlation and linear regression analysis showed a strong association between ADHD symptoms, depression, and substance abuse. The prevalence of subclinical ADHD symptoms mediates the relationship between depression and substance use, such as alcohol and stimulant use, but there is no significant relationship between academic attitudes (engagement and burnout) and ADHD symptoms, except for depersonalization, which was found to be a risk factor for the development of alcohol and stimulant use.

The increased exposure of medical students to stress makes it particularly important to identify and address factors that can lead to more serious mental illness.

None Declared