Psychopathic personality traits (PPT) are known to deteriorate emotional and cognitive functions, however, little is known about their role in depression. Nevertheless, depressive symptoms have also shown to be associated with emotional problems and worse cognitive functions and could thus also interact with PPT.

This study aimed to set up an integrative model by examining the correlative relationships and moderating role of PPT in the association between emotional competence and cognitive functioning in individuals with depression.

Data from 373 individuals diagnosed with depression (158 males, 215 females) were investigated. Subjects filled out questionnaires surveying PPT and emotional competences. Furthermore, a comprehensive neuropsychological test battery investigating the cognitive domains Attention/Psychomotor Speed, Executive Functions and Verbal Learning/Memory was administered.

Correlation analyses revealed a significant positive association between emotional competence and overall cognitive functioning. Further, negative associations between emotional competence and the PPT “Blame Externalisation” and “Careless Nonplanfulness”, as well as positive associations with psychopathic “Social Potency” and “Stress Immunity” were found. Moderation analyses indicated a significant positive influence of psychopathic “Stress Immunity” and “Social Influence” on the relationship between emotional competence and cognitive parameters.

The findings highlight the importance of considering PPT in further research on depression and reflect their impact in therapeutic settings.

None Declared

The development of the 11th edition of the International Classification of Diseases has rekindled the research interest surrounding diagnostic classification systems (DCSs). According to expert consensus, the main purpose of DCSs is to provide guidance in clinical practice. There are no reviews in the international literature, however, assessing what mental health practitioners believe is the main purpose of DCSs.

The aims of this systematic review were to assess what mental health professionals think is the single most important purpose of DCSs and how they rate DCSs’ utility for various purposes. All DCSs were considered.

Two separate searches were conducted in Medline Via Ovid and PsycInfo: one for articles assessing the main purpose of DCSs according to mental health professionals and one for studies on how practitioners rate the utility of DCSs for various purposes. The first search revealed eight articles on the main purpose of DCSs and the second three articles on how practitioners rate their utility for various purposes. The total number of participants from all included studies for the first search was 9,276 and for the second 2,363. The studies included clinicians from a wide range of world regions, languages, and income-level countries.

The results of the meta-analyses for the first search showed that 44% (95%CI=38-49%) of the responders believe that the main purpose of the DCSs is facilitating inter-clinician communication, 20% (4-35%) to inform treatment decisions, 14% (11-16%) to aid the communication between clinicians and patients, 11% (4-18%) to reflect on aetiology/pathogenesis, 9% (2-16%) to facilitate research, 4% (2-7%) to provide a national statistical base and 1% (0.1-2%) to indicate prognosis. Regarding how responders rate the utility of DCSs for various purposes, the highest ratings were given for meeting administrative requirements and inter-clinician communication in the two of the three included studies, and clinical diagnosis and training in the third.

“Inter-clinician communication” was the most voted purpose of DCSs and was rated relatively high in the tier of DCSs’ clinical utility. In contrast, “inform management decisions”, even though it was voted as the second most popular purpose of DCSs, was placed on the bottom of the rating tier of DCSs’ clinical utility. Interestingly, none of the included studies asked the responders whether “making a diagnosis” is the main purpose of DCSs. Further research is needed to assess what mental health professionals expect from DCSs, so as to improve their clinical utility in the future.

None Declared

The Covid 19 pandemic has worsened mental health of teenagers and young adults in particular and highlighted the lack of data for children aged 3 -11 years living in France. To fill this gap, Santé publique France, the national public health agency set up the first nationwide study, Enabee, in 2022.

Enabee (National study on Children wellbeing) aims at monitoring wellbeing and most frequent mental health disorders of children and at understanding associated factors, gathering information from children, parents and teachers. First analyses will be focused on children’ and teachers’ point of view.

Enabee is a nationwide cross sectional study. Elementary and nursery schools were randomly selected in Metropolitan France. Then a maximum of four classes were randomly selected in each school. Elementary school children (from 6 to 11 years old) gave their own assessment of wellbeing and mental health using the following self-administrated questionnaires on tablets: the Kindl and the Dominique Interactive. To get a comprehensive evaluation, parents and teachers also filled the web-administrated Strengths and Difficulties Questionnaire for each child. The parents’ questionnaire also included questions on child’s life habits and global health, parenting attitudes, parent’s mental health, covid 19, major life events and household social situation. A pilot study was launched in January to assess the feasibility and the acceptance before implementing the study at a nationwide level. Key stakeholders of education, family and health participated at the setting up of the study.

706 schools were selected and 399 participated (participation rate 57%). Data were collected from May 2nd to July 31st 2022. In those schools, 1357 classes participated, representing 29 414 children. We collected 15 206 questionnaires filled by children of elementary schools and 21 016 questionnaires filled by teachers for children in nursery and elementary schools. Analysis are ongoing. By March 2023, we will produce weighted estimates of prevalence of children internal and externals disorders based on the children self-assessment and the teachers’ assessment respectively and different dimensions of wellbeing. Prevalences will be presented by sex, age and school levels.

Enabee will provide a representative picture of French children wellbeing and mental health and protective and risks factors. This milestone is essential to guide national policies and build dedicated actions for children in order to promote and improve their wellbeing and mental health. Beyond this edition, Enabee is the first step of a long term monitoring system that will provide regularly updated data and will be completed by ancillary and ad hoc studies.

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After severe brain trauma, patients undergo long periods of intrahospital treatment, rehabilitation and multidisciplinary evaluations. When they are sufficiently autonomous, they can be admitted to institution for health care, psychotherapy, occupational therapy as well as various efforts to improve their autonomy. The place taken by family can vary according to the project of the institution and their disponibility.

The family group therapy with an organized and structured program aim to improve the place that family have in this institution.

Family group therapy can vary from support group to structured cognitive behavioural therapy and psycho-education. To meet our goal, we used the model from an experienced brain trauma center.

As a result, better communication between family and resident, family and staff, improved acceptance and a relief for families were found.

In spite of lesser disponibility, the families already stress their need and gratitude for family group therapy.

None Declared

Treatment resistant schizophrenia and other treatment resistant psychotic disorders are believed to be over-represented in forensic patient clusters. The true rates of treatment resistant psychoses in secure forensic hospitals remain unexplored.

This study aimed to ascertain the prevalence of treatment resistant psychoses within a complete national forensic mental health service. In addition, the study sought to examine the relationships between treatment resistance for psychotic symptoms and treatment resistance in other domains, such as offending behaviour.

This is a cross-sectional study of a complete cohort of patients admitted to the National Forensic Mental Health Service in Ireland during the period 01/11/2021 to 31/01/2022. All inpatients at the time of the study were included. Demographic details, data appertaining to diagnosis, medication, measures of risk (HCR-20), recovery (DUNDRUM toolkit), functioning (GAF), and symptoms (PANSS) were collated. Data were gathered as part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST).

The sample consisted of 170 patients. Majority (n=162) 95.3% were male. The majority (n=116), 68.2%, were admitted from prisons, while a smaller number (n=35), 20.6%, were admitted from other psychiatric facilities. The insanity defense (n=94) 55.3% was the most common legal status, followed by unfit to plead (n=16) 9.4%. The commonest diagnosis was schizophrenia (n=97) 57.1%, followed by schizoaffective disorder (n=27) 15.9% and autism spectrum disorder (n=5) 2.9%. The mean age at admission was 35.52 years and the median age was 34.37 ± 9.43 SD.

Of the total sample, 25.9% of patients were on more than 1000 mg per day chlorpromazine equivalent (CPZE) doses. Those whose psychotic symptoms required treatment with CPZE doses over 1000 mg per day scored poorly on DUNDRUM-3 programme completion, DUNDRUM-4 recovery scale, HCR-20 historical, HCR-20 clinical, HCR-20 risk, HCR-20 dynamic, and had poorer overall functioning (all P<0.001) than those who required lower antipsychotic doses. On binary logistic regression, correcting for age and gender, the only variable that remained significant was GAF (adjusted odds ratio = 0.979, 95% CI 0.962-0.996, P=0.014). In forward entry model regression, only the DUNDRUM-4 recovery scale (odds ratio = 1.13, 95% CI 1.07-1.19, P<0.001) and GAF (adjusted odds ratio = 0.979, 95% CI 0.962-0.996, P<0.001) were significant. This model had a robust forward and backward likelihood ratio.

Rates of treatment resistant psychoses in forensic hospital groups are indeed elevated. Overall functioning on GAF and recovery across a wide range of components in the DUNDRUM-4 scale are the best predictors of treatment resistant psychosis.

None Declared

Aripiprazole is the third generation Antipsychotic, and Dopamine serotonin system stabiliser.It is partial agonist at D2 and 5 HT1 A and antagonist at 5 HT2.Most commonly seen adverse effects are Akathesia, fatugue,insomnia and headache the major advanatage is less propensity for extrapyramidal side effects and lmetabolic side eefects.

To report a case of Schizophrenia treated with Aripiprazole 15mg/day developiing occular gyric crisis which was tratment resistant.

We administered Electroconvulsvive therapy, bidirectional brief pulse constant current 8 ECTS, under General anesthesia with medical fitness .

Patient Showed complete resolution of Dystonia after second ECTs and Showed improvment in Pyschosis Parameterd. Assessment using Naranjo Protocol made.

Electroconvulsive therapy therapy is viable alternative to manage Dystonia when medical treatment fails

None Declared

Despite the scientific requirements and restrictive recommendations, there is a significant disparity between theory and practice in the prescription of benzodiazepine(BZD). Long-term prescribing, defined by a duration exceeding six months has been commonly reported worldwide, some authors explained this by physician’s perceptions.

This study aimed to evaluate the perception of general practitioners practicing in Tunis, in the private or public sector, concerning the prescription of BZDs.

A cross-sectional study was conducted among general practitioners in the private and public sectors practicing in Tunis during the study period (September and October 2021). It is based on the response to a questionnaire, which focused on the perception of prescribing BZD, via google forms distributed to members of the regional committee of the order of physicians.

A total of 75 physicians participated in the study. The mean age was 47.75± 12,2 years, with 17,28 ± 11,8 years of clinical experience. Among the 75 participating physicians, 83% considered that patients on BZD patients had a better quality of sleep and 58% assert that patients on BZDs had restful sleep. 83% of participants agreed that BZDs were associated with fewer nocturnal awakenings 83% and 85% with a decrease in the feeling of irritability. 18% of the doctors think that the easiest way to manage a patient’s anxiety is to prescribe a BZD. 24 doctors believe that chronic use of BZDs is essential to control anxiety. patients’ anxiety. The number of years of practice is inversely correlated with the perception that the patient wakes up less at night (p= 0.059). Male gender correlates with the perception that it is acceptable to continue prescribing beyond the recommended duration as long as they are well tolerated (p=0.035).

BZD prescription decision in general medicine is complex. This study participates in increasing our level of understanding of the reasons behind the long-term prescription of this molecule.

None Declared

The evaluation of healthcare pathways must be considered of fundamental importance. The quality of care provided to patients with severe mental disorders (SMD) does not correspond to the standards set by the recommendations. Therefore, measures such as the real coverage rate of psychiatric patients’ needs (contact coverage), by comparing epidemiological prevalence rates and the number of patients receiving adequate care, could be a valuable resource for implementing the transition to community mental health. However, simple assessment and reporting of rates of contact with mental healthcare potentially overestimate the full expected health benefits of services. Therefore, in addition to monitor the coverage rate achieved by the services, the evaluation of the effectiveness of the care provided (effective coverage) [De Silva et al. Int J Epidemiol 2014;43(2):341–53] is also of relevant importance.

To measure the gap between contact and effective coverage of mental healthcare, i.e., the effectiveness of interventions provided by services for the treatment of SMD in preventing an exacerbation of psychiatric symptoms.

Data were retrieved from Healthcare Utilization databases of four Italian Regions (Lombardy, Emilia-Romagna, Lazio, Sicily). 45,761 newly taken-in-care cases of depression, schizophrenia, bipolar, and personality disorder were included. A variant of the self-controlled case series method was used to estimate the incidence rate ratio (IRR) for the relationship between exposure (use of different types of mental healthcare such as pharmacotherapy, generic contacts with the outpatient service, psychosocial interventions, and psychotherapies) and relapse episodes (mental illness emergency hospital admissions).

11,500 relapses occurred. Relapse risk was reduced (Figure) during periods covered by (i) psychotherapy for patients with depression (IRR 0.67; 95% CI, 0.49 to 0.91) and bipolar disorder (0.64; 0.29 to 0.99); (ii) psychosocial interventions for those with depression (0.74; 0.56 to 0.98), schizophrenia (0.83; 0.68 to 0.99) and bipolar disorder (0.55; 0.36 to 0.84), (iii) pharmacotherapy for those with schizophrenia (0.58; 0.49 to 0.69), and bipolar disorder (0.59; 0.44 to 0.78). Coverage with generic mental healthcare, in the absence of psychosocial/psychotherapeutic interventions, did not affect the risk of relapse.

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Psychosocial interventions, psychotherapies and specific pharmacotherapies can be considered particularly effective in treating patients with bipolar, depressive, and schizophrenic disorders. This study ascertained the gap between utilization of mental healthcare and effective coverage, showing that real-world data can represent a useful resource to monitor mental healthcare paths and to assess the effectiveness of a mental health system.

None Declared

Substance Use Disorders are frequently associated to other medical problems. The temporal evolution of the main drug requests is related to drug and drug users’ facts. COVID-19 pandemic is worthy of investigation.

To analyze temporal trends in the characteristics of all medical requests to the Addiction Liaison Psychiatric Unit from January 2010 to December 2022.

Study data will be obtained from all patients that were referred to the Addiction Liaision Psychiatric Unit during 12 years in Hospital del Mar (Barcelona). Demographics and clinical data (substance use, medical diagnosis, dual diagnosis) will be obtained and analyzed by semesters.

The results will be presented as soon as all data is obtained. We will explore COVID-19 pandemic implications.

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None Declared

The degree of success and effectiveness of the child’s socialization largely depends on the timely formation of social emotions, the ability to understand the emotional states of the participants in the interaction and manage their emotions.

Studying the features of understanding the emotional states of peers and adults by children of preschool age with disabilities.

The study involved 227 children aged 5-7 attending educational institutions: 95 children without developmental disorders; 73 children with severe speech disorders; 9 children with motor disorders; 25 children with visual impairment (strabismus, amblyopia, astigmatism); 15 children with hearing impairment (3rd and 4th degree sensorineural hearing loss); 10 children with autism spectrum disorder. The “Emotional Faces” method (Semago) and the method of studying the child’s understanding of tasks in situations of interaction (Veraksa) were used.

Tasks for the categorization of emotional states cause difficulties in children with speech disorders, since they require a certain mastery of vocabulary for the designation of emotional states. As a result of limited communication in children, there is a lack of understanding of the meaning, causes and motives of the actions of other people, as well as the consequences of their actions, their impact on others.

Preschool children with motor disabilities are inferior to peers without developmental disabilities in accurate verbalization of emotional states, manifested in a primitive description of emotions.

Visually impaired preschool children do not have sufficiently clear ideas about socially acceptable actions in communication situations, about ways of expressing relationships with peers and adults.

Children with hearing impairment better understand the emotional states of their peers than the states of adults, but they do not know how to show their attitude towards their peers. Difficulties in verbalizing emotions are observed.

Children with autism spectrum disorder experience significant difficulties in recognizing various situations of interaction, isolating tasks and requirements set by adults in these situations; children practically did not try to depict an emotion, having difficulty in differentiating it.

The research confirmed the assumption that children with disabilities have significant difficulties in differentiating similar emotions, they do not accurately determine the emotional state of their peers and people around them. This paper has been supported by the Kazan Federal University Strategic Academic Leadership Program.

None Declared

Suicidal thinking is relevant in patients with First Episode Psychosis (FEP). However, longitudinal studies specifically examining treatment response for suicidal ideation in FEP are still relatively scarce, especially with long-term design and in real-world clinical settings.

The aims of this research were (A) to longitudinally assess suicidal thoughts in people with FEP along a 2-year follow-up period and (B) to overtime investigate any significant association of suicidal ideation levels with the specific treatment components of an ‘Early Intervention in Psychosis’ (EIP) protocol along the 2 years of follow-up.

At entry, 232 FEP participants (aged 12–35 years) completed the Brief Psychiatric Rating Scale (BPRS), including a ‘Suicidality’ item subscore. Multiple linear regression analysis was then performed.

Across the follow-up, FEP subjects showed a relevant decrease in suicidal thinking levels overtime. This was specifically predicted by the total number of individual psychotherapy sessions offered within the 2-year EIP protocol and antidepressant dose (at least as regards the first year of our intervention).

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Suicidal ideation is clinically relevant in FEP but seems to improve overtime together with the provision of specific, patient-tailored and integrated EIP treatments, especially individual psychotherapy.

None Declared

Anorexia nervosa is a persistent and often difficult to treat eating disorder with significant physical and mental health consequences. While it is known that the disorder is associated with alterations in brain functional connectivity during the phase of acute underweight, the effect of weight normalization on brain connectivity remains unclear.

This talk focuses on the recovery of intrinsic brain connectivity during weight normalization in severe anorexia nervosa, presenting data from a longitudinal study. Using resting-state functional magnetic resonance imaging, we assessed brain connectivity at three different stages of inpatient treatment. Our findings indicate that patients with severe anorexia nervosa have weaker intrinsic connectivity and altered network topology, which do not improve during treatment. These persistent disruptions in brain networks suggest that severe anorexia nervosa may have long-term effects on the way the brain processes information, even after weight is restored.

None Declared

Stress is an integral part of the profession of health care personnel (HCP) and manifests in higher rates of depressive and anxiety disorders (ADD).

Screening of anxiety and depressive disorders factors among HCPs

A descriptive cross-sectional study in two university hospitals in Ariana was carried out ont september 2022. It included HCP who were examined for medical periodic visit. Data was collect from medical records, anxiety and depression Scale (HAD) and somnolence questionnaire (Epworth).

One hundred and nine HCP were included in the study. Women represented 87.2% of cases. The average age was 38 ±10.7 years. The average occupational seniority varied between one to 38 years. Nurses represented 38.5%, technicians 24% and doctors 7%. They had night work in 12% of cases. Depression and anxiety were found for 20% and 31% of cases respectively. Successive daytime sleepiness was found in 7% of cases. A statistically significant relationship was found between excessive daytime sleepiness and anxiety (p=0.005) and between depression (p=0.002).

Anxiety and depressive disorders in HCP were considerable. they were assiciated with sleepiness disorder. Night or day time shift wasn’t statistically correlated with ADD. Referral to psychiatric consultations after psychological opinion was done in order garantee therapeutic support and decide fitness to work.

None Declared

Bipolar Affective Disorder(BAPD) is characterized by variations in mood from elation and/or irritability to depression.Valproic acid(VPA) is indicated for the treatment of acute manic episodes in BPAD.The use of VPA can be limited by either loss or lack of efficacy or by adverse drug reactions. Stevens-Johnson syndrome(SJS) toxic epidermal necrolysis(TEN) are the rare but fatal cutaneous adverse drug reactions for VPA.

We wanted to draw attention that drug induced bullous lesions which has been seen rarely in the literature caused by valproic acid in bipolar disorder.

We examined the side effects of valproic acid in one of our patients with bipolar affective disorder using our observations and laboratory tests.

A 41 year old man was admitted to the our hospital with complaints of decreased amount of sleep, increased amount of speech, skepticism,irritability and dysphoric mood.The patient who was followed up with a diagnosis of BPAD for about 10 months,attempted suicide by taking lithium 2 days before his hospitalization.Considering that it was a mixed episode and the prophylactic effect of lithium was insufficient,VPA 1000 mg/day and Risperidone 2 mg/day treatment were started.Risperidone was increased to 4 mg/day because psychotic symptoms persisted.Valproic acid dose was increased to 1000 to 1500mg/day after the Valproic acid blood level reached 55.28 in the follow-ups.After 5 days 2 bullous lesions developed on the lower extremity of the patient.Routine laboratory investigations were within normal limits.When we consult the patient with the dermatologist;the dermatologist recommended that the lesion be fixed drug eruption and that valproic acid should be discontinued if possible.It was thought that the lesions of the patient who did not have dermatological disorders and did not describe insect bites,might be due to valproic acid. In addition to all these,the patient’s mother had pemphigus vulgaris.The patient’s valproic acid drug was discontinued and lithium was started.Risperidone treatment was continued.In the follow-ups,the patient’s bullous lesions regressed and no new lesion formation was observed.

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The differential diagnosis of bullous lesions at first may appear overwhelming.In this case traumatic bulla,Pemphigus vulgaris,drug induced bulla,Fixed drug eruption,Steven Johnson Syndrome were among our prediagnosis.Cutaneous drug eruptions associated with VPA can range from maculopapular eruption to severe Stevens-Johnson syndrome or toxic epidermal necrolysis.We were worried that the patient had SJS, but it remained only bullous lesions.We could not biopsy the patient lesions to understand the underlying cause but development of bullous lesions with the initiation of valproate and subsequent remission of the lesions with the discontinuation of the drug and subsequent course clearly suggests a causal relation between valproate and skin lesions.

None Declared

The author wants to share a programme of work from Kent, a County in the south-east of England, where integration of services has enabled system wide quality improvement and innovation to achieve improved time to diagnosis, by best use of available resources and increased diagnostic capacity by engaging with primary care.

Improving dementia diagnosis rate and improved time to diagnosis for people seeking help for memory problems.

The main elements of improving dementia diagnosis rate and improved time to diagnosis are:

1) Pre-diagnostic support through appointment of Dementia Coordinators

2) Transformation of memory services using Quality Improvement methodology to an Enhanced memory assessment and intervention model, which includes diagnosis within six weeks of the GP referral by offering assessment and diagnosis on the same day by clinicians as opposed to a lead time of 18 weeks previously.

3) Increased dementia diagnosis capacity by training primary care colleagues and creating GP with extended roles posts to diagnose non-complex dementia referrals.

4) Introducing a screening tool to diagnose people with dementia in care homes avoiding the need to refer to secondary care services.

5) Having a shared electronic patient record system across the county which enables quick and easy access to patient records.

In the UK dementia diagnosis rates, dropped from 67.6% in February 2020 to 63.2% in December 2020. Post COVID-19 recovery in dementia diagnosis is happening across the country and Kent is ahead at 9% with increase in dementia diagnosis rates compared to a national average of 0.5% increase.

The integrated care system in Kent has enabled collaborative working across organisations to improved dementia diagnosis rates at a fast pace, an example for other health care systems.

In Kent a county-wide, Dementia Special interest group has provided the platform to introduce innovation collaboratively across the entire county and has made a significant difference to people with dementia across the whole pathway of care that has particularly improved time to diagnosis.

None Declared

Current suicidology literature emphasizes the need for suicide prevention and awareness training that include specific approaches tailored for specific professional groups. However, it is necessary that the scales used in the assessment of trainings contain the needs of the evaluated groups on risk management. Cancer patients are one of the groups with a high risk of suicide. Studies show oncology nurses have difficulties in recognising and managing the risk of suicide in oncology patients(Granek et al. Psycho-Oncology 2018; 27(1) 148–154, Öztürk and Hiçdurmaz. Journal of Clinical Nursing 2022; 1-15). Also, these studies underline the need to create training programmes peculiar to oncology that increase oncology nurses’ awareness, knowledge, skills and efficacy in recognising and managing suicide risk. However, no study in the current literature presents scale that can assess the effect of these trainings on efficacy of oncology nurses or other professional who work oncology in the management of suicide risk. Valid and reliable scale is required to assess oncology nurses’ efficacy in suicide risk management.

This study aim to to develop and test the psychometric properties of the Suicide Risk Management Efficacy Scale (SRMES)

The study was conducted in two stages: (1) the creation of conceptual frameworks and scale items (2) assessing the scale psychometric properties. At the end of the feedback from 10 experts (Psychiatrists and Psychiatric Nurses), the scale content validity was completed and the scale was applied oncology nurses sample. Data were collected using a Descriptive Characteristic Form and the 26-item SRMES. Data were obtained from 234 oncology nurses. Exploratory, confirmatory factor analyses and reliability analyses were performed.

Exploratory factor analyses extracted a unifactorial solution. Confirmatory factor analysis revealed that the unifactorial model presented highly satisfied and acceptable fit indexes (CMIN/df=1,927; CFI=.94; GFI=.844; IFI=0,941; TLI=.928; RMSEA=.063: NFI=0,884; RFI=0,86). According to the results of the principal component analysis, factor loads in the unifactorial structure are between 0.534 and 0.843. Cronbach’s alpha value of the scale was 0,96, the inter-class reliability coefficient is 0.928.

The result of exploratory factor analysis and confirmatory factor analysis results were satisfactory. The SRMES is a valid and reliable scale that can be used to assess oncology nurses’ efficacy perception on suicide risk management. The SRMES can also be used to evaluate the efficacy perceptions of other health professionals on suicide risk management who perform psycho-social assessments similar to nurses in oncology.

None Declared

Suicidal behavior is a global public health problem. Among the most investigated theories for the explanation of suicide there is the interpersonal-psychological theory of suicide (IPTS) by Thomas E. Joiner. IPTS focuses on 3 variables related to lethal suicide attempt: thwarted belongingness, perceived burdensomeness and acquired capability for suicide.

We aimed to understand which variables were mostly related to suicidal ideation (SI) and suicide attempts (SA) in a sample of psychiatric patients.

A sample of 80 psychiatric patients including inpatients (n=18), outpatients (n=21) and patients from various Italian rehabilitative psychiatric communities (n=41) was recruited between June 7th, 2021 and September 12th, 2022. We administered a battery of various scales, including State-Trait Anxiety Inventory, STAI, Beck Depression Inventory, BDI, Reasons For Living Inventory, RFLI, Acquired Capability for Suicide Scale-Fearlessness About Death, ACSS-FAD, Rosenberg self-esteem scale, RSES, Mental pain questionnaire, MPQ, Interpersonal Needs Questionnaire, INQ. For each scale we compared a) patients with and without lifetime SI; b) patients with and without history of SA. Then, we performed two logistic regression models (stepwise backward method), one for SI and one for SA.

Both patients with SI and SA have higher anxiety (STAI), depression (BDI), mental pain (MPQ), perceived burdensomeness (INQ), thwarted belongingness (INQ), fearlessness about death (ACSS_FAD) and lower self-esteem (RSES), beliefs about coping strategies (RFLI) and moral objections (RFLI). Depression (BDI) and beliefs about coping strategies (RFLI) were the variables most strongly associated with SI; higher fearlessness about death (ACSS-FAD) and low self-esteem levels (RSES) were the variables most strongly associated with history of SA. The SI model was able to predict 84% of ideation cases; the SA model was able to predict 74% of the attempts.

The results supported that improving the ability to cope with suicidal thoughts is a key component of therapeutic work with suicidal patients. In addition, according to the IPTS, the history of SA has been particularly explained by fearlessness about death. Hence it may be important to focus on these aspects in suicide prevention.

None Declared

Cannabis use is associated with mental illness among men and women, especially induction or exacerbation of psychosis, anxiety, and depression. Although safety and efficacy of cannabis in most medical conditions have not been established, use of medical cannabis is growing exponentially. In particular, albeit sex-related differences in the activity of the endocannabinoid system in animals and humans, differential effects of cannabis on men and women have rarely been sought.

To characterize patterns of use and adverse effects experienced by men and women using medical cannabis.

Data from the Israeli national database of patients licensed to use medical cannabis in Israel from January 2014 to December 2021 was analyzed. The database includes indications for cannabis use, monthly cannabis quantities, Tetrahydrocannabinol (THC) and Cannabidiol (CBD) concentrations, and reports of adverse effects. Comparative statistics were used to evaluate the sex related differences.

161,644 persons (62% men) were issued a license to use medical cannabis during the study period. Men are significantly younger than women (50.5±19.1 vs. 56.5±18.4). The leading indications among both men and women are chronic pain (58% of men, 57% of women), symptoms related to oncological disease and chemotherapy treatment (21% of men, 24% of women) and post-traumatic stress disorder (9% of men, 6% of women). Men consume significantly higher monthly quantities at the beginning of treatment compared to women (31.6 gram vs. 29.3 gram) with a higher THC concentration (13.9% vs. 11.6%) and lower CBD concentration (5.3% vs. 6.7%). Over two years of use, there is an increase among both men and women in the amount and THC concentration, and a decrease in the CBD concentration. The differences between men and women remain significant throughout the whole period. Data on adverse effects are available for 28,629 men and 17,204 women (28.6% of men, 28.0% of women). Women report significantly more physical adverse effects (RR 1.48 [95%CI 1.39-1.57]), anxiety (RR 1.45 [95%CI 1.35-1.56]), depression (RR 1.36 [95%CI 0.95-1.96]) and derealization (RR 3.44 [95%CI 2.42-4.89]).

Although the prevalence of medical conditions for which medical cannabis is indicated are similar for both genders, approximately 60% more men consume medical cannabis. While consuming lower cannabis amount and THC concentration, women report more physical and psychiatric adverse effects than men. Understanding the differences in usage patterns and adverse effects between men and women will enable more accurate policy determinations and more effective and safer treatment strategies.

None Declared

Pediatric acute-onset neuropsychiatric syndrome (PANS) was described in 2010 not related to streptococcus infection (as PANDAS is), and with a clinically distinct presentation, defined as: I) Abrupt, dramatic onset of obsessive-compulsive disorder or severely restricted food intake; II) Concurrent presence of additional neuropsychiatric symptoms; III) Symptoms are not better explained by a known neurologic or medical disorder.

To describe the clinical features in a scholar boy who suffered an abrupt obsessive-compulsive disorder and highlight the need of an specific medical and psychiatric assessment and management from a multidisciplinary perspective.

Clinical case: A 7-year-old boy brought to the emergency department due to his repetitive and hyperactive behavior. After the admission in the hospital a clinical history was identified with PANS diagnostic criteria. He presented repetitive language and ritualized behavior, emotional lability and hyperactivity that has begun in an abrupt manner in the last 5 days. Family history, medical history and physical examination, infectious disease evaluation, neurological assessment and child psychiatric assessment were carried out during hospitalization. Coordination between neuropediatric consultant and child psychiatry was necessary.

Combinated treatment, psychofarmacologic and psychotherapeutic, was effective and the symptoms disapeared gradually in about three months.

In all school-age child presenting with abrupt obsessive-compulsive disorder or eating disorders a possible link to PANS should be evaluated and rule out. It is important a Liaison Child Psychiatry program for a complete multidisciplinary evaluation and management of these patients.

None Declared

Body dysmorphic disorder (BDD) is defined in DSM5 as a preoccupation with one or more perceived defects or flaws in physical appearance causing significant distress or impairment in social and occupational functioning. Despite many studies on mental health disorders related to BDD, the diagnosis is still frequently overlooked.

Previous studies have examined the general personality characteristics of BDD. The objective of this study is to find out how socially aversive personality traits are related.

Total of 86 mentally and physically healthy adults participated. BDD was assessed by BDDE-SR, and aversive personality was assessed by Short Dark Triad (SD3: Machiavellianism, narcissism, psychopathy), Assessment of Sadistic Personality (ASP), and paranoid (PAR), borderline (BOR), and antisocial (ANT) features of the clinical subscales of Personality Assessment Inventory(PAI). Correlations between the reported scores were investigated using Pearson’s and regression was performed on relevant scales.

Thirty seven males and 49 females (mean age 23.8 years) showed no statistically significant difference in total BDDE-SR was reported based on sex(p=0.18) or BMI(underweight, normal, overweight, p=0.236). BDDE-SR, SD3 and ASP were not statistically correlated, but all of the subscales of PAR(PAR-H, PAR-P, PAR-R), BOR(BOR-A, BOR-I, BOR-N, BOR-S) and ANT(ANT-A, ANT-E, ANT-S) were associated with BDDE-SR. Regression results demonstrated in Table 1 show that BOR-I and PAR-R predict BDDE-SR. Correlation of BOR-I and PAR-R with BDDE-SR factors was shown in Table 2.Table 1.Hierarchical multiple linear regression analysis for BOR-I, PAR-R in predicting BDD symptoms

This study shows that BDD symptoms are associated with borderline-identity problems and paranoia-resentment and suggests that we should consider the diagnosis of BDD for individuals with high BOR and PAR scores.

None Declared