We research new neurological viewpoints of psychiatric syndromes in social cohesion regarding, especially the problematic of lymbic system and amygdala in adults. Nowadays, the number of the problematic use of internet is higher than before the COVID-19 pandemic. The development of the digital techniques is impulsive, which can be the main reason of most neurological dysfunctions and the change of the social communication.

In this presentation, we review studies investigating the relationship among the new digital techniques, limbic system and development of psychiatric syndromes. We attempt to provide a summary of new theories and the areas currently being researched around the topic. Another aim of our research is to present the change of the social communication and emotion regulation, which are risk factors of problematic use of internet and behavioral addictive disorders. These appear in different ways in rehabilitation and social inclusion in Europe.

In order to learn about recent international results, we conducted a literature search in 4 databases ( PubMed , Medline , Web of Science, Google Scolar) using keywords (amygdala, psychiatric syndromes, adults, emotion regulation, problematic use of internet, social cohesion) over the past 5 years. From the obtained results, the English empirical journal articles were used to prepare the literature review.

The frequency of co-occurrence of amygdala dysfunction, problematic use of internet and behavioral addictive disorders are correlated. The studies examined the presence of symptoms of impulsivity and dopamine level of the brain primarily through cross-sectional studies. The social cohesion and inclusion regarding types are different in the regions of Europe.

The dysfunctions of lymbic system regulation cause maladaptive emotion regulation and are risk factors and make the person vulnerable to the development of psychiatric symptoms, problematic use of internet and behavioral addictive disorders. The differents of regions and areas in Europe with the new neurological viewpoints in psychiatric disorders can help with rehabilitation in the social cohesion regarding. These changes are particularly pronounced during adolescence, when the demand for self regulation across a variety of emotional and social situations may be the greatest.

None Declared

Mixed results have been reported on the association between prenatal cannabis exposure and preterm birth.

This systematic review and meta-analysis aimed to examine the magnitude and consistency of associations reported between prenatal cannabis exposure and preterm birth.

This review was guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We performed a comprehensive search of the literature on the following electronic databases: PubMed, EMBASE, SCOPUS, Psych-INFO, and Web of Science. The revised version of the Newcastle-Ottawa Scale (NOS) was used to appraise the methodological quality of the studies included in this review. Inverse variance weighted random effects cumulative meta-analysis was undertaken to pool adjusted odds ratios (AOR) after sequential inclusion of each newly published study over time. The odds ratio and 95% confidence interval (CI) limits required for a new study to move the cumulative odds ratio to the null were also computed.

A total of 27 observational studies published between 1986 and 2022 were included in the final cumulative meta-analysis. The sample size of the studies ranged from 304 to 4.83 million births. Prenatal cannabis exposure was associated with an increased risk of preterm birth [pooled Adjusted Odds Ratio (AOR) = 1.35, 95% CI: 1.24-1.48]. The stability threshold was 0.74 (95%CI limit 0.81) by the end of 2022.

Offspring exposed to maternal prenatal cannabis use was associated with higher risk of preterm birth and it is strongly unlikely that any new epidemiological studies will change this conclusion. It is also plausible that avoiding cannabis intake during the prenatal period can reduce the risk of preterm birth.

None Declared

Asthma is the most common allergic respiratory disease and is frequently associated with symptoms of depression and anxiety. However, this association remains poorly understood, especially in active military personnel with asthma who are particularly exposed to a high mental and physical load.

To investigate the presence of anxiety and depression in active military personnel with allergic asthma.

This is a descriptive cross-sectional study conducted at the pneumology department of the Tunis military hospital that interested active military personnel followed for asthma and who consulted the department in the period from January 1, 2022 to October 31, 2022. The Hospital Anxiety and Depression Scale (HADS) was used to assess depression and anxiety.

During the study period, 36 asthma patients were included. The mean age was 35±8 years with a male predominance of 83%. The majority of the participants were non-commissioned officers (91%), whom were in field positions in 68% of cases. The median professional seniority was 9 [6; 17] years. Active smoking was noted in 47% of the participants. Half of the patients had comorbidities. A history of major depressive syndrome was reported by 8% of patients. Current antidepressant treatment was mentioned by only one patient. Asthma was well controlled in 66.7% of cases. Definite anxiety was found in 30% of the patients while it was doubtful in 26% of the population. Depression was present in 18% of the participants. Specialist psychiatric care was recommended for patients with depression and anxiety.

Anxiety and depression are significant comorbidities in asthma patients. Screening for these risks is necessary, especially in the military population whose work requires mental and physical integrity.

None Declared

Autism Spectrum Disorder (ASD) is a multifactorial neurodevelopmental disorder, with both contribution of genetic and non-genetic factors. A collaboration of de novo mutations and prenatal with postnatal environmental factors are likely to play a role. ASD can be syndromic or non-syndromic. The etiology of non-syndromic ASD is still relatively undefined due to its genetic heterogeneity. Contrary to non-syndromic ASD, syndromic ASD is often associated with chromosomal abnormalities or monogenic alterations. Familial cases of ASD support the strong genetic component of ASD.

To collect clinical arguments supporting a genetic cause of autism spectrum disorder.

We present a clinical study of familial cases of ASD. The families were recruited as part of a collaborative project between the department of Medical Genetic and the department of Child Psychiatry in Hedi Chaker Hospital, Sfax, Tunisia. The clinical and paraclinical data were collected retrospectively.

Our study included 11 unrelated families from southern Tunisia, each with two ASD children, among them four couples of twins. Most families (80%) are consanguineous belonging to a middle socioeconomic class. None of the parents suffered from psychiatric disorder and a familial history of autism was reported in one family. Perinatal history, including advanced maternal or paternal age, fetal suffering and/or gestational problems, was found in 35% of cases.

The average age was 9.89 ± 3.787 (3 to 17 years) with a balanced sex-ratio.

ASD was syndromic in seven out of 11 families: facial dysmorphism in half of cases (6/11 families) and/or another comorbidity in 25% of cases (celiac disease, congenital heart disease or idiopathic hydrocephaly). ASD was associated with other(s) neurodevelopmental disorder(s) in all children. Most of cases (14/22) had delayed psychomotor development and all of them had intellectual disability with various degrees. Epilepsy was identified in three cases belonging to unrelated families. Other behavioral problem was identified in 65% of cases.

When the autism spectrum disorder is syndromic and/or associated with other(s) neurodevelopmental(s) disorder(s), this points more towards a genetic origin.

Our study highlights the interest of clinical investigations to determine genetic risk factors of ASD. The identification of a genetic cause in familial cases would contribute not only to better understand the pathological processes of ASD but also to provide an appropriate genetic counseling.

None Declared

The new coronavirus pandemic has brought the issue of life quality to the forefront. Among HIV-infected patients, life quality may be associated with fear of death.

The study aimed to investigate the life quality and death fear among HIV-infected patients during the pandemic second wave in Russia.

The data were collected from February to July 2021 using a Google form that we developed. Fifty-nine patients living with HIV participated in the study. We used the WHOQOL-BREF to examine the quality of life and the Fear of Personal Death Scale to explore fear of death. Both questionnaires were adapted for use in Russia.

We found the following mean values for the domains: “physical and psychological well-being” — M = 21.39±3.61; “self-perception” — M = 17.51±2.28; “microsocial support” — M = 9.15±2.94; “social well-being” — M = 24.81±5.33. We found that physical and psychological well-being were associated with the transcendental consequences of death (rxy = 0.274, p < 0.05), self-perception with body consequences (rxy = -0.304, p < 0.05) and fear of forgetting (rxy = -0.287, p < 0.05), and social well-being with body consequences (rxy = -0.310, p < 0.05).

Life quality is related to intrapersonal, interpersonal, and supra-personal dimensions of death fear during the second wave of the pandemic among patients living with HIV. Such fact may indicate possible psychotherapeutic targets when working with this group of patients.

None Declared

Complex PTSD is a new trauma-related disorder in ICD 11 and it differs from PTSD by the trauma being repetitive or prolonged and some other symptoms, while selective anosmia is the inability to detect a particular odor.

Is there any relationship between severe trauma and selective anosmia as a novel feature?

INTERNATIONAL TRAUMA QUESTIONNAIRE (ITQ), Case report and non-systematic review through literature research in PubMed database, using the key-word “selective anosmia”

Two articles suggest that selective anosmia may present in animals when olfactory epithelium exposures to some chemical substances while the other two articles indicate that cortical nucleus in the amygdala has major olfactory connections and its degeneration is likely to contribute to the early selective anosmia common in Parkinson’s disease, but no one described this feature in psychiatric trauma.

May be this is the first time ever to describe selective anosmia during severe trauma suggesting a role of amygdala as in this case report, therefore Syria and other countries that had similar crisis need more studies to get accurate statistics, explore more rare features, and test the effectiveness of treatment options.

None Declared

One of the methods for early diagnosis in individuals at clinical high-risk state for psychosis could be the identifying specific symptoms, such as thought disorders. Thought disorders may be a separate symptom, unrelated to attenuated positive symptoms (APS) with an independent predictive value.

Correlation analysis of thought disorders and APS in patients at clinical high-risk state for psychosis.

The study included 30 young men (mean age 19.2±2.1 years) hospitalized at the clinic of the FSBSI “Mental Health Research Centre” with the APS in the first depressive episode (F32.1, F32.2, F32.28, F32.8) which is considered as clinical high-risk state for psychosis. The severity of thought impairment was assessed using the Thought, Language and Communication Scale (TLC). Subsequently was performed the search for correlations of scores on the TLC and the severity of “prodromal” symptoms, according to The Scale of Prodromal Symptoms (SOPS).

The median value of the total score on the TLC was 20 [17.25;23.5]. The most important finding is the discovery of only minor correlations of thought disorder with “prodromal” symptoms. Indeed, the total score on the TLC correlated only with the total score on the SOPS at admission (r=0.370, p<0.05). Such symptoms of the TLC scale as «Derailment», «Incoherence», «Perseveration» did not find any correlation with prodromal symptoms (p>0.05).

The obtained data indicates the independent nature of thought disorder in patients at clinical high-risk state for schizophrenia, which leads the need to determine its own prognostic value.

None Declared

In contrast to women, men do no experience a sudden cessation of gonadal function comparable to menopause. However, there is a progressive decline in hypothalamic-pituitary-gonadal function in aging men: testosterone level decline, and there is a loss of circadian rhythm of testosterone secretion.

By age 75 years, mean plasma testosterone levels have decreased 35% compared with young adults, and more than 25% of men of this age are clinically hypogonadal. Age related hypogonadism, which has been termed»andropause«, is thought to be responsible for variety of symptoms experienced by elderly men, including reduced muscle and bone mass, sexual dysfunction, depression, fatigue and irritability.

However, it has been difficult to establish correlations between these symptoms and plasma testosterone levels. Clinical trials of testosterone replacement have documented some symptoms relief (improved muscle strength and bone mineral density), yet studies to date on the specific relation between depression and testosterone level have been methodologically flawed.

Data are presented from systematic clinical and epidemiological studies with bearing on this relation:

1. 1. population-based assessments of the relation between testosterone level, genetic factors and depression in elderly men,

2. 2. placebo-controlled clinical trials of testosterone replacement in men with major depressive disorder.

Results suggest that age-related hypothalamo-pituitary-gonadal hypofunction may have particular etiologic importance in late-onset male dysthimia.

However, there is still the dilemma whether late-onset depression in older men is predominantly biological (in which testosterone decline certainly plays an important role), psychosocial, or stress-diathesis origin.

None Declared

Patients affected by mental disorders are known to have a decreased life expectancy.

One of the main reasons are cardiovascular diseases. It is known that tobacco and hypertension are risk factors to develop them. WHO estimates that hypertension is diagnosed and treated in less than half of adults with hypertension, and even less in patients with severe mental illness.

To describe the demographic characteristics of patients with tobacco comsumption and hypertension admitted to a short-term hospitalization unit.

A three-month retrospective observational study. Data were collected by interviewing incoming patients and performing a blood pressure measurement, with no exclusion criteria.

Of 172 patients admitted, 100 were smokers of whom 49 were men and 51 were women. Among the smokers, a total of 18 patients were diagnosed with hypertension and 79 were not diagnosed. Within the group of patients not diagnosed with hypertension, elevated blood pressure was recorded in 5 of them. A total of 67 patients were non-smokers, 23 of whom were male and 44 female. Among the non-smokers, 19 were diagnosed with hypertension and 48 were not, despite which elevated blood pressure levels were recorded in 4 of them. No data were collected from 5 patients.

The prevalence of smokers in our sample was 58%. The prevalence of patients diagnosed with hypertension was 21,51% which is coherent with the existent literature. We did not find a higher percentage of hypertensive patients among the smokers admitted. There were patients who suffered from hypertension and were not diagnosed or treated previously.

None Declared

The personality construct of psychopathy consists of severe deficits in behavior, emotion and cognition, often categorized in the two dimensions affective-interpersonal and antisocial-lifestyle. Research indicates that a lack of anxiety and fear play an important role in psychopathic personalities. Understanding the interplay of psychopathic traits, fear and threat processing and reactive behavior is important due to its implications for risky and potentially antisocial behavior.

We conducted a mixed reality study using the elevated plus-maze in a non-clinical sample to test anxiety-related behavior in correlation to psychopathic personality traits. Our hypothesis was that higher psychopathy would lead to higher expression of risky behavior and, thus, to longer time on open arms, higher number of entries to open arms and reduced latency for a first visit on open arms and for open arm endexploration.

Healthy volunteers were recruited (N=170) and completed the Sensation Seeking Scale V (SSSV), the Acrophobia Questionnaire (AQ), and the Brief Questionnaire of Psychopathic Personality Traits. The included subjects were tested on the human elevated plus-maze, which consists of a physical life-sized wooden platform and its representation in a virtual environment. Data recording was performed via the virtual reality tracking system (HTC Vive Base Station®, Seattle, USA) and custom soft-ware (A+ cross®) using the following parameters: total time spent on open arms (time on open arms), number of entries to open arms, latency for the first entry of an open arm (latency 1st visit) and time until subjects reach the end of an open arm (latency endexploration).

Statistical analyses were carried out using IBM SPSS Statistics 23.0 (IBM Corp., Armonk, NY, USA) and R software (R version 4.0.2). Pearson correlation was performed to assess associations between psychopathic traits and measures of anxiety-related constructs.

Reduced levels of anxiety were associated with higher psychopathic traits. This was reflected in a correlation between the PPT sum score and all measures of anxiety-like behavior on the EPM (time on open arms: R = .29, p < 0.001; number of entries to open arms: R = .32, p < 0.001; latency 1st visit: R = -.29, p < 0.001; latency endexploration: R = -.30, p < 0.001). Psychopathic traits were also negatively correlated with subjective levels of anxiety on the EPM (R = -.23, p = 0.004). Sensation seeking (SSSV) (R =.33, p < 0.001) but not general levels of acrophobia (ACQ) (R = -.13, p = 0.11) were moreover associated with psychopathic personality traits.

In light of the ongoing discussion, our results demonstrate a correlation between psychopathic personality traits and anxiety-related behavior in a non-clinical sample. This supports the theory of a lack of fear in psychopathy and may influence risky and potentially harmful behavior in this population.

None Declared

Teaching is considered by the International Labor Organization as one of the most stressful professions, with consequences on the mental and physical health and on their professional performance. Intervention programs focused on physical activity usually present a significant decrease in the level of stress and an improvement in the quality of life of teachers. Physical activity is considered one of the main non-pharmacological strategies to reduce stress, generating a positive influence on mental health.

To evaluate the impact of an intervention program based on the practice of physical activity on the level of stress and motivation for the regular practice of physical activity in teachers.

This study employed a pretest-posttest design. Measures: Portuguese versions of Stress Perception Scale and Motivation Inventory for Regular Physical Activity Practice. Sample: 33 teachers from Portugal and Brazil, 57,6% females, 54,5% from Portugal, 63,6% with age between 26 and 35 years. The intervention ran for 8 weeks, with a total of 40 sessions with cardiorespiratory conditioning exercises, muscle strengthening and stretching, relaxation and meditation techniques.

On baseline we found significant relationship between “years of teaching experience” and the level of stress (p=.027). After the intervention, the level of stress significantly decreased in Portuguese teachers (p=.031). In 83% of the sample, there is a decrease in the levels of perceived stress. Concerning Brazilian teachers (p=.006), in 73% of the sample, there is a decrease in the levels of perceived stress. Regarding motivation, there is a significant increase in Portuguese teachers related to “stress control” (p<.001), “sociability” (p=.001), “competitiveness” (p<.001), and “esthetic” (p=.004). In Brazilian teachers there is an increase related to “stress control” (p=.003), and “competitiveness” (p=.001).

Both samples showed positive results, attesting the efficacy of the intervention based in physical exercises to reduce stress and increase motivation to practice physical activity regularly. After intervention, more motivational dimensions are changed in Portuguese teachers, comparing with Brazilian teachers.

None Declared

Substance use continues to be an important problem among mental health patients either as main diagnosis or as comorbidity. Acute care visits, including emergency department visits and hospitalizations, related to substance use disorders (SUD) are increasing and can be opportunities to engage individuals to get proper treatment (Suen LW et al. J Gen Intern Med 2022; 37(10):2420–2428).

Both mental disorders and SUD lead to subsequent chronic physical conditions, premature death, suicide or overdose (Bennett AC. Public Health Rep 2019; 134(1):17-26) that can be accidental or not.

24% to 32% of patients with Substance Induced Psychosis develop later a schizophrenia spectrum disorder or bipolar disorder (Starzer MSK et al. Am J Psychiatry 2018;175(4):343–350) leading to a chronic use of medication and, in several instances, to a necessity of psychiatric in-patient treatment with long hospital stays and high readmission rates (Khan S. Health Reports (2017) 28(8)3-8).

Our goal was to analyze if substance use is associated with higher psychiatric hospitalization rates.

An independent-samples t-test was run to determine if there were more hospitalizations among patients with substance use. Afterwards, the Cohen’s D was calculated to measure the effect size and to see the magnitude of the experimental effect.

A sample of 2604 in-patient treatment episodes was used. The sample had 1696 female patients, 908 male patients and 823 patients had substance use. We found that patients with substance use had a statistically significant higher hospitalization rate (6.82±5.27) than the ones without it (5.32±4.84), t(1483)=6.945, p<0.001. Cohen’s effect size value (d=.30) suggested a small practical significance.

Our findings go mainly accordingly the literature; we found a significant effect of drugs on readmission rates (Böckmann V et al. Front Psychiatry 2019; 10:828) but we might have thought it would be bigger. That could be explain by undiagnosed substance use (refusal to admit the use, drugs not detected on lab tests, not requesting toxic lab tests) or higher sample percentage of confounding comorbid diagnoses.

However, is undoubtable the several risks that drugs bring to our health and so the authors aim to raise awareness among the medical community to the importance being alert for signs of use or psychiatric symptoms to avoid reaching a no turning point. It’s known that doctors frequently fail to diagnose SUD in hospitalized patients and given the linkage between use of certain substances and particular medical reasons for admission, it would be well-advised to search for SUD in certain admission diagnoses (Weintraub E et al. Am J Addict 2001;10(2):167-77). Knowledge of substance use behavior may help reducing relapse rates and to reduce the risk of developing a SUD (Andersson HW et al. Nordic Journal of Psychiatry, 75:3, 160-169).

None Declared

Bladder cancer, which is primarily a non-muscle invasive bladder cancer (NMIBC), is prevalent worldwide and its incidence is increasing. NMIBC shows a high recurrence rate of 50-70%, and in 25% of cases, progresses to muscle-invasive disease (Saginala K et al. Med Sci 2020; 15) (Fernandez-Gomez, J et al. J Urol 2009; 182(5) 2195-2203). Frequent recurrence and consecutive medical interventions in patients with NMIBC lead to psychological problems such as anxiety, fear of recurrence, depression, and stress, resulting in reduced quality of life (Chung et al. Support Care Cancer 2019; 27(10), 3877-3885). It is expected that the increased accessibility and convenience of mobile health (mHealth) will be effective in providing a mobile-based psychological intervention program to promote the mental health of patients with NMIBC.

This study aims to develop a mobile-based mental health improvement program for NMIBC patients, design a protocol for evaluating feasibility, and provide preliminary evidence of the efficacy of the developed program.

The program content was developed based on the results of a needs assessment conducted among patients with NMIBC through a cross-sectional study. The draft program was prepared by referring to the guidelines of the National Comprehensive Cancer Network and publications of the International Continence Society. Based on the developed draft, two professors of nursing, a professor of counseling psychology, a registered nurse, and a counseling practitioner verified the validity of the content before finalizing the program. The final version of the developed program consisted of one session on NMIBC knowledge and symptom management and five sessions on mental health improvement. Researchers sent an online link to the YouTube video comprising lecture materials and voice recordings of health professionals weekly using a mobile messenger (Kakao Talk) (Image 1). The topics of each session were as follows: Session 1 (Understanding of bladder cancer and treatment), Session 2 (Understanding and respecting myself), Session 3 (Maintaining reasonable thoughts and positive emotions), Session 4 (Benefits of positive emotions and healthy communication), Session 5 (Living in a healthy way through stress management), and Session 6 (Finding happiness and meanings in daily life).

The protocol for evaluating the feasibility of the developed program is outlined in Image 2.

Image:

Image 2:

The feasibility of the mental health improvement program for patients with NMIBC based on mobile messenger (KakaoTalk) will be evaluated through the developed protocol. Moreover, by introducing a program that reflects the feasibility of test results into practice, the results of this study can contribute to improving the quality of life of patients with NMIBC.

None Declared

Alcohol consumption is often used in an attempt to reduce anxiety, being an inadequate coping strategy, it can lead to alcohol abuse and dependence.

Anxiety is a transient emotional state of reaction to situations perceived as threatening, frequent in people with alcohol dependence during the abstinence period.

Progressive Muscle Relaxation (PMR) is a technique that allows the person to reduce levels of stress, anxiety, anger and reach an increased state of calm.

To train people undergoing treatment for alcohol dependence to use the PMR after discharge.

To promote anxiety self-management.

To prevent relapse.

To evaluate the effect of the Therapeutic Relaxation Program (TRP) on the anxiety levels of people undergoing treatment for alcohol dependence.

A TRP was conceived and implemented, based on Jacobson’s PMR, consisting of 6 sessions lasting 40 minutes, including 21 participants hospitalized for treatment of alcohol dependence.

Considering the inclusion criteria: clinical status favorable to participation; moderate or high level of anxiety; agree to participate voluntarily. Exclusion criteria: unfavorable clinical status (disorientation, confusion, agitation, delirium tremens, hypoacusis); level of mild anxiety or panic; not knowing how to read or write; refuse to participate voluntarily.

The experimental group (EG - in addition to the institution’s protocol treatment was included in the TRP) and the control group (CG - underwent the institution’s protocol treatment).

Participants gave informed consent.

In the TRP evaluation, the following were used: State-Trait Anxiety Inventory (STAI-form Y1) – before and after the intervention; physiological parameters (heart rate, respiratory rate and blood pressure) – before and after each session; and satisfaction questionnaire at the end of the program.

The evaluation of the physiological parameters showed a decrease after each relaxation session.

Comparing the mean values of the anxiety score (STAI-form Y1) between the two evaluation times (before and after the TRP), in the EG, there was a significant decrease in the anxiety scores, and this decrease was even greater in the group masculine.

In the CG, comparing the average values of the anxiety score (STAI-form Y1) in the same timings as in the EG, an increase in anxiety was verified.

The evaluation of the participants’ satisfaction revealed an increase in well-being and comfort at the end of the TRP, being greater in the male group.

It is concluded that TRP produces positive effects in reducing anxiety levels, reducing physiological parameters and increasing the person’s well-being.

The TRP was effective in reducing the anxiety of people undergoing treatment for alcohol dependence, enabling them to use other coping tools/strategies that will contribute to maintaining alcohol abstinence and preventing relapse.

None Declared

Treatment Resistant Depression (TRD) is a complex, heterogeneous and multifactorial clinical condition that affects patients’ quality of life, their psychosocial functioning as well as suicidal risk. Intranasal esketamine is a new add-on treatment specifically approved for TRD.

The aim of the study was to evaluate the efficacy and safety of intranasal esketamine treatment combined with intensive Cognitive Behavioral psychotherapy (CBT), together with treatment satisfaction, in two complex clinical cases of TRD with high suicidal risk in a 12 months follow-up.

Two male patients, 67 and 63 years old, with TRD, defined by at least two therapeutic failures with SSRI/SNRI and positive screening for high suicidal risk at the Columbia Suicide Severity Rating Scale, were selected for treatment with intranasal esketamine + CBT as an add-on to SSRI/SNRI antidepressant therapy. Psychopathological assessment were made by means of Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Columbia Suicide Severity Rating Scale (C-SSRS), Clinical Global Impression (CGI), Short Form Health Questionnaire (SF-36 items) at T0, every 7 days for the first 3 months, then every month. Treatment satisfaction was evaluated by means of the Client Satisfaction Questionnaire (CSQ-8), administered by trained nursing staff at 1, 3, 6 and 12 months. CBT specifically focused on depression was administered by a certified psychotherapist, weekly for the first 4 months, fortnightly for the next 3 months, monthly for the remaining 3 months.

After 2 administrations of esketamine the total HAM-D score was reduced by an average of 10 units and the suicidal risk was progressively reduced to zero according to C-SSRS. After 12 months one of the two patients reached and actually maintains clinical remission; the other one maintains a condition of mild depression; both without suicidal ideation and with a significant increase in perceived quality of life. Treatment was well tolerated, with mild and temporary adverse effects, self-limited to the administration sessions. CBT has contributed to increasing insight, cognitive resources, social interaction and self-esteem, and has made it possible to structure and carry on new life projects. The variation of the mean scores for CSQ-8 shows that esketamine + CBT treatment was considered as very satisfactory throughout the observation period.

Intranasal esketamine associated with intensive CBT sessions showed to be effective, safe and satisfactory in the real world clinical management of two complex cases of TRD with high suicidal risk, improving quality of life, social functioning and eliminating suicidal ideation within 12 months follow-up. Satisfaction with the treatment contributed to strengthening adherence and improving the operator-patient therapeutic relationship.

None Declared

Bulimia Nervosa (BN) is a highly prevalent eating disorder related to multiple risk factors. In this regard, familial variables can play a critical role in the development and maintenance of BN.

The existing studies frequently explored mothers and maternal factors, while fathers and paternal variables have been less extensively investigated in this field. Therefore, we aimed to systematically review the studies on the role of paternal factors in BN.

This systematic review process was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. As a result of the literature search on PubMed, Web of Science TM, and APA PsycINFO, 419 candidate papers were determined and evaluated based on the eligibility criteria. The quality assessment of the final 59 studies was conducted using the JBI Critical Appraisal Tools.

Then, we thematically arranged and narratively reported the qualitative and quantitative research findings. Paternal attitudes (e.g., critical, abusive, aggressive, uncaring, and unaffectionate), family dynamics (e.g., chaotic, rigid, less communicative, and emotionally involved), and father-specific features (e.g., personality traits, eating psychopathology features) were found as three main groups that could be directly or indirectly associated with the development and maintenance of BN symptoms. The eligible qualitative studies also indicated that fathers could positively influence the recovery process of their daughters with BN (e.g., by helping them develop healthy adaptive body image, self-adequacy, and self-esteem).

The contradictory outcomes were discussed for further research and clinical implications.

None Declared

There are currently no diagnostic or treatment-guiding biomarkers for major depressive disorder (MDD). Microribonucleic acids (miRNA) may facilitate understanding the reorganisation of gene expression networks in MDD. Identifying miRNA and target mRNA pathways that contribute to MDD may open new therapeutic avenues, such as inhibiting endogenous miRNA or administering exogenous miRNA.

This study investigates how miRNAs can clarify the molecular mechanisms of MDD by comparing the miRNA levels in the blood serum of patients with MDD and healthy individuals. The study also investigates the discriminative ability of miRNAs to distinguish between depressed patients and healthy controls.

Sixty depressed patients were matched with 60 healthy controls based on age, gender, ethnicity, and years of education. The severity of depression was measured using the Hamilton Depression Rating Scale, and venous blood was collected for miRNA profiling. Using the QIAGEN Ingenuity Pathway Analysis, networks were constructed to identify the biological pathways associated with MDD influenced by the differentially expressed miRNAs. Analyses of the receiver operating characteristic (ROC) were performed to examine the capacity of miRNAs to distinguish between depressed and healthy individuals.

Six miRNAs (miR-542-3p, miR-181b-3p, miR190a-5p, miR-33a-3p, miR-3690, and miR-6895-3p) were significantly down-regulated in untreated depressed patients compared to healthy controls. miR-542-3p has experimentally validated mRNA targets predicted to be associated with MDD. ROC analyses determined that a panel containing miR-542-3p, miR181b-3p, and miR-3690 distinguished between depressed and healthy individuals with an area under the curve value of 0.67.

Specific miRNAs, including miR-542-3p, miR181b-3p, and miR-3690, may be biomarkers with targets implicated in the pathophysiology of depression. They could also be used to distinguish accurately between depressed and healthy individuals.

None Declared

Although cognitive impairment is a core symptom of schizophrenia related to poore outcome in different functional domains, it still remains a major therapeutic challenge. To date, no comprehensive treatment guidelines for cognitive impairment in schizophrenia are implemented.

The aim of the European Psychiatric Association (EPA) guidance paper was to provide a comprehensive meta-review of the current available evidence-based treatments for cognitive impairment in schizophrenia, structured into three sections: pharmacological treatment, psychosocial interventions, and somatic treatments.

Based on the reviewed evidence, the EPA guidance recommends an appropriate pharmacological management as a fundamental starting point in the treatment of cognitive symptoms in schizophrenia. Among psychosocial interventions, cognitive remediation and physical exercise are recommended for the treatment of cognitive impairment in schizophrenia. As for cognitive remediation, some variables have been confirmed as core elements for treatment effectiveness.

The dissemination of the EPA guidance paper may promote the development of shared guidelines concerning the treatment of cognitive functions in schizophrenia, with the purpose to improve the quality of care and to achieve clinical recovery in this population.

None Declared

ASD are heterogeneous pathological conditions characterized by difficulties in establishing social contacts and the manifestation of repetitive behavior. An atypical trajectory of brain maturation, impaired neurogenesis, synaptogenesis, and an imbalance in the excitatory and inhibitory systems of the CNS form the morphofunctional basis of the ASD.

To understand the functioning of this complexly organized system in time and space, a three-dimensional model is needed. The closest in vitro model of the human brain from early embryonic stages to aging is brain organoids. Human brain organoids are self-organizing three-dimensional cell aggregates derived from pluripotent stem cells (hiPSCs)

Organelles generalize neurogenesis, gliogenesis, synaptogenesis, cell migration and cell differentiation, gyrification of the cerebral cortex, and reflect the connections of brain regions.

The use of telencephalon organelles in the RAS model revealed a deficit in neuronal migration, acceleration and disruption of cell cycle synchronization, aberrant cell proliferation, abundant synaptogenesis, temporary deviations in the development of the cortex, increased branching of neurons, unbalanced inhibitory differentiation of neurons, high activity of ion channels is a consequence of a violation of FOXG1 activity. Organelles generalize neurogenesis, gliogenesis, synaptogenesis, cell migration and cell differentiation, gyrification of the cerebral cortex, and reflect the connections of brain regions.The use of telencephalon organelles in the RAS model revealed a deficit in neuronal migration, acceleration and disruption of cell cycle synchronization, aberrant cell proliferation, abundant synaptogenesis, temporary deviations in the development of the cortex, increased branching of neurons, unbalanced inhibitory differentiation of neurons, high activity of ion channels is a consequence of a violation of FOXG1 activity .

hiPSCs can provide insight into the cellular mechanisms underlying ASD as a neuropsychiatric disorder, providing access to the development of platforms for in vitro drug screening and individualized patient therapy.

None Declared

The context of the COVID-19 pandemic has changed the daily life of families and children. Screen exposure was increased during this period to maintain social relationships, work remotely, and occupy leisure time.

To explore the association of continued above-recommendation screen use for one year since May 2020 with behaviour problems in the summer of 2021 in children aged 3 to 14 years.

Data came from the French EpiCov cohort study, and were collected in May 2020 and at first (Autumn 2020) and second follow-up (Summer 2021) among 1,089 participants with children aged 3 to 14. Children had a 1-year above-recommendation screen use if their daily mean time exceeded recommendations at the three follow-up times (one hour, for children aged 3-5, two for the older ones). Behaviour problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) and valid cut-offs for Internalizing (emotional or peer problems) and Externalizing (conduct problems or hyperactivity/inattention) problems completed in summer 2021. Data were analysed using adjusted logistic regression.

1-year above-recommendation screen use was not associated with internalizing problems (OR [95% CI]: 1.20 [0.90-1.59]). Regarding the subscales, it was associated with a higher risk of peer problems (1.42 [1.04-1.95]). A higher risk of externalizing problems was found only in 11-14-year-olds (1.63 [1.01-2.63]), especially conduct problems in 11-14-year-olds (1.91 [1.15-3.22]) but not in other age groups.

This study found that maintaining screen time beyond recommendations for 1 year since the onset of the pandemic was associated with peer problems in children aged 3-14 years and externalizing and conduct problems in 11-14 years. Despite this very specific context, exposure to screens is not trivial. If this situation were to occur again, we would have to anticipate, with prevention messages, by keeping schools open.

None Declared