Children with parents with psychiatric diagnoses have an increased probability for not only the same condition as their parent, but also for other conditions and behavioral and psychosocial problems. Whereas many studies have focused on parental severe mental illness due to their significant impairment, less attention has been paid to more common disorders despite their higher prevalence. In addition, because most past research only included one exposure or one outcome at a time, it remains difficult to examine and compare broad patterns of intergenerational transmission.

To examine associations between six parental psychiatric diagnoses in parents, and a broad range of psychiatric diagnoses, psychotropic medications, criminality, suicide, violent victimization, accidents, and school and labor performance in their offspring.

Based on Swedish national registers, we linked all individuals born in Sweden between 1970 and 2000 to their biological parents (N = 3 286 293). We used a matched cohort design, analyzed with stratified Cox regression and conditional logistic regressions to examine associations between six psychiatric diagnoses in the parents, and 32 outcomes in their offspring. All exposed and unexposed children were followed from their date of birth to the date of emigration from Sweden, the death, or 31 December 2013 when the offspring were 14-44 years old.

In terms of absolute risk, most children who had parents with psychiatric diagnoses were not diagnosed in specialist care themselves, as the proportion of having any of the 16 types of psychiatric conditions ranged from 22.17% (exposed to parental depression) to 25.05% (exposed to parental drug-related disorders) at the end of follow-up. Nevertheless, in terms of relative risk, all six parental psychiatric diagnoses increased the probability of all 32 outcomes in their offspring, with the Hazard Ratio ranging from 1.04 to 8.91 for time-to-event outcomes, and the Odds Ratio ranging from 1.29 to 3.36 for binary outcomes. Some specificities were observed for parental psychotic and substance misuse diagnoses, which strongly predicted offspring psychotic-like and externalizing-related outcomes, respectively.

The intergenerational transmission of parental psychiatric conditions appeared largely transdiagnostic, even for non-psychiatric outcomes in offspring. Given the broad spectrum of associations with the outcomes, service providers (e.g., psychiatrists, teachers, and social workers) should consider clients’ broader psychiatric family history when predicting prognosis and planning interventions/treatment.

None Declared

Violence is a global phenomenon, destroying the fabric of society and threatening the lives, health and prosperity of all. In recent years, there has been an upsurge in domestic violence in Tunsia. Unfortunately, few studies have focused on the relationship within these couples.

To describe the characteristics of marriage between Tunisian couples where domestic violence prevails.

Our study was descriptive and analytical cross-sectional, carried out with women victims of domestic violence examined in the context of psychiatric expertise.

An anonymous survey was asked to these ladies concerning the socio-demographic characteristics of the wife and spouse and the characteristics of the marriage.

Our population was made up of 122 couples. The average age of ladies was 35.66 years (from18 to 64 years). As for the spouses, their average age was 41.68, with extremes of 22 and 70.

92,6% of couples had at least one child.

Professionally, (6.6%) of the husbands were inactive and 51.6% (n= 63) of couples had an average socio-economic level.

43.4% (n=53) lived in rented houses, 41% (n=50) owned their own homes, 14.8% (n=18) lived in a room with their in-laws and 0.8% (n=1) were homeless.

The average duration of marriage in our study was 11.16 ± 9.12 years and extremes of 1 and 40 years.Judicial records were found in 28.7% of assailants (n=35).The majority of women surveyed, 92.6% (n=113), were victims of three types of violence at once (verbal, psychological and physical). Sixty-two women (50.8%) were victims of four types of violence simultaneously (verbal, psychological, physical and sexual).Various causes of violence were reported, dominated mainly by claims for money, sexual problems, drunkenness and infidelity, with prevalence rates of 38.5%, 23.8%, 22.1% and 21.3% respectively.The majority of women, 66.4% (n=81), had been assaulted by their spouses during the first year of marriage. Forty-seven ladies (38.5%) were subjected to violence on a daily basis.According to the survey, 86.9% of women have been assaulted at least once before, and 38.7% of them have reported previous assaults to the police.The first person contacted after the violence was the mother, with a percentage of 48.4% (n=59).53.3% of ladies were assaulted during pregnancy, 43% of whom suffered obstetrical complications of varying severity.

According to our results, there is no typical profile of a couple where conjugal violence can reign.

Neither the length of the marriage nor pregnancy prevented the woman from being a victim of domestic violence.

None Declared

Several factors can influence the journey of perinatal grief in mothers, including the quality of care during this experience. The objective of our study was to investigate the factors influencing the perception of grieving women during the perinatal period and identify the role of medical and paramedical healthcare professionals in psychological support.

To determine the factors influencing the perception of fetal loss in grieving mothers.

This was a descriptive, longitudinal, retrospective study conducted between july 2021 and march 2022 at the Fetal Pathology Department of the Center for Maternity and Neonatology in Tunis, Tunisia. The study included women who experienced perinatal loss and underwent fetal pathology examination.

The study was conducted in two stages: Initial consultation at the Fetal Pathology Department, five weeks after the date of expulsion, for perinatal grief counseling. Follow-up interview one year after the date of expulsion: The participants were contacted via telephone for an average duration of twenty minutes .The assessment of perinatal grief during both interviews was conducted using the shortened version of the Perinatal Grief Scale (PGS)

The mean age of the patients was 31.41 years (± 5.15). The average gravidity was 2.47 (± 1.43). More than half of the patients had no living children (n=41). The majority of patients had no notable pathological history. Six patients had been followed in psychiatry, and five had a history of subfertility. The majority of patients (n=61) reported having good marital relationships.

Among the participants, 20% (n=14) had a high Perinatal Grief Scale (PGS) score (PGS >= 91) at five weeks post-loss and were subsequently referred for psychiatric consultation.

At one year, all participants had a PGS score > 91, demonstrating the effectiveness of psychiatric management. Multivariate analysis identified four independent factors associated with a high PGS score at five weeks: absence of living children (OR=0.59; 95% CI [0.36-0.98]; p=0.04), quality of marital relationship (OR=1.2; 95% CI [1.1-3.9]; p=0.02), family support (OR=2.52; 95% CI [1.55-4.12]; p<0.001), and quality of loss disclosure (OR=2.52; 95% CI [1.32-3.77]; p=0.003).

To identify patients at high risk of developing complicated grief and improve the quality of psychological care, it is necessary to implement appropriate protocols, provide training to healthcare personnel, and establish well-equipped healthcare facilities.

None Declared

The COVID-19 pandemic was originally of a magnitude exceeding that of previous epidemics, placing a heavy burden on healthcare systems in general and healthcare professionals in particular.

To assess the prevalence of depressive and anxiety symptoms among healthcare professionals at Farhat Hached Hospital in Sousse during the COVID-19 pandemic and to identify associated risk factors.

This is a descriptive cross-sectional study conducted among healthcare professionals practicing in the Farhat Hached Hospital of Sousse, which took place during the period extending between August and November 2021. The 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7), were used to assess depression and anxiety respectively.

Our study included 326 healthcare professionals from the Farhat Hached University Hospital. The mean age of our population was 36.38 ±10.19 years, with a clear female predominance of 81.3%. The prevalences of depression and anxiety were 46% and 35.3% respectively. Female gender and being a paramedical staff were risk factors for depressive and anxiety symptoms. On the other hand, professional seniority of over 5 years was statistically significantly associated with anxiety. Sporting activity was inversely associated with depressive and anxiety symptoms.

The multi-variate analytical study revealed that the practice of leisure activities other than sport was a protective factor against the occurrence of depressive symptomatology in healthcare professionals, while current smoking and the practice of a sporting activity were inversely associated with the occurrence of anxious symptomatology.

These findings underline the need for specific prevention strategies to reduce these symptoms and help healthcare professionals maintain their mental health. This will help to guarantee the quality and efficiency of work in the medical environment, to better control the pandemic.

None Declared

Pregnancy and puerperium are two critical stages for women’s mental health due to the biological stress of pregnancy itself, as well as the emotional stress that surrounds this vital moment. (1) Debut and aggravation of psychiatric symptoms may occur, as well as relapse in women previously diagnosed with Severe Mental Disorder (SMD).

Symptoms of the anxious spectrum are the most frequent within the perinatal mental pathology, being impulse phobias an entity that appears in about 25% of women previously diagnosed with OCD and up to 10-15% of women without previous psychopathology (2)

Exposing the importance of Perinatal Mental Health from the presentation of a clinical case.

Review of the literature available in PubMed. Presentation of the pathobiography and evolution of the patient.

Our case is about a 37-year-old woman, 30 weeks pregnant with her first child and history of having required admission to Psychiatry with subsequent follow-up in Mental Health for anxious-depressive symptoms with the presence of self-injurious ideas who, after two weeks with multiple life stressors, came to the Emergency Department for the presence of impulse phobias focused on pregnancy with significant internal anguish and ideas of death as a resolution to it, which is why it was decided to hospitalize her. During admission, and taking into account the patient’s gestational state, treatment was started with diluted Mirtazapine and Aripiprazole solution at minimal doses, which in this case were sufficient for symptom control.

The latest guidelines addressing psychopharmacology during pregnancy and lactation point to sertraline among the antidepressants and Lorazepam among the benzodiazepines as the safest drugs during pregnancy (3).

• - The exacerbation of anxious symptomatology and the presence of gestation-focused impulse phobias are frequent during pregnancy and their intensity increases as the time of delivery approaches.

• - Sertraline, Lorazepam, Mirtazapine and Aripiprazole are safe drugs during pregnancy.

• - In these women, a close and multidisciplinary follow-up by Psychiatry and Gynecology is advisable.

None Declared

Treatment-resistant psychiatric disorders present a significant clinical challenge, often requiring trial-and-error approaches to find effective therapeutic interventions. Pharmacogenetic testing has emerged as a promising tool to guide medication selection and dosing, potentially reducing the time to achieve remission and alleviating the burden of persistent symptoms. However, the optimal timing and integration of pharmacogenetic testing into psychiatric practice remain underexplored.

Pharmacogenetic tests can identify individuals with genetic variants that may predict their response to psychotropic drugs, thus enabling a more personalized approach to treatment. Evidence suggests that early application of pharmacogenetic testing, particularly after the first failed medication trial, can substantially improve outcomes for patients with treatment-resistant disorders. Such timely intervention can inform drug choice and dosing, averting protracted periods of ineffective treatment and minimizing exposure to unnecessary side effects.

This review synthesizes current literature on pharmacogenetic testing in psychiatry, with a focus on its application in treatment-resistant mood disorders, schizophrenia, and other non-responsive psychiatric conditions. We examine the genetic polymorphisms that influence drug metabolism, efficacy, and the risk of adverse effects, particularly considering cytochrome P450 enzymes and receptor gene variations.

Pharmacogenetic testing holds significant promise in psychiatry, especially for treatment-resistant disorders, by aligning genetic profiles with medication selection to enhance therapeutic efficacy. While cost and access remain barriers, the benefits of early testing support its integration into standard care protocols. Further research is needed to establish clear guidelines and to expand the genetic targets relevant to psychiatric pharmacotherapy.

Adoption of pharmacogenetic testing after the initial treatment failure offers a pragmatic balance between the practical limitations of universal screening and the clinical imperative to alleviate the substantial morbidity associated with treatment-resistant psychiatric conditions.

None Declared

Substance use disorder is a common comorbidity with bipolar disorder, having implications on its diagnosis, treatment adherence, and number of hospitalizations. Understanding the particular characteristics of this population is of the utmost importance to improve clinical outcomes.

Our aim is to analyze the sociodemographic characteristics of the patients in the inpatient unit of a tertiary hospital and to reflect on its impact on treatment. Our study looks over a 3-year period, and all patients analyzed have a dual diagnosis of both bipolar disorder and substance use disorder.

We collected, retrospectively, data from the hospital platform and analyzed it on SPSS Statistics 26, along with a literature review.

In the analyzed period of 3 years, there were 2384 hospitalizations in the Coimbra’s University Hospital psychiatric ward, and 88 hospitalizations were coded with a dual diagnosis of bipolar disorder and substance use disorder.

Regarding gender distribution, 41% of the patients were female and 49% of the patients were male, with a mean age of 47 years.

There were 12 patients who were re-hospitalized once (7 of them were men) and 6 who were re-hospitalized twice (4 of them were men) during the analyzed period.

At the time of hospitalization, 60.5% of male patients were single, 21.1% were divorced, and only 15.8% were married, while female patients were mainly married (35.7%) and only 28.6% were single.

Female patients had more frequent support from social and community institutions (17.9% vs 5.3% in men) while 2.6% of men had no support from family or institutions.

Regarding education, more men accomplished high school education (21.1% vs 17.9% in women) and university education (18.4% vs 14.3%). In our sample, there were 3.6% of women who were illiterate.

During their lifetime, female patients were hospitalized around 5 times and men around 3.7 times, despite the fact that the mean age of female patients on their first hospitalization was 36 years, and in male patients, it was 34 years.

Treatment adherence is more significant in female patients (70.3% vs 69.2% in men), even though women maintain active substance abuse more frequently (42.9 vs 39.5%).

Male and female patients have different backgrounds and different support either in spouses, family, or social institutions. These nuances may play an important role in the number of re-hospitalizations, treatment adherence, and maintenance of abstinence.

Taking these aspects into consideration may help improve clinical outcomes.

None Declared

Patients with schizophrenia confront with stigmatization in their everyday life. Differences in their perception of stigmatization based on the number of hospitalizations and duration of treatment are unsufficiently researched.

Our aim was to investigate whether patients with first-episode schizophrenia differ in their perception of stigmatization from schizophrenia patients with more than one hospitalization,

A consecutive sample of 120 stable outpatients (70 males, 50 female) diagnosed with schizophrenia were included in the study. Diagnosis of schizophrenia was established with Neuropsychiatric Interview. First episode patients consisted 28.3% of the group.

All patients were at least once hospitalized for mental illness. Patients were dichotomised based on the number of hospitalizations.

The study was approved by Ethic committee of the institutions. Stigma was assessed with Internalized Stigma of Mental Illness (ISMI) scale.

ISMI scale contains 29 Likert items rated on a 4-point scale ranging from “strongly disagree” to “strongly agree”. It contains five subscales: Alienation, Stereotype Endorsement, Discrimination Experience, Social Withdrawal and Stigma Resistance. The overall internal consistency for the global ISMI was 0,89; Alienation-0,76; Stereotype endorsement- 0,63; Discrimination- 0,72; Social withdrawal- 0,57.

All analyses were performed using the SPSS 25.0. The differences between groups on continuous variables were evaluated using t-test with Bonferroni correction. For all analyses, the level of statistical significance was defined as an alpha less than 0.05

There were no differences in first-episode and more episode patietns in ISMI and its subscales. Number of hospitalizations was associated with Stereotype endorsement subscale (r=228;p=0,012) Age was correlated with stigma.

Although stigma did not differ between first-episode patients and patients with two or more hospitalizations, stereotype endorsement was strongy associated with the number of hospitalizations leading to conclusion that stigma is associated with psychiatric treatment and our aim must be to destigmatize the treatment and avoid hospitalizations.

None Declared

The Finnish forensic psychiatric service system lacks the standards and criteria guiding the quality and contents of patient care. Ensuring best recovery-oriented practices in forensic psychiatric services need to be developed at several levels.

The purpose of this research project is to develop safe, high-quality psychiatric care. The outcome of this project is the production of quality criteria for the forensic psychiatric care and service system.

The study will be executed at the Department of Nursing Science of the University of Turku during 2023-2026. The research methods include a literature review, a survey based on validated measurement questionnaires (Downes Survey, QPC-FIP, QPC-FIPS), individual and group interviews as well as the Delphi method. The research will cover the multidisciplinary employees at adult psychiatric wards in Finland’s larger hospital districts, employees of forensic psychiatric hospitals, and patients of forensic psychiatric hospitals. International specialists and specialists within Finland from various fields (nursing, medicine, psychology) will be invited to partake in the expert panel.

The research results will allow the development of the service system for forensic psychiatric patients in such a way that the identification of so-called risk patients can be improved already at the early stages of treatment, at the general psychiatric level. Moreover, the substance of care and participation during care can be created and the care following inpatient care and the patient’s transfer out of forensic psychiatric care can be developed. The research may promote the effectiveness of treatment by highlighting areas in the care chains that, when reinforced, will allow patients to receive the right kind of treatment at the right time. A proposal of standardized operating methods and quality criteria will be created for the Finnish forensic psychiatric treatment system. The research project will also reveal previously unresearched information that can be utilized in national health policy.

The project will promote equal prospects for wellbeing and a participatory society for citizens by exploring the views of forensic psychiatric patients and thus developing forensic psychiatric services. The project will promote sustainable employment by exploring the views of psychiatric personnel and increasing the quality and safety of psychiatric services.

None Declared

In recent years, research has focused on the older adults with bipolar disorder (OABD), aged 50 years and over, a constantly growing population due to the increased of life expectancy. Actually, some authors suggest that these individuals constitute a distinct subtype with a specific and different needs such as seen in epidemiologic, clinical and cognitive features. Further research has revealed significant differences between females and males with BD in clinical and cognitive variables in middle-aged and young patients, but this topic among OABD population remains unclear.

The aim of this study is to identify the distinctive profile in clinical, functional and neurocognitive variables between females and males in OABD.

A sample of OABD and Healthy Controls (HC) were included. Euthymic patients or in partial remission were included. Neurocognition was measured with a battery of tests that included premorbid intelligence quotient, working memory, verbal and visual memory, processing speed, language and executive functions. Independent t-test and Chi-squared test analysis were performed as appropriated.

According to the analysis, statistically significant differences were seen between females and males. A more impaired cognitive profile is observed in women. They performed worse in the subscales of Arithmetic (F= 6.728, p = <0.001), forward digits (F= 0.936, p= 0.019) and Total Digits (F= 1.208, p= 0.019) of the WAIS-III, in the Stroop Color Word Test, color reading (F= 0.130, p= < 0.001), in the Continuous Performance Test, block change measure (F= 2.059, p= 0.037), in the Rey-Osterrieth Complex Figure-copy (F= 0.005, p= 0.029) and in the Boston Naming Test (F= 0.011, p= 0.024). Nor significant differences were found in clinical neither in psychosocial functioning variables.

In view of the following results, and since no differences were observed between women and men in terms of clinical and functional outcomes, it could be said that the differences observed in cognition cannot be explained by disease-related factors. Furthermore, these results highlight the need to develop a gender-specific cognitive interventions in OABD population. In this way, we could have an impact on the course of the illness to reach a better quality of life.

S. Martín-Parra: None Declared, C. Torrent Grant / Research support from: Spanish Ministry of Science and Innovation (PI20/00344) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIIISubdireccion General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER), A. Ruiz: None Declared, M. Bort: None Declared, G. Fico Grant / Research support from: Fellowship from “La Caixa” Foundation (ID 100010434 - fellowship code LCF/BQ/DR21/11880019), V. Oliva: None Declared, M. Prisco: None Declared, J. Sanchez-Moreno Grant / Research support from: Spanish Ministry of Science and Innovation (PI20/00060) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdireccion General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER), E. Jimenez Grant / Research support from: Spanish Ministry of Science and Innovation (PI20/00060) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdireccion General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER), A. Martinez-Aran: None Declared, E. Vieta Grant / Research support from: Spanish Ministry of Science and Innovation (PI18/ 00805, PI21/00787) integrated into the Plan Nacional de I+D+I and cofinanced by the ISCIII Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357; the European Union Horizon 2020 research and innovation program (EU.3.1.1. Understanding health, wellbeing and disease: Grant No 754907 and EU.3.1.3. Treating and managing disease: Grant No 945151), B. Sole: None Declared, L. Montejo: None Declared

Negative countertransference in psychiatry refers to the therapist’s unfavorable emotional reactions to the patient, such as anger and frustration, which can hinder the therapeutic relationship and the client’s progress. This is why it is imperative to study the causes of this negative counter-transference, such as cultural causes, to ensure effective treatment, appropriate care and better comfort for psychiatry residents during their professional practice.

To study the cultural causes of negative countertransference among psychiatric residents in Tunisia and their coping behavior.

This cross-sectional study was carried out among Tunisian residents working in psychiatric departments, using a questionnaire deployed via Google Forms.

The study involved 26 residents with 23 females. The average age was 27.57 years with extremes ranging from 26 to 32. The participants were family doctors practicing in psychiatric wards (26.9%), first year psychiatry residents (15.4%), second year psychiatry residents (23.1%), third year psychiatry residents (19.2%), fourth year psychiatry residents (11.5%) and child psychiatry residents (3.8%). The majority of residents admitted having had a negative transference towards a patient (88.5%). The level of frustration felt by residents during this counter-transference on a scale of 100 varied from 1 to 100 with an average of 61.9. Substance abuse was the primary cause in 52.17% of cases. The second cause was the patient’s ideology, with a percentage equal to 43.47%. The same percentage of 17.39% was for traditions, socio-economic level and membership of a particular political group. In 82.6% of cases, residents tried to analyze this counter-transference and 65.2% of them managed to deal with their frustration. The feeling of guilt was experienced by 56.52% of practitioners and the same number of residents tried to avoid the patient. Among the participants, 43.47% discussed this difficulty with their supervising physician and only 4 residents asked to change patients.

In conclusion, our study identified the cultural causes of negative countertransference in Tunisian psychiatry residents, including substance abuse, ideology, traditions, socio-economic level and politics. Understanding these causes is essential to resident training but also to the delivery of quality care in psychiatry. By integrating this knowledge into training, we can help residents recognize and manage negative countertransference, in order to improve the quality of care they provide to their patients.

None Declared

Anxiety is the most prevalent disease in the world. Symptoms of anxiety disorders affect everyone. The symptoms are worse after a long period of time and more severe disease than normal. A study was conducted to support the assumption that it is an opportunity to improve healthcare services.

1. 1. Anxiety disorders of doctors and medical specialists of Selenge Province General Hospital

2. 2. Determine the relationship between certain factors and certain factors of anxiety disorders

The GAD7, SRQ20, and PHQ9, sleep system detection questionnaire methods issued by WHO for doctors of primary health care institutions were analyzed by analytical research snapshot model from 03.15 to 04.05, 2023.03.22. /1/01 was obtained and the survey was conducted.

In the study, 23-65-year-olds received medical care, and the average life expectancy was 37.05 years. 30% (27) of the respondents did not have anxiety disorders, 36.67% (33) had mild anxiety disorders, 18.89% (17) had moderate anxiety disorders, and 14.44% (13) had severe health problems. 6.67% (6) of the respondents had no depression, 10% (9) had very mild depression and could cope on their own, 24.44% (22) had moderate depression and could cope, and 27.78% (25) with healthy depression. 24.44% (22) had major depressive disorder and 6.67% (6) had major depressive disorder. According to correlation analysis, GAD7 score with SRQ20 stress score r=0.76 and PHQ9 mood score with r=0. the inverse association was statistically significant at p=0.00. PHQ9 depression score had a strong effect on SRQ20 stress score r=0.74, p=0.00, and GAD7 score r =0.46, p=0.0000. r=-0.40, p=0.00 had a moderate inverse relationship with age, and r=-0.24, p=0.00 had a weak inverse relationship with age. In linear regression analysis, the GAD7 anxiety disorder score increased by 48.8% (p=0.00) when fixed at one, which was statistically significant. In logistic regression analysis, PHQ9 depression score increased by 35.08% (p=0.01) per entry. In composite logistic regression analysis, the PHQ9 depression score was statistically significant OR=4.07 (p=0.01) multiplied by one.

Doctors and medical professionals include psychological health research, testing, treatment, psychological counseling, and health care. Anxiety disorders are related to stress, depression, satisfaction, and age, while depressive disorders are anxiety disorders.

None Declared

There is a broad consensus that risk taking is largely determined by risk perception. However, previous literature has shown numerous examples of situations associated with potential health risks where our decisions are not made in accordance with the level of perceived risk.

The aim of the present research was to investigate the role of impulsivity in the explanation of the discordance observed between risk perception and risk-taking in health-related domains.

The sample consisted of 612 participants (Mage = 23.54, 73,2% women). All participants were assessed for levels impulsivity and levels of risk perception and risk-taking propensity in contexts related to health.

Results revealed that higher levels of impulsivity were significantly related to a lower tendency to perceive and take risks in the health domain. Most important for our objectives, we observed that the relationship with impulsivity was significantly stronger for risk taking than for risk perception. Moreover, impulsivity significantly predicted risk taking propensity when controlling for risk perception.

These findings suggest that, in the health-related domains, impulsivity can differentially affect risk perception and risk taking, thus, offering a possible explanation for the inconsistencies observed in the previous literature.

None Declared

The role of the pineal gland in psychiatric disorders is poorly investigated. There are studies, primarily on adult patients, that indicate a higher presence of pineal gland abnormalities in patients suffering from depression, schizophrenia and attention-deficit/hyperactivity disorder (ADHD). When it comes to ADHD, there is speculation about the role of melatonin and the influence of the pineal gland on the dopaminergic system. Data on the association between pineal gland cysts and ADHD in juvenile patients are particularly scarce.

Due to all of the above, our goal is to present the case of a nine-year-old male patient who has a confirmed cyst of the pineal gland and is being treated for ADHD.

The patient was examined by a neuropediatrician, EEG and brain MRI were performed. He was also examined by a psychologist and by a psychiatrist. Endocrinological, hematological, rheumatological, pulmonological treatment and karyotyping were performed.

MRI of the brain revealed a cyst of the pineal gland with an anteroposterior diameter of 1 cm without significant compression. The EEG was mildly slowed and paroxysmally dysrhythmic for the age, ie. paroxysms of high-voltage delta waves were described. The EEG findings after sleep deprivation were paroxysmally altered with rare focal changes in the right temporoparietal region. Through psychological analysis, it was determined that specific deficits persist in the area of verbal understanding, perceptual organization and visual processing, information processing speed, numerical reasoning, attention and short-term memory. On the level of visuomotor perception and coordination, deviations are observed by organic type. He is motorically more active, impulsive, emotionally immature, easily distractible.

The etiology of ADHD is poorly researched, and so is the role of the pineal gland, its cyst and melatonin. There is scant knowledge for other psychiatric disorders, but primarily from researches on adult psychiatric patients. Additional researches are definitely needed on this topic, especially in the field of child and adolescent psychiatry.

None Declared

Osteoporosis (OP) prevalence is on the rise as a result of an ageing population and lifestyle factors such as inactivity. Previous research has reported OP in individuals with depressive symptoms. Furthermore, OP has been shown to be a risk factor for anxiety.

In this study, we aimed to describe anxiety and depression symptoms among osteoporotic women in a university hospital in Tunisia.

A cross-sectional study was conducted between January and June 2023 in a university hospital in Tunisia. Women with postmenopausal OP in the rheumatology department were interviewed. A hospital anxiety and depressive scale was used to describe anxiety and depression symptoms among patients. It consists of seven items for depression (HADS-D) and seven items for anxiety (HADS-A). For each component a score ≤ 7 indicated the absence of symptomatology.

Seventy-two women diagnosed with post-menopausal OP participated in the study. The mean age was 72.5 (±1.08). The median duration of menopause was 23 years (IIQ= [10.5-28.5]). All patients were receiving bisphosphonates. Fifty-eight women (80.5%) were identified with depressive symptoms. The median depression score was 17.5 (IIQ= [9-19]). Physical activity was significantly and inversely associated with the presence of depressive symptoms (r= -6.36; p=10-3). Those who were overweight or even obese had significantly more depressive symptoms than those who were not overweight (94%, 57%, p= 0.001).

The median score of anxiety was 16 (IIQ= [9-17]). Sixty-three patients (87.5%) were identified with anxiety symptoms. Physical activity was significantly and inversely associated with the presence of anxiety symptoms (r= -4.89; p=10-3). Women who had bone fractures were significantly more anxious than those without a history of bone fractures (100%, 63%, p<10-3). Patients who were overweight were significantly more anxious than those with normal weight (96%, 57%, p<10-3).

Physical activity and obesity were associated with depression and anxiety among osteoporotic patients. These data are consistent with previous findings That’s why, promoting physical activity and weight loss is essential to preventing mental disorders among osteoporotic women.

None Declared

Koro, also known in Cantonese as Shook Yang, which literally translates to “shrinking penis”, has its roots in a cultural belief that a mythological figure would steal the penis of his victims. Predominantly reported in Southeast Asia, it involves an acute fear of genital retraction, often accompanied by the belief that this retraction may lead to death. Over the last two centuries, Koro has undergone several attempts to establish its definition and classification, without a true consensus having been reached.

This study aims to explore the cultural nuances surrounding Koro and reflect on the various conceptualizations that modulated its definition and nosological classification, from Ancient China until the present.

A non-systematic literature review with the keywords “koro” and “culture” was conducted.

Koro was only introduced to the Western world during colonial expansion, drawing the attention of several psychiatrists who, in Asian territory, reported numerous cases in natives, making the very first attempts at a nosological classification, whether as an anxiety neurosis, or as an obsessive-compulsive disorder. The literature reveals significant cultural variations in the manifestation of Koro, challenging the traditional psychiatric understanding rooted in Western diagnostic categories. Cultural factors, including societal beliefs, religious practices, and regional variations, emerged as influential contributors to the prevalence and presentation of Koro. Additionally, the study identified instances of Koro evolving in response to cultural shifts and globalization, emphasizing the dynamic nature of this syndrome.

This review underscores the need for a comprehensive understanding of Koro that acknowledges its diverse conceptualizations across cultures. Its occurrence, not only in multiple parts of the world, but also in close relation with various comorbidities, has contributed to the dissolution of its primary identity as a culture-bound syndrome, turning Koro into a moving target.

None Declared

Psychiatric disorders are large contributors to the global disease burden and their prevalence is increasing. Global climate is also facing changes, including a rise in temperatures. Many clinical conditions are affected by meteorological factors and there are numerous reports on the effect of climate changes on such conditions. Psychiatric disorders are also influenced by climatic factors but the literature on the effects of climate changes on mental health is limited.

The aim of this study is to investigate the impact of rising temperatures on the risk of acute exacerbation of psychiatric disorders.

Data were collected retrospectively for a total of 139 months, i.e. from January 2012 to July 2023. Recordings of mean monthly temperatures were obtained from registries of the meteorological station of the Department of Physics of the University of Turin. For each of the 139 months, deviations from the average temperature of that month of any year were computed (ΔTm). Anonymised socio-demographic and clinical data on patients admitted during the observation period to the acute psychiatric unit of San Luigi Gonzaga University Hospital (Turin, Italy) were extracted from the hospital registry. Linear regression analyses were used for statistical analyses.

A total of 5420 admissions to our psychiatric ward were recorded over the observation period. Monthly deviations from average temperature and monthly number of admissions were directly correlated, with regression coefficient 1.803 (P = 0.0048) (Fig.1A). Linear regression analysis was performed between ΔTm and number of admissions according to diagnostic group. The regression coefficient was 0.1336 (P=0.5334) for admissions of patients with schizophrenia and related disorders (SCZ) (Fig.1B), 0.4575 (P=0.0295) for bipolar disorders (BD) (Fig.2A) and 0.3381 (P=0.0382) for major depressive disorder (MDD) (Fig.2B).

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These results confirm the impact of meteorological factors on mental disorders. In particular, we observed a positive correlation between monthly temperature and the number of admissions to our acute inpatient unit. The correlation was significant when taking into consideration admissions for exacerbation of bipolar disorder and major depressive disorder, but not when considering admissions for schizophrenia. This highlights the importance of climatic factors especially in mood disorders, provides new insights into their etiopathological mechanisms and provides information that can be implemented for follow up and relapse prevention.

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There is growing evidence of excitation / inhibition (E/I) balance abnormalities in schizophrenia, which might be associated with abnormal gamma frequency oscillations and glutamate concentrations. However, to the best of our knowledge, only one multimodal study have examined such associations between EEG and metabolite characteristics in patients at clinical-high risk of psychosis (CHR) so far.

We aimed to investigate potential associations between GLX (glutamate + glutamine) levels and resting-state gamma-band power in CHR individuals and healthy controls (HC).

Twenty right-handed male patients (16-27 years, mean age 19.9 ± 2.7) fulfilling CHR criteria and 19 healthy male controls (16-27 years, mean age 21.6 ± 3.6) underwent resting-state EEG (16 leads; 10−20 system) and MR spectroscopy at 3T MRI scanner with voxels of 30×30×30mm located in left and right medial prefrontal cortex. Spectral analysis with estimation of gamma-band power (30-45 Hz) were conducted. MEGA-PRESS acquisitions were analyzed with jMRUi (ver. 5.1 Alpha), levels of GLX were calculated as a ratios to creatine + phosphocreatine (GLX/Cr). Gamma-band (30-45 Hz) spectral power and GLX/Cr were compared between groups. Correlations between EEG and metabolite data were analyzed with regression model including age and chlorpromazine equivalents as covariates.

Compared to healthy controls, patients showed reduced spectral gamma-band power in 6 leads (Table). No alterations in GLX/Cr were detected. Positive correlations between altered gamma-power in all leads (except Cz) and GLX/Cr in left medial prefrontal cortex were revealed in CHR (F3: r=0.51, p=0.006; F8: r=0. 54, p=0.004; C3: r=0.37, p=0.037; Pz: r=0.51, p=0.039; P4: r=0.56, p=0.009). No correlations in HC group were found. Chlorpromazine equivalents did not correlate with GLX/Cr of gamma power in CHR group.Table.

Results of between-group comparisons corrected for multiple comparisons

The findings suggest that clinical-high risk of psychosis is associated with widespread alterations in resting-state gamma-band power. Positive correlations of such alterations with GLX/Cr and absence of such correlations in HC group are presumably indicative of disturbances in the excitation / inhibition balance in CHR individuals.

This study was supported by RFBR grant 19-29-10040

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Sexual dysfunctions related to psychotropic drugs are among the most distressing adverse effects and can lead to non-adherence to treatment.

To elucidate the mechanisms of psychotropic-induced sexual dysfunctions and to suggest strategies for their management.

Literature review based on the keywords “psychotropics,” “sexuality,” and “sexual dysfunction”.

Psychotropic medications can impact sexuality either directly or indirectly. The direct effect is primarily due to a decrease in the mesocortical dopaminergic atmosphere, either by blocking D2 receptors or by stimulating 5HT2A receptors. D2 receptor blockade in the tubero-infundibular pathway triggers an increase in prolactin secretion, which can subsequently lead to erection problems, decreased libido, and difficulties achieving orgasm. Action in the nigrostriatal pathway may result in an extrapyramidal syndrome, which can, in turn, hinder intimate physical relations. The indirect effect can also be caused by metabolic complications, which are significant risk factors for sexual dysfunction, as they can lead to male hypogonadism and a negative self-image.

Therapeutic strategies suggest either reducing doses (if the patient’s condition allows), changing the drug, or adding an adjunctive medication. Aripiprazole, being a partial agonist of D2 and 5-HT1A receptors and an antagonist of D3 and 5-HT2A receptors, appears to cause fewer sexual dysfunctions and can reduce hyperprolactinemia when added to other antipsychotics.

Healthcare professionals must proactively gather information on sexuality given its impact on quality of life and treatment adherence. Prioritizing this dimension of well-being demonstrates a respectful approach toward the patient and establishes the foundation for a strong therapeutic alliance.

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The Honest, Open, Proud (HOP) program is an effective peer-led group program to support people with mental health problems in their disclosure to manage self and public stigma. The HOP program will be integrated into the National Anti-stigma Program in Hungary, which was initiated in 2020.

Our goal was to develop the Hungarian version of the HOP program. We conducted the following measures to achieve our aim.

The adaptation process was conducted using community-based participatory research (CBPR) between September 2022 and January 2023. Over ten sessions, a group of eight individuals, consisting of both males and females with varying mental health conditions (mean age = 39.6 ± 8.5), participated in the online-led CBPR. The adaptation process was systematically documented, and regular supervision was provided.

The program comprises three lessons and a follow-up section. We have translated the text of the manual and workbook into Hungarian and adjusted the tone, language, locations, and examples as per the Hungarian context. Although our adaptation process did not involve changes to the content and implementation strategies, we will perform structural modifications and adjustments to ensure the content is suitable for the predefined number of sessions and Hungarian participants.

The HOP could be feasibly implemented in the National Anti-stigma Program in Hungary; both online and in-person programs are planned. Given the lack of such a program in Hungary, it will likely be warmly welcomed and strongly supported for the benefit of people with mental health problems.

D. Őri Grant / Research support from: Fulbright Association supported research, P. Corrigan: None Declared