Insensitivity to pain in schizophrenia is a complex phenomenon. Understanding schizophrenia’s heterogeneity is crucial for personalized treatments.

Individuals diagnosed with schizophrenia often experience gastrointestinal issues and exhibit elevated levels of depression and anxiety. There is an urgent need to understand how these factors interact and how childhood traumas, a significant risk factor for schizophrenia, can affect gastrointestinal symptoms in these individuals.

The study involved 51 individuals diagnosed with schizophrenia. The hierarchical cluster analysis on the principal components (HCPC) was performed to identify groups of similar observations for test scores and the overall results for 14 tests. Hierarchical clustering was performed using Ward’s minimum variance method. Differences in the results of individual tests between clusters were estimated using the V test.

The schizophrenia group was categorized into three clusters. The patients belonging to the first cluster are characterized by high GAF test scores and low scores on tests for gastrointestinal symptoms, ITQ, CTQ, GHQ-28, STAI, CALGARY, BDI II, SAMPS, SANS, and PANNS. In contrast, patients in the second cluster had scores significantly above the group average on the tests SANS, PANNS, and SAPS and low scores on the tests DBZ RZ, CTQ, STAI, BDI II, ITQ, and GAF. Finally, patients in the third cluster had high scores on the tests BDI II, ITQ, STAI, CTQ, GHQ 28, DBZ RZ, gastrointestinal symptoms, TEC PL, CALGARY, and CISS. High CTQ scores may contribute to increased GSSR scores due to childhood trauma’s potential to trigger chronic stress, affect the nervous system, and induce psychosomatic symptoms, including gastrointestinal problems. Elevated BDI II and STAI scores can also impact GSSR results by disrupting the connection between emotions and the gastrointestinal system.

This research underscores the intricate interplay of various psychosocial and physiological factors that influence the perception of pain related to gastrointestinal symptoms in individuals with schizophrenia.

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Childhood maltreatment (CM) is associated with distinct clinical and biologi- cal characteristics in people with eating disorders (EDs). The measurement of local gyrification index (lGI) may help to better characterize the impact of CM on cortical structure.

The objective of this study was to investigate the association of CM with lGI in women with EDs.

Twenty-six women with anorexia nervosa (AN) and 24 with bulimia nervosa (BN) underwent a 3T MRI scan. All partici- pants filled in the Childhood Trauma Questionnaire. All neuroimaging data were processed by FreeSurfer. LGI maps underwent a general linear model to evaluate differences between groups with or without CM. People with AN and BN were merged together.

Based on the Childhood Trauma Questionnaire cut- off scores, 24 participants were identified as maltreated and 26 as non- maltreated. Maltreated people with EDs showed a significantly lower lGI in the left middle temporal gyrus compared with non-maltreated people, whereas no differences emerged in the right hemisphere between groups.

The present study showed that in people with EDs, CM is associated with reduced cortical folding in the left middle temporal gyrus, an area that could be involved in ED psychopathology. This finding corroborates the hypothesis of a ‘maltreated ecophenotype’, which argues that CM may allow to biologically, other than clinically, distinguish individuals with the same psychiatric disorder.

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Men’s violence against women continues to be a major public health problem worldwide. The long-term consequences require a proper management of resources and a thorough screening protocol. The most extensive study on domestic violence was published in 2005 by the World Health Organization (WHO) and has been updated regularly ever since.

The aim of this study was to outline a personality profile for people who could be considered domestic abusers and to provide statistical data on personality disorders which are most common among this group of population.

The quantitative data was collected by administering two scales SCID II and Karolinska Scale.

Inclusion criteria: People who are physically aggressive with family members.

Exclusion criteria: people who are diagnosed with psychosis, people who show aggression with people other than family members

We included 70 people who admit to having committed acts of l physical aggression directed towards family members, who agreed to take part in the study. The scales which were applied are Karolinska scale and SCID II. We identified, using SCID II, DSM IV TR and ICD 10 the following personality disorders types in the 70 intrafamilial aggressors - 10% antisocial personality disorder, 27% borderline personality disorder of which 14% with impulsive emotional instability, 3% obsesive-compulsive personality disorder, 1.4% mixed personality disorder anxious and paranoid.

Being able to recognise a personality pattern shows great benefits for screening the patients at risk to develop an aggressive behaviour directed towards family member, thus being a great tool in prevention of long-term consequences associated with living in a hostile environment.

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Adult and child psychiatry residents encounter unique stressors in their training distinct from those in other medical specialties. Patient suicide has been identified as one of the most distressing experiences during psychiatric training.

This study represents the first Tunisian investigation aiming to assess (1) the impact of patient suicide on psychiatry residents and (2) the limitations of the institutional support system in dealing with such cases.

A Google Forms questionnaire was distributed via email to all residents, gathering socio-demographic data, assessing traumatic impact using the PTSD Checklist for DSM-5 (PCL-5), and soliciting open-ended responses regarding personal experiences and expectations of the institutional support system.

Fifty-three residents participated in the study. Among them, 29 residents had encountered patient suicide, with 12 directly involved. Symptoms of PTSD were detected in three residents. The physician directly involved in treating the suicidal patient reported the highest PCL-5 score. The majority of residents (27 out of 29) expressed the need for a structured support and training program tailored to healthcare professionals dealing with suicide.

The findings suggest that psychiatric residents may require additional training and support to effectively address the complex issue of patient suicide. Implementing specific training programs could significantly enhance their ability to manage such situations.

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The war in Gaza is a stressful life event. Due to its significant human and financial losses, it affected the mental health of people around the world including the middle east citizens.

To study the coping strategies of Tunisian people toward Palestine-Israel war in its first month and the factors associated with them.

It was a cross-sectional, descriptive and analytical study, conducted among Tunisians. Data were collected during October and November 2023, through an anonymous online questionnaire, spread throughout social media (Facebook/Instagram), using the Google Forms® platform. We used a socio-demographic and clinical data sheet and the “Brief-COPE” to assess coping strategies.

A total of 1091 participants completed the questionnaire. Their mean age was 32,7± 9.8 years, with a sex-ratio (F/M) of 3.5. Among participants, 46,1% are married, 42,5% have children and 19,5% have a psychiatric follow history. Sport’s practitioners represent 23,3% of the participants and 10,6% increased their use of sports after the war news.

In terms of coping strategies: problem focused coping was the most used strategy (mean= 2,02) followed by emotional focused coping (mean= 1,98) and avoidant coping (mean= 1,63). Tunisians rely the most on religion, accepting reality and planning as coping mechanisms (score= 2,85; 2,4 and 2,23 respectively). Substance use was the last resort option (score= 1,11).

Our survey revealed significant associations between coping mechanisms and several factors: Venting, humor and behavioral disengagement were significantly correlated with sex gender (p=0,000 ; 0,000 ; 0,000 respectively); Substance use coping mechanism was significantly correlated with participants having a psychiatric follow history (p=0,001); Avoidant coping subscale was significantly correlated with having children (p=0,000); Self distraction was significantly correlated with the increase use of sport among Tunisians (p=0,000).

These findings underscore the need for healthcare and productive coping strategies for Tunisians and middle east people during the Palestine-Israel war.

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Sexual satisfaction is relevant to aging well, throughout the lifespan.

This study aims to compare the perspectives of sexual satisfaction and adjustment to aging in three age cohorts, across the life span; and to analyze whether sexual satisfaction influences the perceptions of AtA.

This cross-sectional study comprised participants from three different age cohorts (18-44; 45-64; and 65+ years). Four measures were used to meet the defined objectives: (a) Adjustment to Aging Scale (ATAS); (b) New Sexual Satisfaction Scale (NISS-S); and (c) sociodemographic, health and lifestyle questionnaire. Data were subject to One-way ANOVAs and hierarchical regression analyses.

Social support emerged as the most relevant dimension in the multifactorial nature of AtA. Generational differences were found in sense of purpose and ambitions [F (2, 616) = 14.203, p = .000], social support [F (2, 616) = 10.65, p = .000] and body and health [F (2, 616) = 8.73, p = .000]. Participants aged 65 and older showed significantly lower levels of sense of purpose and ambition, body and health, and social support. Younger participants showed the highest score for body and health. Age-related decreases in sexual satisfaction were also found, as younger participants showed statistically higher levels of sexual satisfaction, followed by middle-aged and older participants. Sexual satisfaction predicts all the dimensions of AtA, exception made for aging in place and stability, where age is the main predictor. Ego-centered sexual satisfaction positively predicted sense of purpose and ambitions (β = .212, p < .05) and social support (β = .311, p < .001); while partner/sexual activity centered sexual satisfaction was a positive predictor of zest and spirituality (β = .255, p < .01), body and health (β = .239, p < .001), and social support (β = .168, p < .05).

Sexual satisfaction decreases with age and is positively related to all dimensions of AtA, hence gerontological interventions and program policies with older people would strongly benefit of including sexual satisfaction as a relevant variable for aging well.

Keywords: sexual well-being; sexual satisfaction; adjustment to aging; generational groups; lifespan.

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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

The northern region of Italy had been the epicenter of the first wave of Covid-19. The youth population residing in this area experienced an extended period of restrictive measures implemented to curb the spread of the virus. Given the adverse effects of social distancing and lockdown measures, there is a concern regarding the mental health of young individuals in this region. However, there remains a notable scarcity of studies exploring the long-term impact of the pandemic on the mental health of this vulnerable population.

To assess psychopathological symptoms among adolescents and young adults in order to evaluate the extent of their impact in the context of the Covid-19 pandemic. To explore potential risk factors and resilience factors in youth who have experienced the effects of the pandemic.

Two studies are performed. Study n1 has observational design and includes 7,146 adolescents and young adults (age range 14–25) evaluated during the fourth wave of the COVID-19 through standardized measures for depression, anxiety, anger, somatic symptoms, resilience, loneliness and post-traumatic growth. Study n2 has prospective design and includes 153 students (mean age 16.1±0.49), evaluated before the Covid-19 pandemic (November 2019–January 2020) and 1 year later (April–May 2021) to measure anxiety, depression, stress, emotional dysregulation, maladaptive behaviours.

Study 1. Clustering methods identifed two groups of students with different psychological features, that we further defined as “poor mental health” and “good mental health”. Those with poor mental health were characterized by higher scores of loneliness and self-harm, followed by being of female gender, presenting binge eating behaviors and, finally, having unsatisfying family relationships.

Study 2. Over the course of one year, significant changes in various psychological parameters were observed: an increase in anxiety, stress for future uncertainty, and higher frequency of maladaptive behaviours.Stress related to social domains (i.e., school attendance, romantic relationships, peer pressure) decreased over the year. Cluster analysis identified three distinct groups of youths based on their changes in psychopathological symptoms over time: those who worsened (N=23; 15%), improved (N=55; 34%), or remained stable (N=75; 46%). Furthermore, adolescents who reported an increase in self-harm (OR=2.61; p<0.001), binge-drinking (OR=3.0; p=0.007), aggressiveness (OR 1.92; p=0.004), and binge-eating (OR 2.55; p=0.003) were more likely to be associated with a worsened mental health condition.

The findings from these studies substantiated the significant psychological distress caused by the COVID-19 pandemic. Furthermore, they yielded valuable further insights regarding into the factors linked to distinct patterns of mental health outcomes.

None Declared

Cannabis consumption constitutes a public health problem both because of its serious repercussions and complications and the psychological and social problems it causes.

Our objective was to assess the level of cannabis dependence in consumers receiving care at the Sfax detoxification center in Tunisia, to describe the sociodemographic profile of these consumers and the neuropsychological complications that may be caused.

We conducted a cross-sectional study, over a period of 13 months (September 2020 to October 2021), among cannabis users consulting the Sfax detoxification center in Tunisia. We used the Cannabis Abuse Screening Test (CAST) in order to detect a “problematic” cannabis use, along with a clinical information sheet to collect epidemiological and clinical data. All patients gave their free and informed oral consent to participate in the survey while ensuring anonymity.

We included 38 patients. The average age was 26 years old with a median age of starting cannabis use at 17 years old. The sex ratio was 8.5 with an over-representation of men. Most of the subjects were single, lived with their family and had a secondary school education. Consumption was daily for the majority of patients (68.5%) with an average quantity of 4 joints/day. According to the CAST scale, 36 users (94.7%) had problematic cannabis use. The factors favouring cannabis consumption were stress and anxiety in 34 patients (89.5%) followed by depression and the festive atmosphere in 14 subjects (36.8%) each. Among the participants, 26.3% had a psychiatric history including depression (5.3%), a psychopathic personality disorder (10.5%) and cannabis-induced psychotic disorder (10.5%). History of psychiatric hospitalization and history of suicide attempt were found in 21.1% and 26.3% of the patients respectively. Concerning the complications caused by cannabis, 68.4% of the patients described a phenomenon of tolerance, while 63.2% reported the sensation of craving. Psychotic symptoms such as delirium and/or hallucinations were found in 6 patients (15.8%) and 8 subjects (21.1%) reported a history of overdose in the form of cannabis psychosis. Chronic complications were an amotivational syndrome (63.2%) and social disintegration (52.6%). Treatment of cannabis dependence was considered effective with total withdrawal in 31.6% of subjects. Weaning was partial in 42.1% of the patients.

Cannabis use is emerging as one among many interacting factors that can affect psychological and physical health, with an impact on various levels including mood, neurocognition and general health. Although studies have shown functional brain mechanisms underlying the effects of cannabis, the exact mechanisms remain unclear. Overall, treatment for substance use disorders generally prevents these complications and improves prognosis.

None Declared

The present study examines self-reported factors related to discontinuation of ADHD medication in Danish adults. Based on insights from six patient interviews, a questionnaire was developed with themes such as perception of ADHD, perceived beneficial- and adverse effects of the medication, to examine patients’ reasons for continuation or discontinuation of the prescribed medication.

ADHD medication has proven effective for treating ADHD in adults. Large registry-based studies have generally shown high discontinuation rates over time and focused on different risk factors, such as comorbidity, gender and socioeconomic status. However, in the present study we explore patient reported reasons for continuation or discontinuation of ADHD medication as well as what drives their choice of living with or without medication despite ADHD.

The present research is a questionnaire study consisting of 1,050 Danish adults who redeemed a prescription of ADHD medication for the first time between 2017-2019. Questionnaires were sent out by Statistics Denmark to 4.748 adults, a representative sample from the 17.334 Danish adults who redeemed a prescription within that period. A gap of 12 months between redemptions was defined as discontinuation and questionnaires were sent out to an equal number of patients who continued or discontinued the ADHD-medication. Chi2-tests were performed to examine the differences between adults who continued vs. discontinued ADHD-medication in relation to different main themes.

The patients who continued medical treatment more strongly perceived ADHD as a biological illness whereas patients who discontinued, more strongly perceived ADHD as an illness constructed by society. Furthermore, patients who continued medical treatment reported that the medication has a more positive influence on their lives whereas patients who discontinued the medication reported that the treatment involved more negative feelings and decreased the positive sides of themselves. Finally, patients who continued the prescribed ADHD-drugs reported more strongly that they continued the treatment for themselves, to be able to work and be social than the patients who discontinued the medical treatment.

The present findings suggest that the perception of ADHD as being either a biological or social construct is central to why patients choose to continue or discontinue ADHD-medication. Moreover, patients who continued the medical treatment generally reported more positive effects of the ADHD-drugs whereas patients who discontinued the medical treatment reported different negative effects of the medication. From a clinical perspective, these findings show the importance of understanding the individual patient’s perception of ADHD. These perspectives should be addressed in the clinic alongside with awareness of how ADHD-drugs may have a positive and negative effect on the individual patient.

None Declared

Cannabinoid Hyperemesis Syndrome (CHS) is distinguished by a pathognomonic cyclic pattern of hyperemesis characterized by recurring episodes of severe vomiting every few weeks to months, as well as obsessive thoughts and compulsive behavior, such as a proclivity to take frequent hot baths or showers. It is largely accepted as the most commonly used illicit drug in the United States, with estimates ranging from 42% to 46% lifetime consumption. Despite greater awareness of CHS, practitioners continue to lack comprehension, resulting in an unfortunate delay in patient identification and treatment.

The aim of this article is to bring attention to CHS in order to enable clinicians, and more specifically, addiction medicine specialists and psychiatrists, to diagnose it as quickly as possible and thus avoid unnecessary additional invasive examinations and investigations. This will save the patient’s time, prevent financial burdens and mental health stresses, and increase their overall quality of life.

A thorough screening and data extraction of the relevant articles was conducted using PubMed, Cochrane, and Embase. Databases were used to search for articles on CHS published between January 2021 and September 2023, yielding relevant articles. Keywords used were “hyperemesis”, “cyclical vomiting,” “cannabis” and “cannabinoid”.

We present a case of 20-year-old teens who came to emergency with severe dehydration and vomiting of more than 40 episodes at home. He had multiple admissions for abdominal pain, nausea, and vomiting in the past and was evaluated and diagnosed with gastritis, PUD, and H. pylori infection. A more detailed medical history revealed a frequent use of cannabis over the past few years and symptoms manifestation and worsening is associated with the use of cannabis. After the complete cessation of cannabis, there have been no new symptomatic episodes reported in the patient and the patient is stable clinically.

Cannabinoid Hyperemesis Syndrome (CHS) is a serious health hazard that requires immediate discovery and treatment. Despite the widespread use of cannabis, CHS is often misdiagnosed, resulting in unnecessary medical treatments and complications for patients. Given their special knowledge of linking chronic cannabis use to this syndrome, this case report and literature review highlight the critical role of addiction medicine experts and psychiatrists in quickly detecting and treating CHS. Early detection and treatment, particularly complete cannabis abstinence, are critical in alleviating symptoms, minimizing recurrent hospitalizations, and ultimately improving patients’ overall quality of life.

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 main finding of a large-scale collaborative study (Rees et al. Nat Neurosci 2020;23(2) 179-184), which focused on de novo mutations in schizophrenia, was the discovery of an enrichment of these mutations in the SLC6A1 gene. This gene encodes the gamma-aminobutyric acid (GABA) transporter GAT1, thereby encouraging further research into novel schizophrenia targets within the GABA pathway. However, the gene was not highlighted in recent schizophrenia genetic studies, while typically pathogenic SLC6A1 mutations result in epilepsy, motor dysfunction, autistic spectrum disorder (ASD) and developmental delay. The absence of genetic replication for SLC6A1’s involvement in schizophrenia and the differing clinical spectrum for SLC6A1 mutations led us to study in depth one of the only three original probands from the Rees et al. 2020 study.

In our comprehensive case study, we delved deep into the relationship between the SLC6A1 mutation and schizophrenia.

Our subject, a patient who first presented with acute mania symptoms at age 15 and was later diagnosed with schizophrenia, carried the SLC6A1 Arg211Cys mutation. Over a detailed 25-year follow-up, we conducted an array of assessments and tests, including cognitive testing, personality assessments, EEG, and 1H-MRS.

Notably, we discovered abnormal GABA levels, potentially indicating a dysfunction in GABA reuptake, adding a new layer of complexity to our understanding. Further analysis revealed a significant correlation between the patient’s clinical picture and a polygenic background, rather than the SLC6A1 mutation. Despite having a high polygenic risk score for bipolar disorder, the dominant features of his condition were more representative of schizophrenia. Interestingly, neither the patient nor his father, who also showed a higher BP PRS, had a diagnosis of bipolar disorder. The pathogenic significance of the mutation warrants investigation in cells of neuronal origin. We generated induced pluripotent stem cells (iPSC) from the patient and his parents. This approach provides us with a platform for future investigations into the pathogenic significance of the mutation in neuronal cells. The Human Pluripotent Stem Cell Registry accession numbers of those cells are MHRCCGi001-A (patient), MHRCCGi005-A (mother) and MHRCCGi004-A (father).

In the presented case the clinical picture is rather explained by the polygenic background than by the SLC6A1 Arg211Cys mutation. The study is supported by Russian Science Foundation, grant 21-15-00124 (https://rscf.ru/project/21-15-00124)

None Declared

Burnout was reclassified in 2019 as an occupational phenomenon in ICD-11. The new condition includes the classic tridimensional definition with symptoms in areas of fatigue/energy depletion, mental distance/cinism and sense of ineffectiveness/lack of accomplishment.

To evaluate the knowledge and perceptions of psychiatrists regarding new ICD-11 burnout definition.

To analyse the frequency of burnout symptoms in the psychiatric consultations and among the psychiatrists as healthcare professionals.

An online survey (designed with Microsoft® Forms) was sent in June 2023 to psychiatrists from three regions of Spain, contacted form local scientific societies. Psychiatrists, currently working, had to consent and answer a brief survey (average time: 2 min 32 sec) of 9 questions regarding the definition of burnout, their experience in clinical practice, their own symptoms and symptoms observed in colleagues.

164 psychiatrists answered, 114 females (69.5%), mean age: 43.61 ± 11.28 years. 48.2% assured they had never used the term Burnout or the ICD codes Z73.0/QD85, whereas a 9.1% used them frequently in clinical practice. 58.5% considered burnout just a condition related to work and a 38.4% either a syndrome or a disorder.

Most psychiatrists referred that their patients exhibited symptoms of the three dimensions. Fatigue was the most common, attended frequently by 79.5% of the surveyed, followed by ineffectiveness (73.1%) and cinism (65.3%).

When reporting their own symptoms, only 16.5% psychiatrists referred not suffering any symptom. The most frequently involved was fatigue (66.5%), then ineffectiveness (56.1%) and cinism (41.5%). 28,7% reported concomitant symptoms of the three dimensions.

70.7% recognized fatigue symptoms in their colleagues, 61% ineffectiveness, 72.6% cinism and 45,5% recognized symptoms from the three dimensions. Only a 7.3% did not identify any of them.

A younger age was related to higher probability of suffering cinism (T:2.546; p=0.012) and ineffectiveness (T:2.900; p=0.004) and to a higher probability of recognizing cinism (T=3,293; p=0,001) an ineffectiveness in others (T=2.355; p=0.020)

Females showed a higher frequency of ineffectiveness symptoms (61.4% vs 44%; χ2:4.274; p=0,029).

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Psychiatrists’ concept of burnout is diverse but the main construct is convergent with ICD definition, not a medical illness but a condition related to work.

The three classic dimensions of burnout are common in clinical conditions and also in the laboral environment of psychiatrists themselves. Psychiatrists tend to recognized more easily burnout in other colleagues, particularly cinism symptoms. Cinism and ineffectiveness appear to be related to younger age that can be associated to an imbalance between work demands and individual resources.

These results highlight the challenge of preventing, detecting and addressing burnout syndrome in psychiatric services.

None Declared

Medication adherence was defined by the WHO as “the extent to which a person’s behavior coincides with the medical advice given” (WHO, 2003). Existing literature indicates that approximately 49% of patients with major psychiatric disorders do not fully adhere to their prescribed psychopharmacological therapy (Colom et al, 2002). Non-adherence can lead to partial therapeutic responses or treatment resistance, increased risk of relapse, re-hospitalization, elevated suicide risk, and overall poorer functioning, thereby compromising the patient-doctor therapeutic relationship (Garcìa et al, 2016).

The aim of the present study was to assess potential differences in terms of clinical features related to adherence to treatment in a large cohort of psychiatric patients of an Italian psychiatric department.

The study included 307 psychiatric patients, of any gender or age, diagnosed with unipolar depression (UD), bipolar depression (BD), anxiety disorders (AD), schizophrenic spectrum disorders (SS) or a primary diagnosis of personality disorders (PD), based on DSM-5 criteria. Patients were consecutively recruited from the Department of Psychiatry at Luigi Sacco University Hospital, in Milan. The patient’s adherence to treatment was evaluated using the Clinician Rating Scale (CRS), with a cut-off of ≥ 5 defining adherence subgroups (A+: score ≥ 5; A-: score < 5). Comparative and predictive analysis were performed for the whole sample and the two adherence subgroups.

Overall, nearly one-third of the whole sample reported suboptimal medication adherence. Specifically, rates were approximately 35.3% and 32.7% for BD and SS, respectively, followed by 30.8% for PD, 28% for AD and, 20.3% for UD (see Figure 1). Patients with A- showed significantly higher current substance abuse (17.8% vs 4.5%, p<.001), along with a higher rate of lifetime substance abuse, although with a trend towards significance (31.5% vs 20.5%; p=.057). Moreover, the A- group had a significantly higher number of lifetime hospitalizations (1.35 ± 1.8 vs 0.73 ± 1.11; p<.001) and higher rate of previous psychotropic treatment dropouts compared to the A+ group (90% vs. 36.2%; p<.001, see Figure 2).

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Approximately one-third of the whole sample reported a suboptimal medication adherence, with varying rates across different diagnoses. Current and lifetime substance abuse appears to be an unfavorable transdiagnostic factor. Additionally, severe outcomes such as increased hospitalizations and a more acute disease presentation are linked to poorer adherence. Recognizing the characteristics of adherence patterns within specific diagnostic categories is crucial for designing precise interventions to enhance patient outcomes and optimize the overall effectiveness of treatment.

N. Girone: None Declared, B. Benatti Speakers bureau of: Angelini, Lundbeck, Janssen, Rovi., M. Cocchi: None Declared, F. Achilli: None Declared, C. Viganò: None Declared, M. Vismara: None Declared, B. Dell’Osso Grant / Research support from: Angelini, Lundbeck, Janssen, Pfizer, Otzuka, Neuraxpharm, and Livanova, Speakers bureau of: Angelini, Lundbeck, Janssen, Pfizer, Otzuka, Neuraxpharm, and Livanova

There are numerous organic causes that can be related to affective symptoms such as neurological, metabolic, infectious and pharmacological. Neurological conditions associated to affective symptoms include vascular lesions, tumors, infections, seizures and dementia. Within cognitive impairment conditions, depressive symptoms are more frequent in vascular dementia and Alzheimer disease, and behavioral or manic symptoms in frontotemporal dementia although we cannot rule out less common associations.

To review about organic mania due to dementia

We carry out a literature review about organic mania accompanied by a clinical description of one patient with manic symptoms and cognitive impairment.

A 80-year-old male was admitted to the short-term hospitalization unit from the emergency department due to maniform symptoms. He had believed for weeks that he was millionaire and capable to cure all the diseases in the world, reason for which he had given away many of his belongings and had tried to register the patent for his invent. He also had future plans to invest all the money he earned from the patent in the construction of roads in Latin America. He had not previous history of mental illness. Neurological study concluded a diagnosis of Alzheimer disease. It was treated as a manic episode with a mood stabilizer and antipsychotic, with partial resolution of the condition.

It is common to find depressive symptoms in cognitive disorders. Although manic symptoms are much more frequent in frontotemporal dementia or other organic disorders, we can also find them in patients with Alzheimer disease. Since there is no specific curative treatment for this disease, concomitant psychopharmacological treatment is recommended if manic symptoms appear.

None Declared

Medical students have been shown to experience mental health problems more frequently compared to their non-medical student peers. This can manifest in pathological levels of stress and depression, and can lead to substance abuse, reduced academic performance, or even suicide.

A credit course on professional socialization is offered for medical students at the University of Debrecen in the form of peer education. Our goal was to evaluate experiences of this course delivered in the past 5 academic years.

After reviewing the relevant literature, the structure of a focus group interview was developed. The focus group consisted of 8 participants and was moderated by the course supervisor with the help of an assistant moderator. The group summarized the number of students completing the course, and narratives of teaching experiences between 2018/19 and 2022/23. They also revised relevant versions of the tutors’ handbook containing the topics and methodology of the course. The duration of the interview was 90 minutes, and it was tape recorded by the assistant moderator, who also made notes in case the tape is inaudible.

Between 2018/19 and 2022/23 61 students finished the course with the help of 23 tutors. The course is offered for students of general medicine, dentistry and pharmacy to improve their positive professional attitudes and social skills through group work and practical exercises. The medical curriculum includes mandatory courses with practical opportunities for developing professional and social skills, but due to the limited number of contact hours and the varying levels of student interest and motivation, these skills are difficult to master. The credit course was developed using the concept of Bálint groups, offering peer-supervised opportunities for motivated students above year 2 to practice their professional skills in controlled conditions while also receiving feedback from their peer group leaders. The course complements the traditional medical curriculum and sensitizes students in a protected environment in which they can observe their own communication more consciously and recognize unfavourable behaviour patterns. Developing the ability to work in a team, learning to listen, and practicing assertiveness during study years can also reduce performance-related stress and future medical errors along with increasing job satisfaction and patient adherence.

Based on the narrative summary of the focus group, both the experiences of participating students and peer teachers are positive, the handbook is a useful tool. The structured focus group provides a suitable method to evaluate the credit course which should be held once every academic year to evaluate the implemented course and explore options to improve future courses.

None Declared

Beckwith-Wiedemann syndrome (BWS) is a rare and complex congenital disorder characterized by a spectrum of symptoms and somatic findings. The prevalence of classic BWS is 1:26,000 births in Europe, and is equal in both sexes. The causes of the disorder are complex and are related to alterations in the expression of one or more genes in the region of chromosome 11. The heterogeneity of the clinical picture results in a spectrum of clinical features, the most common of which include: excessive growth of one side or certain parts of the body, macroglossia, abdominal wall deficits such as umbilical hernia, hypoglycemia, enlarged abdominal organs and an increased risk of developing certain types of tumors in adulthood.

The aim of this article is to highlight the importance of an early multidisciplinary approach in the management of children and adolescents with BWS.

Using clinical practice and a review of the existing limited literature, we examined the complexity of the disease and the importance of psychiatric, psychotherapeutic, and psychological interventions in the treatment of children and adolescents with rare diseases such as BWS.

According to our clinical practice, a number of uncertain physical symptoms and possible complications may in some children with BWS lead to psychomotor retardation and lack of self-confidence due to the often impaired physical appearance. Affected children and adolescents are more likely to be exposed to abuse at school, show more behavioral and learning difficulties, difficulties in social adjustment, and resultant emotional difficulties. After initial genetic and pediatric treatment and subsequent regular monitoring, it is necessary to pay additional attention to the development of psychological sequelae in order to involve them and their families in psychotherapeutic treatment, and intervene in a timely manner so that they can achieve or maintain psychological stability and functionality. Many adolescent patients with BWS do not have significant somatic difficulties that would require pediatric intervention, but often present with symptoms of mental illness.

Psychological stress in children and adolescents suffering from rare somatic diseases represents a negative experience of an emotional and social nature, which affects the course of the disease and interferes with the treatment. Due to a number of possible physical manifestations and outcomes of such diseases, extensive psychological support and care by child and adolescent psychiatrists and the entire medical team is required. A multidisciplinary approach is crucial in the treatment of these patients and results in improved functionality and quality of life.

None Declared

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

The Department of Social Rights of the Generalitat de Catalunya considered using a unique tool to identify people with complex social needs at Social Services centres and to support the diagnosis processes. After conducting a thorough search and selection process for various tools, the self-sufficiency matrix (SSM), a Dutch tool, was ultimately chosen.

The tool was adapted to the Catalan context through a transcultural translation process, which included a pilot and validation process. This resulted in the creation of the Catalan matrix (SSM-CAT).

A comprehensive implementation program was defined to start the adoption of the tool at basic social services. This program included training trainers and providing online training with practical cases. The implementation process was accompanied by support and monitoring to ensure success.

Through this process, over 3,468 professionals (including 334 trainers) received training on the self-sufficiency matrix, and 31,354 individuals who received basic social services in Catalonia were evaluated. In Barcelona, a more thorough monitoring of the implementation was conducted, assessing a representative sample of the care provided (6,916 individuals attended) generating a more accurate description of the situation of the people attended by social services in the city of Barcelona.

None Declared