Internet Addiction Disorder, a concept introduced for the first time by Ivan Goldberg in 1995, is one of the most recently identified forms of addiction, but already considered a real psychosocial phenomenon, capable of having a profound impact on different aspects of social and psychological life of individuals. One of its most recently identified manifestations is Nomophobia, a neologism formed from the combination of terms such as “no mobile”, “phone” and “phobia”, which can be understood as the fear of feeling disconnected. It is today considered a situational phobia, characteristic of contemporary times. The most common symptoms include excessive cell phone use and constant anxiety at the thought of losing the internet connection. Others are, for example, “Ringxiety”, ringing anxiety, or the “phantom vibration syndrome”.

This study aims to examine the spread of Nomophobia in the Italian population, evaluating psychopathological correlations that can explain its diffusion.

Between January and May 2023, an anonymous online questionnaire was randomly sent to the general population. Alongside with tests to evaluate psycho-social features, the instrument used to study Nomophobia was the Nomophobia Questionnaire (NMP-Q) (Yildrim et al. Comput Hum Behav. 2015; 49:130–7), in its Italian version (Adawi et al. JMIR MHealth UHealth. 2018;6:e24).

The sample consists of 308 people (189 F, 119 M), with an average age of 32 years (sd 14). In our sample, 100% of the subjects tested positive for Nomophobia. Values indicating a state of severe Nomophobia are found in 12.3% of the sample (F 15.9%, M 6.7%). The young population, between 18 and 25 years old, represents 54% of the affected population, but more than 60% of severe cases (95% confidence interval 50-65%). The severe cases correlate positively (p<0,05) with findings of high impulsiveness. There are no other studies that investigate the psychopathological correlates of Nomophobia among Italians.

Despite possible biases, the data obtained are an alarming sign of the spread of internet addiction that characterizes our times, of which the excessive use of cell phones in the form of Nomophobia is an expression. Despite their now undisputed usefulness, mobile devices are capable of causing the onset of serious health problems, starting from exposure to radiation capable of causing dermatitis, tumors, and infertility. Furthermore, they dramatically interfere with driving safety, becoming a major cause of road accidents. Considering these consequences, it appears to be extremely important to characterize the phenomenon, as well as its psychosocial determinants, in order to proceed with its better definition and prevention.

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Intimate partner violence (IPV) is a major source of perceived stress for the women who suffer from it. To cope, they tend to implement multiple coping strategies depending on a number of contextual factors including, among others, the severity and frequency of abuse, the duration of the relationship, and available resources such as social support and financial resources.

To study the coping strategies used by women who are victims of IPV.

To study the factors associated with coping strategies among these women.

We conducted a descriptive and analytical cross-sectional observational study, carried out over a 10-month period from March 2021 to December 2021, among female victims of IPV consulting psychiatric emergencies at UHC Hedi Chaker, Sfax, Tunisia for medical expertise at the request of the court.

The Brief-COPE is a 28-item self-assessment questionnaire designed to measure coping with a stressful life event. It can be divided into 3 subscales: problem-focused, avoidance-focused, and emotion-focused.

The total number of participants was 120 with an average age of 37.27 years. The majority had secondary education or less (62.5%), were professionally active (53.3%), and were financially dependent on their partners (26.7%). As for the women’s clinical characteristics, 19.2% were under psychiatric care and 15% had attempted suicide (SA). Almost all the women surveyed (99.2%) had reported at least one previous incident of IPV. These incidents were daily in 60.5% of cases. Emotional violence was severe in 75.8% of women.

The emotion-focused strategy was the most widely used, with a mean score (29.68) on the Brief cope scale. It was correlated with the absence of a personal psychiatric history (p=0.02), the absence of SA (p=0.036), and the occasional frequency of IPV (p=0.037). The scores for problem-focused coping and avoidance-focused coping are 19.3 and 17.24 respectively. Avoidance-focused coping was negatively correlated with the presence of severe emotional abuse.

The most used strategy by our population was the emotion-focused strategy, with a relatively high average score compared to the other strategies. Indeed, it may be an extremely effective strategy for recovering from a traumatic event, through actions designed to help these women manage and relieve their psychological distress and reduce its negative impact.

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Supervision is an essentail tool in medical training and especially in psychiatry and psychotherapy. It emcopasses two distinct aspects namely: coaching in the workplace aimed at developping competences (pyramid of Miller) and on the other side a safe place to reflect on ones personal development as a professional. This mentoring should be distinguised from the personal training psychotherapy. The mentoring supervisor will take the doctor’s pledge as a starting point of professional development. But will also encourage the resident to become aware of elements of transference and counter transference in his/her clinical work, helping to foster empathy “maximal understanding with respect for professional distance. This, not only for the benefit of the patient and his/her security, but also in order to take care of one’s own health and developing a sound balance between work and private life.

Too often supervision is taken for granted once the resident has become a consultant. Along with examples of the techniques and the pitfalls of supervison, the presenters will plea for training and intervision as part of the development of the supervisor!

Raise awareness for the competences needed to become a valuable supervisor and the place supervision in its two aspects (coaching and place of reflection) should take in the training of medical doctors and especially psychiatrists

• - an inventory of the place of supervision in training in psychiatry throughout Europe

• - looking into competences needed in order to develop a sound professional attitude

• - looking into the competencies needed to become a valuable supervisor

• - supervision is differently defined and given in training in psychiatry throughout Europe

• - the competences needed in order to develop a sound professional attitude are defined in the Doctor’s Pledge (World Medical Association 2017) but should be refined according to the specialty with special attention to aspects of psychiatry alien to other specialities

• - along with Teaching the Teachers - special trainings are available to become a supervisor

Supervision is an essential tool in medical/psychiatric training, but it needs to be taken seriously in terms of developing the competences needed but also maintaining them in intervision with the colleagues of the training staff

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Haematological alterations, especially in the red blood cell series, are a rare adverse effect of olanzapine treatment. A 64-year-old female patient with a diagnosis of long-standing schizophrenia was admitted to the psychiatric room for psychotic decompensation and leukopenia in control laboratory tests. She had a history of mild psoriasis, allergy to sulphonamides and infectious bursitis nine years earlier secondary to neutropenia due to clozapine. On previous admission, episodes of anaemia and neutropenia related to increased doses of olanzapine were observed. On current admission, a new episode of anaemia and neutropenia occurred with doses of up to 20 mg/day of olanzapine, hemoglobin levels of 63g/L ann neutrophil count of 0,8*10^9 neutrophils/l were detected.

Report a very rare but serious adverse effect in patients treated with olanzapine.

Haematological analysis were periodically carried out from 2009 to 2023.

A complete study was carried out with parameters of haemolysis, autoimmunity, a pharmacogenetic study and a myelogram.

The autoimmunity and haemolysis study excluded an autoimmune or haematological illness that could justify the haematological alterations.

The myelogram showed normal cellularity.

The pharmacogenetic study showed no relevant alterations.

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The case was classified as a non-immune haemolytic anaemia secondary to olanzapine and improved with withdrawal of the drug.

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Depressions are the most common mental disorders in elderly and senile patients. In these patients, there is a decrease in neurotrophic potential. Treatment of such patients with antidepressants alone does not always allow to achieve complete normalization of the secretion of neurotrophic factors and complete restoration of neurogenesis processes. In this regard, it is important to expand therapeutic opportunities to develop new therapeutic strategies for pharmacotherapy of late-age depression.

Comparative evaluation of the effectiveness of two types of complex antidepressant therapy with the inclusion of different neuroprotectors (actovegin or cerebrolysin) in the treatment of late-life depression in the therapeutic regimen.

The study included 2 groups of patients with mild and moderate depressive episode (DE), comparable in basic demographic and clinical parameters.

The 1st group included 21 people, including 7 men (33.3%) and 14 women (66.7%), median age were 69 years [66; 76]. In 10 patients (47.6%), DE was diagnosed as part of recurrent depressive disorder (DDR), in 9 patients (42.9%) - as part of bipolar affective disorder (BAR), and in 2 patients (9.5%) is a single DE. Group 2 included 20 patients, 5 of them men (25%) and 15 women (75%), median age were 64 years [62; 70]. In 11 patients (55%), DE was diagnosed as part of DDR, in 6 patients (30%) - as part of BAR, and in 3 patients (15%) – single DE.

The 1st group of patients received complex antidepressant therapy with the inclusion of actovegin for one month, the 2nd group - with the inclusion of cerebrolysin. The effectiveness of the therapy was assessed on the HAMD-17 and HARS scales.

A comparative study demonstrated the effectiveness of both types of complex antidepressant therapy used.

A comparative assessment of the effectiveness of the therapeutic response in two groups of patients showed no statistically significant differences in the reduction of depressive disorders after 2 weeks of therapy. Only by the end of the therapeutic course there was a more pronounced reduction of depressive disorders in the 1st therapeutic group (73.6% vs 63.6% (p < 0.05)).

Reduction of anxiety disorders, assessed on the HARS scale, was noted both by the 14th and 28th day of therapy in both therapeutic groups. However, it turned out to be more pronounced in the 1st therapeutic group: by the 14th day of therapy, the reduction of anxiety in the 1st and 2nd groups of patients was 36.4% and 30.0%, respectively (p < 0.05), and by the end of therapy - 77.7% and 60.0%, respectively (p < 0.01).

The augmentation of antidepressant therapy with drugs with multimodal activity, actovegin and cerebrolysin, should be considered as effective and it can be recommended for inclusion in the therapeutic regimen for the treatment of late-age depression in a psychiatric hospital.

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The recent wildfires in Canada provide a clear illustration of the significant and lasting damage they inflict on the well-being of individuals and communities. Evaluating the occurrence and factors associated with post-traumatic stress disorder (PTSD) and low resilience is valuable for policymakers in public health.

The study aimed to assess the prevalence and predictors of low resilience and likely PTSD among subscribers of Text4Hope, an e-mental health program that delivered daily supportive messages to residents of Nova Scotia (NS) and Alberta (AB) during the recent wildfires.

Data collection was through a self-administered online survey completed by residents of the affected regions of NS and AB from May 14 to June 23, 2023. Data were analyzed using Statistical Package for the Social Sciences.

Out of 298 respondents, the prevalence of low resilience and likely PTSD in our sample were 52.0% and 39.3% respectively. Unemployed respondents were about 3 times more likely to experience both low resilience and PTSD symptoms compared to those employed. Respondents with a history of mental health diagnosis were about 4 times more likely to experience likely PTSD compared to those with no history of mental health diagnosis.

This research demonstrated that the likelihood of PTSD was predicted by both unemployment and a history of mental health diagnosis, with unemployment also being linked to low resilience during the wildfire. These results provide valuable insights for designing clinical interventions and developing psychosocial support programs tailored for vulnerable populations.

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Efforts are critically needed to increase the armamentarium of options that clinicians can use to treat patients with alcohol use disorder (AUD). Numerous preclinical studies support the hypothesis that mineralocorticoid receptor (MR) pharmacological antagonism may represent a novel and promising treatment for AUD. Namely, the non-selective MR antagonist spironolactone dose-dependently decreased 1) the intake of alcohol in mice in a model of alcohol binge drinking procedure and 2) alcohol self-administration in dependent and non-dependent rats (Farokhnia, Rentsch, Choung et al., Mol Psychiatry 2022; 27(11):4642-4652). Furthermore, two U.S.-based independent human pharmacoepidemiologic studies utilizing electronic health records data showed that patients treated with spironolactone for any indication reduced their weekly alcohol use in a primary care-type medical setting (Palzes et al., Neuropsychopharmacology 2021; 46(12):2140-2147) and Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) score in a Veterans Affairs medical setting (Farokhnia, Rentsch, Choung et al., 2022; 27(11):4642-4652). In both studies, spironolactone-treated patients were compared to matched ones without spironolactone prescription using propensity score matching.

We are conducting a Phase 1b human study to assess the pharmacokinetics and pharmacodynamics of spironolactone-alcohol co-administration and testing the safety and tolerability of spironolactone, alone and combined with alcohol in individuals with AUD.

Spironolactone in Alcohol Use Disorder (SAUD) is a double-blind, placebo-controlled, randomized, within-subject, ascending dose study with spironolactone (0, 100, 200, 400 mg/day) PO for 5 days to reach steady-state, followed by oral fixed-dose alcohol administration aimed at reaching a blood alcohol level of approximately 0.08 %. Our sample consists of 12 adults diagnosed with AUD.

The primary endpoint is to measure spironolactone and alcohol PK during concomitant administration. Our secondary endpoints are 1) assessment of subjective and cognitive effects of acute alcohol administration during concomitant spironolactone treatment; 2) number and severity of adverse events (AEs) experienced, compared between placebo (0 mg/day) and all three spironolactone doses; 3) PK characteristic of spironolactone active metabolites, canrenone, 7-α-thiomethylspirolactone (TMS) and 6β-hydroxy-7α-thiomethylspirolactone (HTMS), before and after administration of alcohol. Recruitment is underway.

The above-mentioned preclinical and clinical evidence suggest that spironolactone may be repurposed for the treatment of AUD. Our Phase 1b study is a key step before moving to larger efficacy trials.

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Autism Spectrum Disorder (ASD) is considered a neurodevelopmental disorder characterized by changes in cognitive aspects that influence the process of social communication development in these individuals. The Speech-Language Pathologist is the professional qualified to evaluate and intervene in cases of language impairment, however, there are few accessible cognitive assessment instruments. The Cognitive Speech Therapy Protocol (PROFOCO) is a questionnaire to assess cognitive aspects directed to children with a clinical diagnosis of Autism Spectrum Disorder (ASD).

The present study aims to present the construction phases of the Cognitive Speech Therapy Protocol aimed at Autistic Spectrum Disorders (PROFOCO-ASD), with emphasis on the panel of experts.

The Cognitive Speech Therapy Protocol was prepared as a PhD thesis in the area of Rehabilitation Sciences at the Faculty of Medicine of the University of São Paulo (FMUSP). This is a questionnaire to investigate cognitive aspects aimed at children between 2 and 12 years old, diagnosed with Autism Spectrum Disorder, to be applied by a speech therapist and answered by parents or guardians. The construction of the protocol took place in 4 stages: experience of the authors, review of updated literature, a pre-test applied in person to 10 parents and guardians of children with ASD and the panel of experts where the protocol was analyzed by 3 specialists from area of speech therapy linked to USP AND UNIFESP, with experience in language and in the construction of protocols as criteria for selection, which analyzed the content of the questions, the vocabulary, the structure of the protocol and the answer

The authors’ experience in the construction process made it possible to observe the need to introduce issues involving the adequate state of brain regulation, conditions for reception, analysis and storage of information and conditions for programming, regulation and execution of activities. The updated bibliographic review made it possible to elaborate each question based on scientific evidence. The pre-test made it possible to analyze the understanding of the proposed questions, the vocabulary used and the time required for application. The expert panel provided an analysis of the content and vocabulary, leading to relevant changes in its general context, demonstrating the importance of the expert panel phase in the development of a reference protocol.

The present study demonstrates the importance of the expert panel phase in structuring a screening instrument, since a different perspective from people involved in the language area can give more clarity to the questions, as well as the vocabulary used, ease of A protocol capable of being understood by a population in different contexts, its vision also evolves, in different regions.

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Individuals who suffer from substance use disorder (SUD) are at increased risk of Hepatitis C (HCV). Mount Carmel Hospital (MCH) is the only public service in-patient mental health care facility on the island of Malta. Individuals with SUD are referred to MCH for support with comorbid mental health conditions.

To assess whether current practice meets the UK Clinical Guidelines on Drug Misuse and Dependence (2017) recommendations- yearly screening for HCV, further testing and referral to infectious disease specialists for those who screen positive for HCV. To compare current practice at MCH, Malta with other countries in the European Union and United Kingdom.

Retrospective analysis of HCV screening, investigation and referral practices as recorded on iSoft Clinical Manager records for SUD-related admissions to MCH under the care of addiction specialists in 2022 (n=120). Admissions data were provided by the data protection office, with permission from the Chairman of the Department of Psychiatry, and de-identified at source to safeguard patient confidentiality.

60% (n=72) of the SUD inpatient population underwent screening for HCV according to guideline recommendations. 37% (n=44) of this cohort has received a positive HCV antibody result. 32 persons had HCV RNA load records, 34% (n=11) of whom had a detectable viral load. 50% (n=17) of those who screened positive for HCV were offered an appointment with an infectious disease specialist within the year, 7 attended. The table below compares HCV status between our group and published data for the UK, Austria and Greece. Despite heterogeneity in study designs and populations (we describe an inpatient cohort with diagnosed SUD, not all of whom inject drugs) comparable proportions have undergone HCV screening in the preceding twelve months and similar proportions have chronic HCV infection.

Most SUD inpatients at MCH undergo HCV screening according to guideline recommendations but current practice falls short of ideal coverage and follow-up care. Current screening practices and chronic HCV infection rates at MCH are comparable to other countries in the EU and UK.

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Parasitosis delirium represents a rare mono-symptomatic psychosis characterized by the delirious firm belief of the patient, against all evidence, of being infested by cutaneous parasites. The syndrome affects in particular middle-aged women, and can be the single manifestation of psychological uneasiness or represent one of the aspects of a more complex psychiatric case, compromising almost totally any normal daily work and/or social activity. It is often accompanied by a refusal to seek psychiatric care. This condition can be associated with various underlying causes, including substance use disorders and psychotic depression. Understanding the differences and similarities between delirium of infestation in the context of cocaine use and psychotic depression is crucial for accurate diagnosis and effective treatment.

This study aims to compare and contrast the clinical features, etiology, and treatment approaches of delirium of infestation in individuals with cocaine use and those with psychotic depression. By examining these two distinct populations, we can gain insights into the unique challenges and considerations associated with each condition.

A case report of a 44-year-old woman with delirium of parasitosis, depressive symptoms and cocaine use in the last three days. Also a comprehensive literature review using the PubMed database to identify relevant clinical articles on delirium of infestation, cocaine use, and psychotic depression.

Cocaine use and psychotic depression can both cause delirium of infestation. Cocaine-induced delirium is characterized by agitation, paranoia, and delusions of infestation. Psychotic depression is characterized by a depressed mood, delusions, and hallucinations. Delusions of infestation are a common feature of bothconditions. However, the underlying mechanisms and treatment approaches differ. Cocaine-induced delirium is primarily associated with the acute effects of cocaine on the central nervous system, while psychotic depression involves a complex interplay of biological, psychological, and environmental factors. Treatment for cocaine-induced delirium involves addressing the underlying cocaine use, while treatment for psychotic depression involves antidepressant and antipsychotic medications. Otherwise, Anti-Parkinson drugs were most frequently associated with delusional infestation

Delirium of infestation can occur in individuals with cocaine use and those with psychotic depression, albeit with different etiologies. Clinicians should consider the underlying cause when diagnosing and treating patients with this condition. Further research is needed to explore the specific neurobiological mechanisms and optimal treatment strategies for delirium of infestation in these distinct populations.

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Addiction to video games, cybersex, internet gambling, social media, texting and emailing, and online auctions can be as addictive as substances. These technological addictions have real-world ramifications and lead to the loss of jobs, money, and loved ones. As technology becomes integrated into many facets of modern life, the appreciation of such addictions has become increasingly challenging. This session will explore the addictive potential of technology and discuss the legitimacy of technological addictions as psychiatric conditions worthy of medical assessment, diagnosis, and treatment.

1. 1. List five forms of Technological Addictions as they appear in the scientific literature of 2023.

2. 2. Describe the psychology and culture surrounding Internet Gaming addiction.

3. 3. Distinguish between normal use and addiction.

Lecture and discussion

1. 1. Research on the phenomenology and nosology of these illnesses helps us further elucidate the distinction between problematic and nonproblematic use of technology, especially in children and young adults.

2. 2. Another area of new research involves emerging technologies. By the time clinicians get a firmer grasp of today’s ailments, the technology of tomorrow—such as virtual reality and smart devices powered by artificial intelligence—will be commonplace enough to bring about a host of new problems.

Though data on the prevalence of technological addictions are sparse, most people use computers, tablets, and smartphones regularly with great benefits and no serious adverse consequences. We will need to be ready to guide our patients, our colleagues, and the general public on how to best handle technology with an eye on maximizing its enormous potential for fulfillment, gratification, and happiness while minimizing its significant risks for dissatisfaction, misery, and despair.

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We have previously found significant alterations in activities of glutathione dependent enzymes in blood cells of patients with late-life depression (LLD) compared with age-matched controls.

The revealing subgroups of LLD patients by glutathione-metabolism enzymes’ activities in blood cells using cluster analysis.

LLD patients (n=101) of 60-86 age (69 patients with recurrent depression (RD), 23 with bipolar disorder (BD) and 9 patients with a single depressive episode (DE)) were assessed by Hamilton depression rating scale (HAMD-17), and Hamilton Anxiety Rating Scale (HARS). Activity levels of glutathione reductase (GR) and glutathione S-transferase (GST) were determined in patients’ platelets (-pl) and erythrocytes (-er). The control group consisted of 51 peoples 55-84 years old without mental pathology. Cluster analysis module of the STATISTICA software was used for clustering the patients by baseline blood parameters.

Three clusters of patients were obtained: C1, n=39, C2, n=31, C3, n=31, differing significantly in all biochemical parameters (Kruskal-Wallis test, p<0.001), except GST. When compared with control group by Mann-Whitney test, GST-pl, GST-er, and GR-er were significantly decreased in C1; GST-er was significantly increased in C2; GST-pl, GR-pl, and GR-er were significantly decreased in C3. Several significant correlations were found between the measured parameters and scores by HDRS or HAMD-17. In C1, baseline activity of GST-er correlated with total scores by HAMD-17 (R=0.335, p=0.043) after treatment. In C2, baseline activity of GR-er correlated with total scores by HARS (R=-0.376, p=0,037) after treatment and GR-pl correlated with delta scores by HAMD-17 under the treatment (R=0.484, p=0.006). No significant correlations were found in C3. Patients with BD distributed significantly unevenly between C1, C2, and C3, with significantly more BD patients clustering in C1 (61%) compared with C2 and C3 (Yetes-corrected Chi-square =7.73, p=0.0054), whereas patients with RD and DE distributed evenly.

Patterns of activity levels for glutathione-dependent enzymes in patients with BD differ from those in patients with RD and DE. Significant correlations of the measured biochemical parameters with scores by HDRS or HAMD-17 assessed after the treatment and evidenced for the treatment efficacy seem to be promising biomarkers for further evaluation of the treatment efficacy in heterogeneous group of LLD patients using the proposed approach to their stratification into subgroups.

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Postpartum insomnia is a significant and often overlooked mental health concern affecting mothers during the postnatal period. Sleep disturbances during this critical time can have far-reaching implications for maternal well-being and the quality of care provided to newborns.

The primary objective of this review is to analyze recent clinical literature on postpartum insomnia to gain a deeper understanding of its epidemiology, clinical features, and management approaches. By synthesizing the latest research findings, this review aims to inform healthcare professionals and policymakers about the significance of postpartum insomnia and promote early recognition and intervention.

A case report of a 43-year-old woman in the fifth month postpartum after a twin birth who comes to the emergency department accompanied by her partner with thoughts of death and impulse phobias due to insomnia of months of evolution. Also a systematic search of the PubMed database was conducted using the keyword “Postpartum insomnia,” and articles published between 2013 and 2023 were included. A total of 20 clinical articles meeting the inclusion criteria were analyzed to provide a comprehensive overview of postpartum insomnia.

The review reveals that postpartum insomnia is a prevalent and often underdiagnosed condition, affecting a significant proportion of new mothers. Risk factors such as maternal age, parity, social support, and hormonal fluctuations have been identified. Diagnostic challenges arise due to the overlap of symptoms with postpartum mood disorders, necessitating a comprehensive clinical assessment. Recent research emphasizes the importance of non-pharmacological interventions, including sleep hygiene education, cognitive-behavioral therapy for insomnia (CBT-I), and mindfulness-based approaches, as the first-line treatment options. However, pharmacotherapy may be considered in severe cases. Untreated postpartum insomnia has been associated with adverse maternal and infant outcomes, including impaired bonding, increased risk of postpartum depression, and developmental delays in infants.

In conclusion, postpartum insomnia is a prevalent yet often underrecognized mental health concern with multifaceted clinical implications. This review highlights the importance of early detection and intervention to mitigate its impact on maternal well-being and infant development. The integration of non-pharmacological interventions, particularly CBT-I and mindfulness-based strategies, into routine postpartum care holds promise in improving sleep quality and overall postnatal mental health. Healthcare providers should be vigilant in assessing and addressing postpartum insomnia to optimize the well-being of both mothers and infants

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tardive dysphoria is a relatively new term used to describe the phenomenon of clinical worsening of depression after long-term antidepressant use. Most of the theories proposed to explain this talk about antidepressants tachyphylaxis that implies the loss of efficacy with its prolonged use, or even a pro-depressant effect of antidepressants when used for long periods of time.

to explore the concept of tardive dysphoria, potential causes and clinical implications, by making a literature review on the topic. Moreover we pretend to understand the challenges in its diagnosis and treatment.

bibliographical search in PubMed database, using the key-words “long-term antidepressant”, “tardive dysphoria” and “antidepressant tachyphylaxis”, limited to works published in the last twenty years.

from our search resulted 53 articles, 26 were chosen for further analysis.

the concept of tardive dysphoria is controversial, namely doubt persists if it constitutes a clinical entity by itself caused by long-term antidepressant use or if it simply relates to cases of treatment-resistant depression. We conclude that it is necessary further investigation in this area given the significant implications on clinical practice specifically in the psychopharmacological treatment with antidepressants, which is very common in psychiatric and general practices, with antidepressants being used to treat many mental health conditions.

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Non-adherence to treatment is a major concern for mental health professionals. Knowledge of prescribed medications can influence patients’ willingness to adhere to them.

The aim of this study was to assess the knowledge of patients with mental disorders about their prescribed medication and to evaluate their attitudes and beliefs toward treatment.

Our quantitative descriptive study involved 52 patients hospitalized in the psychiatric “C” department of the Hedi Chaker University Hospital in Sax between the 23rd and 30 October 2023. Excluded were aggressive patients, those who were unable to communicate, and those who refused to participate. Thirty-nine patients were included. For each patient, we collected sociodemographic, clinical, and disease progression data, as well as information, beliefs, and attitudes concerning the prescribed treatment.

The mean age of our patients was 35.49 ± 10.24 years, with an exclusively male sample. Most patients had no occupation (69.2%). Only 10.3% were married. Over half of the patients had achieved primary school (61.5%) and lived in rural areas (64.1%). The mean duration of the mental disorder was 10.69 ± 9.07 years. Patients were hospitalized 3.62 times on average. The most frequent diagnoses were schizophrenia (35.9%) and bipolar disorder (33.3%). More than half of the patients (61.5%) knew the color and shape of the prescribed medication, and 48.2% knew the name and dose.

The source of treatment information was mainly doctors (33.3%) and family members (15.4%). Adherence to treatment was poor in 69.2% of cases. The majority of patients denied stopping treatment and 12.8% reported that they stopped treatment because of financial difficulties. Twenty-four patients confirmed that taking the treatment made people see them differently and that they preferred not to reveal they were taking it. Two-thirds of patients reported that the treatment relaxed them (71.8%) but could be stopped when they felt better (69.2%).

It is essential for mental health professionals to develop and implement effective intervention strategies that maximize therapeutic impact and reduce the risk of relapse.

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The literature indicates that parental reflective functioning (PRF) is crucial to a good parent-child relationship. Furthermore, genuine parental mentalizing also promotes adaptive emotion regulation in attachment relationships. However, no prior study assessed the relationship between parental mentalizing, emotion regulation and object relation in the early years.

We examined the relationship between PRF, cognitive emotion regulation and perception of the infant among parents of children up to five years old.

In our cross-sectional, non-clinical study, 136 parents completed the Parental Reflective Functioning Questionnaire, the Cognitive Emotion Regulation Questionnaire and the Mother’s Object Relationship Scale - short form. In our 12 moderator models, we chose the subscales of the parental perception of the infant (invasiveness and warmth) as dependent variables, the subscales of adaptive and non-adaptive strategies of cognitive emotion regulation as independent variables, and the three subscales of PRF (pre-mentalization, interest and curiosity, certainty about mental states) as moderators.

Warmth had a positive, weak correlation with adaptive strategies (r(134) = 0.27, p < 0.007), with certainty in mental states (r(134) = 0.24, p < 0.007) and interest and curiosity (r(134) = 0.23, p < 0.007); the correlation between interest and curiosity and non-adaptive strategies was moderate and positive (r(134) = 0.32, p < 0.007). None of the subscales of PRF moderated the relationship between the subscales of emotion regulation and the perception of the infant. The use of adaptive emotion regulation strategies was more likely to affect the perception of warmth (B = 0.05 (t = 2.0584, p = 0.0415), B = 0.04 (t = 1.7887, p = 0.0760)), and the use of non-adaptive strategies was more likely to affect the perception of invasiveness (B = 0.08 (t = 2.1333, p = 0.0348), B = 0.09 (t = 2.3164, p = 0,0221).

Our results suggest that cognitive emotion regulation plays a role in object relation; therefore, we recommend promoting adaptive cognitive emotion regulation strategies among mothers in the early years.

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Insecure attachment is considered a general risk factor for eating disorders (ED). Emotion dysregulation has been proposed as one of the possible mechanisms by which attachment insecurity may affect ED psychopathology.

Aim of the present study was to investigate whether difficulties in acceptance of emotions or emotional clarity may mediate the connection between insecure attachment and ED psychopathology.

One hundred and twenty patients participated and completed the Italian version of Eating Disorder Inventory‐2 (EDI-2), Experience in Close Relationship questionnaire (ECR) and Difficulties in Emotion Regulation Scale (DERS). A mediator path model was performed, in which insecure attachment dimensions were set as independent variables, ED specific psychopathology measures as dependent variables, and non‐acceptance of emotion and lack of emotional clarity as mediators.

The association between both attachment avoidance and anxiety and ED specific symptoms was mediated by emotional non‐acceptance, but not by emotional clarity.

This study showed the importance to address emotion regulation in individuals with ED, focussing on improving emotional acceptance. Exploring early developmental processes which lead to non‐acceptance of emotions could improve this psychological trait in people with ED.

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We are facing increased suicide attempts and deliberate self-harm from persons with borderline personality disorder (BPD) who are also on antidepressants, multiple antidepressant prescriptions and antidepressant augmentations. Our previous observations suggest that antidepressants might increase suicide attempts in those on this medication and who have BPD. The absent response to antidepressants is due mainly to the comorbid dysthymia, cyclothymia, rumination, autism and ADHD in BPD.

To generate forecasting models and preventive policies to deal with BPD crises and improve the effectiveness of the UK National Healthcare Service (NHS) in suicide prevention.

The underlying analysis framework is stochastic forecasting. We used current knowledge and data to complete systematic future predictions extracted from recent trends. A logical-mathematical model generated the required expressions. The software for logic prediction and annotation was Wolfram Alpha (Wolframalpha.com). The four parameters for stochastic predictions are, BPD (A), antidepressant No. 1 (B), antidepressant No. 2 (C), and suicide attempts (D). Boolean function metrics can help analyse the impact and truth of forecast modelling with truth density.

The logic expression for suicide prediction due to liberal antidepressant prescribing is Ψ = A intersects B, intersects C, intersects D; that is,. Ψ = A ∩ B ∩ C ∩ D, which yields a Boolean truth density of 6.25%. The truth table always has a positive outcome as long as any of the factors exist except when none is present.

The predictive Boolean function and truth table suggest that suicide presentation is predictable if there is a prescribing of one or more antidepressants in BPD and if there is an antidepressant augmentation or dose maximisation. We speculate that SSRI antidepressants block self-regulatory mechanisms of fear of death while triggering impulses to self-harm and suicide from overstimulation of SSRI receptors. Without fear mechanisms, death by suicide is felt as not terrifying.

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Impulsivity and compulsivity are natural behaviors controlled by brain mechanisms that are essential for survival in all species. Understanding these brain mechanisms may lead to targeted treatment strategies for these symptom domains when impulsivity and compulsivity become dysfunctional.

Pathological impulsivity and compulsivity characterise a broad range of mental disorders.

This study aimed to synthesise the latest evidence about the conceptualization of the impulsivity-compulsivity spectrum.

A review was conducted, drawing on reputable sources (PubMed and Web of Science databases).

The concept of impulsivity can be defined as a predisposition toward rapid, unplanned reactions to internal or external stimuli without regard to the negative consequences of these reactions to the impulsive individual or to others. However, impulsivity is not always unplanned. Impulsive behaviours can be conceptualised as the core symptoms of a broad range of psychiatric disorders.

In contrast, compulsivity refers to repetitive behaviours that are performed according to certain rules or in a stereotypical fashion. Compulsivity is a tendency to repeat the same, often purposeless acts, which are sometimes associated with undesirable consequences.

Impulsivity and compulsivity may be viewed as diametrically opposed, or alternatively, as similar, in that each implies a dysfunction of impulse control. Each involves alterations within a wide range of neural processes, including attention, perception, and coordination of motor or cognitive responses.

The neurobiology of impulsivity and compulsivity may involve inhibitory neurotransmitters, excitatory neurotransmitters, the prefrontal cortex, and/or limbic dysfunction.

Impulsive and compulsive features may present at the same time or at different times during the same illness. Although both compulsive and impulsive disorders may be related to prefrontal cortex dysfunction, compulsive disorders would be related to hyperactivity and impulsive disorders to hypoactivity of the prefrontal cortex. Compulsiveness appears to be associated with increased frontal lobe activity, while impulsiveness may be associated with reduced frontal lobe activity.

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Psychiatryai.com was launched in 2021 and initial findings were published at EPA 2023. The portal is an advanced computing science project in Applied Data Science and Evidence-Based Healthcare for my MSc studies at the University of Oxford (Kellogg College). Artificial Intelligence (AI) and Data Science (DS) technology are utilised to analyse live Real-World Evidence (RWE) in Psychiatry and Mental Health from PubMed to provide CPD/CME online. A two-year review of the site and its performance will be presented to EPA 2024.

To develop and study an experimental real-time AI and DS platform in Global Mental Health and Psychiatry, to provide the latest RWE from PubMed for online education and training, and to report findings to EPA 2024 for peer review in Budapest. AI and misinformation are newly identified risks in healthcare (AI Safety Summit 2023). The site also aims to raise awareness about “Aiatrogenesis” to address this problem, with RWE and CPD/CME utilising AI and DS technology for the categorisation and meta-analysis of evidence, rather than the production of possibly misleading or false Generative AI evidence (Monteith et al. BJP 2023; 1-3).

As reported to EPA 2023 in Paris, a free open-code WordPress site was launched on the 22nd of November 2021 (Psychiatryai.com). The portal has been further developed and now features over 90k pages comprising 7GB of data with Cloudflare security and speed. Live evidence is collected into an open database and research articles are categorised into evidence nodes with AI. The results are presented in a real-time Evidence Matrix and Blueprint, creating 15-minute CPD/CME reflection modules. Data analytics from Psychiatryai.com with Google Analytics (G4A) along with platform insights from two years of development and research will be presented to EPA 2024. The site is conceptualised and designed to be viewed in an interactive VR headset.

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Psychiatryai.com has successfully developed a novel AI and DS platform that incorporates the latest research in mental health and psychiatry, providing real-world evidence (RWE) for psychiatrists and healthcare professionals worldwide, along with CPD/CME online. This enhances hypothesis testing in research by presenting a related Evidence Matrix and Blueprint (from the last 365 days) for each evidence node on the site (RAISR 4D). These matrices provide a real-time visual table (8 x 8 / 64) of global research related to the evidence node in the preceding year. The site is VR-ready and has a special focus on AI and Psychiatry, Disaster and Traumatology Sciences, and Youth Mental Health. This project is dedicated to the memory of Dr Denis O’Leary and Dr Navin Venkatraman.

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