The prevalence of depressive symptoms and cognitive decline increases with age, reducing quality of life. However, the temporal relationship between the two remains elusive.

We aimed to explore the temporal relationship between depressive symptoms and cognitive decline in individuals aged 85 years, during up to 5 years follow-up.

Participants eligible for this study were selected from the Leiden 85-plus Study, who participated for at least 3 follow-up measurements. Depressive symptoms were assessed at baseline and at follow-up in a period of 6 yearly assessments, utilizing the 15-item Geriatric Depression Scale (GDS-15). Cognitive decline was measured through various tests including the Mini Mental State Exam (MMSE), Stroop Test, Letter Digit Coding Test, and immediate and delayed recall using the 12-word learning test. Dynamic Time Warping (DTW) analysis was employed to model their temporal dynamics, in undirected and directed analysis, to ascertain whether depressive symptoms precede cognitive decline, or vice versa.

The study included a total of 325 (54.2%) of 599 patients, of whom 68.0% were female, 45.0% with intermediate to higher education, and all aged 85 years. Depressive symptoms and cognitive functioning significantly covaried in time, and directed analyses showed that depressive symptoms preceded most of the parameters of cognitive decline in the oldest old. Of the 15 GDS symptoms, those with the strongest outstrength were worthlessness, hopelessness, low happiness, dropping activities/interests, and low satisfaction with life (all p<.01).

We found a strong temporal link between depressive symptoms and subsequent cognitive decline in a population of the oldest old. This highlights the importance of a holistic approach that considers both mental and cognitive well-being in the aging population. As depressive symptoms were an early indicator of cognitive decline, it is of importance that healthcare professionals recognize and address depressive symptoms early to allow for appropriate interventions and support, to potentially mitigate the impact on cognitive decline.

None Declared

Neurobiological studies have shown that genetic variations affecting the intensity of monoamine neurotransmission play an important role in aggressive behavior and borderline personality traits. Also, the effect of family environment has been repeatedly shown on aggressive behavior and interpersonal functioning. Population-based longitudinal studies pointed out interactions between the so-called monoaminergic sensitivity alleles and childhood adversities.

Our study aimed to analyze the associations between the most studied variable number tandem repeats of monoaminergic genes and the different psychological factors in adult patient and healthy control groups, checking for the moderating effects of the parental occupation and education, childhood abuse and trauma.

The recruited 73 patients with BPD diagnosis and 98 healthy controls were assessed by the Structured Clinical Interview for DSM-5. Participants filled out online questionnaires including the Level of Personality Functioning Scale – short version (LPFS-SR) and the Buss-Perry Aggression Questionnaire (BPQ). Childhood social environment and traumatic experiences were assessed by the Barratt Simplified Measure of Social Status and the Early Trauma Inventory or the Childhood Trauma Questionnaire. Genomic DNA samples were obtained either from peripheral blood, saliva or buccal swabs using the desalting technique. Functional dopaminergic and serotonergic polymorphisms were chosen based on previous findings, implicating them as sensitivity gene variants, e.g., the variable-number tandem-repeats of the dopamine D4 receptor, serotonin transporter and the monoamine oxidase-A (MAO-A) genes. Since the MAO-A gene is located on the X chromosome, sex-stratified analyses were also carried out.

Family environment indexed by the Barratt Simplified Measure Social Status had significant effect on anger, hostility and interpersonal functioning (p < 0.01). In the pooled sample of patients and controls, individuals carrying the high activity alleles of MAOA had elevated scores on the BPQ subscales. When analysis was limited to female participants, the genetic effect stayed significant only at the anger scale of the BPQ.

Family environment had pronounced effect on aggressive behavior and personality functioning, interaction with common monoaminergic genetic variants was detected only in women.

This study was supported by the National Research Development and Innovation Office grants NKFI K 129195 and NKFI K 135437.

None Declared

ADHD is a neurodevelopmental disorder characterised by: inattention, hyperactivity and impulsivity.Diagnosis of ADHD in adults is complex, owing to the need for retrospective evidence that symptoms began in childhood as well as the high rates of comorbid mental health conditions. There are no public specialized clinics for adults with ADHD in Ireland. In their absence, referrals are sent to general adult psychiatry.

An audit of standards of care received by patients with ADHD against those set by the NICE guidelines.

Care received pre and 8 weeks post MDT (multi-disciplinary team) educational session. Inclusion criteria: existing adult community mental health team (CMHT) patients with a diagnosis of ADHD. Recommendations as per NICE guideline used for assessment: Specialist MDT team input, OT/ Psychology input, MDT review of reports, Specialist consultant with training in diagnosis and treatment, Diagnosis based on structured assessment e.g. DIVA, Detailed psychiatric assessment, Physical health monitoring before commencing treatment (e.g. ECG), Ongoing physical health monitoring (BP, HR, weight), Patient regularly attending follow up

There were 7 patients with diagnosed ADHD attending the CMHT, 4 male, 3 female aged 19-42yo. 4 patients were diagnosed privately (average age at diagnosis 31yrs). 2 were diagnosed by CAMHS. And 1 was diagnosed by primary care psychology (age 27). 8 weeks following MDT meeting; 2 patients had been commenced on ADHD medication. Those on the wait list for OT/psychology remained on the wait list.

ADHD is a specialised area which requires a specialist MDT led by a consultant with expertise in diagnosis and treatment. As evidenced by this audit, despite the best efforts of adult psychiatric services, teams are not sufficiently resourced to meet the needs of adults with ADHD and fall short of the expected standards of care.

None Declared

Behavioral disorders are a frequent reason for consultation in child psychiatry. Children and adolescents with epilepsy are at risk of behavioral disorders that can affect their quality of life.

The aim of this study was to investigate the electroencephalographic aspects of children with behavioral disorders and to determine the prevalence of comorbidity with epilepsy.

This was a retrospective descriptive study conducted from January 2019 to May 2022. We included all children and adolescents referred to the functional explorations department at Habib Bourguiba hospital, Tunisia for Electroencephalogram (EEG) as part of a workup to explore a behavioral disorder.

A total of 117 patients were included in the study. The mean age was 14 ±4.2 years. The sex ratio was 1.29. Agitation was reported in 66.7% of patients. One case of attempted suicide was noted. Among these patients, 29.9% reported audiovisual hallucinations. Concentration difficulties were associated with 59% of cases. Ten patients had a history of epileptic seizures. Of the 117 EEGs performed, 59.8% were pathological. The abnormalities observed were paroxysms in 67.1% of cases and focal slowing in 25.7%. Five patients had a rapid rhythm on the EEG. An absence-type electro-clinical seizure was recorded in one patient. Patients with visual hallucinations had epileptiform abnormalities of occipital location in 41.7% of cases, and slow waves of anterior location in 50% of cases. Patients with auditory hallucinations had parietal epileptiform abnormalities in 89% of cases.

Ictal and interictal manifestations seem to play a part in the genesis of behavioral disorders in children and adolescents. An EEG would therefore be preferable in this age group, for better management.

None Declared

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.

None Declared

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.

None Declared

Multiple Sclerosis (MS) is an inflammatory disease affecting primarily the central nervous system, characterized by focal lesions of white-matter demyelination. It can present with a variety of neurological symptoms, including monocular vision loss, sensory loss, paresthesias, limb weakness, ataxia and bladder dysfunction, and has a typically chronic and progressive course. Neuropsychiatric manifestations including depressive or manic symptoms, anxiety disorders and psychosis, are also frequently observed, and are of particular importance to mental health practitioners.

To describe a case of a 45-year-old female patient with a history of suspected MS presenting with manic symptoms, and to discuss the possible neuropsychiatric manifestations of Multiple Sclerosis.

Clinical case report and literature review.

A 45-year-old woman was brought to the emergency department presenting with severe acute agitation, irritable mood, rapid speech and persecutory delusions. She had no prior history of neuropsychiatric symptoms, but her medical history was notable for a suspected diagnosis of MS, having suffered an episode of optic neuritis 16 years before the present episode. Magnetic Ressonance Imaging performed 3 months before emergency admission documented non-specific white-matter lesions presenting as hyper-intense in long TR sequences, as well as a cervical lesion of atypical characteristics, representing possible spondylotic myelopathy or demyelination. A head CT performed at emergency admission did not reveal relevant acute findings. The patient was hospitalized and initiated risperidone and valproic acid therapy. She responded favorably to medication, with progressive stabilization of mood and remission of delusional ideas over three weeks.

Neuropsychiatric symptoms are a common and concerning manifestation of Multiple Sclerosis. The present case illustrates that clinicians should be on alert for signs of mood and psychotic symptoms in patients with suspected or confirmed MS, as these can manifest at any point during the disease course.

None Declared

The process of recovery of mental reactions in children after acute traumatic brain injury is determined by complex methods with an interdisciplinary approach. Studies of emotional, communicative and behavioral reactions are based on an assessment by a psychiatrist and a teacher-defectologist.

to study mental reactions and identify predictors of positive recovery of consciousness after acute brain injury in children in early rehabilitation.

psychiatric and pedagogical examinations; also - neuroimaging data and others.

Three groups of children were identified, depending on the different severity of emotional, communicative and behavioral indicators:

Group 1 (11%): The level of consciousness is minimal positive. Reactions: stable gaze fixation; emotional reaction to sound (smile) and the face of an adult; short-term tracking of the gaze of the object; the ability to touch an object and hold it; sits himself.

Group 2 (33%): The level of consciousness is minimal positive / negative, with an advantage of positive. Reactions: unstable gaze fixation; emotional reaction and involuntary movements to sound; reflex seizure of an object; sits with support.

Group 3 (56%): The level of consciousness is minimal negative. Reactions: no emotional reactions, low motor and sensorimotor activity.

predictors of emotional-communicative and behavioral indicators of recovery of the level of consciousness were identified: sensory and motor, cognitive and socially-oriented (orienting reactions to the voice and face of an adult, tracking the gaze of an object, sensory and motor activity, etc.). These predictors are the basis for choosing a rehabilitation program with interdisciplinary support and a treatment strategy.

None Declared

Lack of adherence to antipsychotic medication in patients with schizophrenia spectrum disorders is a major risk factor for relapse and rehospitalizations which contributes to major social and economic consequences. A high proportion of patients with schizophrenia are partially or completely unaware of their mental disorder.

The aim of this study was to investigate the association between insight and medication adherence.

A total number of 30 outpatients with schizophrenia spectrum disorders ,according to (DSM-V) diagnostic criteria who were attending the department of psychiatry A Razi hospital between august and September 30, 2023 were included in this study. Patients’ insight was measured by the birchwood insight scale. The degree of medication adherence was measured by using Medication Adherence Rating Scale (MARS).

Patients enrolled in the study had a mean (SD) age of 43.2 .There was no significant correlation between patients’ insight and patients’ ages, duration of illness and hospitalization times. In addition, there was no significant association between medication adherence and age, duration of illness, number of hospitalization or social level. Impaired insight was associated with poor antipsychotic medication adherence in patients with schizophrenia spectrum disorders .Higher insight was correlated to higher therapeutic adherence. Our results showed that the level of insight and compliance to treatment are positively correlated.

The results of this study support the hypothesis that insight and treatment adherence are closely related. Interventions to enhance insight may be helpful in improving medication adherence.

None Declared

Studies conducted up to date on the subject of deprivation of sleep (DS) primarily focused either on its impact on certain cognitive abilities or mood-enhancing effects in patients with depression. A notable body of evidence suggests that both might be related to alterations in neurotrophin synthesis induced by DS. However, the role of NTs as an interface between DS, mood, and cognitive functions is unclear.

The study aimed to investigate associations between cognitive abilities measured by Trail Making Test (TMT) and Stroop Color and Wort Test (ST), serum protein concentrations of brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), neurotrophin-3 (NT3), neurotrophin-4 (NT4) as well as the expression of their respective genes after a night of sleep deprivation.

Each participant (n=76) underwent a 24-hour DS under the control of actigraphy. Venous blood collection, TMT, and ST were carried out in the morning after DS. Mood was evaluated twice, after DS and in the preceding evening; based on the alleviation of depression symptoms participants were divided into respondents (RE; n=47) and non-respondents (NR; n=29). Serum protein concentration was determined using ELISA kits. Gene expression was evaluated by quantitative real-time polymerase chain reaction with gene-specific probes (reference gene: β-actin). Relative expression was calculated using the Livak formula. TMT is a neuropsychological instrument; Part 1 is thought to evaluate mostly attention, whereas Part 2 executive functions. ST is a 2-part test applied in the assessment of response inhibition and complex attention.

In RE, cognitive abilities were not associated with expression levels of any of the studied proteins or mRNA (all p>0.05). In NR, BDNF and GDNF mRNA expressions negatively correlated with TMT Part 1 (p=0.017, p=0.048, respectively); scores obtained in TMT Part 2 bore a similar relation to BDNF, GDNF, and NT4 mRNA (p=0.034, p=0.041, p=0.026, respectively). In this group, expression of all BDNF, GDNF, NT3, NT4 mRNA correlated negatively with both parts of ST (p<0.001, p=0.009, p=0.042, p=0.009 for Part 1; p<0.001, p=0.003, p=0.031, p=0.014 for Part 2, respectively).

Those results suggest that alterations in the synthesis of NTs might be an element of the molecular milieu characterizing different types of DS response. Negative correlations between test scores and NT mRNA expressions could imply that the reduction of the production of NT proforms might protect against the decline of cognitive functions in the aftermath of DS. Projects using a larger battery of tests as well as analyzing immature forms of NTs would be desirable in order to further investigate mechanisms underlying DS response.

None Declared

Speaking prospectively we use the concept of “at risk mental state” (ARMS) to describe the state in which a person has a heightened risk of developing a psychotic disorder. Young people who are experiencing ARMS can be more precisely defined as being at ultra-high-risk of psychosis using a specific set of criteria known as the UHR criteria.

To clarify the concept of ultra-high-risk individuals and to characterize the clinical and functional characteristics and general psychopathology of those individuals that do not transition to psychosis during the follow-up period.

Research on UpToDate using the terms “Ultra-High-Risk”; “psychosis”, “transition”.

Recent literature has suggested that less than 30% of those who meet established criteria for being at Clinical-High-Risk of psychosis (CHR-P) go on to develop a psychotic illness. It is therefore of crucial importance and relevance to assess and clarify what happens to high-risk individuals who do not transition to psychosis, who make up the vast majority.

One of the most recent studies (NAPLS-2) that encompassed 764 of CHR-P individuals who were followed for 2 years, concluded that 278 did not transition to psychosis during the follow-up period. Three clinical outcomes were recorded: 1 group had experienced a psychopathological remission (39.57%); the other kept symptomatic but not currently meeting criteria for a prodromal risk syndrome (33.45%); the third group had a prodromal progression (26.98%). The study concluded among others that although the remission group had improved social functioning at 2 years compared with the other groups, they were still functioning below the healthy control group.

Another meta-analysis that included a total of 2756 CHR-P individuals with a mean duration of follow-up of 30.7 months evaluated several clinical outcomes in CHR-P that didn’t transitioned to psychosis and between CHR-P non-transitioning versus those transitioning to psychosis. It concluded that CHR-P that do not transition to psychosis have an overall improvement of symptoms (APS, negative, depressive) and functioning at follow-up compared to baseline.

The occurrence of a first psychotic episode is often devastating for the patient and their family, especially given its usual onset in adolescence and early adulthood. This is a critical period in the individual’s development as a person, and disorders at this stage can threaten the potential for a productive and inclusive adult life. Studies have suggested that less than 30% of individuals classified as UHR actually develop a psychotic disorder.

However, little is known about the individuals belonging to this group who do not transition to psychosis. We therefore consider it is relevant to clarify the clinical and functional outcomes of this group of individuals.

None Declared

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.

None Declared

The literature has emphasized the importance of implementing evidence-based occupational therapy teleinterventions to enhance work participation in adults with attention-deficit/hyperactivity disorder (ADHD).

This study aimed to evaluate the efficacy of an innovative metacognitive self-tailored teleintervention for adults with ADHD performance at work enhancement (Work-MAP). The outcome measures were efficacy of and satisfaction with the performance of self-selected work goals (Canadian Occupational Performance Measure), executive functions (Behavior Rating Inventory of Executive Function-Adult), and quality of life (Adult ADHD Quality of Life Questionnaire).

In this randomized controlled trial, participants were 46 adults with ADHD. Group A (n = 31) received the synchronous, hybrid-telehealth intervention in 11 weekly 1-hour individual sessions, while Group B (n = 15) completed the same intervention after a waiting phase.

Following the intervention, participants demonstrated and maintained significant improvements in all outcome measures (strong-to-moderate significant effects) to the 3-month follow-up.

Work-MAP seems to be effective intervention for enhancing work participation (i.e., performance at work), executive functions, and quality of life of adults with ADHD. Future studies with larger samples and additional objective measures are needed to further validate these findings.

None Declared

Autism spectrum disorder (ASD) is a childhood onset neurodevelopmental condition, that leads to permanent disability in a high proportion of cases. ASD is associated with a heterogeneous symptom presentation, which - besides social interaction and communication difficulties - encompasses altered sensory reactivity, including excessive hyper-sensitivity to stimuli, especially in the visual domain. Meta-analyses of fMRI studies revealed increased reactivity in visual task conditions in the temporal and occipital brain regions. Neural oscillations in the EEG gamma band are viewed as a candidate neurobiological marker for higher order sensory and perceptual processes, and social interactions.

We investigated changes in gamma activity in the EEG in the eyes open (EO) vs. eyes closed (EC) condition in order to identify the neurobiological underpinning of the enhanced sensitivity to visual input in ASD as compared to typically developing (TD) subjects.

EEGs were obtained in EC and EO condition in ASD (N=23) and TD subjects (N=24) in an ongoing study. For EEG recording we used a high-density 128-channel BioSemi system, with 0.5 Hz frequency resolution. The spectral power in the gamma band (30-100Hz) was quantified by the power spectral density. To investigate whether changes in the gamma band were linked to changes in arousal instead of enhanced visual processing, we also examined alterations in the alpha band (8-13Hz) in the EO condition. Spectral power changes were determined for each EEG channel by computing the difference between the EC and EO conditions (EO-EC).

Spectral power in the gamma band showed changes in the opposite direction in the two study groups: ASD subjects manifested significant (p<0.05) increase, while TD subjects had a decrease in the EO vs. EC condition in the temporal and occipital brain regions. By contrast, the changes in the alpha band were similar, with both groups exhibiting a spectral power decrease in the EO compared to the EC condition.

In ASD, an enhancement of gamma activity is present in the EO as compared to the EC condition in the posterior brain areas. These brain areas are involved in the processing of visual information, and gamma activity is considered as a measure of perceptual processes. Thus, the gamma alterations in the EO vs. EC condition may underlie the hyper-sensitivity symptoms to visual stimuli in ASD, and EEG can offer a simple to use tool to delineate the neurobiological foundation of the symptom presentation.

Funding statement: Hungarian Brain Research program,#NAP2022-I-4/2022

None Declared

Mood symptoms, especially depressive ones, occur in the majority of patients with schizophrenia spectrum disorders (SSD). Therefore, depression is often identified as one of the symptomatological dimensions of schizophrenia. Catatonia is also considered by some researchers as one of the dimensions of schizophrenia, or as an independent transnosological formation. Catatonia in SSD may be associated with affective dysregulation and is often accompanied by depression. Although the clinical course of SSD has been well studied previously, its relationship with psychopathological structure of episodes of SSD remains not entirely clear.

To determine the impact of episodes of catatonic depression on the course and prognosis of SSD.

A sample of 60 patients with episodic course of SSD who met the criteria for catatonia according to the Bush-Francis Catatonia Screening Instrument (BFCSI) and for depression according to the Calgary depression schizophrenia scale (CDSS) was analyzed. An analysis of the clinical course of SSD was carried out on the basis of the medical history of all patients in the study sample and follow-up observation of 42 patients for 5 years. Global Assessment of Functioning Scale (GAF) was used to assess the prognosis of SSD.

Patients were divided into two groups depending on the period of manifestation of catatonia in the clinical course of SSD: during the first episode or during subsequent episodes. The sample of patients with the first episode (n=43, 71.7 %) was divided into three subgroups. A relatively favorable course of SSD was observed only in 13 patients (30.2 %; 21.7 % of SSD sample). The course of disorder was characterized by similar episodes with a high proportion of affective symptoms, long-term remissions and minimally expressed negative symptoms (GAF score=75.2±5.82). A relatively unfavorable course of SSD was observed in 15 patients (34.9 %; 25.0 % of SSD sample). It was characterized by moderate negative and chronic subdepressive symptoms with low frequency of catatonic and psychotic relapses (GAF score=62.3). An unfavorable course of SSD was also observed in 15 patients (34.9 %; 25.0 % of SSD sample). It was characterized by a high frequency of relapses with a tendency to form a chronic conditions with residual catatonic signs and psychotic symptoms (GAF score=50.1). In the sample of patients with manifestation of catatonia in the second or subsequent episodes (n=17; 28.3 %), the clinical course of SSD was unfavorable. It was characterized by a rapid augmenting of negative symptoms with the formation of psychomotor poverty syndrome with residual catatonic symptoms (GAF score=52.7).

Our study shows that the occurrence of catatonic depressive episodes in the clinical course of SSD in most cases is an unfavorable prognostic factor.

None Declared

Opioid use disorder is still the main presenting illicit substance use disorder that patients present within Addiction and Mental Health Services even though the majority of the patients are polysubstance users. Innovation in the field will allow providers to understand better how systems work to support a population with physical and psychological morbidities

We will present novel narratives in describing:

1. 1. Standards and principles

2. 2. Pharmacology

3. 3. Delivery systems

4. 4. Neuroscience based interventions

5. 5. Systems and implementation

The above desscriptors will allow a landscape that is less stigmatising and better in responding to the needs of the people who are highly stigmatised and multidisdvantaged.

None Declared

Psychiatry is one of the most fast developing and agile discipline within human medicine. But more work is necessary to complete these advances.

I address the following questions:

How does the future of psychiatry look in the eyes of early career psychiatrists?

What strengths, weaknesses opportunities and threats will come?

And what can we learn from different mental health systems and reagions?

Oral or written statements to the raised questions followed optimally by a discussion

In low- and middle-income countries, a vast majority of people with mental disorders do not receive adequate treatment. Even in high income countries, roughly a third of people with severe forms of mental illness are not receiving the appropriate therapy. Laws concerning mental health are outdated in different countries. The protection of the human rights of the mentally ill is still incomplete and imperfect. The emphasis on economic gain and the digitalization of medicine in recent years has not helped. And new technical advancements such as artifical intelligence are becoming more important.

More discussion needs to be done on the identity and understanding of the psychiatric profession.

None Declared

Non-suicidal self-harm, i.e. the intentional self-infliction of bodily harm without apparent suicidal intent, is a powerful risk factor for suicidal ideation and behavior [1]. Although non-suicidal self-harm and suicidal behaviour are distinct concepts, the two forms of deliberate self-harm frequently coexist and share key instrumental functions, such as escaping aversive internal states, reducing dysphoria or communicating distress, especially in patients with personality disorders. [2]

Some individuals also report using non-suicidal self-harm to ameliorate suicidal thoughts or urges [2].

To assess the relationship between non-suicidal self-harm and suicidal ideation in patients with borderline personality disorder followed at the Arrazi psychiatric hospital in Salé.

This was a descriptive cross-sectional study using a questionnaire including sociodemographic criteria, clinical criteria and the Beck suicidal intentionality scale to assess the relationship between non-suicidal self-harm and suicidal ideation in patients with borderline personality disorder followed and hospitalised at the Arrazi psychiatric hospital in Salé.

The inclusion criteria were as follows: both sexes with a diagnosis of borderline personality disorder according to DSM 5 criteria.

Exclusion criteria were current psychosis and severe intellectual disability.

We collect 63 participants.

The average age of the participants was 23, and they were predominantly female (89%). About 85% were single and 97% had no occupation. The majority of participants had a substance use disorder.

All participants had a history of non-suicidal self-harm and 36% had a history of suicide attempts.

Suicidal intent was strong in 45% of participants who had already attempted suicide.

Approximately 46% of participants reported that non-suicidal self-harm was intended to alleviate suicidal ideation and approximately 27% of participants reported having experienced suicidal ideation shortly after non-suicidal self-harm.

Non-suicidal self-harm is very common in patients with borderline personality disorder often considered to have a mitigating effect on the internal stress of these patients and sometimes even neglected. The relationship between non-suicidal self-harm and suicidal ideation is an important one, and may reduce suicidal ideation in the short term but subsequently encourage further self-harm, thereby increasing the risk of suicide.

Particular attention must be paid to these patients and their self-harm, and specialised, comprehensive care is required.

None Declared

Job satisfaction is a fundamental pillar of the modern workplace. Recognizing the significance of job satisfaction and actively promoting it has become a strategic imperative in today’s work environment.

The present study aimed to assess job satisfaction and work ability among workers in a confectionery factory.

A cross-sectional study conducted in a Sfax confectionery factory included 200 workers. Data were collected between December 2022 and July 2023 using a pre-established questionnaire. This questionnaire encompassed an evaluation of socio-demographic and professional data, measuring the degree of professional satisfaction and the level of work ability using a visual analogue scale ranging from 0 to 10.

The gender ratio was 0.64. The mean age was 33.2 ± 8.8 years. Among our workers, 77.5% reported being satisfied with their work. The average perceived work ability score was 8.15 ± 2.087. Employees with higher levels of satisfaction were more likely to have increased work capacity (p = 0.000). Elevated job satisfaction not only boosts work capacity but can also reduce stress levels, improve overall mental well-being, and contribute to a healthier workplace environment. These factors collectively lead to higher work ability.

These findings emphasize the importance of prioritizing employee well-being to enhance overall productivity and company success. Fostering a work environment that prioritizes job satisfaction can lead to a more productive and successful workplace.

None Declared

Schizophrenia, a chronic and complex psychiatric pathology, can be isolated. However, it can be associated with other comorbidities and thus be accompanied by addictive behaviors that complicate their management.

The objectives of our study were to estimate the prevalence and identify the characteristics of addictive behaviors in patients with schizophrenia.

A retrospective study of 151 patients with schizophrenia hospitalized in the psychiatry department of Taher Sfar University Hospital in Mahdia from January 2017 to December 2021.

The mean age of the patients was 39.8 ± 11.23 years, with a predominance of the 36-45 age group (38.4%). All patients were male. Three quarters of the patients (75.5%) were users of psychoactive substances (PAS): nearly three quarters (72.8%) were addicted to tobacco, more than one third (39.7%) were addicted to alcohol, more than one quarter (29.1%) were addicted to cannabis and nearly one quarter (26.5%) were addicted to other PAS. In more than half of the cases (54.4%), the age of onset of substance use was between 16 and 25 years. The use of PAS preceded the onset of schizophrenia in 62.3% of cases. The relationship with the entourage was marked by hetero-aggressiveness in 77.5% of patients, withdrawal from the entourage in 16.6% of patients and conflict in 5.3% of patients. The impact on the relationship with oneself was marked by self-aggressiveness in 18.5% of patients. Concerning the professional impact, three quarters of the patients (76.1%) had to stop working. The majority of patients (84.1%) continued their usual treatment, while 15.2% of patients stopped it. Only one patient required an increase in dose.

Subjects suffering from schizophrenia are particularly vulnerable to addictions, mainly to tobacco and alcohol. They are thus a group more at risk of the deleterious effects of psychoactive substances and of the aggravation of the clinical and psychosocial evolution of their psychiatric disorders. Measures for early detection and treatment of their addictive behaviors even before the onset of schizophrenia should be proposed.

None Declared