The studies on various groups of patients with schizophrenia revealed impairments in immune system, glutamatergic, and antioxidant systems contributing substantially in schizophrenia pathogenesis.

To search for links between the activities of platelet enzymes involved in glutamate and glutathione metabolism and monocytes’ subpopulation compositions in patients with schizophrenia and to identify possible correlations of the biomarkers with clinical data. Research objectives: determination of subpopulation ratio of monocytes; measurement of the activity levels of glutamate dehydrogenase (GDH), phosphate-activated glutaminase (PAG), glutathione reductase (GR) and glutathione S-transferase (GST) in blood platelets; search for correlations between these parameters and the scores by psychometric scales.

The study included 36 women aged 16-45 years with acute schizophrenia hospitalized in the Mental Health Research Centre with their current condition assessed as depressive-delusional. The control group consisted of 17 women 18-45 years old without somatic or mental pathology. GDH, PAG, GR and GST activities were measured by spectrophotometric methods, and numbers of monocyte subpopulations - “classical”, “intermediate”, “non-classical” - by flow cytometry. The Hamilton Depression Rating Scale (HAMD-17) was used to assess depression severity. The data was processed using the Statistica 8.0 software.

The detected changes in monocyte subpopulations’ composition towards the increase in the proportion of cells having a pro-inflammatory phenotype (CD14++CD16+ “intermediate”) indicated the activation of inflammatory reactions. Also, the activities of platelet enzymes of glutathione metabolism (GR and GST) were significantly decreased (p<0.05). Moreover, GDH and GST activities significantly correlated with the scores by HAMD-17 (r=0.40, p=0.022 and r=0.45, p=0.030, respectively). The results indicate the presence of pathological inflammatory process, the decrease in activities of glutathione antioxidant metabolism enzymes and a link to glutamate metabolism involvement (GDH) in the studied patient group.

The identified redistribution in the monocyte subpopulations’ composition and decrease in the activity of enzymes involved in glutamate metabolism and antioxidant system indicate the involvement of the immune, glutamate and antioxidant systems in the pathogenesis of schizophrenia and may reflect a functional interaction between these systems.

None Declared

Individual Placement and Support (IPS) is a supported employment method used for the vocational inclusion of individuals with mental disorders. There is vast evidence that IPS is effective for finding jobs. However, evidence concerning the applicability of IPS for persons with mental disorders receiving a disability pension and concerning the sustainability of IPS is scarce.

The aim of the studies included in this report was to a) control for the applicability of IPS for persons receiving a disability pension and b) to gain insight in the sustainability of IPS in this context.

A randomized controlled trial with 250 participants was conducted. The participants in the intervention group received job coaching according to the IPS standard. Members of the control group received no organized support but were allowed to seek assistance on their own. The initial phase of the study lasted 24 month. Job coaching was delivered only in the first phase of the study and discontinued after 24 month. A follow up was performed six years after the start of the study to clarify the further course (number of employment relationships, degree of employment, duration of employment, salary).

In the first phase of the study, the overall dropout rate was 32%. 114 participants (46% of the original number of participants) took part in the follow-up survey. The intervention was superior to the control condition in the first phase. There were no significant differences between the groups in terms of number of employment relationships, degree of employment, length of employment, and salary in the follow up.

The effect of a clear superiority of the IPS intervention with regard to the number of employment relationships, which was measured during the originally planned duration of the study, was only slightly detectable six years after the start of the study and up to four years after the end of the intervention and was no longer statistically significant. This result underlines the importance of continuing job coaching for an unlimited period of time, as called for in the IPS concept, in order to perpetuate the positive effects such as finding and maintaining a job in the primary labor market.

None Declared

Mental health-related stigma occurs not only within the public community but is also an issue among healthcare professionals. The relationship between national culture and provider stigma remains yet to be empirically attested.

We performed a cross-sectional multicentre study across 32 European countries to investigate the attitudes of psychiatrists towards patients with mental health problems. We aimed to examine the relationship of attitude with country-specific indicators.

We measured stigmatizing attitudes using the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) within an online survey among specialists and trainees in general adult, child and adolescent psychiatry. Its total score was correlated with the Human Development Index (HDI), the Democracy Index (DI), the Social Progress Index (SPI), the number of psychiatrists per 100,000 people, and the Hofstede dimensions. Latent class analysis was done to find subgroups of countries according to the stigmatizing attitudes of psychiatrists and the six Hofstede dimensions.

Altogether, n=4245 participants completed the survey. The total score of the OMS-HC significantly correlated with the long-term orientation (r=0.453, p=0.015) and indulgence dimensions (r=-0.629, p<0.0001) and with the HDI (r=-0.503, p=0.005), DI (r=-0.418, p=0.024), SPI (r=-0.348, p=0.040). The latent class analysis separated high- and low-stigma countries. High stigma was associated with high power distance and uncertainty scores.

Findings from this study not only expand knowledge of factors related to stigmatizing attitudes of healthcare professionals, but also enlighten the cultural aspects of the stigma that could contribute to the further development of anti-stigma programs.

D. Őri Grant / Research support from: Research grant form the Fulbright Association, P. Szocsics: None Declared, T. Molnár: None Declared, L. Bankovska Motlova: None Declared, O. Kazakova: None Declared, S. Mörkl: None Declared, M. Wallies: None Declared, M. Abdulhakim: None Declared, S. Boivin: None Declared, K. Bruna: None Declared, C. Cabaços: None Declared, E. A. Carbone: None Declared, E. Dashi: None Declared, G. Grech: None Declared, S. Greguras: None Declared, I. Ivanovic: None Declared, K. Guevara: None Declared, S. Kakar: None Declared, K. Kotsis: None Declared, I. Klinkby: None Declared, J. Maslak: None Declared, S. Matheiken: None Declared, A. Mirkovic: None Declared, N. Nechepurenko: None Declared, A. Panayi: None Declared, A. Pereira: None Declared, E. Pomarol-Clotet: None Declared, S. Raaj: None Declared, P. Rus Prelog: None Declared, J. Soler-Vidal: None Declared, R. Strumila: None Declared, F. Schuster: None Declared, H. Kisand: None Declared, A. Reim: None Declared, G. Ahmadova: None Declared, M. Vircik: None Declared, H. Yilmaz Kafali: None Declared, N. Grinko: None Declared, Z. Győrffy: None Declared, S. Rózsa: None Declared

Bipolar disorder is a chronic, recurrent, and disabling condition that typically begins in late adolescence or early adulthood. It is characterized by alternating phases of depression, mania, or hypomania. Childhood traumas are more frequently found in adults with bipolar disorder, suggesting their contribution to its development. They are also associated with more severe and complex clinical forms and a less favorable prognosis.

Our objective is to assess the prevalence of childhood trauma rates in adults with bipolar disorder and to study the impact of childhood traumas on the clinical course of bipolar disorder, in comparison with a group of patients with bipolar disorder who did not experience trauma during their childhood.

This is a descriptive cross-sectional study using a questionnaire comprising sociodemographic criteria and the Childhood Trauma Questionnaire Short Form (CTQ-SF) to evaluate the connection between physical and psychological traumas during childhood and bipolar disorder. The study also examines the types of these traumas and their impact on the course of bipolar disorder in these categories.

Data were collected from 54 patients with bipolar disorder at Ar-Razi Psychiatric University Hospital. Among this sample, 60% were female and 40% were male. The age of the participants in our study ranged from 18 to 54 years. According to the Childhood Trauma Scale, approximately one-third of patients with bipolar disorder had experienced childhood trauma. Moreover, most participants who had survived childhood trauma experienced more relapses than patients who had not experienced traumatic incidents during their childhood.

Childhood traumas and bipolar disorder appear to have a significant causal association, both in the development of the disease and its course. The results of our study support evidence published in articles to better clarify the nature of this association. However, our study has several limitations, including a limited sample size and difficulties in long-term follow-up during the disease. Therefore, further studies exploring this subject are desirable for better management of this condition.

None Declared

Early onset psychosis (EOP) and bipolar disorder (EOBP), occurring before the age of 18, have been linked to early signs of atherosclerosis and an elevated risk of cardiovascular disease (CVD). Physical exercise is a well-established factor in reducing the risk of developing CVD. However, it remains unclear whether regular physical activity can mitigate cardiovascular risk factors and signs of atherosclerosis in individuals with EOP and EOBP.

This study aimed to explore the impact of physical exercise on cardiovascular risk factors in these populations.

We assessed the physical exercise habits of 71 individuals, including 22 with EOP, 21 with EOBP, and 28 age-matched healthy controls. Participants’ physical exercise routines were categorized as 0, 1, 2, or 3 or more times per week, with each session lasting at least 30 minutes. Our analysis included adjustments for conventional CVD confounders. Additionally, we used high-frequency ultrasound (22 MHz) to evaluate different layers of the arterial wall in the left common carotid artery (LCCA).

Compared to the control group, adolescents with EOP and EOBP exhibited significantly thicker LCCA intima thickness (0.132 vs. 0.095 mm, p<0.001) and intima/media ratio (0.24 vs. 0.17, p<0.001). Remarkably, adolescents with EOP and EOBP who engaged in physical exercise three times or more weekly (n=13) displayed significantly less intima thickness (0.142 vs. 0.116 mm, p<0.01). However, we did not observe a significant association between exercise and other CVD risk factors. Even when considering factors such as the extent of antipsychotic medication use or the severity of the disorders in our regression analysis, the significant association between exercise and reduced intima thickness persisted (p<0.05).

Among adolescents with EOP or EOBP, those who engaged in physical exercise three or more times weekly exhibited less pronounced LCCA intima thickness compared to their less active counterparts, although it remained thicker than that of healthy controls. These findings, if replicated, suggest that regular physical exercise, specifically three or more times a week, could potentially offer protection against the future development of CVD in individuals with EOP and EOBP. Further research is warranted to confirm and expand upon these promising results.

None Declared

This is a descriptive cross-sectional clinical study with professionals from the Nursing Team (Nursing Assistant, Nursing Technician and Nurse).

To assess the psychological impact of the Covid-19 pandemic on nursing staff professionals.

A descriptive, quantitative, cross-sectional study will be applied to a structured interview aimed at collecting sociodemographic and occupational data, Mental Health Scales evaluating professional exhaustion - Oldenburg Burnout Inventory and Beck’s Anxiety Rating Scale to assess the state of anxiety.

About 13,587 nursing professionals were interviewed, including nurses, technicians and nursing assistants. They were evidenced through the behavior indexes related to insomnia, the desire to cry and appetite variation may be related to the long working hours, the fear of contamination and the consequent absence from work, as well as the fear of getting sick may be related to the fact that the professional stops being a caregiver and starts to be cared for.

the study denotes the importance and need for interventions to promote and prevent mental well-being in health professionals exposed to COVID-19, these need to be implemented immediately, for nursing professionals, as they are on the front line, demanding attention Special. In this sense, the Nursing Council of the State of São Paulo created and implemented some bills such as the Obligation of Rest Rooms in Health Units, the Cuidando de Quem Cuida Program and the Yellow September Campaign in Allusion to actions for Nursing professionals for the prevention and promotion in mental health category.

None Declared

In psychosocial rehabilitation (PSR), rank scales are widely used to assess the severity of functional disorders in patients. The main problem of evaluating the effectiveness of PSR is related to the methods of processing data obtained using psychometric scales used to evaluate the effectiveness of interventions within PSR. J. Pfanzagl (1968) obtained the proof of the non-numerical nature of ranks. Incorrect processing of rank information obtained in the framework of psychosocial research leads to contradictions in the assessment of the patient’s condition. Consequently, rank processing does not allow classical mathematical operations (summation, average), which makes it impossible to correctly estimate the effectiveness of PSR numerically.

Development of algorithms for numerical evaluation of PSR efficiency based on rank information processing using the analytic hierarchy process (AHP) [1].

Clinical, psychometric, AHP algorithms.

The analysis of the problems of assessing the patient’s conditions on the basis of categorical and psychometric (rank) scales and subscales shows that these problems can be presented in the form of appropriate hierarchies [2], the structure of which must be taken into account when processing the initial information.

According to the results of the analysis of the data of preliminary studies, the main areas of impaired functioning of patients affecting the evaluation of the effectiveness of PSR have been identified. Rank estimates of changes in the relevant areas of the patient’s dysfunction after the PSR program compared to the initial level are the basis for the conclusion about the effectiveness of the PSR components. Algorithms of the AHP normative approach were used to translate rank information into numerical information [2]. The weight of the areas of the patient’s functioning disorders was used in the formation of integral estimates of the effectiveness of PSR.

The fundamental difference between AHP-based assessments and rank assessments is due to the fact that numerical estimates of the weight of the criteria and the corresponding changes in the patient’s condition are obtained, which depend on the qualifications of specialists, the characteristics of the scales used to measure violations in the relevant areas and the procedures of the PSR.

Obtaining the results of processing rank information in a numerical scale allows to obtain the correct integration of the patient’s personal characteristics when considering PSR procedures and to obtain correct models of the patient’s state. 1. Saaty T. European Journal of Operational Research.1990; 48(1):9-26. https://doi.org/10.1016/0377-2217(90)90057-I 2. Mitikhin V.G., Solokhina T.A. et al. Psychiatry, 2022; 20(2): 51-59. DOI: 10.30629/2618-6667-2022-20-2-51-59

None Declared

Somatic disorders in patients suffering from psychiatric disorders have become an important issue in the overall care of these patients

Comorbidity studies show that 30 to 60% of patients consulted or hospitalized in psychiatry present an associated organic pathology

However, the detection of somatic conditions in psychiatric patients remains too late and this exposes them to sometimes lethal somatic complications

To evaluate the prevalence of somatic disorders in patients followed for a psychiatric disorder at Ar Razi hospital in Salé – Morocco, and to determine the associated factors

We carried out a cross-sectional study with 80 patients followed for a psychiatric disorder at Ar Razi hospital in Salé presenting clinical signs in favor of an organic pathology and transferred for specialized advice to the medical-surgical services, in the period from September 1st, 2022 until August 31st, 2023.

Most of our patients were male (65%) with ages ranging from 18 to 65 years. Addictive behaviors were found in more than half of our patients.

The most frequent reasons for requests for advice from medical-surgical services was the suspicion of an organic cause of psychiatric symptoms in 25% of cases or the presence of an organic warning sign in 30% of cases.

The comorbidity of somatic illness and psychiatric disorder was noted in 35% of cases.

Somatic comorbidities were essentially: infections and cardiovascular diseases.

Side effects of psychotropic drugs were predominantly neurological in 40 % of cases

Somatic comorbidities in patients hospitalized or in consultation in psychiatric hospitals are very common, often unrecognized, hence the need for early screening in order to improve care.

None Declared

An undeniably significant amount of psychotropic medication can evidently affect the corrected QT (QTc) interval, which puts patients’ lives at risk. More specifically, certain anti-psychotic medication can increase the risk of QTc prolongation and by extension the risk of a potentially fatal arrhythmia or sudden cardiac death.

Electrocardiograms (ECG) were contacted in one hundred and four (104) chronic patients, with psychosis, through out their hospitalization in several enclosed psychiatric facilities in Corfu. Almost the entirety of the patients along side their anti-psychotic medication were also taking various other medication for their individual pathological issues. We observed any changes that might have occurred on the ECG in comparison with each patient’s medication and it’s potential effect on the QTc.

The measurements of the QT interval were made manually in lead V5 and the mathematical conversion was contacted using the Hodges correction formula.

At least one ECG (n = 104) was performed. Among them 29,8% (n=31) had ECG abnormalities, including 13,5% (n=13) with a prolonged Qtc (481.2 ± 26,8 ms). Covariates significantly associated with the QTc were gender (+17.2 ms if female, p < 0.0001) and age (+0.4 ms/year, p = 0.0001).

The QTc prolongation that was evident in a notable number of patients, emphasizes the importance of QTc monitoring in patients who are taking anti-psychotic medication. QTc prolongation risk factors should be assessed before the administration or prescription of any anti-psychotic medication.

None Declared

The metaverse, a term first employed in Neal Stephenson’s 1992 novel “Snow Crash”, is a digital environment delivered via artificial intelligence in which multiple users can use avatars to engage in social, economic and cultural activities. Broadly speaking, metaverse encompasses technologies as diverse as augmented reality (AR), “lifelogging” (smart watches, smart phones and other wearables), “mirror” worlds (e.g. Google Earth, Waze, …) and virtual reality (VR). There is a pressing need to understand the potential of metaverse for medicine in general and psychiatry in particular. The therapeutic use of VR technologies is already a reality in clinical practice, particularly in terms of online treatments and exposure and response prevention for anxiety disorders, obsessive-compulsive and related disorders, and trauma-related disorders. Avatar integrated therapies may increase treatment seeking via anonymity, decrease in physical and communication barriers, and facilitation of expression. In terms of research, the metaverse allows manipulation of the therapeutic environment in order to answer specific questions.

None Declared

ADHD is a very frequent reason for consultation in child psychiatry. It affects 2.5% of children and 5% of adults. Diagnosis is clinical. Treatment is based on medication combined with psychosocial interventions.

Develop an ADHD guide for caregivers.

We carried out a literature review covering the last 5 years using the google scholar and pubmed search engines, including the key words ADHD, in order to produce a printable guide for caregivers working with children, in particular school teachers and healthcare personnel.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting 5% of school-age children.

It is characterized by abnormally high levels of developmental inattention, hyperactivity and impulsivity, leading to impaired personal, social, academic or occupational functioning. Because of its pervasiveness, ADHD can interfere negatively with general well-being, as well as with social life, academic performance and the development of social skills, which can lead to low self-esteem.

ADHD has multiple etiologies. It is thought to be due to a complex interaction between genes and environment. In fact, genetic vulnerability predisposes to the disorder which, under the influence of an unfavorable environment, expresses itself in clinical symptoms represented by 2 dimensions: inattention, hyperactivity and impulsivity.

Diagnosis is essentially clinical, and treatment is based on medication combined with psychosocial interventions.

ADHD is one of the most frequently encountered disorders in general practice, pediatrics and child psychiatry. Early recognition of the disorder enables appropriate management, while limiting the impact of the disease on the functioning of the young person and his or her family.

None Declared

The expression Binge Drinking (BD) refers to dysregulated alcohol consumption, characterized by the intake of large quantities of alcohol, regardless of their nature, consecutively in a limited period of time. BD is a significant public health problem in many European countries, including Italy. According to data from the Istituto Superiore di Sanità, dated 2020, over 4 million Italians exhibit episodic excessive alcohol consumption (compared to 2019 data, there was an increase of approximately 5,3%).

This study aims to examine alcohol consumption habits 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, to estimate the presence of alcohol abuse or dependence the AUDIT scale (Saunders et al. Addict Abingdon Engl. 1993; 88:791–804) was used. It included two specific questions to frame the phenomenon of BD (Cranford et al. Alcohol Clin Exp Res. 2006; 30:1896–905). No other study conducted in Italy has so far used the aforementioned validated questions.

The sample consists of 308 people (189 F, 119 M), with an average age of 32 years (sd 14). The AUDIT indicates a state of chronic alcohol consumption in 11,7% (95% confidence interval 8,5%-15,7%), of the recruited sample, positively correlating with the element of impulsivity (p<0,005) confirming what has already been reported in literature. BD prevalence reaches 56% (M 57%, F 55%) without any significant correlation with impulsivity, personality disorders, emotional dysregulation, or sensitivity to rejection. Among university students the prevalence of BD exceeds 70% (95% confidence interval 60%-76%), with a number of drinks reported for a single occasion reaching up to 25 units and a reported number of binge episodes, in a two-week span, ranging from 2 to 10.

Despite possible biases, this study raises the relevant issue of the extremely high prevalence of BD disorder, which is particularly alarming in light of the numerous issues related to the behavior itself. A direct correlation with reduced school performance, an increase in risky sexual behavior, and an increase in cases of drunk driving have been evaluated. Considering these consequences, it is of primary importance on a medical, but even more social level, to best characterize this phenomenon in such a way as to be able to implement awareness-raising and prevention interventions.

None Declared

Metabolic syndrome and cardiovascular diseases are a very important cause of morbidity and mortality among patients with schizophrenia who live an average of 10-20 years less than the general population. Second generation antipsychotics are associated with obesity and other components of the metabolic syndrome.

The aim of this paper was to provide complete insight into the existing recent evidence for metabolic risks associated with the use of new antipsychotics, and establish recommendations for monitoring metabolic syndrome and other risks, as well as current options for treatment and prevention of metabolic syndrome.

This review article is based on a literature search. We identified relevant publications and articles by searching the PUBMED database from 1999 to the present day according to the given parameters. The search criteria were the keywords “metabolic syndrome” combined with “schizophrenia” and “new antipsychotics”.

All researches has convincingly shown that patients with schizophrenia tend to be overweight and have a three to four times higher risk of developing diabetes than the general population. There are also more and more evidence in recent literature about the impact of new antipsychotics on the frequency of metabolic syndrome in patients with schizophrenia. The World Health Organization (WHO) defines metabolic syndrome as an elevated insulin level or a fasting glucose concentration of 5.6-6.0 mmol/l in combination with two or more of the following parameters: abdominal or central obesity and dyslipidemia and/or arterial hypertension. The research results systematically showed a 1.5 to 3 times higher frequency of metabolic syndrome in people suffering from schizophrenia compared to the general population. Therefore, regular control of all components of the metabolic syndrome is necessary, from waist circumference, which is the easiest to measure, to all others that can be carried out and done in the general practice doctor’s office.

Metabolic changes in patients with shizophrenia who receive new antipsychotics in addition to their unfavorable lifestyle (improper diet, lack of physical activity, smoking) can lead to the development of metabolic syndrome and increase the risk for diabetes and cardiovascular diseases. It is therefore necessary to establish protocols for monitoring these risks and preventing comorbidities.

None Declared

Acupuncture has long been used in treating anxiety, and a literature exists on its effectiveness. However, acupuncture is rarely covered by government insurance (Medicaid or Medicare) or even by many commercial insurance carriers in the United States, making it inaccessible to those who cannot pay separately.

We asked if adding acupuncture to an anxiety group would improve outcome.

We provided acupuncture during group psychotherapy for anxiety as a non-billable service. This was feasible since patients were already being billed for group psychotherapy. A physician and a social work intern led the group. At the start of the group, the physician went around the circle of group members and inserted acupuncture needles, using points in the ears, head, hands, feet, and, in the summer, arms and lower legs). The size of the group ranged from 4 to 12 people. We used Battlefield auricular points, the four gates (Large Intestine 4 and Liver 3, bilaterally), and GV24, GV29, Ht7, and Sp6. Sometimes, other points were added for other symptoms (back pain, neck pain, etc.) People sometimes joined the group without anxiety as a core problem in getting access to acupuncture. A core group of patients formed who came weekly while others came and went. The Hamilton Anxiety Scale measured anxiety after treatments 4, 8, and 12. The group lasted 90 minutes and consisted of mindfulness training, guided imagery, and CBT for anxiety. All patients met the criteria for generalized anxiety disorder. The t-test procedure was used to compare the differences between the means for the two groups.

Thirty-five patients received acupuncture, while another 55 patients attended the group and did not elect to receive acupuncture. All patients were covered by MaineCare health insurance, Maine’s version of Medicaid. All patients had multiple other medical problems, which was why they were referred to the group. Seventy percent of the patients were women, and 30% were men. The average age was 40.1 years. Anxiety ratings on the Hamilton Anxiety Scale decreased by the last time measured for those not receiving acupuncture by an average of 5.17 points (S.D. 2.9; n = 55). Anxiety ratings for those receiving acupuncture decreased by an average of 7.19 points (S.D. 2.5, n = 35). The difference of the means was -2.02 (S.E. 0.595; 95% CI = -2.203 to -0.837; t = -3.394; p = 0.001). Headaches, shoulder pains, and upper back pain also decreased. Patients reported high levels of benefit from the acupuncture and encouraged other patients to continue to come and try the acupuncture. Usually, the needles could be placed within the first third of the group.

Acupuncture improved anxiety ratings for people in group psychotherapy for anxiety over group alone, though the possibility of a placebo effect cannot be eliminated. Patients chose acupuncture, which could also present a potential bias.

None Declared

Depression, a pervasive mood disorder, significantly impairs one’s quality of life. Early Maladaptive Schemas (EMS), ingrained thought patterns stemming from early life experiences, play a pivotal role in shaping adult beliefs and behaviors. This study delves into the relevance of specific EMS domains—Emotional Inhibition (EI), Negativity/Pessimism (NP), and Social Isolation/Alienation (SI)—in influencing the severity of depression among medical students and diagnosed patients.

Our primary goal was to assess the correlation between specific EMS domains and depression severity in medical students and clinically diagnosed patients. We aimed to elucidate whether these schemas could serve as indicators for potential depressive tendencies or if they had a stronger association in those already diagnosed with depression.

We conducted a prospective cross-sectional analysis involving 73 medical students and 61 diagnosed depression patients (aged 18-32). Four key variables—Depression, EI, NP, and SI—were measured using the Beck Depression Inventory-2 and The Young Schema Questionnaire-Short-form-3 in the Romanian context. Statistical analyses, including correlation coefficients and t-tests, were employed to explore the relationships between EMS domains and depression severity.

In the non-clinical sample, we identified moderate, statistically significant correlations between depression and EI (r=0.63), NP (r=0.71), and SI (r=0.59). Conversely, the clinical sample exhibited slightly weaker, yet significant correlations (EI-r=0.42, NP-r=0.39, SI-r=0.29). Notably, significant differences emerged between the groups in all measured variables. These findings imply that while a positive correlation between EMS variables and depression exists in both samples, the association weakens in diagnosed patients, indicating that these schemas may be less predictive in this population.

Our study underscores the importance of understanding EMS domains in assessing depression severity. While specific schemas—EI, NP, and SI—correlate with depression in both medical students and diagnosed patients, this link is notably weaker in the latter group. Elevated EMS variables suggest a potential for future subclinical depression in medical students, but they might not strongly predict depression in those already diagnosed. These nuanced insights have implications for preventive interventions and therapeutic approaches tailored to individuals at different stages of depression, thereby enhancing targeted mental health care strategies.

None Declared

Bipolar disorder in children is characterized by a different course than in adults, which is a diagnostic difficulty. DAT-1 is a dopamine transporter gene that regulates dopaminergic neurotransmission through the mechanism of active reuptake of this neurotransmitter from the synapse. Polymorphisms within the described gene can result in changes in dopamine levels, which may have implications for the development of bipolar disorder.

The aim of the project was to analyze the relationship between single nucleotide polymorphisms (SNPs) within the dopamine transporter gene DAT-1 and the risk of development of bipolar disorder in a population of children and adolescents.

21 healthy controls (12 females, 9 males) have been recruited into the study and 13 patients (9 girls, 4 boys) with bipolar disorder diagnosis from Department of Psychiatry and outpatient clinic, were recruited for the study group. Questionnaires such as the KSADS-PL were carried out and blood was taken for laboratory tests of four SNPs within the DAT-1 transporter. PQStat, Microsoft Excel 2013 and StatSoft STATISTICA were used to perform the statistical analysis.

SNPs within the dopamine transporter gene and environmental risk factors influenced the risk of developing bipolar disorder in the population of children and adolescents.

The ambiguity in results emphasizes the necessity for further investigations into correlation between genetic factors in bipolar disorder etiology. Future research should involve more participants. The results of this project are likely to make a significant and valuable contribution to the current knowledge of bipolar disorder and to the development of innovative diagnostic methods, making a significant contribution to the advancement of science.

None Declared

Most patients show temporary impairments in clinical orientation (i.e., orientation in person, place, and time) after electroconvulsive therapy (ECT)-induced seizures. It is unclear whether postictal reorientation is related to electroencephalography (EEG) restoration. This tentative relationship may shed light on mechanistic aspects of reorientation after ECT.

To study whether postictal EEG restoration after an ECT-induced seizure is related to recovery of clinical orientation in the cognitive domains person, place and time.

We performed a longitudinal study in ECT patients and collected continuous postictal EEGs. Postictal EEG restoration was estimated by the evolution of the normalized alpha/delta ratio (ADR). Recovery of orientation in the cognitive domains of person, place, and time was assessed using the Reorientation Time (ROT) questionnaire. In each cognitive domain, a linear mixed model was fitted to investigate the relationship between ROT and postictal EEG restoration. In these models, other (ECT-)parameters including seizure duration, use of benzodiazepines and electrode placement were included.

In total, 272 ictal and postictal EEG recordings of 32 patients were included. In all domains, longer ROT was associated with slower postictal EEG recovery. Longer seizure duration and use of benzodiazepines were related to longer ROT in all domains. Increased total charge of the ECT-stimulus was associated with increased ROT in place and age was positively associated with ROT in time.

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We show a relationship between restoration of the postictal EEG and clinical reorientation in person, place and time after ECT-induced seizures. This indicates that clinical reorientation probably depends on gradual cortical synaptic recovery. Increased seizure duration and the use of benzodiazepines were also related to increased ROT values. Longer seizures and use of benzodiazepines may induce longer postictal synaptic depression.

None Declared

Over the last two decades, a growing volume of research has discovered a correlation between severe mental disorders (SMD) and early mortality. This is attributed to the elevated incidence of chronic physical illnesses s and multimorbidity, resulting in a reduction of life expectancy by 10-20 years. Individuals with SMD exhibit lower rates of prevention, diagnosis, and treatment for medical comorbidities when contrasted with the general population (GP).

The objective is to assess the prevalence of CPM and its impact on psychiatric treatment outcomes in individuals with SMD, and to propose preventive interventions to enhance physical health.

This nested cross-sectional study enrolled 343 SSD patients and 620 GEP.

Individuals diagnosed with SMD encounter CPM earlier in life compared to the GP. Notably, individuals under 35 years old within the schizophrenia spectrum disorder have almost three times higher odds for experiencing CPM compared to their GP counterparts, a difference that is both clinically and theoretically significant. This disparity is especially pronounced among younger women, with the gap widening the younger the patient is in comparison to peers in the general population. CPM has been identified as a factor affecting the outcomes of psychiatric treatment.

The treatment approach for SMD should be tailored to accommodate the diverse physical multimorbidity patterns of patients. It’s imperative for future research to delve into how CPM impacts the outcomes of SMD treatments. There’s a pressing need for detailed treatment guidelines addressing CPM in patients with SMD.

None Declared

Growing clinical interest in psychedelic-assisted therapies has led to a second wave of research involving psilocybin, LSD, MDMA and other substances. Data suggests that these compounds have the potential to treat mental health conditions that are especially prevalent in older adults such as depression, anxiety, existential distress and post-traumatic stress disorder.

The goal of this study was to quantify the prevalence of older adults enrolled in psychedelic clinical trials and explore safety data in this population.

A systematic review was conducted following the 2020 PRISMA guidelines. Search criteria included all trials published in English using psychedelic substances to treat psychiatric conditions, including addiction as well as existential distress related to serious illness. Articles were identified from literature searches on PubMed, EBSCO and EMBASE.

4,376 manuscripts were identified, of which 505 qualified for further review, with 36 eventually meeting eligibility criteria. Of the 1,400 patients enrolled in the 36 studies, only 19 were identified as 65 or older, representing less than 1.4% of all trial participants. For 10 of these 19 older adults, detailed safety data was obtained. No serious adverse events (AEs) occurred in any older adults and only transient mild-to-moderate AEs related to anxiety, gastrointestinal upset, and hypertension were reported during the psychedelic dosing sessions.

While existing data in older adults is limited, it suggests that psychedelic-assisted psychotherapy is safe and well tolerated in older adults. Therefore, psychedelic-assisted psychotherapy should be more rigorously investigated for the treatment of psychiatric conditions in this population.

None Declared

Virtual Reality (VR) represents an emerging and promising tool to enhance standard care for patients with eating disorders (EDs). Indeed, VR provides an immersive and interactive experience in a safe and controlled environment that can simulate real-life situations, showing encouraging findings on various components of psychological treatments such as exposure therapy, psychoeducation, and emotional regulation.

This study aims to evaluate the Zen Garden VR App in patients with anorexia nervosa (AN) in order to obtain pilot data regarding changes in mood, relaxation, anger, anxiety, and weight and shape concerns. A secondary aim was to receive feedback from participants about the VR experience, its components, and its possible application for people with AN.

Self-reported baseline and post-intervention data were collected from a sample of six female inpatients with AN recruited at the Eating Disorders Service at the Bethlem Royal Hospital of the South London and Maudsley NHS Foundation trust (SLaM). The technology used during the VR session consisted of an Oculus head-mounted display headset and two controllers which provided continuous rotational and positional tracking (Figures 1, 2 and 3).

Findings showed a global improvement after the VR Zen Garden App session, mainly in reducing levels of anxiety (Cohen’s d= 1.07) and promoting relaxation (Cohen’s d= 0.95), with possible applications especially before and after meals when food fears are at their highest. In addition, the music that was played during the intervention had a particularly positive effect.

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Despite limitations, such us the small sample size and the one time point measurement, positive clinical implications have been highlighted for the Zen Garden VR App in patients with AN, although further studies are needed to confirm these preliminary findings. It is possible that VR could usefully augment and personalize care for people with an EDs. A range of interventions might be used to target the most compromised symptoms such as designing interventions that can help with triggers to eating disorder psychopathology.

None Declared