Therapeutic leave, the temporary and authorized absence of a patient from a psychiatric inpatient facility, is a practice rooted in the shift of mental illness towards more humane and recovery oriented care. This shift began to gain momentum in the mid-20th century, with the deinstitutionalization movement, which sought to treat psychiatric patients in less restrictive environments and facilitate their integration into the community. Today, therapeutic leave remains relevant in general psychiatry inpatient treatment facilities, and on an international level. It’s additionally used as a way to assess the progress and the stability of the patient outside the controlled environment that is the hospital, and to provide a gradual transition back into independent living and potential stressors of the outside world. But it is administered more on tradition and perceived benefits than on solid scientific grounding, reflecting a practice guided by clinical experience rather than empirical data or guidelines.

Our review aims to evaluate the existing body of research on therapeutic leave in general psychiatry inpatient units. We intend to identify the outcomes that have been studied, and assess the extent and nature of their impact.

This scoping review was conducted through a comprehensive search of academic databases, including Google Scholar, PubMed, Embase, Cochrane Library, and PsycINFO. Search terms were carefully selected to capture relevant publications, and the results were screened for their pertinence to the review’s aims. Studies focused on forensic settings were excluded.

The literature on therapeutic leave is notably limited, and the prevalence of its utilization in clinical practice remains unclear. Scientific publications primarily address readmission rates, with two indicating an increased risk in patients granted leave during their inpatient treatment. However, one report suggested a potential reduction. Length of stay (LOS) was negatively impacted, with prolonged hospitalization in these patients shown in one report. Post-discharge emergency room visits seem unaffected. A rise in readmission rates and LOS typically suggests higher subsequent healthcare costs. However, findings from another study contradict this expectation, with reduction of costs post-initial inpatient treatment. The literature also explores the hazards linked to therapeutic leave, highlighting that a significant portion, between 30 to 80%, of inpatient suicides transpire during such leave. Additional concerns extend to non-fatal self-harm, as well as the possibility of patients causing harm to others or to property.

Our review reveals a significant research gap in therapeutic leave’s effects, with a reduced number of outcomes studied and inconclusive findings. Future studies should aim to clarify these outcomes and eventually define therapeutic leave protocols.

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According to immunological theories of schizophrenia prenatal and postnatal exposure to pathogens may contribute to the etiopathogenesis, suggesting that chronically activated immune system cells (macrophages and T lymphocytes) constantly secrete proinflammatory cytokines which affect the development and function of central nervous system.

In the present work we aimed to evaluate IL-1β plasma levels in schizophrenic patients during their first psychotic episode and to compare the obtained results to those from healthy subjects.

Plasma was obtained from 32 drug-naive schizophrenic patients, without history of substance abuse or addiction, immediately after their admission to the medical ward, while the control samples were obtained from 20 healthy volunteers.

Levels of IL-1β were measured using ELISA assay, which measures IL-1β protein in a range from 7.81 to 500 pg/ml. Results revealed that the levels of IL-1β in patients with first psychotic episode were not increased and were below the limit of detection in all studied samples. The same was found in the samples belonging to the control group.

These data contribute to the poll of knowledge and a still unresolved dogma about the etiopathogenesis of schizophrenia since the results obtained by some studies are also questioning this marker. Thus, whether or not an increase of IL-1β is congenital, acquired during the prodromal phase or absent until the time of first psychotic episode has not yet been investigated.

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Since its beginning in the 1970s in Wisconsin, Assertive Community Treatment (ACT), has been adopted by numerous hospitals worldwide. It improves outcomes for people who are most at-risk of psychiatric hospitalization. The main goal is to provide a global attention with a focus on promoting maximum autonomy and facilitating integration into society. In 2012, the Health Care Complex of Zamora, Spain, adopted this pioneering approach to Mental Health. The main efforts were focused on creating a community network for individuals with severe mental disorders. It embraced a biopsychosocial model of intervention aimed at facilitating patient recovery, giving them tools to create a new life project based on their own autonomy.

The primary objective of this study was to assess the progress of the Assertive Community Treatment (ACT) since its introduction at the Health Care Complex of Zamora, with a specific focus on analyzing the number of hospitalizations as the dependent variable.

A quantitative analysis about psychiatry number of hospitalizations was conducted using the database of the Zamora’s Psychiatry Hospitalization Unit. SPSS Statistics for Windows was used to calculate statistical values related to number of hospitalization. The dataset covers de period from 2010 to 2017.

The implementation of ACT has resulted in a significant reduction in hospitalizations reaching up to 75% in the Psychiatry Service of Zamora. It has been revealed a decrease from 17107 hospitalizations registered in 2011 to a total reduction to 4869 stances in 2013. A consistent trend in the reduction of hospitalizations has been observed (figure 1).A restructuration of the Hospitalization Unit was performed in order to implement de community model and reduce hospitalizations. Removal of more than 50% of the beds was developed.Besides, there has been implemented a community subunit with the objective of regaining their autonomy after a psychiatric exacerbation.

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Getting hospitalized in a Psychiatry Unit can have many different socio-laboral consequences. The ACT model has demonstrated a significative reduction in hospitalizations and it has evolved into a support network dedicated the integration of individuals that are usually left behind by society. Moreover, it presents itself as a positive cost-benefit intervention.ACT allows us to envision a future with fewer hospitalization and greater integration of mental health patients into modern society.

It is important to emphasize that the city of Zamora possesses unique characteristics that have facilitated the adaptation of this model. Not only are the rental prices for housing usually affordable, but the city’s small size, which easy walking, allows for easy access to Community Mental Health resources and services.

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Electroconvulsive therapy (ECT) is a psychiatric intervention that has proven effectiveness and safety in various psychiatric conditions, such as major depressive disorder, prolonged or severe manic episodes and catatonia. Despite positive scientific evidence, ECT was always seen as controversial by patients, caregivers, and even some psychiatrists, which lead to a decrease in its use over the years.

To investigate the way young psychiatrists view the place of ECT in modern psychiatry by assessing their knowledge, attitude and access to training opportunities in ECT.

An anonymous survey was disseminated online among early career psychiatrists and psychiatric trainees. The questionnaire consisted of 36 multiple-choice and Likert scale questions.

Most of our respondents consider ECT both an effective and a safe treatment option and would recommend ECT to their patients when indicated. Early career psychiatrists who had access to ECT training are more knowledgeable about the indications, precautions and side effects of this method, but more than half of the participants mentioned ECT training was unavailable during their residency programme. Almost all respondents stated that they are interested in enhancing their theoretical and practical competencies in ECT.

Early career psychiatrists have a positive attitude towards ECT but express the need of targeted education aimed at improving levels of knowledge about ECT.

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Adjustment disorder is characterized by an emotional or behavioral response to a stressful event or change in life. This condition can impact a student’s academic performance, social life, and overall well-being. Adjustment disorder with the stressor is a psychological response to identifiable stressors that result in the development of emotional or behavioral symptoms. These symptoms cause significant impairment in various areas of functioning, such as social, occupational, or academic performance.

Students with adjustment disorder may experience a range of symptoms, including feelings of sadness, anxiety, hopelessness, and a lack of concentration. They may also have trouble sleeping, feel overwhelmed, and struggle to cope with daily responsibilities. These symptoms can be triggered by various factors such as academic pressure, relationships, family issues, or cultural adjustments.

This study aims to determine the prevalence of adjustment disorder among undergraduate students and investigate the potential risk factors of stress that can lead to adjustment difficulties.

Recognize the signs of adjustment disorder, how to access support, and how to create a supportive environment, therefore, students can effectively manage this condition and thrive in their academic and personal lives.

To prioritize mental health and provide the necessary resources for students to navigate the challenges of adjustment disorder effectively.

Adjustment Disorder‑New Model 20 (ADNM‑20) was used to assess prevalence of adjustment disorder among undergraduate students. It is a diagnostic tool used to assess adjustment disorder in individuals experiencing significant life stressors. The ADNM 20 is specifically designed to capture the nuanced manifestations of adjustment disorder with the stressor, enabling clinicians to make accurate assessments and develop targeted treatment plans.

Adjustment disorder is a real and impactful challenge and a common mental health condition among undergraduate students at Prince Mohammad Bin Fahd University, Al Khobar, Saudi Arabia.

Adjustment disorder can significantly affect a student’s academic performance. The inability to focus, persistent feelings of distress, and a lack of motivation can lead to a decline in grades and overall achievement. By recognizing the signs, accessing support, and creating a supportive environment, students can effectively manage this condition and thrive in their academic and personal lives. It’s crucial to prioritize mental health and provide the necessary resources for students to navigate the challenges of adjustment disorder effectively.

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Huntington’s Disease is a neurodegenerative disease inherited in an autosomal dominant fashion.The underlying genetic defect is unstable CAG trinucleotide repeat expansion with a repeat length longer than 36 resulting in pathological aggregation of abnormal protein causing cell death.

The clinical symptoms encompass 3 main domains-motor,cognitive and psychiatric.The psychiatric symptoms often in atypical form appear decades before other symptoms causing significant impact on patient’s functioning and quality of life.

Here, we discuss an unusual presentation of Huntington’s Disease causing diagnostic dilemma.

Case report discussing the unusual presentation of Huntington’s Disease.

Case: Mr X is a 61 year old Caucasian male.He had an uneventful birth and early childhood attaining milestones appropriately. He experienced childhood adversity in the form of sexual abuse between ages 2-14 years. His mental health difficulties started following sexual abuse when he attempted to end his life by hanging and overdosing at age 15. He got married twice, both of which broke down. There is a history of significant alcohol abuse between ages 40-50. Following this, he had a myocardial infarction and a stroke requiring stenting.

He presented to Psychiatric Outpatient Services in 2011 with auditory hallucinations, social anxiety with panic attacks, OCD type rituals, claustrophobia and feeling hot all the time. He was started on an antipsychotic medication for psychosis ,but clinically deteriorated. He started having anger outbursts, marching on the spot ,and head banging. He was diagnosed with Huntington’s Chorea in 2021 after he had developed chorea. He currently has low mood and is head banging for hours.

Psychiatric symptoms in HD can span a variety of domains but most common are symptoms of frontal lobe dysfunction-disinhibition, poor attention, irritability, impulsivity and personality change. Apathy, emotional blandness and social withdrawal are also prominent features.

Mr X had strong family history of Paranoid Schizophrenia (aunt and cousin).There was no family history of HD. His mental health problems started early in life with DSH, Depression and Harmful use of Alcohol. He presented predominantly with psychotic symptoms like auditory hallucinations, social anxiety, paranoia. Motor symptoms started late which he incorporated into voluntary movements like head banging which made it difficult to differentiate from deliberate self harm.

Psychiatric symptoms constitute the core of HD. Studies have shown that though depression and personality change are typical of HD, there are number of other psychiatric symptoms that can impair quality of life. Early diagnosis and treatment of these symptoms will help patients and families to cope better with severe symptoms of this progressive disease.

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Previous research has shown that:

• - problem focused coping strategies aim to change the reaction to the stressful situations

• - self-compassion may reduce anxiety and depression. It is associated with happiness, it increases with age, it is negatively correlated with perceived stress and in older adults seems to be associated with higher levels of wisdom, integration, acceptance of one’s past life experiences and higher levels of meaning in life.

• - job related low LPLA (Low pleasurable Low arousal emotions) and high LPHA (Low pleasurable High arousal emotions) levels corelate to depression, anxiety, and stress.

Case report of 60 years old computer scientist

Psychiatric interview and scales:

Self-reported questionnaires: The Brief-COPE, The Self-Compassion Scale (SCS-SF), The Perceived Stress Scale (PSS 10), The Depression Anxiety Stress Scale (DASS-10), The Job-related Affective Well-being Scale (JAWS), The Subjective Happiness Scale (SHS), The Meaning in Life Questionnaire (MLQ)

60 years old male computer scientist, single, without children, multiple times a week in recreative activities and physical activities. He is not satisfied with close friendships, he sleeps 6 hours in day, he didn’t have traumatic experiences in life. He is not religious. He works 45 hours per week, from that 5-10 hours weekly works at the site of primary employment.

The Brief-COPE: High score for using problem focused coping strategies-acceptance, planning, positive reframing, and informational support. Maladaptive coping strategies used in lower grade: self-blame and self-distraction.

SCS-SF: Much higher levels of self-compassion than the norms established by previous research.

DASS-10: low.

SHS: lower happiness level than the norms established by previous research.

JAWS: High negative emotional reactions to job and low level of overall job-related affective wellbeing together with lower HPHA, higher LPHA, and lower LPLA in comparison to previous research. According to previous research this person is not satisfied with his job and have a lot of negative emotions regarding his job.

PSS 10: Levels of perceived stress are lower than the norms established by previous research.

MLQ: this person scored below 24 on the scale- presence of meaning and below 24 on the scale search for meaning. According to previous research person with this score do not feel their life has a valued meaning and purpose and they do not not actively explore that meaning or seeking meaning.

Problem focused coping strategies and high self-compassion can be seen as protective factors to lower stress, negative emotional reactions to job and anxiety

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Lack of adherence to pharmacological treatment is considered a multifactorial phenomenon, remarkably frequent in clinical practice. Non-adherence is associated with increased number of relapses, poor clinical and functional outcomes, and worsening of patient health status, with a resulting increase in healthcare costs, particularly in people with severe mental disorders (SMD). Treatment adherence rates remain extremely low, highlighting the need to develop innovative and integrated strategies; one of these is represented by the promotion of healthy lifestyle behaviours, including regular physical activity.

The aim of this study is to assess how the rates of treatment adherence vary in patients with SMD after receiving a psychosocial intervention, focusing on the positive relationship between treatment adherence and physical activity.

LIFESTYLE is a randomized controlled trial comparing the efficacy of a structured psychosocial lifestyle intervention involving moderate physical activity exercises over a brief psychoeducational intervention. Levels of physical activity was assessed thorough the IPAQ scale, while treatment adherence was evaluated by the Morisky Medication Adherence Scale (MMAS).

The sample includes 401 patients, with a mean duration of illness was 16.3 (±17.8) years. All patients were receiving a pharmacological drug treatment; in particular, 59.6% (N=239) were treated with a second-generation antipsychotic and 54.9% (N=220) with a mood stabilizer. Our results show that moderate physical activity improves rates of treatment adherence. After 6 months, adherence to treatment increased from 35.8% at baseline to 47.6% at baseline in the experimental group, along with improvement in clinical health parameters (reduction in BMI, weight, and metabolic parameters). Another significant inverse correlation was found between adherence and quality of life (Rho di Person: -.140, p<.005). Furthermore, this study indicates that having a diagnosis of major depression, a better cognitive functioning, a shorter duration of illness and contact time with the local mental health centre are factors that positively influence treatment adherence. Remarkably, treatment adherence was not influenced by symptom severity and type of pharmacological treatment.

Moderate physical activity can represent a valid strategy to increase treatment adherence in patients with SMD. Therefore, promoting physical activity exercises in our clinical practice may be associated with better outcomes. However, further studies that evaluate patients with acute mental disorders are needed.

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Depression is a widespread problem that affects individuals of all ages. This study looks at the use of omega-3 polyunsaturated fatty acids (PUFAs) as an additional therapy for depression in people of different ages. Depression has an impact on everyone, from youth to the elderly, causing therapeutic concerns such as treatment resistance and recurrence. Omega-3 PUFAs, which may be found in fish and flaxseed, are important because of their impact on neurochemistry, inflammation, and neuroprotection. While pharmacotherapy, including antidepressants, has proven beneficial for many, the likelihood of remission and recurrence remains substantial. In recent years, there has been a growing interest in the potential role of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in mitigating depressive symptoms. The primary constituents of n-3 PUFAs are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Understanding the potential of omega-3 PUFAs across the lifespan can help address the multifaceted challenges posed by depression and improve mental health outcomes for diverse age groups.

This review aims to assess the role of omega-3 fatty acids in depression treatment across different age groups: children and adolescents, adults (18–60), and the elderly (60+). It investigates the effectiveness and potential differences in omega-3 supplementation among these age cohorts.

A comprehensive literature search was conducted from 2003 to 2023 using PubMed, Google Scholar, and EMBASE, using specific keywords. Studies with inadequate age group information or Omega-3 intervention were excluded.

In children and adolescents, several studies indicate a positive association between omega-3 supplementation and improved depressive symptoms. In adults, results are mixed, with some studies showing benefits while others do not. In the elderly, omega-3 PUFAs appear to have a more consistent positive effect on depression. In contrast, a consistent positive association was observed in the geriatric population, suggesting that Omega-3 PUFAs may hold particular promise in the treatment of depression among older adults. However, variations in methodology, dosage, and study populations contribute to these mixed findings.

Omega-3 PUFAs show promise as an adjunct therapy for depression across different age groups. Further research with standardized methodologies and larger sample sizes is needed to clarify their role and establish optimal dosage guidelines. Omega-3 PUFAs should be considered as a potential complement to conventional depression treatments, emphasizing the need for personalized approaches in depression management.

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Psychiatric pathologies are more common in people with epilepsy than in the general population and have a negative impact on the quality of life of these patients.

The objective of this work is to illustrate, through a series of cases, the complex relationship between epilepsy and psychiatric pathologies.

We report the cases of four patients with different psychiatric pathologies associated with epilepsy admitted to the psychiatry department of Hedi Chaker Sfax. We collected the clinical characteristics of these patients based on their medical files.

The patients were aged 64, 45, 38 and 26 respectively. The first patient had a late-onset vascular epilepsy following the psychiatric pathology onset by 20 years. In the remaining cases epilepsy onset preceded the psychiatric pathology by 6, 3 and 1 year respectively. The aetiology of epilepsy was juvenile myoclonic epilepsy, and idiopathic in 2 cases. The psychiatric pathologies were schizophrenia, obsessive compulsive disorder with schizoid personality, schizoaffective disorder in the bipolar type and mild intellectual disability with histrionic personality, respectively. Familial history of psychiatric disorders was found 2 patients and of epilepsy in one.

Epilepsy and psychosis have a complex and bidirectional relation. Not only are patients with epilepsy at a greater risk of developing a psychotic disorder, but patients with a primary psychotic disorder are also at greater risk of developing epilepsy. The fact that the association between these pathologies is more frequent than expected should prompt more in-depth studies concerning the underlying etiopathogenic mechanisms to improve their management.

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Internet gaming disorder has been associated with an excessive number of hours spent playing video games, which leads to a detriment of other daily activities and interests. In addition, it is associated with personality traits such as aggression and anger. In Portugal this relations are almost unexplored.

To explore the relationship between video game use, internet gaming disorder and aggression.

This study was applied to a sample of 202 subjects, aged between 18 and 29 years old (M = 22.5, SD = 3.006). Subjects fulfilled a sociodemographic and viodeogame pattern questionnaire, and the Portuguese versions of the Internet Gaming Disorder Scale (short form), and the Buss-Perry Aggressiveness Questionnaire.

In this study 20.3% (n = 27) of the males and 5.8% (n = 4) of the females use excessively videogames, considering the screen time recommended by the American Academy of Pediatrics. However, 81% (n = 70) of the sample have a positive self-perception of their use. 21.4% (n = 45) use videogames during day, 71% (n = 49) during night and 3.8% (n = 8) during dawn. The total score for internet gaming disorder was of 15.17 (SD = 6.006), but only 1 subject (0.5%) presented probable videogame disorder considering the sutt-off points. A positive and significant correlation was found between internet gaming disorder and physical agressiveness (.32**), verbal agressiveness (.28**) and hostility (.45**). Finally, a positive correlation was found between internet gaming disorder and time spent playing video games.

Our results, despite being merely exploratory, show us the relationship that exists between the use of video games, internet gaming disorder and aggressiveness. In that sense it is important to continue to explore internet gaming etiology and consequences.

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Internet and smartphone use that reaches the level of addiction often leads to deterioration in the quality of life and functionality of individuals.

In our study, we aimed to investigate possible differences in retinal nerve fiber layer (RNFL) thickness and central macular thickness obtained by optical coherence tomography in internet and smartphone addiction.

A total of 212 volunteer university students participated in our study. All participants were administered the Sociodemographic Information Form, Chen Internet Addiction Scale, Smartphone Addiction Scale-Short Form. Participants who completed the scales underwent routine eye examinations by experienced physicians in the ophthalmology outpatient clinic. Retinal nerve fiber layer (RNFL) thickness and central macular thickness were measured by optical coherence tomography (OCT).

In our study, internet addiction rate was 17% and smartphone addiction rate was 38.2%. RNFL thickness was found to be statistically significantly increased in the temporal superior and temporal inferior quadrants in those with internet addiction compared to healthy subjects (p<0.05). In smartphone addiction, RNFL thickness was found to be statistically significantly increased in the temporal inferior quadrant compared to healthy subjects (p<0.05). In the analyses comparing OCT measurements according to sex, it was found that nasal inferior (p<0.01) and global (p<0.05) quadrants in women and central macular thickness (p<0.01) in men were statistically significantly increased.

The correlation analyses in our study revealed statistically significant positive correlations between internet addiction scale scores (p<0.01) and smartphone addiction scale scores (p<0.01), RNFL temporal superior quadrant thickness (p<0.01); smartphone addiction scale scores and RNFL temporal superior quadrant thickness (p<0.05).

Internet and smartphone addiction are seen considerable rates among university students. In OCT measurements, RNFL thickness was found to be increased in various quadrants in patients with addiction. In addition, RNFL thickness was found to be increased in all quadrants in female gender and central macular thickness was found to be increased in male gender. Correlation analysis revealed that internet addiction scale scores, smartphone addiction scale scores, and RNFL temporal superior quadrant thickness were positively correlated. In addition, there was a positive correlation between smartphone addiction scale scores, and RNFL temporal superior quadrant thickness

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White matter hyperintensities (WMH) is common among the elderly. WMH are associated with accelerated cognitive dysfunction and increased risk for Alzheimer`s disease (AD). Although WMHs play a key role in lowering the threshold for the clinical expression of dementia in AD-related pathology, the clinical significance of their location is not fully understood.

The aim of this study was twofold: 1) To investigate the quantitative association between WMH and cognitive function in AD; 2) To investigate whether there is any difference in the association between subclassified WMH and cognitive function in AD.

A total of 171 patients with AD underwent clinical evaluations including volumetric brain MRI study and neuropsychological tests using the CERAD-K neuropsychological assessment battery. WMH volume was calculated using automated quantification method with SPM and MATLAB image processing software. According to the distance from the lateral ventricular surface, WMH within 3 mm, WMH within 3-13 mm, and WMH over 13 mm were classified as juxtaventricular WMH (JVWMH), periventricular WMH (PVWMH) and deep WMH (DWMH), respectively. WMH volume data was logarithmically transformed because it was right-skewed.

WMH volume in AD was 20.7 ± 18.2 ml. Total WMH volume was associated with poor performance in categorical verbal fluency test (p = 0.008) and word list memory test (p = 0.023). JVWMH volume was associated with poor performances on categorical verbal fluency test (p = 0.013) and forward digit span test (p = 0.037). PVWMH volume was associated with poor performances on categorical verbal fluency test (p = 0.011) and word list memory test (p = 0.021), whereas DWMH volume showed no association with cognitive tests. Total WMH and PVWMH volume were also related to Clinical Dementia Rating scale sum of boxes score (p=0.022).

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Greater JVWMH and PVWMH are related with concurrent impairments in semantic memory and frontal function independent of the hippocampal volume. However, DWMH volume is not associated with any cognitive function. Only PVWMH among subclassified WMH are related to the severity of AD.

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Psychotic experiences show a dynamic pattern over time, often in interaction with the environment. In my talk, I will discuss how Ecological Momentary Assessment (EMA) or Experience Sampling Methodology can be used to assess psychotic symptoms in the flow of daily life. I will focus on the assessment of both positive and negative symptoms, where I will discuss both how we can measure such symptoms as well as what the dynamic patterns look like in everyday life. Furthermore, I will also focus on how ESM can be used to transfer psychological treatment to daily life using an app. I will discuss the INTERACT trial, a trial in people at the early stages of psychosis, where we investigated the effect of Acceptance And Commitment Therapy in Daily Life, compared to Treatment As Usual.

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Symptoms of anxiety can worsen cognitive decline in people with dementia, and symptoms of dementia and fears of further cognitive decline can cause anxiety. Advanced dementia is not necessarily associated with a loss of emotion, which means that people may still experience anxiety, but their ability to cope in a healthy way is reduced. The problem is exacerbated by the fact that hospital care alone can contribute to the severity of anxiety symptoms due to change in routine of daily activities, unfamiliar surroundings, uncertainty about health status, prognosis and various medical procedures. There are differences between women and men in the prevalence, course and manifestation of both dementia and anxiety disorders.

To examine whether there are differences between women and men in the association of hospital anxiety with eight symptoms of dementia: difficulties with memory, orientation, judgement, problem solving, fulfilling social obligations, daily activities at home and with hobbies, or personal care, in patients with mild to moderate dementia.

A cross-sectional study was conducted at Sveti Ivan Psychiatric Clinic in Zagreb in June 2023. The target population were hospitalised patients diagnosed with dementia, both genderes, aged 60-90 years, without psychotic disorder. Anxiety during hospitalisation was measured using the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A), and the severity of dementia symptoms was measured using the Dementia Assessment Instrument (CDR). The hypothesis was tested using Wald test of differences between women and men in unstandardised linear regression coefficients of the HADS-A on individual dementia symptoms, after adjustment for age, education, presence of a married or stable non-marital partner and duration of current hospitalisation.

We enrolled 65 women and 35 men of comparable age. There were significant gender-related differences in the association between hospital anxiety and difficulties with judgement (P = 0.01), fulfilling social obligations (P < 0.001), difficulties with home and hobbies (P = 0.02), and personal care (P = 0.00). In women, more pronounced difficulties with judgement and with home and hobbies were associated with higher anxiety, and in men the presence of these two symptoms of dementia was associated with lower anxiety. Difficulties with fulfilling social obligations are associated with lower anxiety in women and higher anxiety in men. Difficulties with personal care were associated with lower anxiety in both genders, but this effect was stronger in men.

There are differences between women and men in the association between anxiety during hospital treatment and the severity of individual dementia symptoms. These differences are present in difficulties with judgement, fulfilling social obligations, home, hobbies and personal care.

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Childhood trauma and depression are both associated with increased risk of metabolic disorders, but their joint effects and underlying mechanisms are not well understood. This talk will present recent findings from large-scale epidemiological and biobank studies that explore the metabolic signature of childhood trauma, depression, and their interplay. For example, using longitudinal data from the NESDA cohort, we investigated the association of childhood trauma with metabolic syndrome in ˜3000 adults, including patients with depression and/or anxiety and healthy controls, over 9 years of follow-up. The talk will also describe preliminary results from an individual patient data meta-analysis pooling >160,000 subjects from the Early Cause European Consortium. In this study, we examined the differences in markers of obesity and dyslipidemia across individuals with neither childhood trauma nor depression (controls), those with childhood maltreatment, those with depression, those reporting both of these conditions. The findings described in the talk shed light on the complex interplay between early life stress, mood disorders, and metabolic health.

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Borderline personality disorder (BPD) is associated with excess suicide risk, natural-cause mortality, comorbid medical conditions, poor health habits and stress related epigenomic alterations. This presentation will report findings of BDNF and stress system associated epigenetic alterations in a group of severely impaired BPD and suicidal patients. Further, findings of GrimAge – a state-of-the-art epigenetic age (EA) estimator- in patients with BPD and attempted suicide patients will be presented. Genome-wide methylation patterns were measured using the Illumina Infinum Methylation Epic BeadChip in whole blood from well characterized 97 BPD patients, 88 suicide attempters and 32 healthy controls.

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Police-officers are in a strategic position of providing the first immediate response to a crisis as mental health frontliners.

In this nation-wide cross-sectional study, we explored knowledge and attitudes towards suicide in the local police force, a crucial first step in the design and implementation of effective suicide prevention programmes.

An online, anonymous questionnaire was distributed to all local police-officers (n=2600). It contained questions about their demographics and their experience with suicide while on duty, along with 34 statements from the validated tool Attitudes Towards Suicide (ATTS) (Renberg & Jacobsson. Suicide Life Threat Behav. 2003; 33 52-64), scored on a 5-point Likert Scale (1 = Strongly Disagree, 5 = Strongly Agree).

The sub-scale “Suicide as a right” was positively correlated with “Tabooing” (r (201) = .25, p=<.001), “Normal-common” (r (201) = .29, p=<.001), and “Resignation” (r (201) = .47, p=<.001), but negatively correlated with “Incomprehensibility” (r (201) = -.26, p=<.001), and “Preparedness to Prevent” (r (201) = -.19, p=<.001), meaning such individuals had a more permissive attitude towards suicide. On the other hand, the subscale Preventability was found to be positively correlated with Incomprehensibility (r (201) = .21, p=<.001) and Preparedness to Prevent (r (201) = .30, p=<.001).

Females scored higher in the sub-scale Non-communication (M=3.40, 95% CI [3.29, 3.51]) while males scored higher in Preventability (M=3.35, 95% CI [3.27, 3.44]). The higher the educational status of police-officers, the more they adopt a pro-prevention attitude to suicide (M=3.67, 95% CI [3.44, 3.89]) and the more likely they are to appreciate that suicidal thoughts and behaviour can be common (M=3.40, 95% CI [3.20, 3.60]). Participants with a mixed/different composition at home (M=4.05, 95% CI [3.86, 4.24]) and/or have experienced only between 0 to 2 situations related to suicide in the past one year alone (M=4.05, 95% CI [3.94, 4.16]), were the most likely to feel prepared to prevent suicide.

This study brings out different attitudes police-officers hold towards different aspects of suicide, influenced by their gender, educational background, personal life at home and total exposure to suicide during their career. Training programmes can help improve their knowledge and attitudes towards suicide, leading to a more positive behavioural response to individuals in crisis and create a safer environment. Malta, through an EU-funded programme, is currently investing its resources on drafting a national suicide prevention strategy, and such educational opportunities for our frontliners will ensure we have the right tools in screening, identifying, treating, and saving more lives.

Abbreviations: M: Mean score; CI: Confidence Interval

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Anxiety is one of the most common Mental Health diagnosis in underage population. We decided to study if there was any variable that would lead us to a specific treatment indication using the MASC (Multidimensional Anxiety Scale for Children).

Prevalence of psychiatric disorders and comorbidities in an underage population.

Possible association between MASC questionnaire scores and the indication for pharmacological and/or psychological treatment.

This is a descriptive, observational, retrospective, quantitative study with data from patients between June 2016 and 2023. Inclusion criteria: 3-18 year-old-spanish-speakers who met criteria for a ICD-11 disorder. Exclusion criteria: absence of legal representatives, intellectual disability. Variables: Age, sex, psychiatric family history, ICD-11 diagnosis, treatment indication and MASC’s subscales (physical symptoms, harm avoidance, social anxiety and separation anxiety). Statistical analyzes were performed with STATA-15 program, using as independent variables MASC questionnaire, and dependent ones the indication treatment and diagnosis.

The sample contains 1024 patients, with a mean age of 12 (SD 4.028). Table 1 shows that the most frequent diagnosis is ADHD, with combined presentation with a prevalence of 22.27%, followed by Anxiety Disorders, without differentiating by subtypes (17.93%). It also shows that Defiant and Oppositional Disorder is the most prevalent comorbidity (9.66%) followed by Anxiety Disorder not specified (4.99%). Table 2 stands that there are significantly higher scores in all MASC subscales in those patients who do have prior psychiatry family history. We founf in Table 3 statistically significant differences were found between the score on the Physical Symptoms subscale based on whether the patient was undergoing previous treatment, both pharmacological (8.45 vs. 7.59) and psychological treatment (9.01 vs. 7.95) compared to those who were not (pharmacological 7.36 vs. 7.06), psychological (7.21 vs. 6.92). All these data have been adjusted.

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Anxiety disorders are the most common form of Mental Disorder in young people, with a global prevalence of 6.5% (Rapee et al.2023). However, in our sample the most common one is ADHD as our center is specialized in it. We found that the most prevalent one was Oppositional Defiant Disorder, as it is the most frequent comorbidity of ADHD (Vallejo-Valdivielso et al,2019; Faraone et al,2021). The increase of one point in the Physical Anxiety subscale increases the probability of indicating pharmacological treatment, which could be explained because of how functional limitation these symptoms cause. The increase in all the subscales of the MASC implies an increase in the probability of an indication for psychological treatment as it is the gold-standard treatment for anxiety in children.

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Schizophrenia is a common chronic disease in psychiatric long-term care institutions. Taipei City Hospital Songde Branch Psychiatric Nursing Home (TCHSBPNH) is the first public psychiatric nursing home in Taipei City. There’s not only a complete interdisciplinary care system, but also detail initial evaluation at admission of residents, including basic demographic information, cognitive assessments, activities of daily living, and so on. It is known that patients with schizophrenia are generally accompanied by cognitive impairments, which further affects their activities of daily living (ADL) performance, but we still don’t know the correlation between of them.

This study aimed to investigate the relationships between cognitive function and ADL function of psychiatric nursing home residents with schizophrenia. The results would promote clinical intervention in ADL training for institutional patients.

39 participants with chronic schizophrenia (mean age =63.95±6.59 years) were recruited for the study from 2020 to 2021 in TCHSBPNH. We collected every resident’s assessment data, including Mini-Mental State Examination (MMSE), Barthel Index, Lawton - Brody Instrumental Activities Of Daily Living Scale (Lawton IADL scale) and Composite Physical Function (CPF) Scale. The Pearson correlation coefficient was used to examine the correlation between cognitive function and ADL.

Moderate positive correlations were showed between cognitive function and ADL (p<.05). The statistic results as follow, MMSE and Barthel Index (γ=.627, p<.001), Lawton IADL scale (γ=.431, p=.006), and CPF (γ=.341, p=.034) respectively exhibited significant correlations.

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There is a positive correlation between cognitive function and ADL in psychiatric nursing home residents with schizophrenia. The better cognitive function performance becomes, the better independent ADL functions will be. Thus, the psychiatric nursing home residents’ independent ADL training will also vary from person to person.

None Declared