The Strengths and Difficulties Questionnaire (SDQ) is a widely used assessment tool for measuring the psychological well-being of children and adolescents. It consists of 25 items that assess emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship difficulties, and prosocial behavior.

The present study aimed to investigate the relationship between parental perceptions of difficulties and the results obtained from the SDQ.

Participants were recruited from the initial consultation of Child and Adolescent Psychiatry (N=132). Parents completed a questionnaire assessing their subjective perceptions of their child’s difficulties in various domains (home, school, learning activities, relations with friends) on a 4-point scale ranging from “no notion of difficulties” to “very severe difficulties”. They also completed the SDQ scale. Data were analyzed using SPSS software.

In this study, 74% of participants had scores on the SDQ indicating potential psychological difficulties. Additionally, 17.4% of participants had scores on the borderline between normal and abnormal results. 47% of patients scored above the cut-line for problems on the hyperactivity/inattention subscale, indicating higher levels of difficulties in this area. Conversely, only 3% of participants scored problematic scores on the peer relationship difficulties subscale. There was no statistical difference between sexes in terms of SDQ scores. A correlation analysis revealed a significant positive correlation (p < 0.01) between parental perceptions of difficulties and higher SDQ scores and the mean score on the SDQ scale was found to be significantly higher in patients who were rescheduled for another consultation following the evaluation by doctors, compared to those patients who received clinical discharge from the initial consultation (p-value 0,040).

This study provides valuable insights into the concordance between parental perceptions and objective assessments of difficulties in children and adolescents. Parents who perceived their child to have more difficulties also reported higher levels of psychological difficulties on the SDQ. This study highlights the importance of using tools like the SDQ to assess psychological well-being in children and adolescents. It also emphasizes the practical utility of the SDQ as a time-efficient assessment tool for use during initial consultations in child and adolescent psychiatry.

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The Gaza-Israel conflict has far-reaching consequences that extend beyond the immediate geographic confines of the conflict zone.This war certainly has repercussions on people who follow it via the media.

To study the prevalence of acute stress disorder among Tunisian people and determinate the factors associated to it.

It was a cross-sectional, descriptive and analytical study, conducted among Tunisians. Data were collected during October and November 2023, through an anonymous online questionnaire, spread throughout social media (Facebook/Instagram), using the Google Forms® platform.

We used the the National stressful Events survey acute Stress Disorder Short scale (NSESSS) to assess the severity symptoms of acute stress disorder .

The National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS) is a 7-item patient assessment measures that assesses the severity symptoms of acute stress disorder in individuals age 18 and older following an extremely stressful event or experience.

A total of 1091 participants completed the questionnaire. The participants had a mean age of 32.7 ± 9.8 years. More females (77.7%) than males (22.3%) participated in the study with a sex ratio (F/M) = 3.5. They were divorced in 2.1% .A history of psychiatric follow-up was found in 19,5% of case.

Results demonstrated that 100% of the respondents closely monitored the war, primarily relying on social media (98.6%) as their primary source of information.

According to the NSESSS ,83.4% of the participants had an acute stress disorder. The breakdown of acute stress disorder severity indicated that 29.7% experienced mild symptoms, 27.5% moderate, 21.6% severe, and 4.6% extreme symptoms.

The factors associated with high score of NSESSS were: female sex ( p=0.000), the divorced people (p=0.001)and previous history of psychiatric follow-up (p=0.000)

These findings indicate a substantial impact of the Palestine-Israel conflict on the mental well-being of the Tunisian population, as evidenced by high rates of acute stress disorder.

Understanding the heightened prevalence of acute stress disorder among different demographic groups following such international conflicts is crucial for developing tailored interventions to support the mental health and well-being of affected individuals.

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Significant and measurable cognitive symptoms are present at the onset of the disorder and these remain stable in the subsequent period between 2 and 5 years. Their deterioration increases with the course of the disease. Attention, concentration, psychomotor speed and resolution of conceptual tasks are usually affected and are more significant in the presence of positive symptoms.

Sometimes, the typical positive or negative symptoms of the disease do not adequately reflect the severity of cognitive impairment. Measuring this deterioration can be very relevant when evaluating the severity and the prognosis of the disorder.

31-year-old male with a previous diagnosis of schizophrenia of 4 years of evolution. He gets a maintained treatment with amisulpiride 400mg with an apparent good response. A single hospitalization at the onset of the disease. An assassination attempt on his mother is done by suffocation with a pillow and observing a significant cognitive impairment despite an apparent control of the symptoms of schizophrenia.

An exhaustive neuropsychological evaluation is carried out, observing a very important cognitive deterioration that had not been previously detected and allowing a pharmacological adjustment of the underlying disease with global improvement of the patient.

It is very important to evaluate the patient as a whole without forgetting the frequent cognitive damage that these patients can have. An intense neuropsychological study can be very useful to evaluate the prognosis and adequate treatment of the patient in order to reduce serious risks.

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Chronic pain patients often contend with insomnia symptoms, creating a reciprocal relationship that adds complexity to their condition. Evaluating interventions targeting insomnia in this population becomes paramount, given the intertwined nature of pain and sleep disturbances.

This retrospective pretest design aimed to assess the efficacy of an Internet-delivered sound healing intervention in reducing insomnia severity and addressing sleep- and pain-related parameters among individuals with chronic pain.

Conducted as a community-based project, Tuning for Health provided support to individuals grappling with long-term illnesses. The intervention involved the virtual delivery of a specially crafted sound track using tuning forks over a 6-week period, supervised by an experienced therapist and administered weekly for an hour. Participants were instructed to play the track daily at a time convenient for them. A total of 68 participants (mean age 59.3 years) completed the intervention. Outcome measures, including the Insomnia Severity Index (ISI), a sleep diary, and assessments for anxiety, depression, and pain-related parameters, were collected at the end of the 6-week intervention and repeated after a 6-month follow-up. Negative effects were monitored and reported.

Significant immediate interaction effects (time by treatment) were observed for the pain severity, ISI and various sleep parameters, such as sleep efficiency, sleep onset latency, early morning awakenings, and wake time after sleep onset. A time effect for anxiety and depression was noted at the 6-month follow-up. The group exhibited highly significant improvements in pain-related parameters. At the 6-month follow-up, sustained enhancements in sleep parameters and mental health were reported, with no reported side effects.

These unique results suggest the potential efficacy of sound healing in alleviating chronic pain and associated insomnia. Further research with a larger sample size is warranted to validate these findings. Combining sound healing with other treatments may offer enhanced outcomes for individuals dealing with both chronic pain and comorbid insomnia. This study lays the groundwork for future investigations into the promising intersection of sound healing, chronic pain management, and sleep improvement.

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Cerebrovascular insult (CVI) in patients with psychiatric diseases is to a large extent more prevalent and is accompanied by a worse prognosis after a incident. Despite the higher mortality, these patients are less frequently subjected to CT angiography and interventional intervention on the blood vessels of the brain.

To show the frequency of cerebrovascular insults in patients with schizophrenia (SCH), bipolar affective disorder (BP), and depression, depending on age, gender, socioeconomic characteristics, professional qualifications, and dietary habits.

A total of 1200 patients with SCH, BD and depression were treated over a period of five years.

11.1% SCH patients had CVI and 3,7% a cases of bipolar afective diseases. CVI was most often experienced by patients who were married, employed, or retired, and who lived in urban areas. Smoking, elevated blood pressure values, elevated BMI do not have a significant impact on the occurrence of CVI in all groups. Patients with elevated values of glucose, total cholesterol and LDL cholesterol and CRP had a higher incidence of cerebrovascular insult.

It is necessary to work on raising the awareness of people suffering from psychiatric diseases regarding lifestyle and eating habits, and to conduct periodic health examinations. It is important to recognize high-risk patients and educate them about preventive measures.

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Misophonia is a condition characterized by extreme emotional reactions, such as irritation or anger, triggered by specific sounds. Despite its prevalence, there is a lack of evidence-based treatment methods for misophonia.

This case report aims to explore the effectiveness of combining psychoeducation with Cognitive Behavioral Therapy (CBT) in the treatment of a misophonic patient. The focus is on reducing the patient’s emotional distress and improving their quality of life.

The patient is a 28-year-old woman employed as a salesperson in a busy city. Mouth smacking, gum chewing and clock ticking are the sounds that bother her the most. She has never used any medications or attempted any methods to alleviate her misophonia. Neither she, nor her family has a history of a psychiatric disorder.

The therapeutic intervention spanned eight sessions, each lasting around half an hour. The first two sessions, a patient history was taken and Mısophonia Interview Scale (MIS) was conducted. MIS comprised the Misophonia Checklist (MCL), which involved reading fifty misophonic sounds to the patient one by one. She then rated her discomfort in response to each sound on a four-point Likert-type scale. From the MCL responses, a total severity score (Misophonia Total Score - MTS), was calculated.

The treatment commenced with a psychoeducational component focused on enhancing the patient’s comprehension of misophonia. This phase aimed to elucidate the neurobiological underpinnings of the condition, common triggers, and the emotional reactions associated with it.

Then, CBT was employed to identify and challenge the patient’s negative automatic thoughts (NATs) linked to her misophonia. Three sessions primarily concentrated on identifying and managing NATs associated with her misophonia. These sessions equipped the patient with the skills to recognize and confront NATs through structured discussions and practical assignments.

The last three sessions centered on exposure therapy, with the goal of reducing emotional and physiological responses to triggers. Homework assignments during this phase encouraged the patient to independently practice exposure exercises.

The initial MTS was 54, indicating significant distress. After the interventions, the final MTS decreased to 35 and the impact of misophonic symptoms on her life decreased from severe to moderate.

Misophonia is a challenging disorder to treat due to its limited evidence-based interventions. This case report demonstrates that a combination of psychoeducation and CBT methods may hold promise in managing misophonic symptoms. However, it is essential to acknowledge the need for further research in this area, as misophonia’s treatment strategies require more robust empirical support. This case highlights the potential benefits of psychoeducation and CBT, emphasizing the need to explore and develop effective treatments for this debilitating condition.

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Fatal youth overdose (FYO) in the US has been driven by fentanyl and polysubstances since 2016. Youth suicide have also been increaing since the year 2000. The manner of FYO may be accidental, intentional or undetermined, Psychoactive drug use including opioids has been known to increase suicidality in youth.

Examine and compare the rate of intentinal and accidental FYO as well as specific drug toxicology in youth under 26 years of age in the state of Connecticut, USA; between the years 2016-2018 (Kaminer et al. JCASA 2020;29 80-87) and 2019-2021.

We reviewed N=286 consecutive FYO case files of youth who died between 2019-2021, from the Connecticut office of the Chief Medical Examiner.

Comparing the periods of 2019-2021 2016-2018: A) FYO attributed to fentanyl increased significantly; B) Intentional YFO rates doubled from 3.8% to 7.7%; C) No gender differences were found between and within age groups; and D) hispanic rates increased significantly while caucasian rates decreased signficantly; F) for the first time YFO of youth under the age of 15 years was recorded and G) the age group of 15-19 years old constitute 10% of the YFO and remined unchanged.

The use of lethal drugs leading to youth accidental and intentional FYO should be addressed by developing prevention-intervention approach. Focus on acute modifiable high-risk is prudent. The increase of intentional (i.e., suicidal) determined YFO is a major public health concern.

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Relapse is defined as the return of psychotic symptoms after a period of improvement/stability. Relapse is often associated with the disruptive re-hospitalization of patients. Importantly, relapse history is a strong predictor of subsequent relapses and poorer outcomes. Therefore, relapse prevention in the beginning of the disorder is especially important. Cariprazine, a novel D3-D2 partial agonist, has been effective in preventing relapse compared to placebo in stabilized patients with schizophrenia.

To present the efficacy of cariprazine in preventing relapse in patients with early-stage schizophrenia.

Post-hoc analysis of data from a ˜96 weeks, multicentre, randomized, double-blind, placebo-controlled, parallel-group study in adults with schizophrenia. The study was composed of two parts: a 20-week open-label treatment phase and a double-blind treatment phase up to 72 weeks. During the open-label phase, patients were stabilized with cariprazine 3.0-9.0 mg/day. Then, they were randomized to continue cariprazine (fixed dosing: 3.0, 6.0, or 9.0 mg/day) or receive placebo. Relapse was defined as a deterioration of symptom scores as measured by the Positive Negative Syndrome Scale (PANSS), admission to a psychiatric hospital, exhibiting aggressive behaviour, or risk of suicide. In the present analysis, patients with a schizophrenia diagnosis history of 0-5 years were defined as early-stage patients. Baseline characteristics, and risk ratios (after the double-blind phase) with number-needed-to-treat (NNT) were calculated.

Of 200 patients, 71 (35.5%) met the early-stage criteria: 32 patients in the cariprazine (CAR) and 39 in the placebo (PBO) arm. The mean age was 31.6 years in both groups with an average illness duration of 2.51+/-1.03 years in the CAR and 2.75+/-1.24 years in the PBO arm. 47% of patients in the CAR arm and 77% in the PBO arm were men. The average number of previous hospitalisations was comparable in the two groups (CAR: 2.3; PBO: 2.6), as was the severity of illness: mean PANSS Total score: 89.2 (CAR), 90.4 (PBO). Patients in both groups were highly compliant (pill-count: CAR: 98.2%; PBO: 99.5%). The main reported adverse effects were headache (CAR: 11.3%, PBO: 7.0%), insomnia (CAR: 5.6%, PBO: 4.2%), and increased triglycerides (CAR: 5.6%, PBO: 1.4%), discontinuation due to adverse event was 3.1% in the CAR and 2.6% in the PBO group. Altogether, 9.4% of patients relapsed in the cariprazine group compared to 48.7% on placebo (risk ratio=0.19 (95% confidence interval (CI): 6.3-59.2%, p=0.0041;NNT: 2.5 (95%CI: 1.7-5.1).

In this post-hoc analysis of patients within the first five years of schizophrenia, the relative risk of relapse was 81% reduced with cariprazine with prevention of one additional relapse after each third patient exposed to cariprazine vs placebo. Cariprazine seems to be a good treatment option for early-stage patients for preventing relapse.

C. Correll Consultant of: AbbVie, Acadia, Alkermes, Allergan, Angelini, Aristo, Biogen, Boehringer-Ingelheim, Cardio Diagnostics, Cerevel, CNX Therapeutics, Compass Pathways, Darnitsa, Denovo, Gedeon Richter, Hikma, Holmusk, IntraCellularTherapies, Jamjoom Pharma, Janssen/J&J, Karuna, LB Pharma, Lundbeck, MedAvante-ProPhase, MedInCell, Merck, Mindpax, Mitsubishi Tanabe Pharma, Mylan, Neurocrine, Neurelis, Newron, Noven, Novo Nordisk, Otsuka, Pharmabrain, PPD Biotech, Recordati, Relmada, Reviva, Rovi, Sage, Seqirus, SK Life Science, Sumitomo Pharma America, Sunovion, Sun Pharma, Supernus, Takeda, Teva, Tolmar, Vertex, and Viatris., Z. Dombi Employee of: Gedeon Richter Plc., P. Herman Employee of: Gedeon Richter Plc., Á. Barabássy Employee of: Gedeon Richter Plc.

Low back pain (LBP) is a serious threat to electricians. It is well known that LBP is associated with physical strain. But the impact of psychological workload on the occurrence of LBP needs further investigation.

This study aimed to assess the link between LBP and perceived psychological workload among electricians.

The study was conducted with a sample of workers from a Tunisian Electricity society. Data were gathered between January-June 2022 using a self-administered questionnaire including socio-professional characteristics and the Nordic musculoskeletal questionnaire during the last 12 months and the last 7 days. To assess the perceived workload, we used the National Aeronautics and Space Administration Task Load Index (NASA-TLX). In this study, we evaluated raw NASA-TLX scores.

Our study included 68 male electricians. The mean age was 39.2 ± 10.3 years. The average job tenure was 16± 11.4 years. According to the Nordic musculoskeletal questionnaire, 32.4% of participants reported low back pain during the last 12 months. Thirty participants (19.1%) had low back pain during the last 7 days. The mean score of mental demand, physical demand, performance, effort, frustration level and temporal demand were respectively 88.2±14.3, 61.1±24, 84.8±13.3, 82.6±14.5, 35.8±29.2 and 60.4±28.8. The frustration level was associated with the presence of LBP during the last 12 months and the last 7 days (p<0.05).

From the results of this study, we conclude that LBP was associated with the perceived psychological workload. Hence, the prevention of LBP should go through the improvement of work conditions to enhance the mental health of the electricians.

None Declared

Autism spectrum disorder (ASD) is a complex neuro-developmental condition. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), restricted interests and repetitive behaviors and difficulties with social communication and interaction characterize ASD. Different ways of learning, moving, or paying attention are related to the degree of impairments. By reducing environmental and social obstacles in school, work, and other areas of life, architecture could play a pivotal role in helping people on the spectrum become more independent and acquire more abilities.

The aim of this study was to outline the recommendations and guidelines of the inclusive architecture design for ASD.

We conducted a comprehensive review of the scientific literature using the following keywords: inclusive design, architecture, autism or ADS.

Our research found that the Autism ASPECTSS design index reported in 2013 by Magda Mostafa from Canada, which was based on the sensory design theory, is the world’s first set of evidence-based design guidelines for managing built environments to serve ADS individuals interaction, particularly in schools and workspaces. ASPECTSS conceptual framework delineate seven design concepts: acoustics, spatial sequencing, escape space, compartmentalization, transition spaces, sensory zoning, and safety. In 2023, the same author published an autism friendly design guide for the world’s first autism-friendly university. This guide is characterized by a better understanding of human-centered design and advocates beyond the mere inclusion, aspiring to a state where the boundaries between ‘normal’ and ‘special’ are blurred in order to treat all users as human beings with equal rights, thus calling for equal opportunities beyond the ADS spectrum.

With such well-established conceptual framework, it is nowadays imperative to expand our buildings in cities, schools, workplaces, hospitals, and public areas using the guidelines of autism-friendly environments. These buildings will enhance our individual and social well-being.

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Panksepp paved the way for neuropsychoanalysts to better delineate the differences between emotions, feelings, and affect, and their evolutionary purposes. Affect pertains to an individual’s capacity to engage in emotional responses to stimuli, events, memories, and thoughts, while feelings denote the conscious perceptions of emotions, which are primarily social in nature.

Feelings are personal and biographical, while affect remains largely impersonal. Panksepp’s theory of basic affective systems in mammals, dividing emotions into positive and negative categories, is another major contribution to neuropsychoanalysis. Three primary emotions -joy, fear, and disgust- have been identified in humans, which are associated with specific peptides and monoamines (e.g., dopamine and endorphins for joy, norepinephrine and CRH for fear, serotonin and substance P for disgust). These basic emotions are thought to have evolved to address basic life tasks in a phylogenetic and ontogenetic primary stage.

This study aims to provide an overview of Jaak Panksepp’s theories and assertions on the journal Neuropsychoanalysis.

The authors employed a neuropsychoanalytic approach to analyse articles published in the Neuropsychoanalysis journal between 2015-2023.

Emotions primarily function to maintain homeostasis and protect the organism, as in fight or flight responses. In social animals, emotions can sometimes be recognized among individuals of the same and different species. The neurobiological basis of emotional transfer and empathy-like behaviors shed light on cross-species emotion transfer.

The facial feedback hypothesis and the interoceptive inference theory are also discussed as examples of theories for the recognition of emotions as well as the neural mechanisms involved in emotion perception and recognition.

Jaak Panksepp’s valuable insights shed light on the mysteries of human affect, and lay the foundation for future work in the field.

None Declared

The russian invasion in Ukraine has significantly affected the mental health (MH) of the local population while access to mental health support remains limited due to multiple reasons coming from both the provider and acceptor sides. The war obviously negatively impacts MH but has also paradoxically given an “open window” for shifting current practices both in the healthcare system and within society. Investigation of current people’s attitudes on this matter should be the primary step to address the issue and initiate any change.

5 main objectives identified to analyze within the convenience sample were: MH state and self-care behaviors during the full-scale invasion, MH stigma and self-stigma, intention to use professional MH support, beliefs on access to professional MH support, query to change current MH attitudes and practices.

This research was conducted using primary data collection. The online questionnaire consisted of 5 blocks and was designed based on PHQ-9, DASS-21, PCL-5, Brief-COPE and CAMI. 332 civilians underwent the survey in March-April 2023 and were divided by age, gender, location and situation; inclusion criteria were to be >16 y.o. being affected by war and capable of completing the survey in Ukrainian. Relevant ethical measures were applied. Descriptive and correlational analysis was used to analyze the data.

The majority of respondents rated their mental health as good. Anxiety was the most prevalent emotion, particularly among younger age groups. Different genders and age groups exhibited varying combinations of emotions, such as fatigue, peace, anger, sadness etc. Many participants felt self-reproach for not doing enough; coping strategies varied among age groups. Females were 8.14 times more likely to seek mental health support, and those inside Ukraine were 0.32 times less inclined. 66.2% never seek any MH services, with older men leading; only 8.7% consult specialists during crises, showing gender differences. Distrust in specialist qualifications is one of the barriers on access in people’s beliefs and is more prevalent among older generations. The absence of self-mental health stigma makes individuals 1.91 times more open to accessing support. Location affects openness to change, with Ukraine-based individuals being less open. Lastly, 29.5% consider alternative stress-coping methods, with 40% open to future psychological help.

Our findings show differences in populational attitudes towards MH in Ukraine during the war and therefore the importance of any potential intervention to precisely tailor certain subgroups, beliefs behaviors and needs within them to have a higher chance of being accepted and increase MH support utilization in the population overall.

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Deviant sexual interest for children (pedophilia, hebephilia) is associated with a higher risk of sexual offending against children (CSA) and consuming child sexual abuse images (CSAI). There is a general shortage of therapeutic programs for individuals who feel sexually attracted to juvenile bodies and are concerned about their sexual behaviour. Efforts to establish regional centres throughout Germany offering preventive support led to the prevention network “Don’t become an offender” (“Kein Täter werden”).

To identify dynamic risk factors (DRFs) and evaluate a treatment programme aiming to reduce CSA and CSAI among potential or existing pedosexual offenders (who have not been legally charged). In addition, changes in the course of therapy are examined to provide information about the accessibility and motivation of the target group and its therapeutic responsiveness.

Participants undergo standardized diagnostic and treatment procedures. Therapy comprises an outpatient psychotherapy program (group therapy) over the course of approx. 48 weekly sessions, optional individual and partner/relative including sessions, as well as additional pharmaceutical treatment. Assessments are carried out through self- and other-reported psychometric test batteries pre-, during and post-treatment up to a 3.5 year follow-up. The test battery includes clinical questionnaires (WHO-5, CTQ-SF), personality questionnaires (ISK-K, NEO-FFI), sexuality questionnaires (EKK-R, KV-M, MSI, HBI-19) and risk assessment procedures (VRAG-R, STATIC-99, VRS:SO). Main outcome measures are self- and externally-reported DRF changes well as offending behaviour characteristics.

By September 20, 2023, N=12 individuals were enrolled in the treatment program. All individuals had a deviant sexual preference (exclusive/non-exclusive pedo-/hebephilia). Nine individuals reported past and/or current use of CSAI. Of these, two individuals reported at least one CSA in the past. Three had no previous use of CSAI or CSA history.

In the first treatment group (N=6), preliminary results show reduction in dynamic risk factors (e.g., Cognitive Bias, Sexual Compulsivity, Impulsivity) after the first 12 weeks of treatment. The evaluation of additional clinical data is pending.

To date, therapy for individuals with pedophilia or hebephilia has been insufficient – particularly when not offending. Ongoing evaluation of the therapy program should provide further insight into responsiveness and therapeutic motivation of this target group. In particular, the impact of therapy on changing dynamic risk factors for CSA and CSAI remains to be examined.

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Adherence to treatment for addictive disorders remains a clinical challenge. Despite detoxification admissions being scheduled and initiated voluntarily by the patient, several factors may contribute to treatment discontinuation.1 Understanding these factors will enable the development of specific interventions for a more effective approach.2

To identify and analyze the relationship between specific clinical factors and voluntary treatment discontinuation.

An observational and descriptive study was conducted using a retrospective database of 1146 patients admitted to the “Hospital Universitari Vall d’Hebron” Detoxification Unit between June 2008 and December 2019. Bivariate analysis was conducted to identify individual associations between clinical factors and voluntary discharge. Subsequently, a multivariate analysis was performed to assess the combined influence of these factors while controlling for potential confounding variables.

A total of 135 patients (11.8%) requested voluntary discharge. Significant differences were found between the voluntary discharge and non-voluntary discharge groups in patients with dual diagnosis (91.1% vs 80.9%, p<0.0001), specifically the presence of psychotic disorder (18.7% vs 12%, p<0.05) and cluster B personality disorder (66.7% vs 31%, p<0.0001). Significant associations were also observed with prior detoxification admissions (64.5% vs 54.1%, p<0.05), heroin as the main admission substance (29.6% vs 13.3%, p<0.0001), lifetime use of more than three substances (65.3% vs 45.3%, p<0.0001), and pre-admission binge-pattern substance use (72.1% vs 51.4%, p<0.0001). A significant relationship was found with therapeutic discharge in the diagnosis of major depressive disorder (14.6% vs. 24.8%, p<0.05), admission for alcohol detoxification (25.9% vs. 42.8%, p<0.0001), and participation in group therapy during admission (27.4% vs. 49.9%, p<0.0001).In the multivariate analysis, it was found that cluster B personality disorder (p<0.0001), heroin as the primary substance of admission (p<0.05), and pre-admission binge-pattern substance use (p<0.05) were independently related to voluntary discharge.

Cluster B personality disorder, admission for heroin detoxification, and pre-admission binge-pattern substance use are factors associated with voluntary treatment discontinuation.

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Corticosteroids are a key part of many cancer treatment regimens and neuropsychiatric side effects have long been recognised. Steroid-induced psychosis is a disorder classified under substance or medication-induced psychosis in the Diagnostic and Statistical Manual of Mental Disorder, 5th edition. Management strategies include treatment with antipsychotic medication and reducing corticosteroid dosage.

To describe the case of steroid induced psychosis in a patient with mediastinal lymphoma and provide a concise literature review.

Clinical case report and brief literature review.

27-year-old male with a diagnosis of Stage IV Primary Mediastinal Lymphoma according to the Ann Arbor classification was admitted to the Haematology ward for chemotherapy treatment (R-DA EPOCH). Two days after admission the patient developed acute psychotic symptoms consisting of thought block, kinaesthetic hallucinations, and delusions. Prior to admission, the patient had been on corticosteroid treatment for two months (up to 8mg/day of dexamethasone), with a significant dose increase (up to 200mg/day of prednisone) at the beginning of chemotherapy treatment two days prior to symptom development. The patient had no personal or family history of mental health issues, no substance misuse and had not received any psychopharmacological treatment prior to admission.

Medical evaluations including a cranial CT scan, an MRI, EEG, blood tests and lumber puncture were all within normal parameters, discounting organic or metastatic causes for the symptoms.

Considering a potential episode of steroid-induced psychosis, the patient was started on olanzapine at a dosage of 10mg per day. The patient exhibited a positive response, with symptoms alleviating within 24 hours of the initial dose. In terms of corticosteroid therapy, haematologists adjusted the prednisone regimen to 100mg per day, and due to the encouraging progress, the olanzapine dosage was subsequently reduced to 5mg per day.

This case underscores the importance of considering the possibility of steroid induced psychosis as a differential diagnosis specially in patients on high dose steroids presenting with psychotic symptoms. A multidisciplinary approach is crucial to ensure optimum treatment and care.

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Menstrual psychosis has an acute onset and is characterised by confusion, stupor and mutism, delusions, hallucinations, or a manic syndrome lasting for a brief duration, with full recovery. These symptoms maintain periodicity in rhythm with the menstrual cycle. The symptoms may appear in the premenstrual phase or may begin with the onset of menstrual flow (catamenial psychoses). Usually, menstrual psychosis has a polymorphism of both psychotic and affective symptoms (Brockington I. Menstrual psychosis. World Psychiatry. 2005;4(1):9-17.). In this article we present a case of menstrual psychosis with premenstrual onset.

A 26 years old, nulliparous single female with one mentally ill relative on her mother’s side (her grandmother) presented with an episodic illness characterized by mood swings, irrelevant speech, irritability, suspiciousness and thought disorder related to her menstrual cycles. She had earlier suffered prolonged attacks of mania, developed a recurrent episodic illness which returned every month for five years. Her menses began at 15. She presented with the history of a few episodes of manic illness starting five days before and ending suddenly with the onset of the menses.

On mental status evaluation during the index episode, the patient was agitated, had labile affect, grandiose and referential delusions and erotomania. A detailed physical examination, routine biochemistry, and gonadal hormonal assay were unremarkable.

She was started on olanzapine 10 mg/day, lithium 1200 mg/day and low-dose clonazepam. Although the severity of the psychotic and affective symptoms gradually reduced during the future menstrual cycles, they did not completely resolve.

The pathophysiology of menstrual psychosis is not exactly understood, but it has been postulated that fluctuation of the sex hormones occurring during the menstrual cycle is responsible. Previous studies have reported the association of psychosis with estrogen withdrawal (Mahé V, Dumaine A. Oestrogen withdrawal associated psychoses. Acta Psychiatr Scand. 2001;104(5):323-331.). Treatment strategies for menstrual psychosis include the use of oral contraceptive pills for the regulation of hormones during the menstrual cycle, in our case patient did not want to use oral contraceptive pills.

None Declared

Very late onset schizophrenia-like psychosis takes the 3rd place among late-life psychosis, after dementia and affective disorders associated psychosis. It’s still unknown the real place of this psychosis.

to investigate the clinical and psychopathological features and short-terms outcomes of late-onset schizophrenia and schizophrenia-like psychosis

45 patients, mean age 70,6 ±8,70 years, median age of manifestation psychosis - 68 [61; 75] years with late-onset schizophrenia (n=19, 42,2%), late-onset schizoaffective disorder (n=9, 20%), late-onset delusional disorder (n=7, 15,5%) and late-onset organic schizophrenia-like disorder (n=10, 22,3%) underwent clinical examination. Psychopathological, psychometric (PANSS, HAMD, CDSS, MoCA) and statistical methods were applied.

3 clinical groups were allocated. The 1st group included 15 patients (33%) and was characterized with severe polymorphic psychotic symptoms, included catatonic and paraphrenic signs with mental disorganization. They had the highest score of PANSS (105,46±17,99, p=0,002) and the lowest score of MoCA (14,2±2,16, p=0,05) in compare with 2nd and 3rd groups. They also had symptoms of depression (CDSS 6,28±5,29), compared with the 3rd group (HAMD 21,00±5,92, p=0,05). In short-terms outcomes was formed negative symptoms and cognitive impairment with decreasing social and daily activity. The 2nd group (22 cases, 49%) included patients with prevalence of delusions of persecution, more rare auditory hallucinations and more often acoasms. They had medium score PANSS (90,22±16,79), with minimal cognitive declare (MoCA average score 20,33±4,27). The short-term outcomes were characterized with formation of residual positive and negative symptoms, that impact on daily and social activity. The 3rd group included 8 patients (8%) with prevalence of delusion symptoms, such as misidentification, persecutory and reference delusions, which were mood-congruent. They had medium PANSS score (89,75±18,90) with more severe depressive symptoms by HAMD scale in compare with 2nd group (22,00±10,00, p=0,07) and minimal cognitive declare (MoCA average score 25,00±1,00, p=0,05) in compare with 1st group. This group was characterized with high level of reduction of productive symptoms and restoration of premorbid social and daily activity in short-term outcomes.

features of clinical characteristics, including the nature and severity of cognitive impairment at the onset of disease, are significant for prognosis and outcomes of disease. The data obtained could be served for the development of personalized therapeutic approaches that take into account the syndromic features and course of late-onset psychosis.

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Cognitive dysfunction has been reported in acute psychiatric patients for a long time and has profound implications for the management of severe mental disorders. The Screen for Cognitive Impairment in Psychiatry (SCIP) is a scale developed for screening cognitive deficits. This tool is simple and easy to administer.

To translate and to validate to Portuguese the SCIP.

The accepted back-translation method is employed for translating from English into Portuguese. One-hundred individuals in good health were characterized using demographic questionnaires and a neuropsychological battery. Subsequently, the new version of the scale was administered on two distinct occasions with a minimum one-week gap between them.

High internal consistencies as well as strong correlations with comparable neuropsychological tests were obtained.

The results obtained from the Portuguese version of SCIP are in line with those from the English version. Effectively, SCIP serves as a key instrument for the initial assessment of cognitive function. Its characteristics, particularly its conciseness and independence from a technological platform, allow it to be integrated into clinical practice. Our aim is to use this version and apply it to different pathologies, comparing patients with controls. This will allow us to study different patients and apply it to our population.

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Heart failure is a progressive and unpredictable heart disease. How to work with these patients to decrease their psychological distress and promote their self-care behaviors is important. Transition care is the continuity of medical care for heart failure patients returning home from the hospital. Intervention through transition care may improve the continuity of medical care for patients with heart failure but it has not been examined in clinical settings in Taiwan.

The aims of this study were to explore the effects of a newly developed transition care program on depression, self-efficacy, and self-care behavior of heart failure patients.

Using an experimental research design and block randomization, participants were divided into the experimental group (received transition care and routine care) and the control group (received routine care only). The Patient Health Questionnaire-9 (PHQ-9), the General Self-Efficacy Scale (GSES), and the Self-Care of Heart Failure Index (SCHFI version 6.2) were used to collect data before discharge and the first month after discharge.

A total of 20 patients with heart failure were recruited. No significant differences were found between the experimental (n=10) and control groups (n=10) in the degree of depression (Z=-.077, p=.938), self-efficacy (Z=-1.214, p=.225), and three self-care behaviors subscales (self-care maintenance Z= -1.214, p=.225; self-care management Z= -.401, p=.689; self-care confidence Z=-.436, p=.663) at discharge. After the one-month posttest, only self-efficacy (Z=-2.545, p=.011) and three self-care behaviors subscales (self-care maintenance Z=-3.097, p=.002; self-care management Z= -2.595, p=.009; self-care confidence Z=-3.671, p<.001) reached a statistical difference between the two groups.

Based on the preliminary results, heart failure patients can improve their self-care behavior and self-efficacy but not depression through transitional care intervention.

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Affective disorders represent a category of psychiatric syndromes with high prevalence and associated disability. While effective, both pharmacological and psychosocial, treatments are available for depression and bipolar disorder, the many therapeutic needs of affected patients are far from being properly addressed under routine conditions. Along the past decade, several digital treatments, tools and approaches have been developed and tested in clinical settings, showing an highly promising potential to fill the treatment gap of affective psychopathology. In more detail, reviewed here will be telepsychiatry solutions for affective disorders, also encompassing the available officially approved digital therapies for major depression and bipolar disorder. Furthermore, the impact of artificial intelligence, serious gaming, social media and virtual/augmented reality in the treatment of mood disorders will be also discussed, in the light of the most recent research evidence on these topics.

None Declared