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

I address the following questions:

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

What strengths, weaknesses opportunities and threats will come?

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

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

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 Laws concerning mental health are outdated in different countries.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

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

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In operating rooms, the routine use of radiological procedures is commonplace. However, this essential tool brings about significant concerns for healthcare workers due to the associated radiological risks. Understanding healthcare workers’ attitudes and perceptions about ionizing radiation is crucial for addressing these concerns.

This study aims to assess the perceptions and concerns of healthcare workers regarding radiation risks and their practices in the operating room.

A cross-sectional study was conducted in February and March 2023 among the operating room staff of Habib Bourguiba University Hospital in Sfax, Tunisia. We used a self-administered questionnaire that included socio-professional data. Self-assessment of exposure risk and protection level against ionizing radiation was evaluated on a scale from 0 to 10, and attitudes were assessed using a 5-item Likert scale.

Our study population consisted of 92 healthcare workers, with 54.3% being male. When asking operating room workers about the availability, accessibility, and quality of lead aprons, the median scores were 3 (IQR [0;6.5]), 2 (IQR [0;5]), and 2 (IQR [0;5]), respectively. The median self-assessment score for exposure risk was 8 (IQR [5.5; 10]), while the median self-assessment score for protection against ionizing radiation was 1 (IQR [0;3]). Sixty percent of the population had limited knowledge of the harmful effects of ionizing radiation, with a median self-assessment knowledge score of 1.5 (IQR [0;3]). Sixty-two percent reported concerns regarding radiological risks. In terms of practices, 44.5% of the staff maintained a distance from the radiation source during intraoperative radiography, and 21.7% used the apron for protection. Dosimeters were not used by any of the participants. Concerns level was associated with self-assessment of exposure risk (p = 0.027).

In conclusion, awareness of the risks generates anxiety and concern among staff; however, it alone is insufficient to alter our practices. This underscores the imperative for a proactive approach in implementing robust safety measures and comprehensive training programs.

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Low back pain (LBP) is common among electricians caused by work conditions. Even when symptoms are short-term and not medically serious, LBP can be associated with psychological distress.

This study aimed to assess the link between LBP and psychological distress according to the job tenure among electricians.

The study was conducted in a group from a Tunisian Electricity society. Data were gathered between January-June 2022 using a self-administered questionnaire including socio-professional characteristics, the Nordic musculoskeletal questionnaire during the last 12 months and Kessler Psychological Distress Scale (K6). Our population was divided into two groups according to job tenure. The first group (G1) consisted of electricians with less than ten years of job tenure and the second (G2) consisted of electricians with more than ten years of seniority.

G1 consisted of 10 participants with a mean age of 30.6 ± 6.7 years and with average job tenure of 3.3 ± 1.1 years. G2 consisted of 64 participants with a mean age of 40.7 ± 10.3 years and average job tenure of 17.4 ± 10.9 years. According to the Nordic musculoskeletal questionnaire, LBP during the last 12 months was present in the first and the second group in 30.8% and 14.3% of participants, respectively.

The proportion of respondents with high levels of psychological distress (K6 score of 13 or greater) in the first and the second groups was 10 % and 9.4% of participants, respectively. The presence of low back pain during the last 12 months was significantly associated with a high score of K6 in the second group (p < 0.05).

From the results of this study, we conclude that LBP was associated with psychological distress when the job tenure is high. Therefore, the prevention of LBP should go through programmes to build ergonomically safe working conditions to enhance the mental health of electricians.

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There is a growing concern about the link between musculoskeletal disorders (MSD) and psychosocial risk (PSR) among electricians. Both MSD and PSR represent a threat to the electrician’s health, quality of life and productivity.

This study aimed to assess the link between PSR and MSD among electricians.

The study was conducted in a group from an electricity society. Data were gathered between January-June 2022 using a self-administered questionnaire evaluating socio-professional characteristics, the Nordic musculoskeletal questionnaire during the previous year and the validated French version of the questionnaire KARASEK.

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, 50% of participants experienced pain during the last 12 months.

About half of the electricians had high psychological demand (48.5%), 63.2% had a low latitude, and 76.5% had low social support. According to the Karasek model, tense electricians accounted for 26.5% and assets 22.1%. MSDs were associated with high psychological demand at work (p = 0.02).

This study demonstrated that PSR and MSDs are associated among electricians and are highly prevalent. They represent an important concern of the occupational and safety health system. The prevention of MSD should take into account the specific working conditions of electricians to reduce their exposure to psychosocial risk factors in the workplace.

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Being a doctor is a profession with special medical requirements. Therefore, the assessment of medical fitness for work among physicians remains a complex decision, particularly for those with psychiatric disorders.

To assess the fitness for work decisions among physicians with psychiatric disorders.

Descriptive and retrospective study including physicians with psychiatric disorders referred to the occupational department of the Charles Nicolle Hospital in Tunis for a medical fitness for work from January 1, 2018 to August 30, 2023.

The study included 28 patients with a female predominance (sex ratio M/F at 0.3) and a mean age of 44.1 ± 12 years. Participants were general practitioners (N=12), junior doctors (N=10), specialists (N=5) and one dentist. They worked in the public health sector in 93% of cases, and had a mean professional seniority of 12.4 ± 9.3 years. A psychiatric history was found in 20 patients. Current psychiatric disorders recorded were: depression (N=15), bipolar disorder (N=7), anxiety-depressive disorder (N=4), personality disorders (N=1) and addiction (N=1). Concerning the fitness for work, six patients were fit for work and 11 were temporarily unfit. Job adjustments were proposed for 11 physicians, mainly night shift exemption.

Physicians are exposed to several occupational hazards and require strict medical qualifications. The impact of psychiatric disorders on medical fitness for work is considerable, and could be avoided by appropriate prevention by occupational health practionnairers, starting from professional orientation.

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Numerous studies have shown a link between hypnotic susceptibility, the hypnotically altered state of consciousness, and the intensity of experienced emotions (De Pascalis et al., 1987; De Pascalis, Marucci, & Penna, 1989; Bryant & McConkey, 1989; Crowson, Conroy, & Chester, 1991; Crawford, Kapelis, & Harrison, 1995). One of the most suitable experimental psychological methods for modeling real-life decisional conditions is the Iowa Gambling Task (IGT) (Bechara, Tranel, & Damasio, 2000). Hypnosis has the potential to provide several benefits in decision-making, although there is limited scientific research on the subject.

The main goal of this study was to determine if a hypnotically altered state of consciousness could affect decision efficacy in a real-life modeling situation.

Forty-eight healthy students (including 28 females and 20 males) from the University of Szeged participated in both the delayed punishment and delayed reward versions of the Iowa Gambling Task under alert and hypnotic states.

During the mid-phase of the tasks while in hypnosis, notably higher performance levels were recorded compared to the alert state. In a simulated real-life scenario, the delayed reward had a more pronounced effect on decision-making efficiency than the delayed punishment. It became evident that the efficient decision-making strategy evolved more rapidly under hypnosis than in an alert state.

The hypnotic state of consciousness in an experimental decision situation modeling real life may accelerate the development of somatic markers, leading to earlier correct decision-making.

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The psychosocial and mental health-oriented variables of people are determinants for their life in society and their roles within organizations, especially educational institutions that are endowed with social complexities.

The objective of this research was to understand the meaning of work for teachers in educational institutions in the department in order to recognize elements such as the level of importance that work holds for them and the factors that either promote or hinder that centrality.

This is a descriptive study with a quantitative methodology, and the sample selection was done for convenience, taking into account ethical aspects such as the handling of confidentiality for both the individuals who participated in this study and the educational institutions involved.

Regarding the meaning attributed to work by teachers, the results indicate that 29.6% of teachers declare themselves neutral when it comes to the statement that “the most important things in people’s lives are related to work”. 26.8% of teachers are neutral regarding the statement that “the primary function of work is to generate income”, and 17.9% somewhat agree. 20.7% disagree to some extent. 15.6% disagree with the statement that “people’s primary goals in life should be oriented toward work”. 25.1% of teachers are neutral, and 17.9% somewhat agree with the statement that “the main function of work is to enable interesting contacts with other people”. Only 11.7% strongly agree with the statement that “work is, in general, one of the most important things in people’s lives.

It is concluded that there is a need to implement strategies that contribute to the strengthening of the teaching profession and contribute to improving educational quality

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Dissociative Identity Disorder (DID) is a complex and enigmatic mental disorder in which an individual maintains two or more distinct identities or personality states. We present a rare and captivating case report of a 27-year-old female patient who exhibited a remarkable 17 distinct identities, developed in a clear and unprecedented timeline following a series of specific traumatic events. The novelty of this case lies in the comprehensive documentation and analysis of the sequential emergence of these identities, offering valuable insights into the development and progression of DID.

Our aim in presenting this case study is to offer a unique presentation to the constantly evolving understanding of DID. This case offers insight and provokes the need for research into the traumagenic nature of DID. This case showcases the influence on the chronological evolution of the patient’s 17 identities following a multitude of traumatic events.

Structured interviews, psychiatric assessments, and psychological measurements, including self-reported measures of the Dissociative Experiences Scale, were employed to assess the identities and their individual experiences of the traumatic events. The patient was diagnosed with DID and received treatment including pharmacotherapy, psychoeducation, and trauma-focused psychotherapy. As a result of the therapeutic process, the patient was able to develop a higher sense of self-awareness and thus was able to integrate their 17 fragmented identities into a single host identity, demonstrating improvement in the functioning of interpersonal relationships.

The patient’s history reveals that the onset of her DID was linked to a traumatic event that occurred during early childhood, triggering the emergence of her first alternate identity. Over time, additional identities manifested, each appearing to serve as a coping mechanism to contend with the psychological distress stemming from subsequent significant trauma episodes. This case report meticulously outlines the chronological development of these identities and explores the distinct characteristics, behaviors, and roles assumed by each personality.

This case report offers valuable information on the complex development and pathogenesis of DID with a trauma influence. The presentation of this patient may lead to further research and more tailored therapeutic interventions for individuals suffering from DID.

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Psychosocial and mental health-related variables are crucial determinants of individuals’ lives in society and their roles within organizations, especially in educational institutions that are characterized by social complexities. In this regard, this research aims to determine the levels of emotional intelligence among teachers in educational institutions in the Department of Magdalena.

Determine the levels of emotional intelligence among teachers in educational institutions in the Department of Magdalena

Methodologically, it is situated within the empirical-analytical paradigm with a quantitative approach, using the descriptive method. A convenience sample of 179 teachers was used, and the TMMS-24 questionnaire was administered.

The results revealed that 37.7% of the teachers completely agree, and 30.9% strongly agree with the statement that they pay a lot of attention to their feelings. On the other hand, only 12.2% somewhat agree, and 1.2% strongly disagree with the statement that they normally worry about what they feel.

Additionally, 33.9% agree with the statement that they usually take time to think about their emotions, while 25.6% somewhat agree, and only 1.2% strongly disagree with the statement that it is worth paying attention to their emotions and mood. Furthermore, 6.4% agree, and 5.2% strongly agree with the statement that they let their feelings affect their thoughts.

As for thinking about their mood constantly, 16.7% strongly disagree, and 39.1% somewhat agree. Moreover, 6.9% strongly disagree, and 21.4% somewhat agree with the statement that they pay a lot of attention to what they feel.

Only 1.1% strongly disagree with being able to frequently define their feelings. and only 1.7% strongly disagree, and 10.2% somewhat agree with the expression “I often become aware of my feelings in different situations.” 34.1% strongly agree, and 26.6% completely agree with the statement “I can always tell how I feel.” Finally, 5.1% strongly disagree, and 19.4% somewhat agree with the statement “Sometimes I can tell what my emotions are.”

In conclusion, the study emphasizes in the importance of teachers’ emotional intelligence and its potential impact on their performance and students’ learning outcomes. It also highlights the need for intervention strategies to strengthen this psychosocial variable in educational institutions in the Department of Magdalena.

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This study explores attitudes toward blood donation in Greece, where maintaining an adequate supply is challenging. Using the Health Belief Model, we examine factors like perceived severity, vulnerability, and self-efficacy.

The main aims of this study are to assess public perceptions and barriers concerning blood shortage in Greece, and to identify motivators and self-efficacy levels for regular blood donation.

A cross-sectional study was conducted using a self-administered questionnaire distributed to a sample of Greek adults. The questionnaire was designed based on the constructs of the Health Belief Model and included questions related to perceived severity, vulnerability, self-efficacy, and barriers and facilitators to blood donation. Descriptive statistics were used to analyse the responses, calculating means and standard deviations (SDs) for each variable.

Perceived Severity and Vulnerability

Participants in our study show a heightened awareness of the severity of blood shortages, especially in summer months and during increased surgical interventions. They also acknowledge Greece’s dependency on more than just voluntary donations to meet blood supply needs. These findings align with the Health Belief Model’s constructs of perceived severity and vulnerability, suggesting avenues for promoting donation.

Perceived Benefits and Barriers

A significant 74% of participants believe they can regularly donate blood and plan to do so in the next six months. However, fear of needles, health concerns, and fears of transmissible diseases act as barriers. According to the Health Belief Model, targeting these barriers could facilitate blood donation.

Self-Efficacy

A high percentage (74%, SD=5) of participants displayed strong self-efficacy, suggesting they are likely to engage in blood donation if encouraged. This aligns with the Health Belief Model’s emphasis on self-efficacy as a motivator for health actions.

Cues to Action

Participants identified informational campaigns, digital reminders, and social encouragement as cues to action, with a disfavor for financial incentives. These cues could serve as triggers for blood donation, consistent with the Health Belief Model.

By aligning these findings with the Health Belief Model, it becomes evident that there are strong perceptions of severity and vulnerability, but also considerable barriers to overcome. The high self-efficacy among participants and the cues to action identified could serve as bases for targeted interventions to improve blood donation rates.

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

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

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

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

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

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

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Traumatic childhood has increasingly high incidence rates and can be predictive of negative health outcomes. There is a large consensus indicating that childhood trauma is significantly involved in the development of mood disturbances in adulthood.

The aim of this study was to examine the relationship between retrospectively recalled childhood trauma and adulthood anxiety and depression in a sample of undergraduate university students.

A cross-sectional study was conducted among a sample of 365 university students randomly selected from 8 universities in Sfax (Tunisia). Information about childhood maltreatment, depressive and anxiety symptoms were gathered through the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and the Hospital Anxiety and Depression Scale (HADS) respectively. To test the hypothesis, examining the relationship between anxiety, depression, and childhood trauma, we used Spearman’s correlation test. Multivariate logistic regression models were used as well.

The mean age of our participants was 20.3 years. More females (68.2%) than males participated in the study. Our findings showed that the five childhood trauma subtypes (emotional abuse and neglect, physical abuse and neglect, sexual abuse) were significantly correlated with anxiety and depression symptoms severity (p<0.01). Emotional abuse was the strongest risk factor for adulthood anxiety symptoms (OR=6.002, 95% CI= [3.238; 11.125]) while emotional neglect was the strongest risk factor for depressive symptoms in adulthood (OR=6.214, 95% CI= [3.428; 11.267]). Multivariate analysis revealed that, in subjects with childhood trauma, scores of anxiety symptoms were positively and highly associated with the severity of emotional abuse (adjusted B=1.438, 95% CI= [1.951; 9.092], p=0.000). Depression symptoms severity were as well positively correlated with severity of emotional abuse (adjusted B=0.848, 95% CI= [1.043; 5.224], p=0.039), and severity of emotional neglect (adjusted B=1.044, 95% CI= [1.263; 6.389], p=0.012).

This study highlighted the relevance of childhood trauma as a factor contributing to anxiety and depression in adulthood. Thus, early psychological support of victims of childhood trauma can reduce the rate of anxiety and depression among these subjects.

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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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The delicate balance between the need to ensure quality patient care and the reality of physicians dealing with psychiatric diseases poses a major challenge within the medical field. This issue raises fundamental ethical, legal, and medical questions, highlighting the complexity of decision-making regarding professional aptitude for practitioners affected by mental disorders.

To examine the impact of psychiatric diseases on the medical aptitude of physicians.

This was a retrospective descriptive study that focused on physicians with psychiatric diseases referred to the occupational pathology clinic at Charles Nicolle Hospital in Tunis for medical evaluations of their work aptitude between January 1, 2021, and September 15, 2023.

During the study period, we collected data from 20 patients. The mean age was 38 ± 11 years, with a sex-ratio (F/M)of 4.5. Five examined physicians had family histories of psychiatric disorders. Medical specialties were the most represented (N=17), including three general practitioners, two family medicine practitioners, and two anesthesiologists. The study population included 10 residents, eight hospital assistants, and two medical interns. The most common psychiatric diagnosis was depression (N=7), followed by bipolar disorder (N=5). The medical treatment prescribed was combinations of antidepressants and anxiolytics in seven cases, antipsychotics in five cases, and antidepressants in two cases. Medication adherence was noted in 10 physicians. Fourteen physicians had taken long-term sick leave, with an average duration of 203 days. Five physicians were declared fit to continue their regular professional activities, seven physicians were declared fit with restrictions on night work, and one physician was declared fit with workplace accommodations.

This study highlights the challenges surrounding the medical aptitude of physicians with psychiatric diseases. However, it is imperative to promote mental health awareness and to implementsupport measures to ensure both compassion for physicians and patient safety.

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Psychopathological exploration (PPE) involves an assessment of the mental state of patients, where psychological signs and symptoms are analyzed, which collectively form a syndrome. To conduct this assessment, the clinician must utilize their expertise to identify the presence and authenticity of a series of symptoms that, once recognized, allow for a diagnosis (1). The presence of this subjective component could explain why, despite the continuous growth of artificial intelligence (AI), its application in clinical psychiatry practice remains limited. However, the combination of the clinician's work with AI could enhance diagnostic accuracy and our understanding of diseases (2).

The objective of this study is to investigate whether AI can make accurate diagnoses through an initial psychopathological evaluation.

A random sample was selected from our medical records of all patients admitted to our acute mental health inpatient unit through the hospital's emergency services in the year 2022. An anonymized database was created, including sociodemographic information, the results of the psychopathological assessment in the emergency department, and the diagnosis at the time of discharge. The psychopathological assessment conducted in the emergency department was provided to the AI chatbot ChatGPT, with a request to establish a diagnosis according to the DSM-5. Diagnoses such as brief psychotic disorder, schizophreniform disorder, and schizophrenia were considered, given their acute symptom similarities, as well as major depressive disorder (unipolar) and bipolar disorder. The level of agreement between both diagnoses was evaluated using the kappa coefficient.

The sample consisted of 15 patients, of whom 60% were male, with a mean age of 45 years (standard deviation = 15.6). 73.3% of the patients had prior mental health follow-up, and 66.7% had been previously hospitalized. Diagnoses included psychotic disorder in 33.3% of cases, bipolar disorder with manic episode in 26.7%, depressive disorder in 13.3%, delusional disorder in 13.3%, schizoaffective disorder in 6.7%, and borderline personality disorder in 6.7%. A kappa value of 0.561 was obtained, indicating a moderate degree of agreement between the diagnoses.

Despite the inherent subjectivity in psychopathological assessment, this study suggests that AI, in the form of natural language processing chatbots like ChatGPT, can be a useful tool to assist mental health professionals in the diagnostic process. While AI shows promising potential, it should not entirely replace the experience and clinical judgment of mental health professionals. Instead, the importance of potential collaboration between AI and clinicians for achieving more precise and comprehensive diagnoses is highlighted.

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Dermatitis artefacta (DA), also known as factitial dermatitis, is a condition among factitious disorders, whereby self-induced skin damage is the means used to satisfy a conscious or unconscious desire to assume the sick role, particularly in those with an underlying psychiatric diagnosis or external stress. DA should be distinguished from malingering, in which skin damage may be inflicted for the purpose of secondary gain.

Review what dermatitis artefacta and factitious disorders in general consist of and the challenges they present.

Presentation of a patient’s case and review of existing literature, in regards to factitial dermatitis and factitious disorders.

In general, in regards to factitious disorders in literature, the majority of patients were female with mean age at presentation at thirty. A healthcare or laboratory profession was reported most frequently, as well as a current or past diagnosis of depression was described more frequently than personality disorder in cases reporting psychiatric comorbidity, and more patients elected to self-induce illness or injury than simulate or falsely report it. Patients were most likely to present with endocrinological, cardiological and dermatological problems. In our patient’s case, common factors described previously are dermatological lesions, comorbid psychiatric disorder and the beginning of the disorder at an earlier age.

Specifically, when it comes to DA, the hallmarks of diagnosis include self-inflicted lesions in accessible areas of the face and extremities that do not correlate with organic disease patterns. Importantly, patients are unable to take ownership of the cutaneous signs.

Management in these cases is challenging, and different modalities may be employed, including topical therapies, oral medications, and cognitive behavioural therapy; adopting a multidisciplinary team approach has been shown to be beneficial in allowing patients to come to terms with their illness in an open, non judgmental environment.

DA is a rare cutaneous condition that must be considered when the clinical presentation is atypical and investigations do not yield an alternate diagnosis. Few are referred to psychiatric services and even fewer accept care. They have a protracted course, complicated by repeated hospitalizations, ultimately leading to their premature deaths. Clear guidelines on the management of these patients need to be set to protect both patients and providers in light of the ethical and legal considerations.

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Many mental health conditions, including anxiety, mood disorders, and depression, can be effectively treated at a relatively low cost. Exercise interventions can be a therapeutic strategy, but even though exercise has consistently been shown to improve physical health, cognitive function, and psychological well-being, as well as reduce depression and anxiety symptoms, this intervention is often neglected in mental health care services.

The study aims to assess the feasibility of incorporating an Exercise Intervention Program (EIP) as a therapeutic pathway within the Mental Health and Addictions Program (MHAP) in Nova Scotia, as well as to evaluate the effectiveness of the program on mental health outcomes and incremental costs, and the patient acceptability and satisfaction with the program.

This proof-of-concept study has a pragmatic, prospective, controlled observational design with an embedded one-phase qualitative component. Patients with a primary diagnosis of depression or anxiety attending the Rapid Assessment and Stabilization Program (RASP, Halifax, Nova Scotia, Canada) will be offered to receive 60-minute exercise sessions three times per week, per 12 weeks. Patients with similar mental health conditions that have opted to wait for Cognitive Behavioral Therapy (CBT) with the community provider and declined from the EIP will be part of the control group. A certified recreational therapist will conduct the EIP. Participants of both groups (EIP and control condition) will be assessed at baseline and then weekly for four weeks, six weeks and then at 12 weeks post-enrollment. Primary outcomes include differences in the mean change in functional (well-being, resilience, and recovery) and symptom variables (depression, anxiety, and suicidal risk), which will be assessed through online validated scales/questionnaires. Service variables (patient acceptance and satisfaction) and health care utilization (crisis calls, emergency department visits, hospital admissions and readmissions, length of stay for each admission) will comprise the secondary outcomes.

The results of the study will provide information about the effectiveness of EIP in the treatment of anxiety and depression compared to those only wait-listed to receive CBT or counselling from a CMHA provider. The study will also inform about the acceptability and satisfaction of the EIP, as well as the incremental cost-effectiveness of the intervention compared to the control condition.

This proof-of-concept study will demonstrate the effectiveness of EIP as an adjunctive or alternative therapeutic option for the treatment of anxiety and depression in patients seeking mental health support from the MHAP in Nova Scotia.

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Personality hardiness expresses the characteristics that help to overcome stress and achieve well-being.

This study focused on the Hardiness as the important personality trait, which allow coping with stress and the relationship of empathy, emotional sensitivity and the personality hardiness.

88 healthy volunteers, students aged 17 to 26 years (mean age = 19, SD = 1,69), participated in this study. We used Cloninger’s Temperament and Character Inventory (TCI), the Maddi Hardiness Survey (adapted by Leontyev), Buss Perry Aggression Questionnaire (BPAQ), the Barratt impulsiveness scale (BIS-11), Maslach Burnout Inventory (MBI), the Questionnaire Measure of Emotional Empathy (QMEE).

The cluster analysis was used to identify groups of hardy personalities. We demonstrated a negative relationship between hardiness and depression and burnout. It revealed significant differences between these groups by the following traits: Attention (BIS-11), Self-Control (BIS-11), Cognitive Complexity (BIS-11), Hostility (BPAQ), Exploratory activity (NS1 TCI), Shyness of strangers (HA3 TCI), Resourcefulness (S3 TCI). Regression analysis was used to identify Hardiness factors and to build the following regression models. For the first group the models describe 100% of dispersion (R-square=1,000, Durbin-Watson statistic = 1,419) and are:

Control = -16,998 - 2,922*С2 + 3,549*С5 + 3,264*CI + 0,723*ST2 + 0,747*S4 - 0,306*SC + 0,166*RD3 - 0,020*C — 0,003*NS2, where C2 – scale Empathy (TCI), C5 – scale Principles (TCI), CI – cognitive instability, ST2 – Transpersonal identification scale (TCI), S4 – Self-acceptance (TCI), SC – Self-Control (BIS-11), RD3 – Social attachment (TCI), C – Cooperativeness (TCI), NS2 – Impulsive decision making (TCI).

The Hardiness model described 50% (R-square=0,456) of dispersion:

Hardiness = 63,527 – 4,080*C2, where C2 –Empathy scale (TCI) (p=0,003).

The regression models of the second group explain 50% of group dispersion (R-square=0,512) and are Independent variables significance p<0,05:

Challenge = 12,484 + 0,389*SC + 0,197*EE — 0,702*RD1 — 0,206*A,where SC- Self-Control scale (BIS-11), EE – Emotional Empathy (Personality test of Emotional Empathy), RD1 – Sentimentality scale (TCI), A – Anger (BPAQ).

The Hardiness model describes 35% of dispersion (R-square=0,364, Durbin-Watson statistic = 2,066):

Hardiness = 100,352 + 0,941*SC — 0,527*H, where SC – Self-Control scale (BIS-11) (p=0,009), H – Hostility scale (BPAQ) (p=0,021).

Thus, the attention and self-control problems, hostility, cognitive complexity and shyness have a negative impact on hardiness.Our results suggest that the excessive use of empathy leads to decrease of ability to control situation and cope with the stress.

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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.

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The purpose of my presentation is to introduce the Hungarian Association of Psychiatric Trainees (HAPT), - our NAT - to you, which includes residents and young specialists within five years of training.

Currently we have 108 members, from 15 cities and villages throughout Hungary, and one person is working in Denmark. The vast majority (58 %) of the members are from Budapest, our capital city. There are 14 members, who are young specialists, the others are doing residency training. We have 21 members who are working in child and adolescent psychiatry.

HAPT has been existed since 2013, so in the previous years, our founder members have reached the point when they no longer meet the criteria of being ‘psychiatric trainee’ or ‘young specialists’, however every year we encourage the new residents to join us.

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OUR DUTY: The main goals of HAPT are educating ourselves, forming a community and making connections with colleagues country-wide and last but not least, trying to stand up for our interests, when needed.

Throughout the year we organize educative presentations about topics that are somehow left out of focus during the official training program. Every year our main event is a three-day long weekend, where we can go deeper into a couple of topics via presentations or workshops, and it is also a great opportunity to get to know each other better.

We also organize case-discussion-groups according to the Balint method, considering the residents’ daily difficulties and trying to pay more attention to their mental well-being.

Last year we tried some other ways to broaden our perspectives in the form of cultural events, when we watched a movie or a play and then discussed it together as a group, had been led by a psychotherapist.

HAPT is part of the Hungarian Psychiatric Association and the relationship between the two Organizations has a constantly changing dynamics – in some ways we are trying to be more independent, however, there are common goals that are important for all of us, for example being present on at international events.

FUTURE GOALS: One of our future plans include being more active in the European community, like getting to know the EFPT or the ECP better. This conference is a perfect opportunity for all of us to make new professional connections.

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