The use of smart technology in supporting older adults is a growing field of research. However, there is little qualitative research on the experiences of patients utilizing this technology, particularly those attending psychiatry services.

To explore the experiences of staff and patients utilizing smart-hubs implemented during the Covid-19 pandemic to provide remote audio/visual communication and smart AI personal assistant technology for the management of patients in a rural Psychiatry of Old Age service.

Smart hubs were installed in patient homes and in the Psychiatry of Old Age base during the Covid-19 pandemic when lockdown restrictions limited in-person service provision. Patients and staff utilized the smart hubs for its assistive technology and to engage with each other. Semi-structured qualitative interviews were conducted of 10 staff and 15 patients at 6-12 months following the introduction of the smart hubs and thematic analysis was conducted to generate themes.

Three themes were generated from the thematic analysis: 1) Openness to SMART hub technology, 2) Getting set-up and 3) Keeping SMART. The majority of participants did not have much experience using smart technology prior to the intervention. However, many participants reported that they would be comfortable using technology. The Covid-19 pandemic contributed to the rapid adoption of this intervention within the service with mixed views regarding the smart hub prior to implementation. The role of key individuals such as staff and family was highlighted in supporting older persons with setting-up the smart hub. Technical needs included the need for a strong internet connection and technical limitations were driven by privacy, cost and regional considerations. Many patients were able to utilize the smart hub independently to access interests, therapeutic activities and as a memory aid. The smart hub offered a novel way to connect to services and families and was also seen as a companion by some patients and staff to help address loneliness and isolation. The majority of participants found the use of smart hubs acceptable and were willing to utilize the smart hub in the future as an adjunct to face to face psychiatric interventions. However, suggestions for future use included the need for additional training as users felt that there was more they could do with the smart hub, continued support to manage any challenges and improved information leaflets to better engage users.

Smart hub technology offers an alternate means of providing remote and inclusive psychiatric care to older patients unable to access services in person and at risk of deterioration without intervention in the community.

None Declared

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

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

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

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

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

None Declared

Breast cancer is the most common type of cancer and the leading cause of death from malignant neoplasms in women in Russia and in most countries in the world (Lima et al. EClinicalMedicine 2021; 38 100985). According to an analysis of the incidence and mortality from 36 cancers in 185 countries (Sung et al. CA Cancer J Clin 2021. 3 209-249) in 2020, 2261419 new cases of breast cancer were identified in the world in both sexes, which is accounted for 11.7% of the total cancer incidence. Mortality from breast cancer in 2020 amounted to 684996 cases. Patients with comorbid depression and anxiety disorders experience more severe symptoms, have longer recovery time, use more healthcare resources and have poorer outcome compare to those with cancer alone (Katon et al. Gen Hosp Psychiatry 2007; 2 147-155).

Analytical review of data on the impact of depressive spectrum disorders as comorbid conditions on the survival of breast cancer patients and their quality of life.

The following databases were searched for publications: PubMed, Embase, CINAHL, PsycINFO, Scopus, Science Citation Index/Social Sciences Citation Index, Cochrane Evidence Based Medicine database. The searches were limited to English language and studies with more than 100 subjects with diagnosed breast cancer where this information was mentioned. The analyzed period is between 1977 and 2018.

The reported prevalence of depression in breast cancer patients, according to researches, varies 4,5 to 38%. In patients with I-III stage breast cancer depression increased hazards of all-cause mortality by 50% compared to non-depressed patients. Stage-specific analyses demonstrated a 2–2.5 fold increase in breast cancer-specific and all-cause mortality in patients with stage I and II disease (Vodermaier et al. Breast Cancer Res Treat 2014; 2 373-384.). Women with non-metastatic breast cancer who report mild to moderate depressive symptoms in the weeks after surgery have approximately 2.5 times greater risk of death 8–15 years later than women who report little or no depressive symptoms post-surgery (Antoni et al. Gen Hosp Psychiatry 2017; 44 16-21). Depression in advanced cancer not only reduces quality of life but is also an independent predictor of poorer survival (Lloyd-Williams et al. J Affect Disord 2009; 113 127-132.).

Depression and anxiety both have adverse effects on recurrence and all-cause mortality in patients with breast cancer. Untreated depression leads to significant increase in incidence and mortality. Depression can debut at any stage of cancer, including the stage of diagnosis. It proves the necessity for affective disorders screening in patients with cancer on the stage of diagnosis. Patients with diagnosed affective disorders should be observed not only by oncologist, but also by a psychotherapist in order to receive the necessary treatment to improve the quality of life and reduce the risk of mortality.

None Declared

Chronic Lower Back Pain (CLBP) is a frequently encountered health issue in primary care settings, leading to global disability and imposing a considerable economic burden.

This study aimed to: (1) compare socio-demographic, health, lifestyle (sleep, physical activity) and psychological factors (depression, anxiety) between people with and without CLBP; and (2) quantify the correlations between these psychological and lifestyle factors, and clinical outcomes (intensity of CLBP and CLBP-related disability) in people with CLBP after considering other confounders.

A cross-sectional study was undertaken at the neurosurgery and orthopedic outpatient department of Heraklion University Hospital between 2019-2021. Two hundred fifty three volunteers with CLBP and 116 without CLBP provided sociodemographic information, daily habits, medical history, subjective sleep/ sleep complaints, low back pain intensity and disability using a10-point numeric Visual Analogue Scale pain rating scale and Quebec Back Pain Disability Scale, as well as questions assessing impact of pain on mobility, self-care, routine activities and psychological status, respectively. Participants also completed the Zung Self-Rating Scale (SDS) for self-assessment of depression and Self-rating anxiety scale (SAS). Associations among CLBP, demographics, psychosocial or sleep disorders parameters and clinical outcomes were analyzed using multivariate models.

People with CLBP exhibited a substantially greater prevalence of depressive, insomnia and obstructive sleep apnea (OSA) symptoms than controls (p < 0.05). CLBP diagnosis was independently correlated with female gender, older age, as well as worse physical and mental health outcomes measured by (i) higher level of sleep symptoms such as sleepiness, OSA and insomnia symptoms and (ii) higher prevalence of physician-diagnosed depression, and moderate to severe depressive symptoms. The level of functional disability for CBLP patients (based on Quebec score) was independently associated with age, physician diagnosed depression, lower educational status, moderate to severe depressive symptoms and OSA symptoms. The combination of moderate to severe depressive symptoms with OSA or insomnia symptoms was the most important predictive factor for functional disability for CBLP patients (OR 13.686, 95% CI 4.581-40.885; p<0.001).

Depressive symptoms and subjective sleep disorders appear to relate to greater CLBP-intensity and/or CLBP-related disability in people with CLBP. To achieve the desired outcomes when treating patients with chronic CLBP, it is essential to employ a holistic approach, involving assessment and management of their psychological comorbidities, and sleep issues, that may improve quality of life in these patients.

None Declared

Anorexia nervosa (AN) is a severe and chronic psychiatric disorder, resulting from a voluntary food restriction, vomiting, use of laxatives and excessive exercises, leading in dramatic weight loss and high mortality. AN is a multifactorial disease involving genetic and epigenetic factors supporting that AN is a metabo-psychiatric disorder. The molecular mechanisms involved in the etiology of AN remain unclear. One work reported gene expression by RNA sequencing in peripheral blood before and after weight restoration in 6 AN patients (Kim 2013), and one RNA sequencing in human iiPSC-derived neurons from 4 patients and 4 controls (Negraes 2017). To date, the profile of expression of genes and proteins in AN is undetermined.

In this study, our goal is to identify specific gene expression signatures from circulating blood nuclear cells to decipher the pathophysiology of AN and characterize biomarkers that can be used for diagnostic or prognostic of AN.

All consented participants are recruited at Sainte-Anne Hospital, Paris, France, using DSM5 criteria. They had a blood draw in Paxgene tube for the collection of RNAs. Total RNA was extracted from peripheral blood mononuclear cells of 15 patients suffering of AN and 15 healthy controls. All messenger RNAs are sequenced on a Novaseq plateform. Reads are aligned to the human genome 19 and statistical analyses on the read counts for differentially expressed genes are computed with DESeq2.

The total RNA sequencing allows us to identify 673 dysregulates genes (p adjusted value <0.01, fold change >1,5). Among them, 248 are down-regulated and 425 are up-regulated genes in AN patients compared to controls. From them, 151 transcripts are annotated as pseudogene and 45 are referenced as antisense RNA. Of the 522 remaining transcripts, 424 correspond to a transcript or protein annotated by HGNC and ENSEMBL and 93 are known pseudogenes. A large number of proteins resulting from the expression of deregulated genes interact with each other and form a statistically enriched network impacting biological processes. They are mainly increased and acting in the cellular machinery allowing protein synthesis (biological process: transcription, ribosome, spliceosome and mitochondria). In contrast, down-regulated genes present an enrichment in genes involved in immunity pathways. Finally, several genes are also expressed in the brain. We observed a significant enrichment of genes expressed in the blood and brain tissues.

We identify specific profiles of gene expression in AN. Several genes are both blood and brain tissue expression. Some genes are good candidates for biomarker of the diagnostic in AN that need to be investigated in a longitudinal study to evaluate their useful as prognostic biomarker of AN.

This work is supported by Fondation de France & Fédération Recherche sur le Cerveau.

None Declared

Numerous studies have established a heightened prevalence of anxiety and depression (A&D) in individuals diagnosed with Inflammatory Bowel Diseases (IBD) when compared to the general population. Research indicates that patients with active IBD exhibit a higher frequency of anxiety symptoms and depression symptoms compared to those with inactive disease. In patients with IBD, anxiety was linked to reduced medication adherence and an increased likelihood of undergoing surgery. Furthermore, associations were identified between depression and an elevated risk of disease relapse, as well as a poorer response to treatment in IBD patients. In both IBD and depression, there is evidence of disruptions in circulating miRNAs.

One facet of the ongoing project titled “The brain-gut axis linking inflammatory bowel disease with anxiety and depression: the inflammation-microbiome network” (CRP/ROU21-01) involves the exploration of circulating miRNA profiles in various patient groups.

These groups encompass IBD patients with symptoms of anxiety and/or depression (IBD+A&D+), patients lacking anxiety and depression symptoms (IBD+A&D-), a cohort of individuals without IBD but experiencing depressive and anxiety symptoms (IBD-A&D+), and a control group (IBD-A&D-). Thus far, our investigation has entailed screening a comprehensive panel of 179 miRNAs in the plasma of six IBD patients and 12 non-IBD patients (CTRL) to identify a subset of highly dysregulated miRNAs. MiRNA isolation was achieved using the miRNeasy Serum/Plasma Kit, and miRNA expression levels were assessed via quantitative reverse transcription-polymerase chain reaction (qRT-PCR) utilizing the Human serum/plasma focus, MIRCURY LNA miRNA Focus PCR panel (Qiagen).

Our statistical analysis revealed significant differential expression in 45 miRNAs (p<0.05). Specifically, we identified 29 miRNAs with elevated expression and seven miRNAs with reduced expression. Among these dysregulated miRNAs, 15 (miR-223-3p, miR-143-3p, let-7f-5p, miR-30b-5p, miR-26a-5p, let-7a-5p, miR-339-5p, let-7d-5p, miR-221-3p, miR-191-5p, let-7g-5p, miR-24-3p, miR-107, miR-26b-5p, miR-320b) were associated with depression and/or anxiety and were previously identified as dysregulated in the plasma of patients in other studies. These miRNAs will soon undergo evaluation in the plasma of IBD-A&D+ and IBD+A&D+ patients.

These initial findings provide us with a panel of circulating miRNAs that warrant further investigation in the aforementioned patient groups. The miRNA profile we obtained may either be unique to IBD or linked to the intricate phenotypes of IBD occurring concurrently with anxiety and depression. A more profound comprehension of these mechanisms will aid in the development of enhanced

diagnostic tools and disease monitoring strategies, as well as the exploration of innovative therapeutic approaches.

None Declared

Longitudinal neuroimaging studies focused on adolescents with internalising psychopathology (i.e. with clinical anxiety and/or depression) are scarce, even though anxiety and depression are highly prevalent mental illnesses in adolescence. Often linked to comorbidity with anxiety disorders, a large proportion of depressed adolescents displays more severe symptoms and poorer response to treatment. Previous longitudinal resting-state fMRI (RS-fMRI) studies of intrinsic functional connectivity (iFC) in depressed adolescents point to dysregulation of underlying neural networks such as the corticolimbic network, including among others the amygdala and frontal regions, which are involved in emotion processing and regulation.

This naturalistic study investigates longitudinal changes in resting-state iFC in adolescents with internalising disorders, compared with healthy peers.

23 treatment naïve adolescent patients with clinical depression and comorbid anxiety (INT) and 24 healthy controls (HC) participated in RS-fMRI scans at baseline and after three months. Questionnaires measuring anxiety and depression were completed at both timepoints. Imaging analyses were conducted using independent component analysis (ICA) to extract 7 networks, being the default mode, frontoparietal (bilateral), affective, salience, executive control and dorsal attention network. Additional iFC of amygdala subregions, being laterobasal (LB) and centromedial (CM), was investigated using seed-based analyses. To investigate changes over time between groups, voxelwise analyses were conducted using FSL’s PALM.

No significant results within ICA defined networks were found. iFC between the left LB amygdala and left frontal pole significantly increased over time in patients and decreased in HC. iFC between the right LB amygdala and right pre- and postcentral gyrus also significantly increased over time in patients and decreased in HC, and was significantly associated with reduction in depressive symptoms within patients.

This study provides initial evidence that iFC between the laterobasal amygdala and frontal regions develops differently over time in adolescents with internalising disorders compared to healthy peers and that it is associated with reduction in depressive symptoms.

None Declared

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent psychiatric condition that frequently originates in early development and is associated with a variety of functional impairments. Despite a large functional neuroimaging literature on ADHD, our understanding of the neural basis of this disorder remains limited, and existing primary studies on the topic include somewhat divergent results.

The present meta-analysis aims to advance our understanding of the neural basis of ADHD by identifying the most statistically robust patterns of abnormal neural activation throughout the whole-brain in individuals diagnosed with ADHD compared to age-matched healthy controls.

We conducted a meta-analysis of task-based functional magnetic resonance imaging (fMRI) activation studies of ADHD. This included, according to PRISMA guidelines, a comprehensive PubMed search and predetermined inclusion criteria as well as two independent coding teams who evaluated studies and included all task-based, whole-brain, fMRI activation studies that compared participants diagnosed with ADHD to age-matched healthy controls. We then performed multilevel kernel density analysis (MKDA) a well-established, whole-brain, voxelwise approach that quantitatively combines existing primary fMRI studies, with ensemble thresholding (p<0.05-0.0001) and multiple comparisons correction.

Participants diagnosed with ADHD (N=1,550), relative to age-matched healthy controls (N=1,340), exhibited statistically significant (p<0.05-0.0001; FWE-corrected) patterns of abnormal activation in multiple brains of the cerebral cortex and basal ganglia across a variety of cognitive control tasks.

This study advances our understanding of the neural basis of ADHD and may aid in the development of new brain-based clinical interventions as well as diagnostic tools and treatment matching protocols for patients with ADHD. Future studies should also investigate the similarities and differences in neural signatures between ADHD and other highly comorbid psychiatric disorders.

None Declared

Depression in Alzheimer’s disease (AD) differs from major depression in terms of clinical features and treatment. Antidepressants do not provide the expected benefits in depressive symptoms accompanying cognitive decline in AD, suggesting distinct mechanisms. Emerging research suggest that compromised mitophagy, the selective removal of damaged mitochondria, may contribute to the pathogenesis of AD. However boosting nicotinamide adenine dinucleotide (NAD+) to induce mitophagy reduces amyloid β (Aβ) aggregation and enhances cognitive function in AD models (Kerr et al.,Trends Neurosci 2017;40:151-66). Nevertheless, data on NAD’s impact on depression in AD remains limited.

This study aimed to examine the impact of the NAD+ precursor nicotinamide riboside (NR) on cognitive and neuropsychiatric symptoms in a AD rat model.

To induce the AD, a single dose of 5 μl Aβ1-42 was injected into each lateral ventricle of rats (day 0), while the control group received an intracerebroventricular (icv) saline (0.9%NaCl).Four experimental groups were designed: control (icv saline+po saline), NR (icv saline+po NR), Aβ (icv Aβ+po saline), and Aβ+NR (icv Aβ+po NR).After the injection, to reduce Aβ clearance (Kang et al. Science. 2009;32 1005-7.) rats were subjected to 96 hours of sleep deprivation.Starting from day 6, rats were given either 700 mg/kg oral NR or saline, and handling test scores were recorded daily.The procedures were repeated daily until the rats were sacrificed on day 28.Behavioral experiments were randomly conducted at the end, and statistical analysis was performed using repeated measures ANOVA, followed by the Tukey post hoc test.

Passive avoidance test results showed that the Aβ group had the shortest latency to enter the dark area. However, the Aβ+NR group exhibited a prolonged latency compared to the Aβ group (F(3,2)=5.5;p<0.05). Aβ injection induced depressive-like behavior in rats, as indicated by the forced swim test (FST) for behavioral despair and the sucrose preference test (SPT) for anhedonia. In AD rats treated with NR (Aβ+NR), Aβ-induced depressive-like behavior was reduced, with lower FST immobility scores (F(3,2)=6.2;p<0.05) and increased sucrose preference in the SPT (F(3,2)=7.5;p<0.05). There were no significant differences in anxiety-like behaviors among the groups, assessed by the time spent in the open arm in the elevated plus maze test (F(3,2)=1.9;p>0.05). During the 28-day monitoring period, the Aβ+NR group of rats exhibited a more rapid decrease in aggression levels compared to the other groups in the handling test. This decrease was significant between days 7 and 10 compared to the Aβ group (F(48,5)=1.5;p<0.05).

NR improved memory, reduced depressive behavior, and lowered aggression in AD rats. This suggests that NAD+ precursor NR effectively treats cognitive decline and neuropsychiatric symptoms in an AD model.

None Declared

Post-traumatic stress disorder (PTSD) and personality disorders are highly comorbid. There is some evidence that trauma-focused treatment normalises activation in brain areas involved in the fear circuit and regions involved in emotion regulation in people with PTSD. Although we assume that working mechanism of personality disorder treatments relies on improving emotion regulation and associated brain regions, there is as of yet little evidence of neurobiological effects of personality treatment on people with PTSD and comorbid PD.

To 1) study the effect of trauma-focused and/or trauma-focused and personality disorder treatment n brain activation in participants with PTSD and comorbid personality disorders and 2) relate change in brain activation to symptom improvement.

Participants with PTSD and comorbid borderline and/or cluster c personality disorders from the PROSPER-trials (Prediction and Outcome Study for PTSD and personality disorders) were randomized to either trauma-focused treatment (TFT) or TFT with personality disorder treatment (TFT+PT). Brain activation was measured with an emotional face task during functional magnetic resonance imaging scanning before and after treatment. Regions of interest for the analyses were the amygdala, dorsal ACC, insula, ventromedial prefrontal cortex (PFC), ventrolateral PFC and dorsolateral PFC. Bayesian multilevel analyses were conducted to analyze change in brain activation. Clinical measures were clinician-administered PTSD severity, self-rated emotion regulation problems, depression severity and dissociation severity.

We included 42 participants with a pre- and posttreatment scan (24 with TFT, 18 TFT+PT). Analyses on the pre-post data are currently being run and will be presented in April.

This is one of the first studies to conduct functional MRI analyses on treatment in participants with both PTSD and personality disorders.

None Declared

There has been rapidly growing interest in understanding the pharmaceutical and clinical properties of psychedelic and dissociative drugs, with a particular focus on ketamine. This compound, long known for its anesthetic and dissociative properties, has garnered attention due to its potential to rapidly alleviate symptoms of depression, especially in individuals with treatment-resistant depression (TRD) or acute suicidal ideation or behavior. However, while ketamine’s psychopharmacological effects are increasingly well-documented, the specific patterns of its neural impact remain a subject of exploration and basic questions remain about its effects on functional activation in both clinical and healthy populations.

This meta-analysis seeks to contribute to the evolving landscape of neuroscience research on dissociative drugs such as ketamine by comprehensively examining the effects of acute ketamine administration on neural activation, as measured by functional magnetic resonance imaging (fMRI), in healthy participants.

We conducted a meta-analysis of existing fMRI activation studies of ketamine using multilevel kernel density analysis (MKDA). Following a comprehensive PubMed search, we quantitatively synthesized all published primary fMRI whole-brain activation studies of the effects of ketamine in healthy subjects with no overlapping samples (N=18). This approach also incorporated ensemble thresholding (α=0.05-0.0001) to minimize cluster-size detection bias and Monte Carlo simulations to correct for multiple comparisons.

Our meta-analysis revealed statistically significant (p<0.05-0.0001; FWE-corrected) alterations in neural activation in multiple cortical and subcortical regions following the administration of ketamine to healthy participants (N=306).

These results offer valuable insights into the functional neuroanatomical effects caused by acute ketamine administration. These findings may also inform development of therapeutic applications of ketamine for various psychiatric and neurological conditions. Future studies should investigate the neural effects of ketamine administration, including both short-term and long-term effects, in clinical populations and their relation to clinical and functional improvements.

None Declared

According to UNICEF, 2 million children have left the country since the beginning of the war. 2.5 million Ukrainian children are internally displaced persons. Minors often become victims or witnesses of violence.

The events of 2022-2023 are the largest military conflict in the world since World War II. The impact on the mental health of the population is characterized by the variety and mass of traumatizing factors.

Mental trauma causes PTSD, depressive disorders (DD), anxiety disorders (AD), behavioral disorders (CD), attention deficit hyperactivity disorder (ADHD).

The aim of the study was to determine the prevalence of PTSD and its comorbidities at different stages of experiencing a traumatic experience.

785 teen`s displaced from the zone of military operations, occupied territories were surveyed. Examinations included: K-SADS-PL, PSC-17, SCARED, CATS. 260 teen`s were examined during - 6, 400 – 6–12 months after traumatization.

After 6 months of trauma, PTSD was diagnosed in 9.8%, ADHD – 10.2%, DD-22.3%, AD-30.8%, CD – 15.4%, 28.8%; examined 6 to 12 months after the injury, respectively: 21.9%, 12.6, 33.3%, 11.5%, 18.0%.

In war-affected children, PTSD is a risk factor for the subsequent development of comorbid depression, anxiety, conduct disorders, and ADHD. Female sex, secondary traumatization after displacement increase the risk of developing depression, signs of pervasive development and ADHD - the risk of destructive and self-injurious behavior. The prevalence of PTSD, DD, ADHD increases within 6-12 months after the trauma, the sensitivity of children with PTSD to secondary traumatic events increases.

None Declared

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked genetic enzymopathy that impacts 4.9% of the population, with greater prevalence among Mediterranean, East Asian, and African populations. G6PD deficiency results in levels of nicotinamide-adenine dinucleotide phosphate (NADPH) and glutathione (GSH) that are insufficient for maintaining the balance of oxidation-reduction in the body. This results in elevated production of reactive oxygen species (ROS), oxidative stress on proteins and lipids, damage to DNA, and potential activation of chemokine and cytokine pathways by astrocytes and microglia. We propose that these direct and indirect effects of G6PD deficiency are associated with development of ADHD.

This study investigated the association between G6PD deficiency and Attention Deficit/Hyperactivity Disorder (ADHD).

The study involved 7,473 G6PD-deficient patients and 29,892 matched case-controls (selected at a 1:4 ratio) from a cohort of 1,031,354 within the Leumit Health Services database. Clinical characteristics were analyzed using Fisher’s Exact Tests for categorical variables and Mann-Whitney U tests for continuous variables.

The average age of patients was 29.2 ± 22.3 years, with 68.7% being male. The mean follow-up duration was 14.3 ± 6.2 years. Individuals with G6PD deficiency showed a significant 16% higher risk of being diagnosed with ADHD (Odds Ratio (OR) = 1.16 [95% CI, 1.08-1.25], p < 0.001) on follow up. Furthermore, G6PD deficiency was associated with a 30% greater likelihood of seeking care from adult neurologists (OR = 1.30 [95% CI, 1.22-1.38], p < 0.001) and a 12% higher probability of consulting adult psychiatrists (OR = 1.12 [95% CI, 1.01-1.24], p = 0.048). The use of stimulant medications among G6PD deficient individuals was 17% higher for methylphenidate class drugs (OR = 1.17 [95% CI, 1.08, 1.27], p < 0.001), and use of amphetamines elevated by 16% (OR = 1.16 [95% CI, 1.03, 1.37], p = 0.047).

This study establishes a significant association between G6PD deficiency and an increased risk of ADHD diagnoses. These findings suggest potential opportunities for the development of culturally sensitive interventions.

B. Krone Consultant of: HIPPO T&C, Signant Health, J. Newcorn: None Declared, I. Manor: None Declared, E. Merzon: None Declared

Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric conditions, maintaining its presence well into adolescence and adulthood, resulting in impaired functioning. Evaluating ADHD symptoms through self-reporting plays a crucial role in assessing individuals within these age groups. The novel self-report version of the Strengths and Weaknesses of ADHD and Normal Behaviors (SWAN) scale offers a comprehensive assessment of behaviour, extending beyond just focusing on the typical signs and symptoms of ADHD, thus providing a more holistic perspective.

Our goal was to assess the factorial validity of the Hungarian version of the SWAN self-report by comparing a two-factor model with bifactor models with a general and 1) two specific factors (inattention, hyperactivity/impulsivity), 2) three specific factors (inattention, motor hyperactivity/impulsivity, verbal hyperactivity/impulsivity) in a community sample.

Data from 717 adolescents and young adults (mean age = 20.0 years, SD = 3.10, range: 14 - 25 years, female: N = 664, 92.6%) were analysed. Participants completed an online questionnaire including the SWAN scale after giving informed consent. Confirmatory factor analyses were conducted based on the maximum likelihood estimator (ML).

The bifactor model with a general and three specific factors demonstrated the best fit to our data (CFI = .933, RMSEA = .064 [90% CI: .058 – .071], SRMR = .038). While the overall composite reliability was excellent (ω = .91), the reliability of the specific verbal hyperactivity/impulsivity factor fell below acceptable (ωh = .40).

In line with previous studies, the fit indices of the bifactor models were superior to the non-hierarchical two-factor model. Our results support the existence of a strong general factor but suggest uncertainty in the capacity of the specific factors to consistently explain the distinct variance in observed variables, particularly when compared to the overarching influence of the general factor.

This work was supported by the ÚNKP-22-2 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund (grant number ÚNKP-22-2-I-ELTE-854).

None Declared

Children with parents with psychiatric diagnoses have an increased probability for not only the same condition as their parent, but also for other conditions and behavioral and psychosocial problems. Whereas many studies have focused on parental severe mental illness due to their significant impairment, less attention has been paid to more common disorders despite their higher prevalence. In addition, because most past research only included one exposure or one outcome at a time, it remains difficult to examine and compare broad patterns of intergenerational transmission.

To examine associations between six parental psychiatric diagnoses in parents, and a broad range of psychiatric diagnoses, psychotropic medications, criminality, suicide, violent victimization, accidents, and school and labor performance in their offspring.

Based on Swedish national registers, we linked all individuals born in Sweden between 1970 and 2000 to their biological parents (N = 3 286 293). We used a matched cohort design, analyzed with stratified Cox regression and conditional logistic regressions to examine associations between six psychiatric diagnoses in the parents, and 32 outcomes in their offspring. All exposed and unexposed children were followed from their date of birth to the date of emigration from Sweden, the death, or 31 December 2013 when the offspring were 14-44 years old.

In terms of absolute risk, most children who had parents with psychiatric diagnoses were not diagnosed in specialist care themselves, as the proportion of having any of the 16 types of psychiatric conditions ranged from 22.17% (exposed to parental depression) to 25.05% (exposed to parental drug-related disorders) at the end of follow-up. Nevertheless, in terms of relative risk, all six parental psychiatric diagnoses increased the probability of all 32 outcomes in their offspring, with the Hazard Ratio ranging from 1.04 to 8.91 for time-to-event outcomes, and the Odds Ratio ranging from 1.29 to 3.36 for binary outcomes. Some specificities were observed for parental psychotic and substance misuse diagnoses, which strongly predicted offspring psychotic-like and externalizing-related outcomes, respectively.

The intergenerational transmission of parental psychiatric conditions appeared largely transdiagnostic, even for non-psychiatric outcomes in offspring. Given the broad spectrum of associations with the outcomes, service providers (e.g., psychiatrists, teachers, and social workers) should consider clients’ broader psychiatric family history when predicting prognosis and planning interventions/treatment.

None Declared

From recent epidemiological studies to emerging epidemiological evidence, it becomes evident that numerous primary studies have investigated the prevalence of ADHD in children and adolescents. Additionally, several systematic reviews and meta-analyses have explored this subject. The objective of this umbrella review is to offer a robust synthesis of evidence derived from these systematic reviews and meta-analyses

To conduct a comprehensive umbrella review that synthesizes emerging epidemiological evidence regarding the prevalence of ADHD in children and adolescents, drawing insights from numerous primary studies as well as systematic reviews and meta-analyses.

We conducted a systematic search across multiple databases, including PubMed, Web of Science, PsychINFO, and Scopus, to identify relevant studies. The study was preregistered with PROSPERO (registration number: CRD42023389704). To assess the quality of these studies, we utilized the Measurement Tool to Assess Systematic Reviews (AMSTAR). We employed an inverse variance-weighted random-effects meta-analysis to combine prevalence estimates from the included studies.

The final analysis incorporated thirteen meta-analytic systematic reviews, encompassing 588 primary studies and a total of 3,277,590 participants. A random-effects meta-analysis of these studies revealed that the global prevalence of ADHD in children and adolescents stood at 8.0% (95% CI: 6.0%–10%). Notably, the prevalence estimate was twice as high in boys (10%) compared to girls (5%). Among the three subtypes of ADHD, the inattentive type (ADHD-I) emerged as the most prevalent, followed by the hyperactive type (ADHD-HI) and the combined type (ADHD-C).

The comprehensive umbrella review findings emphasize the high prevalence of ADHD in children and adolescents, with a notable gender disparity, wherein boys are twice as likely to be affected compared to girls. These results underscore the urgency of prioritizing prevention, early identification, and treatment strategies for ADHD in children and adolescents.

None Declared

World Health Organization estimates that climate changes are expected to cause an additional 250 000 deaths worldwide per year between 2030 and 2050 (1). We do not know, in what extense, population mental health will deteriorate due to climate change. Unfortunately, not all European countries, including Poland collect the evidence-based information about current and possible future risks for mental health.

(1)World Health Organization. Climate change and health; 2018. Available from who.int/news-room/ fact-sheets/detail/climate-change-and-health [cited 20 October 2020]

The aims of present study are: (1) summarize the available literature through a current review and (2) make recommendations for future actions/ prevention strategy for Poland.

Medline database (through PubMed) and Polish authorities documents was searched for records published in 2010–2024. Mental health-related descriptors (i.e. „mental health” OR “mental disorders”) and „climate change” and “Poland/ Polish” and “Europe” term were used in particular searches. The results of the screening were included in the final selection list. References of screened full-text articles and raports were manually searched for further literature. Additionally, European and worldwide publications and reports prepared by mental health and/ or climate change organizations were taken into account.

Mental health risks of climate change can stem from climate-related natural disasters (e.g., extreme weather events), slower moving events (e.g., drought), or concern about the phenomenon of climate change itself. Primary mental health impact is related mostly to disasters itself and its consequences: environment of disruption, trauma and grief. Direct consequences include increased rates of high-risk behaviours. Secondary effects of climate change are due to various processes of environmental changes and ecological disruptions. They consist of damages to physical and social infrastructure, physical health effects, food and water shortages, conflict, and displacement. Long-term droughts affect food and water supplies and can subsequently affect the economic and mental wellbeing not only the land-based workers.

A focus on climate change impact on mental health can help enhance the understanding of factors that strengthening psychosocial resilience and adaptation. The future mental health challenges of climate change in Poland cover:

• - developing scientific knowledge regarding adaptation process and resilience,

• - focusing on high-risk groups (i.e. children, rural workers),

• - strengthened community engagement,

• - developing available locally strategies for mental health improving.

None Declared

Autism Spectrum Disorder (ASD) is a condition with varying degrees of social, emotional and behavioural disability. These children require focused and individualised learning plan to facilitate social integration. Robots have been used for this purpose but are not routinely available in several parts of the world. Effective, point of care (POC) digital therapies that can be used anywhere by anyone is the need of the day.

To evaluate the effectiveness of Artificial Intelligence (AI) driven individualised learning plans delivered through POC digital platform (CognitiveBotics) for children with ASD.

After Ethical approval and parental consent, children diagnosed with ASD (Childhood Autism Rating Scale CARS 2) aged 2 years and above were screened for study inclusion and exclusion criteria and enrolled. AI driven individualised learning plan was administered through CognitiveBotics software that could be used on either computer or a tablet. Initially, interactive questions were administered to parents by the AI tool to understand child’s functioning. Based on these, an individualised learning plan was assigned. Each task is delivered using either interactive videos, chatbot and/or animated/AI games. The child’s progress is captured for attention (attempted questions, retries and timeouts) and retention (first time corrects and corrects) continuously. The initial interactive questions administered to parents were repeated to assess child’s progress in real life. Paired ‘t’ test using SPSS version 26 was used to compare initial and final data.

Out of 85 registered children, 41 regularly used the AI tool. Mean age was 43.93 months (range 26 to 72 months). 37 (90.24%) were boys. The baseline mean scores (ranges), were CARS 33.48 (30-39.5); Social quotient 53.4 (27.25-80.32), Developmental quotient 71.35 (45.90-93.33) and IQ 62.34 (36.58-86.83). The base line mean score of parents assessed child function was 115.24 (range 58 to 215). A mean of 15.54 tasks were given (range 5 to 48). At the time of analysis with a mean follow up of 3 months (range 2 to 5 months) the children completed a mean of 10.10 tasks (range 0 to 42). There was significant improvement in child’s learning captured by the AI software based on attention and retention parameters (p = <0.00001). This improvement was also reflected in parent assessed child function (mean 147.15, (59 to 231)) (p = <0.00001). The percentage of improvement in both software captured and parent assessed child function was directly related to the amount of time spent by the child on the software.

AI driven individualised learning approach is effective in teaching skills and promote social integration for children with ASD. Such technology can capture the child’s progress on a day-to-day basis and deliver personalised training.

None Declared

Bipolar disorder (BD) is a multifaceted illness encompassing mood, energy, cognitive and biorhythms alterations. Sleep disturbances are common in prodromic, acute and inter-episodic phases of BD. Suicidality presents a known association with sleep disturbances. However, their interplay in BD remains intricate and not fully elucidated.

The aim of the present systematic review (SR) and meta-analysis (MA) is to summarise the available evidence and to provide an estimate of the association between sleep disturbances and suicidality, defined as presence of suicide ideation, behaviour and suicide attempts, in patients with BD.

We conducted a comprehensive literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across PubMed, PsycINFO, and SCOPUS databases. We included all studies reporting an association between sleep problems and suicidal behaviour in BD patients. No language restriction was imposed. Effect sizes were calculated as odds ratio (OR) for dichotomic variables, standard mean difference (SMD) for continuous outcomes, and Spearman’s coefficient (r) for correlations. Heterogeneity was assessed using the I2 statistic. Global inconsistency was evaluated using the Q statistics with the corresponding p-value.

The initial search yielded 911 unique abstracts, of which 62 underwent full-text screening. Fourteen publications were included, comprising twelve cross-sectional and two longitudinal studies. The total sample consisted of 19,601 subjects diagnosed with BD, of which 51.76% were females and 69.52% had a diagnosis of BD type 1. We found that people with BD and sleep disturbances tend to have higher suicidality, both current (SMD=0.79, 95%CI=0.53, 1.05) and lifetime (OR=1.8; 95%CI=1.41, 2.55), when compared with people with BD and no sleep disturbances. Additionally, patients with BD and a history of suicide attempts tend to have more sleep problems (OR=1.37, 95%CI=1.21, 1.55). Moreover, a positive correlation exists between suicidality and poor sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI) (r= 0.24, 95%CI=0.10, 0.36). No heterogeneity was found, except in the subanalysis of correlation (I2=66.67%, Q p-value=0.01).

Our SRMA outlines a positive relation between sleep disturbances and suicidality in patients with BD. The small number of included studies and the scarcity of longitudinal studies, preventing the inference of a causal relationship, represent the major limitations of this study. Also, studies with objective measures of sleep alterations are currently lacking. The prompt recognition, objective measurement, and treatment of sleep alterations could be crucial in averting or reducing suicidal attempts in BD.

C. Possidente: None Declared, M. Bort: None Declared, M. De Prisco: None Declared, V. Oliva: None Declared, G. Fico Grant / Research support from: Fellowship from “La Caixa” Foundation (ID 100010434 - fellowship code LCF/BQ/DR21/11880019), L. Bracco: None Declared, C. Sommerhoff: None Declared, L. Montejo: None Declared, A. Murru Grant / Research support from: Spanish Ministry of Science and Innovation (PI19/00672, PI22/00840) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdireccion General de Evaluacio ́n and the Fondo Europeo de Desarrollo Regional (FEDER), E. Vieta Grant / Research support from: Spanish Ministry of Science and Innovation (PI18/ 00805, PI21/00787) integrated into the Plan Nacional de I+D+I and cofinanced by the ISCIII-Subdireccio ́n General de Evaluacio ́n and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357; the European Union Horizon 2020 research and innovation program (EU.3.1.1. Understanding health, wellbeing and disease: Grant No 754907 and EU.3.1.3. Treating and managing disease: Grant No 945151).

Pediatric Bipolar Disorder (BPD) is a chronic psychiatric disorder that alters normal and psychological development processes among patients. Although cognitive deficits in BPD have identified in recent studies, little is known about the developmental trajectory of these deficits. DMDD is a newly defined diagnosis included in the DSM-V. Since it added a new dimension to the clinical spectrum but few studies conducted on DMDD, there are some conflicting discussions in the literature about how to distinguish this disorder from other childhood psychiatric disorders and how to treat it.

The aim of this study was to determine the phenomenological and neuropsychological differences between children and adolescents with a diagnosis of BPD (Pediatric Bipolar Disorder), DMDD (Disruptive Mood Dysregulation Disorder), and children and adolescents who are genetically at high risk for Bipolar Disorder (BD), and healthy controls (HCs) who do not have any psychiatric diagnosis, to investigate endophenotypes that may be predictive for BD.

Our study sample consists of four groups, the BPD group (n=30), the Risk group (n=25), the DMDD group (n=36), and the Healthy Control group (n=29). All participants were evaluated by the “Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Now and Lifetime Pattern (K-SADS-PL)”. “Young Mania Rating Scale/Parent Form (YMRS-ABF), Conner’s Parent Rating Scale (CPRS-48), Child and Adolescent Behavior Rating Scale (CBCL)” scales were filled by parents, and “Child Depression Inventory (CDI), Youth Self-Report Form for 11-18 Years Olds (YSR)” scales were filled by children and adolescents. Neurocognitive test battery was applied to each participant: Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST), Stroop Color and Word Test (SCWT), Trait Making Test A and B sections (TMT-A/B), California Verbal Learning Test-Child version (CVLT-C).

While it was determined that the cases in the BPD and DMDD groups performed significantly worse in CPT, SCWT, CVLT-C, TMT A/B tests compared to healthy controls, it was found that the subjects in the Risk group performed worse at the CPT test than healthy controls. In addition, the cases in the BPD, Risk and DMDD groups reported more clinical and behavioral problems than the healthy controls.

There is a significant deterioration in the areas of continuous attention, processing speed, cognitive flexibility, response prevention, verbal memory and working memory in the BPD and DMDD groups, and in the continuous attention area in the Risk group compared to healthy controls. Prospective follow-up and imaging studies using larger samples and a larger neurocognitive test battery in the future will better reveal the neuropsychological characteristics of the BPD, Risk and DMDD groups.

None Declared