In the last 30 years, Switzerland has been established as a destination country for psychiatric trainees. The needed competences for the work as a trainee deviate regarding colleagues from foreign countries though, hindering a viable solid development professional without specific on-boarding program. A similar approach to the figure of tutor anchored in the Spanish postgraduate medical training is still missing in the Swiss medical System. Hereby we performed a survey in the new colleagues who are part from the medical team in an observer status before beginning with the responsibilities as a trainee.

Recognizing competences and needs of the onboarding in current trainees that are still allocating because of the work conditions as stated in the following paper, (Bischof et al. Swiss Arch Neurol Psychiatr Psychother. 2021;172:w03198)

Survey with open questions collecting needs and competences expected to fulfil in Switzerland were distributed in 5 different medical colleagues in an observer status between August 2022 and September 2023.

Response rate was 62,5 %. Main reasons for the migration were considering better perspectives in education and professional development in the goal country, coming push factors as the current work situation in the original country to the fore. Support regarding the local language and an overview of the interprofessional communication were outlined as the advantage of the internship prior to the duties as a psychiatric trainee.

An structured on-boarding program is a demand for the newcomers - majority of trainees from foreign countries - to step in better in the Swiss health system. Elements of the Spanish trainee system could be adapted for a suitable allocation and integration process in the goal country.

None Declared

The treatment of dual disorders, the co-occurrence of a major psychiatric disorder and a substance use disorder, represents a great challenge. Recent articles recommend antipsychotics with a dopamine partial agonism as first line treatment for these patients. Studies also postulate that drugs targeting the dopamine D3 receptors specifically might have an advantage, as these receptors are involved in drug-related reward, drug-seeking, and drug-intake behaviour. One compound that has both, partial agonist- and D3- activity is cariprazine.

To evaluate the real-world evidence of the effectiveness of cariprazine in patients with dual disorders.

We performed a systematic literature search on PubMed, looking for English language articles published between January 2017 - September 2023 with the following search terms: (cariprazine) AND (psychosis OR schizophrenia OR schizoaffective OR bipolar depression OR bipolar mania OR bipolar disorder OR major depressive disorder) AND (“substance use disorder” OR cocaine OR alcohol OR cannabis OR heroin OR “double diagnosis” OR “dual diagnosis”) NOT (animal OR rat OR mouse) NOT (review or meta-analysis). An additional targeted hand search of congress reports, posters, and case reports was also conducted.

The search yielded 8 articles with 11 case reports. Mental health disorders included psychosis, schizophrenia, schizoaffective disorder, PTSD, and bipolar disorder while the abused substances were methamphetamine, cannabis, alcohol, and cocaine. All case reports described an improvement in both the symptoms of mental and substance use disorder with reduced craving and drug use and in some cases even ceasing drug use all together.

In summary, evidence suggests that cariprazine seem to be a potential candidate for dual disorders as it improves symptoms of both mental and substance use disorders.

Á. Barabássy Employee of: Gedeon Richter Plc., Z. Dombi Employee of: Gedeon Richter Plc., R. Csehi Employee of: Gedeon Richter Plc., D. Djuric Employee of: Gedeon Richter Plc., G. Németh Employee of: Gedeon Richter Plc.

Nurses working in psychiatric departments regularly encounter intricate, stress-inducing, and emotionally challenging situations. The mental well-being of these nurses directly influences the quality of care they deliver.

To assess the prevalence of psychological distress among psychiatric nurses and to identify the socio-demographic and clinical factors associated with it.

Cross-sectional, descriptive, and analytical study conducted over the course of one month from October 11th to November 8th 2023. Participants included were psychiatric nurses working in Razi Hospital, Tunisia. We collected data using pre-established questionnaire which included socio-demographic and clinical data of the participants. The assessment of psychological distress was conducted using the Depression, Anxiety and Stress Scale (DASS-21), validated in Arabic. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) in its 25th version

We collected data from 55 nurses working in Razi psychiatry hospital during the time of the study. Among them, 80% (n=44) were female. Their median age was 35 (Min=25, Max=62). Most of participants were married (81.8%, n=45) and 70.9 (n=39) had kids. In our sample, 5.5% (n=3) and 23.6% (n=13) had respectively personal psychiatric and somatic history. Some addictive behaviors were identified among our participants, especially smoking (14.5%, n=379) and alcohol use (3.6%, n=2).

Regarding working conditions, 81.8% (n=45) were assigned shift work. They worked in the men’s ward (43.6%, n=24), the women’s ward (34.5%, n=19), or in both (21.8%, n=12). Furthermore, 45.5% (n=25) reported witnessing a suicide attempt during their work, and 74.5% (n=41) were victims of aggression, primarily by patients (82.5%, n=33). Sixty percent (n=33) said expressed a desire to transfer.

Moderate to extremely severe depression, anxiety and stress was observed in respectively 34.5% (n=19), 61.8% (n=34) and 36.4% (n=20) of cases.

A significant association was found between stress among psychiatry nurses and personal somatic history (p <10-3). No further links were found between depression, anxiety, stress and other clinical factors.

These results emphasize the difficult working environment within psychiatric settings, emphasizing the critical requirement for specific interventions aimed at improving the mental health and well-being of psychiatric nurses.

None Declared

The ongoing conflict in Ukraine has resulted in a significant influx of refugees seeking asylum in other countries, including Poland. Among these refugees are individuals who are struggling with mental health issues. Polish psychiatrists have stepped up to provide care for these patients, despite facing a number of challenges in the process.

This presentation aims to shed light on the experiences of Polish psychiatrists treating refugees during the war in Ukraine, highlighting the difficulties they have encountered and the strategies they have employed to provide the best possible care to their patients. The presentation also examines the impact of war on mental health, and the long-term effects on the well-being of refugees.

A questionnaire study was done among Polish Psychiatrists about the forms of support they provided for Ukrainin psychiatric patients they consulted after 24 February 2022. The responses to questionnaires were collected during psychiatric Congresses.

The most commonly reported symptoms were anxiety (44.1%), followed by depression (35.3%), and panic attacks (23.5%). Other symptoms like irritability and sleep disorders were reported by 11.8% and 8.8% of the respondents, respectively. Disturbingly, thoughts of resignation and suicidal ideation were also reported, albeit at lower frequencies (8.8% and 2.9%, respectively). A small percentage (2.9%) reported no new symptoms.

The high prevalence of anxiety and depression suggests that the war has had a profound impact on the mental health of the affected population. The emergence of severe symptoms like psychotic thoughts and suicidal ideation, although less frequent, is alarming and calls for immediate intervention. It is also noteworthy that a small but significant portion of the population reported no new symptoms, which may indicate resilience or other coping mechanisms at play.

The war in Ukraine has led to a range of new psychological symptoms among the affected populations, with anxiety, depression, and panic attacks being the most prevalent. Immediate and long-term psychological interventions are urgently needed to address these emerging mental health issues. Further research is also required to understand the resilience factors among those who reported no new symptoms.

None Declared

Children, who are particularly vulnerable in emergency situations, need tailored mental health strategies.

We investigated the impact of the COVID-19 pandemic on anger and life satisfaction in children.

September 2021, we conducted a cross-sectional study in Preveza, Greece, interviewing 91 students aged 10-12 years from four elementary schools. The survey included socio-demographic questions, the Anger Expression Scale for Children (AESC), and the Satisfaction with Life Scale (SWLS). AESC scores range from 6 to 30 indicating anger severity, while SWLS scores between 5-9 signify extreme dissatisfaction and 31-35 extreme satisfaction.

Significant correlations were found between the number of siblings (p 0.004), duration of electronic play (p 0.005), and duration of sleep (p 0.014) with life satisfaction. Children without siblings, with limited play consumption, and early bedtimes had lower life satisfaction. The presence of a television in their room (p 0.027) and daily use of television and social media (p 0.007) correlated with anger management and behavior. Social media/TV use was associated with better anger management.

Despite the pandemic lasting almost two years, children’s anger levels in Preveza remained stable, possibly due to outdoor activities and online interactions. These findings provide insights for policy makers, healthcare professionals, and parents seeking to improve anger management of children.

None Declared

In the workplace, a smoke-free environment is crucial to guaranteeing the health of workers and those around them. Understanding the relationship between smoking and work is a prerequisite for implementing effective tobacco control measures.

To assess the prevalence of smoking in an electricity and gas company in Sfax and to determine the relationship between workers’ nicotine dependence and perceived workload.

We conducted a cross-sectional survey evaluating the smoking behavior of 100 employees of an electricity and gas company. The survey was carried out from July to December 2022 using a two-part questionnaire. The first part was completed by the participants, and the second was administered by the interviewer. Nicotine dependence was assessed using the Fagerström test, while perceived workload was evaluated using the raw NASA-TLX questionnaire.

Our study population consisted of 82 male participants. Active smoking was reported by 45.1% of participants. Among smokers, 40.5% had moderate to high nicotine dependence as assessed by the Fagerström test. According to the raw NASA-TLX questionnaire, the mean scores for mental, physical, and temporal demands were 88.8±13.5, 63.6±24.7, and 59.1±28.4, respectively. The mean scores for effort, performance, and frustration were 83.8±14, 85.4±13.1, and 34.5±28.1, respectively. Bivariate analysis indicated an inverse correlation between nicotine dependence and physical demands at work. However, a significant positive correlation was found between nicotine dependence and frustration at work.

Smoking among electricity and gas company workers is a prevalent issue, highlighting the urgent need for smoking cessation interventions. The association of smoking with perceived workload underscores the importance of preventive measures to reduce work-related stress.

None Declared

Social support have affected the recovery and adherence with treatment in bipolar patients.

This research aims to understand the contribution of social support mechanisms to treatment adaptation processes in individuals struggling with bipolar disorder and the effects of these support mechanisms on recovery. In this way, the importance of the social support factor will be tried to be understood in order to provide more effective and customized support to individuals living with bipolar disorder.

This study will planned to descriptive correlational design. The data will collect to using the Morisky Treatment Adherence Scale (MTAS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Recovery Process Inventory (RPIS), and the Sociodemographic Data Form from individuals diagnosed with Bipolar disorders. By filling out these scales, participants will evaluate their treatment compliance, perceived social support levels, and recovery processes. The data will be subjected to appropriate methods for statistical analysis and will be used to understand the relationships between social support and treatment compliance and recovery processes.

Data extraction is still on going in detailed style by principal authors. Description of studies and the key findings will be presented.

It is thought that the results obtained from this research will be an important guide in providing more effective support to individuals with the level of social support, treatment adherence and recovery processes in individuals struggling with bipolar disorder

bipolar disorder, social support, treatment adherence, recovery.

None Declared

In Colombia the traditional treatment model implies the needing of a total cessation of consume to be able to acces an impatientand long stance rehabilitation program. However, literature in other countries expériences had sugested and used a harm reduction program with an otpatien rehabilitation program.

As this programs are more cost-effective and enables the patient to continue his daily life, perpetuate his life style, keep and enhance the psychosocial network, an outpatient comprehensive multimodular program was designed to adapt to a health promotion company (EPS for its spanish acronym) and has been used since 2017.

• - share the expérience aquired in an undeveloped country of latin America

• - The tipification in the main substance consumption in the development group as well as it’s differentiation in gender and age group

Expérience and results

• - The majority of patients are men over women

• - the predominant age group is between 29-59 years old

• - there is a difference between the age group depending on the substance of impact

The experience have shown that up to 30% of the population treated have gotten to a controlled consumption or the total suspension without the needing of an impatient program In général thé patient have shown motivation and adherence to an outpatient program

None Declared

Attention–Deficit/Hyperactivity Disorder (ADHD) is a heterogeneous neurodevelopmental disorder encompassing developmentally inappropriate inattentiveness, hyperactivity, and increased impulsivity (DSM-5). Symptoms presentation is different for different stages of life; moreover, individuals with ADHD symptomatology can develop abilities and strategies that help them adapt and mask the distinctive features of the condition, thus reducing the functional impairment usually seen in ADHD subjects, and ultimately not receiving neither a clinical diagnosis nor a proper therapeutic support. They might express their lack of well-being through other transdiagnostic symptoms, and finally reach psychiatric attention for potential comorbidities. Hence, it was argued that the existence of children and adolescents with subthreshold and underrecognized symptoms that subsequently develop into a full diagnosis suggests that ADHD should be significantly more considered in adult mental health settings.

Here we aimed to analyse the prevalence of ADHD symptoms and traits in a heterogeneous clinical psychiatric sample of young adults (aged 18 to 24 years old), who referred to a specialized outpatient clinic for various psychiatric and psychological disturbances.

259 participants completed three validated self-report screening questionnaires for ADHD: the Wender Utah Rating Scale (WURS), the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5 (ASRS-5), and the Conners’ adult ADHD rating scale (CAARS).

12.4% of our sample scored above the cut-off at both the WURS and the ASRS-5 and was considered at risk of ADHD.

The prevalence rate in our sample is higher than the one found in the adult general population (6.76%), and in the lower range of the one found in the adult clinical population (6.9% to 38.8%). We discuss the potential role of sociodemographics (age, sex, gender identity, and employment) and comorbidity factors. Differences in the clinical presentation of ADHD according to sex assigned at birth and age should be considered during every psychiatric evaluation to minimize the risk of underdiagnosis. We advocate for further studies investigating the prevalence of ADHD in different psychiatric services for adults, and for a stronger presence of specialistic ADHD services and trained clinicians on the territory: this would increase diagnostic reliability, consequently providing a better treatment for ADHD in adults, and facilitate the transition from pediatric to adult’s services.

None Declared

The DiSCoVeR Project: ‘Examining the synergistic effects of a cognitive control videogame and a self-administered non-invasive brain stimulation on alleviating depression’ is a double-blind, sham controlled, randomized controlled trial investigating the feasibility and efficacy of an innovative, self-applied treatment approach for patients diagnosed with major depressive disorder. The trial is conducted at three clinical trial sites (Hadassah, Israel; Riga Stradiņš University, Latvia; Ludwig-Maximilian-University, Germany). The treatment approach combines prefrontal transcranial direct current stimulation with a videogame designed to enhance cognitive and emotional control. This treatment is self-applied at home and remotely monitored. At the beginning of the intervention the patients are randomized in an active group receiving both active stimulation and videogame and the other group receiving sham stimulation and visually similar but not active videogame.

The present interims analysis after half of the patients included examines patients’ intrinsic motivation after completing the first five sessions (of 30) of the treatment. We also examine patients’ interest/enjoyment, perceived competence, effort, felt pressure/tension, and perceived choice following the first week of treatment. Intrinsic motivation has been associated with enhanced learning and performance, so it can be used as one of the predictors for patient compliance.

At the end of the 5th session, the patients filled in the Intrinsic Motivation Inventory (IMI) including the following subscales: interest/enjoyment, perceived choice, perceived competence, effort/importance and felt pressure/tension (scored on a 7-point Likert scale, ranging from 1 “not at all true” to 7 “very true”).

This report includes the first 55 patients randomized (27 patients in the active group and 28 patients in placebo group) for the DiSCoVeR trial. Patients rated their overall interest/enjoyment at 4.50 out of 7 (SD±0.17 95% CI 4.16 to 4.84), their perceived choice at 5.55 (SD±0.16; 95% CI 5.23 to 5.87), their perceived competence at 4.52 (SD±0.15; 95%CI 4.22 to 4.82), their effort/importance at 5.07 (SD±0.16; 95%CI 4.74 to 5.40) and their pressure/tension at 3.00 (SD±0.13; 95% CI 2.73 to 3.26).

We conclude that overall patients were quite interested in the treatment and had inherent pleasure while doing the sessions, felt that it was their choice to do them, felt that they performed the task quite effectively, were invested in doing the sessions and the experienced pressure and tension were low. The perceived choice and competence are positive predictors of intrinsic motivation. This aligns with the previous published data of a smaller patient subset (L. Konosonoka et al Medicina (Kaunas) 2022;58(Supplement 1):72) with the standard deviations being smaller in our larger patient sample.

None Declared

Addictive disorder, characterized by the tendency to abuse an illicit substance or manifest a repeated risky behavior, is a fairly common phenomenon occurring in the last 50 years, predominantly in middle and high income countries. While psychotherapy has an evident positive impact in the treatment of the disorder, data has shown that it is often not sufficient to achieve full remission and have optimal positive impact in the quality of life compared to simultaneous use of psychotherapy, pharmacotherapy and psychosocial rehabilitation.

The aim of the study is to highlight different specifics of the inpatient treatment of “Mr. E”, living in a post-war middle-income country with rapid social and cultural transition.

Subject of this case study is “Mr. E” a 17 year old student with a history of family trauma with a long history of abuse and ambulatory psychiatric treatment. Data has been analyzed from the medical history of the patient treated in 2023, in the substance abuse unit of the Department of Psychiatry, University Clinical Center of Kosova. Semi structured interviews, daily abstinence symptoms evaluation and self - report measures were used to gather qualitative data throughout the treatment process. Treatment protocol consisted on: detoxification, pharmacotherapy and simultaneous supportive individual and group psychotherapy, with the goal to evaluate, treat and reintegrate “Mr. E” into the society free of illicit substance abuse. Comorbidities are correlated with underlying causes, while a healthy lifestyles are promoted through the work on behavior changes that will support optimal social reintegration in a rapid changing social and cultural environment.

The findings revealed several significant therapeutic objectives such as: Enhanced self – awareness; Reduced ruminations and increased self-control; Enhanced quality of life; and Decreased substance abuse. Detoxification protocol in the treatment of addictive disorder in inpatient psychiatric treatment was essential for abstinence symptom management during crisis. Strengthening the body parallel to healing the mind was found as an important stepping stone.

Combined, detoxification, psychopharmacological, and psychotherapeutic approach was essential for successful treatment of a young adult in a post-war middle income country with rapid social and cultural transition.

None Declared

The gut-brain axis establishes the relationships between bacteria, neurotransmitters and psychophysiological responses associated with a neuronal and behavioral correlate in autism and different mental disorders.

In recent years, there has been an increase in studies on the implications of the gut microbiota (MI) in children with autism spectrum disorders (ASD).

1. To study if there is a dysbiosis or alteration of the MI can trigger the appearance of ASD symptoms.

It is considered that there is a frequent comorbidity with gastro-intestinal symptoms (GS), pain and sensory reactivity in ASD, and that these are indicators of a possible alteration in the gut-brain axis.

In this sense, children with ASD have hypersensitivity to certain visual, olfactory, tactile, etc. stimuli. which makes them be more picky about food and have certain repetitive patterns of behavior, as a consequence they present gastrointestinal symptoms such as constipation and abdominal pain. Sensory reactivity can influence both feeding and sleep patterns in autism.

Currently, there are measuring instruments for sensory reactivity, pain and gastro-intestinal symptoms. However, there are several limitations of these instruments and especially with sensory reactivity in autism because: (1) the items had not been developed in collaboration with interested parties (pediatricians, neuropsychologists, etc.) and (2) the lack of structural validity analysis. Thus, it appears that most validation studies do not meet the criteria of sufficient psychometric quality according to the COSMIN guidelines. Additionally, there is a lack of consensus around terminology (e.g., sensory overreactivity, hyperreactivity, SOR, etc.) and components relevant to sensory functioning.

In the present work, preliminary data are presented on new measures to take into account to evaluate sensory reactivity and pain in the population with autism. This is a first step to obtain an index of the gut-brain axis for the ASD population.

Keywords: ASD, gut-brain, sensory reactivity, pain

None Declared

Mental health problems have increased following the pandemic and are associated with considerable health, economic and societal outcomes, particularly affecting youth. In co-creation with young people several European prevention and early intervention strategies to promote mental wellbeing of youth are currently being developed. The development and implementation of easy-access youth mental services across Europe will be presented and discussed. In addition pilot data of online, hybrid treatment platforms and self-management ecological momentary intervention apps will be presented. Ultimately the aim is: 1) to develop clinical guidelines, best practices, and policy recommendations to mitigate the youth mental health challenges and 2) improve (cost-) effectiveness of early intervention strategies for promotion and prevention in mental health, including enhancing mental health literacy, resilience and self-management, while 3) actively involving young people in the process of these innovative developments. To amplify the reach, campaigns designed in co-creation with young people, to increase awareness, literacy, wellbeing and help-seeking among young people, targeting schools, further-education colleges, universities and other specific settings will need to be developed, specifically paying attention to high-risk groups within this young population, including children of parents with mental disorders, migrants, young people growing up in poverty, those in/leaving care, and the LGBTQ+ community, with coordination across domains: schools, general practitioners, and specialized mental healthcare facilities.

None Declared

Psychedelics are substances consumed for recreational use, the majority of these psychoactive substances are illegal and hard to obtain. Therefore, there is a demand for psychedelics legal and easier to access, these types of drugs are called ‘legal highs’. LSA (lysergic acid amide) is one of these new psychoactive substances, this drug is searched because it is known to have an effect similar to LSD. LSA has negative effects on body functioning not fully understood by the medical field.

This project aims to conduct a systematic review of the scientific health literature on LSA.

The following information was included in this review: articles reporting original data on physical effects, neurobiological effects, various bodily symptoms, social and cultural aspects in humans related to LSA, published in English, Portuguese, Spanish, Italian, and French. Studies involving animals, in vitro research, botanical studies, and non-original research were excluded. The following keywords were searched in the PubMed, Google Scholar, and Web of Science databases: (ergine or d-lysergic acid amide or LSA or d-lysergamide or lysergic acid amide). This study followed the PRISMA statement for systematic reviews and PRISMA checklist. The resulting data were tabulated and analyzed according to relevance.

LSA, also known as ergine, is an ergot alkaloid with a chemical formula very similar to LSD. Ergine is found in plants of the Convolvulaceae family and is primarily consumed through chewing the seeds of these plants, soaking them in alcohol, or preparing an extract. The amount of LSA in each seed is inconsistent, making it unpredictable how much will be consumed, and these seeds may contain other harmful compounds.

LSA is a partial agonist and antagonist of serotonergic receptors, with a preference for 5-HT1A and 5-HT2, and stimulation of D2 is related to nausea. It can cause symptoms including euphoria, hallucinations, anxiety, nausea, weakness, fatigue, tremors, and elevated blood pressure. In some cases, the use of LSA is associated with the use of other drugs, and there are case reports of LSA-induced PRES (Posterior Reversible Encephalopathy Syndrome), post-use suicides and the need for hospitalization due to psychosis-like states.

Studies conducted on the quality of information about LSA on digital platforms indicate misinformation with incorrect data that can be harmful to those who ingest the drug. Additionally, there are studies suggesting that LSA may improve symptoms of cluster headaches.

LSA is a legal drug in most countries, with widespread misinformation on the internet and limited control over its use. There are potential serious adverse effects caused by the drug, and it is often associated with other psychoactive substances. Greater knowledge about the drug is needed for diagnosing its use and abuse, as well as for educating the public.

None Declared

Reviewing the histories of patients with childhood and adolescent schizophrenia, on numerous occasions, traumatic factors with great emotional and social impact are observed, such as situations of mistreatment, abuse and emotional deprivation, where help is requested but resources are scarce and the approach is limited without work in network.

1. Analysis of the consultation pathways in adolescents with severe psychiatric and socio-familial symptoms and the time delay in optimal guidance. 2. Evaluate the services involved. 3. Evaluate the clinical control of treatment with aripiprazole.

Retrospective observational analysis, 5 months, of prodromal symptoms of childhood psychosis and help-seeking pathways in a 13-year-old adolescent, as well as a description of the pharmacological approach and professional teams involved.

A 13-year-old adolescent who went to the emergency room with her mother for ingesting anti-cockroaches with self-inflicted intent. Reviewing his medical history, 4 serious autolytic gestures were detected in the last 2 months. Referred to Mental Health who did not attend.

On clinical examination, florid psychotic, with perplexity, self-reference, ideation of harm, language and behavioral disorganization. Auditory and kinesthetic hallucinations. A situation of neglect of the minor and abuse by the parents is detected; the risk had not been previously reported. Oral aripiprazole (up to 15 mg/day) was prescribed with good tolerance and progressive improvement in symptoms.

We worked jointly with Social Services, the Juvenile Prosecutor’s Office, Education and the hospital Psychiatry unit. In some of the resources the situation was already evident, the scope of their action was limited and delaying attention for months.

Based on cases like this, we ask ourselves if psychiatrists are sensitized to the comorbidity of serious mental pathology and the existence of risk situations in minors and if they are oriented toward multiprofessional management. Networking provides us with an early diagnosis, improving the therapeutic approach.

None Declared

The vaccination of children and adolescents against covid 19 is an ongoing debate. While in some countries the program of vaccination of children under 12 years old is already implemented, in others the balance of risk and benefits is a dilemma. Parents’ perception and decision about covid vaccination is an important parameter to consider.

The ain of this study is to evaluate the parents’ attitude about childhood vaccination against Covid 19 in Tunisia.

The “vaccine hesitancy scale (VHS) adopted from WHO’s Strategic Advisory Group of Immunization” with 8 items translated in tunisian dialect and an additional ten survey idem about the Characteristics of parents and their vaccination status against Covid 19. The survey is distributed on social media groups of parents of tunisian children and adolescents.

Thirty parents have answered the survey.More than 80% of the participants were female with an average age of 38 years old.Among 30 participants 24 were vaccinated against covid 19 at least for once, but only one of them 10% decided to vaccinate their children against covid 19,while 3% are indecisive about the subject.Although 97 % of the children and adolescents have already been vaccinated completely according to the national vaccination program. The most common reasons for the refusal were.Parents consider that routine childhood vaccines are safe, necessary and useful more than covid vaccine. Some parents reported that their children have been infected by the virus so they have doubts about the usefulness of the vaccination.

A year after the pandemic, covid 19 contamination and vaccination against the virus are still an issue. With the emergence of new variants, the decline in protective measures, vaccination against covid is in the process of integrating routine programs. But the lack of information on the effectiveness of the vaccine and the adverse effects are a source of hesitation and refusal for parents. a large-scale national study is necessary before.

None Declared

A 36-year-old man with a history of cannabis use disorder since age 16, consuming 8-10 units/day, experienced irritability and tremors upon reducing consumption. His psychiatric issues emerged in 2020, marked by anxiety, abdominal pain, and severe vomiting, leading to a dyspepsia diagnosis. Subsequently, he received psychiatric care at CAS Hospitalet, diagnosed with severe cannabis use disorder. No prior inpatient admissions occurred.

Our project aims to show a case report and summarize the available evidence on cannabinoid hyperemesis syndrome (CHS).

In May 2023, he voluntarily sought admission to Barcelona’s “Hospital Sant Pau,” aiming for cannabis detox and treatment of cannabinoid hyperemesis. He’d endured years of intense abdominal pain, nausea, and vomiting, worsening over the last two years, with uncontrollable vomiting hindering daily life. Admission saw reduced cannabis use to 3-4 units/day. Inpatient care revealed anticipatory anxiety, rumination, and somatic anxiety, accompanied by distal tremors and internal restlessness due to abdominal discomfort, partially alleviated by 5-10 mg of diazepam.

Treatment included domperidone 10mg/8h, haloperidol drops (5-10 drops/8h), capsaicin ointment, hot showers, and cryotherapy, resulting in gradual relief from abdominal pain. Moderate cravings for tobacco and cannabis led to acetylcysteine 600mg/12h and gabapentin up to 1200mg/8h. Gastric discomfort with SSRIs led to vortioxetine 10 mg/day, well-tolerated with a positive response. Consultation with the GI department confirmed the treatment’s efficacy, emphasizing cannabis abstinence. Upon discharge, cannabinoid hyperemesis symptoms markedly improved, and the patient was referred to “Hospital de Dia.”

CHS is a cyclic vomiting syndrome, preceded by daily to weekly chronic longstanding use of cannabis that can be difficult to diagnose and treat(1,3,4). It is unique in presentation, because of the cannabis’s biphasic effect as anti-emetic at low doses and pro-emetic at higher doses, and the association with pathological hot water bathing (2). The major characteristics are as follows: history of regular cannabis for any duration of time (100%), cyclic nausea and vomiting (100%), resolution of symptoms after stopping cannabis (96.8%), compulsive hot baths with symptom relief (92.3%), male predominance (72.9%), abdominal pain (85.1%), and at least weekly cannabis use (97.4%)(1). Treatments such as topical capsaicin, haloperidol, benzodiazepines, and propranolol have shown symptom relief (3) whereas opioids should be avoided (4). Cannabis cessation appears to be the best treatment (1,3).

1. 1. Sorensen et al. Journal of Medical Toxicology 13 (2017):71-87.

2. 2. Perisetti et al. Annals of gastroenterology 33.6 (2020):571.

3. 3. Senderovich et al. Medical Principles and Practice 31.1 (2022):29-38.

4. 4. Leu, et al. Journal of Emergency Nursing 47.3 (2021): 483-486

None Declared

Psychotic patients are a vulnerable population from a social and health point of view. The SARS Cov-2 pandemic affected millions of people around the world, however, its effects on psychotic patients in Avilés Spain, have not been analized.

The objective of this study was to determine and compare the mortality of patients with psychosis due to SARS Cov-2 in Avilés, Spain with others regions and countries in the European Union. Determine the influence of social condition and antipsychotic treatment on the condition of these patients.

This is a descriptive, observational study, in which patients diagnosed with psychosis in the period 2020-2021 who contracted SARS Cov-2 infection in Avilés, Spain, were studied to determine those who died from this cause. The influence of social status and antipsychotic medication, as well as sociodemographic factors (age, sex, marital status) were analyzed and compared with other regions and countries of the European Union.

Despite the high mortality rate in patients with psychosis, during the years of the pandemic SARS Cov-2 played an important role given the vulnerability of these patients.

The negative effects and deaths during the COVID-19 pandemic were at the time a major problem for public health worldwide. This study concluded that the morbidity and mortality of psychotic patients who contracted COVID-19 was lower than the rest of the population.

None Declared

Bipolar disorder (BD) is a chronic and severe psychiatric disorder, characterized by the alternance of episodes of (hypo)-mania and major depression. Lithium (Li) is the first-line treatment for BD but unfortunately response to Li is highly variable: after at least two consecutive years of treatment, only a fraction of patients receiving Li will display significant improvement in the frequency and/or severity of mood recurrences. This interindividual variability of treatment response is difficult to predict, in the bipolar disorder context. This could be determined by genetic factors still misidentified by available genetic studies. In addition, no clinical or biological markers are available to reliably define eligibility criteria for a lithium treatment in bipolar disorder. A consequence is a long process of therapeutic trials (18-24 months) to phenotype Li response, delaying the stabilization.

To identify objective biomarkers of the prophylactic response to lithium in order to improve patient care and propose therapeutic alternatives to patients who do not respond to lithium.

Using a genome-wide methylomic approach, and then logistic regressions incorporating as covariates the different types of treatments, we were able to identify differentially methylated regions (DMRs) whose methylation difference between responders and non-responders was not impacted by co-prescribed treatments. Then, we used Methylation Specific High-Resolution Melting (MS-HRM), a PCR based method than can be implemented in any medical laboratory at low cost and with minimal equipment, to estimate methylation proportion of 9 DMRs in 61 samples of bipolar patients.

In the sample of 61 individuals with BD, the 9 MS-HRM-measured DMRs combined with clinical variables (age, sex, cigarette smoking status, lifetime number of hospitalizations, age at onset of BD, polarity at onset, psychotic symptoms at onset, family history of BD, lifetime alcohol/cannabis misuse, panic disorders, Li prescribed as the first mood stabilizer (vs 2nd or 3rd choice)) correctly classified 83,6% of individuals as good or non-responders (n=61, prophylactic response phenotype defined using the “Alda” scale). Excluding the partial responders, the percentage of correctly classified individuals is as high as 100% (n=43, 18 non responders and 25 responders). The AUC are respectively AUC=0.913 and AUC=1.0.

The MS-HMR method allow to identify the response status of individuals with BD with 9 DMR. These DMRs discriminate good from non-responders and can be used in combination with clinical variables.

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Ferroptosis is a programmed form of cell death characterized by excessive accumulation of intracellular iron fraction, uncontrolled lipid peroxidation, impairment of glutathione-dependent antioxidant functions, and loss of oxidative-antioxidant balance. Nerve cells are sensitive to excessive amounts of iron, which impairs the functioning of mitochondria and leads to their death. Ferroptosis has been identified in neurological diseases such as stroke, Alzheimer’s disease, Parkinson’s disease. Features of ferroptotic cells have been observed in models expressing cognitive deficits, and ferroptosis-related genes have been associated with the development of mental illnesses.

The aim of the study was to analyze the available literature on the relationship between the occurrence of ferroptosis and cognitive impairment occurring in mental diseases, such as schizophrenia

The publications found in the PubMed database were analyzed after entering the following entries: ferroptosis, mental illness, cognitive functions, schizophrenia.

Ferroptosis occurs in mental illnesses. Increased expression of the TP53 and VEGFA genes, which are associated with ferroptosis, has been identified in patients suffering from schizophrenia. Animal research confirms that disturbed iron homeostasis causes iron overload in nerve cells, which leads to ferroptosis and has a neurodegenerative effect, as well as deepens cognitive deficits. The use of iron chelator has a neuroprotective effect and reduces the occurrence of cognitive disorders.

Genes associated with ferroptosis may influence the development of schizophrenia, which means that ferroptosis may be involved in the pathophysiology of schizophrenia. Excess iron inside nerve cells, as a feature of ferroptosis, may affect the deterioration of cognitive functioning. Administration of iron chelators protects neurons by reducing the toxic effects of iron.

None Declared