In contrast to women, men do no experience a sudden cessation of gonadal function comparable to menopause. However, there is a progressive decline in hypothalamic-pituitary-gonadal function in aging men: testosterone level decline, and there is a loss of circadian rhythm of testosterone secretion.

By age 75 years, mean plasma testosterone levels have decreased 35% compared with young adults, and more than 25% of men of this age are clinically hypogonadal. Age related hypogonadism, which has been termed»andropause«, is thought to be responsible for variety of symptoms experienced by elderly men, including reduced muscle and bone mass, sexual dysfunction, depression, fatigue and irritability.

However, it has been difficult to establish correlations between these symptoms and plasma testosterone levels. Clinical trials of testosterone replacement have documented some symptoms relief (improved muscle strength and bone mineral density), yet studies to date on the specific relation between depression and testosterone level have been methodologically flawed.

Data are presented from systematic clinical and epidemiological studies with bearing on this relation:

1. 1. population-based assessments of the relation between testosterone level, genetic factors and depression in elderly men,

2. 2. placebo-controlled clinical trials of testosterone replacement in men with major depressive disorder.

Results suggest that age-related hypothalamo-pituitary-gonadal hypofunction may have particular etiologic importance in late-onset male dysthimia.

However, there is still the dilemma whether late-onset depression in older men is predominantly biological (in which testosterone decline certainly plays an important role), psychosocial, or stress-diathesis origin.

None Declared

Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis and is a major public health problem in Morocco. The World Health Organization (WHO) recommends a four-drug combination therapy for two months (isoniazid (INH), rifampicin, pyrazinamide and ethambutol), followed by two drugs (INH and rifampicin) for 4 months, as first-line treatment for newly diagnosed pulmonary TB in children and adults. This regimen is generally considered effective, safe, and cost-effective. However, adverse effects and drug interactions often complicate the treatment of TB. Isoniazid is associated with 32% of adverse events, of which 1.9% are psychiatric.

focus on drug-induced etiologies of acute psychotic symptoms make the diagnosis of isoniazid-induced psychosis report the literature on the management of this condition. focus on drug-induced etiologies of acute psychotic symptomsmake the diagnosis of isoniazid-induced psychosis report the literature on the management of this condition.

The patient and guardians were interviewed to obtain information after their consent. Data from the patient profile forms and laboratory test reports were evaluated. Causality assessment was done by the WHO scale and the Naranjo scale. Oral informed consent was obtained from the patient and parents.

We report a case of acute psychosis in a child with a temporal sequence strongly in favor of INH-induced psychosis. Treatment with risperidone at an appropriate dose improved the symptomatology while waiting for the end of the antituberculosis protocol. As soon as the isoniazid was stopped, there was a clear return to the child’s premorbid state.

The acute onset of psychotic symptoms in a patient taking isoniazid should lead to suspicion of this psychiatric side effect and prompt intervention, involving discontinuation of isoniazid and/or a trial of an antipsychotic.

As protective measures, the authors suggest adjusting the dose of isoniazid to weight, possibly performing a genetic test if slow acetylation is suspected, and closely monitoring patients with a favourable background.

The acute onset of psychotic symptoms in a patient taking isoniazid should lead to suspicion of this psychiatric side effect and prompt intervention, involving discontinuation of isoniazid and/or a trial of an antipsychotic.As protective measures, the authors suggest adjusting the dose of isoniazid to weight, possibly performing a genetic test if slow acetylation is suspected, and closely monitoring patients with a favourable background.

None Declared

The Covid-19 pandemic has exacerbated mental health problems in many countries, yet little evidence has focused on older adults.

The aim of this study was to qualitatively explore the impact of the pandemic on the mental health and well-being of older adults living in Uganda

Semi-structured interviews with older adults, family carers, and people living with dementia, plus focus groups with care professionals were conducted remotely via the telephone. Data were collected at two time points between March and July 2021. Non-professionals were asked about their experiences of the pandemic and their mental well-being. Data were analysed using thematic analysis. All transcripts were also translated into English and a selection were second-coded by the another team.

A total of 30 interviews were conducted with older adults, people with dementia, and unpaid carers participating at baseline (n=30). Using inductive thematic analysis, we generated three overarching themes: Mental health needs overridden by need for basic necessities; Social isolation; Increased worry about restrictions and pandemic in dementia. For most people, limited access to basic necessities, including food, featured more prominently in responses than any direct acknowledgement of how the pandemic has affected their mental well-being. Participants were upset and worried about being socially isolated, with carers concerned about the welfare of many people with dementia and often feeling emotionally exhausted.

Older adults, carers, and people living with dementia in Uganda not only require support to cope with the mental health impact of the pandemic, but most importantly require improved financial governmental support to be able to access sufficient food and other basic necessities, as a group their health is poor and associated risk of deterioration high

None Declared

Crohn’s disease is a chronic inflammatory bowel disease of multifactorial etiology. Its association with psychiatric disorders has frequently been reported, mainly with depressive or anxiety disorders.However, its association with schizophrenia remains exceptional.

we will try to discuss this association.

In this regard, we report the case of a young patient, aged 24, diagnosed 5 years ago with Crohn’s disease, evolving by remission flares, currently treated with Azathioprine, after failure of corticosteroid bolus.

The patient was admitted to psychiatry for aggression towards his parents.In view of the history of the disorders as reported by the family and the psychiatric interview, the diagnosis of schizophrenia was retained and the patient was put on amisulpride.

Schizophrenia and Crohn’s disease are relatively frequent diseases, generally occurring at a young age, whose etiopathogenesis, multifactorial, involves in both cases genetic, environmental and immunological factors.Their association does not seem fortuitous and arouses both etiopathogenic and therapeutic interest, but studies involving a large number of patients would make it possible to elucidate the link between these two diseases.

None Declared

Previous researches have not distinguished between-person effects from within-person effects when exploring the relationship between self-esteem, coping styles, and anxiety symptoms among adolescents.

To address this gap, this study investigated reciprocal associations among self-esteem, coping styles, and anxiety symptoms in a three-wave longitudinal panel survey, using an analytical strategy that disaggregates within-person and between-person variance.

The data was drawn from the Longitudinal Study of Adolescents’ Mental and Behavioral Well-being Research study conducted in 10 public schools in the Guangdong province of China. All participants had a baseline visit (N = 1957, age 13.6, grades 7 and 10) and follow-up interviews at one-year intervals for 3 years. A random intercept cross-lagged panel model combined with mediation analysis was performed.

At the within-person level, following results were observed. (1) Low self-esteem and anxiety symptoms bidirectionally predicted each other. (2) Low self-esteem and negative coping style bidirectionally predicted each other. (3) Anxiety symptoms predicted subsequent negative coping style but not vice versa. At the between-person level, we obtained the following main results. (1) Significant predictive effects on the random intercept were found among all three study constructs. (2) There were sex differences regarding the association between self-esteem and anxiety symptoms and the correlation strength of females was greater than that of males. (3) Self-esteem mediated the reciprocal relations between coping styles and anxiety symptoms.

These results could be an important advance by elucidating the reciprocal relationships among self-esteem, coping styles, and anxiety symptoms at the within-person level, suggesting that interventions targeted at promoting self-esteem and cultivating positive coping style may help reduce adolescent anxiety.

None Declared

In Japan, the effectiveness of health checkups for children aged 5 years has attracted attention as the basis for a support system for early detection and support of children with developmental disabilities. However, these have not yet become statutory health checkups, and their assessment has not been standardized. This study employed the Strength and Difficulties Questionnaire (SDQ) in examining the health of a 5-year-old child. This study aims to demonstrate the scores’ distribution and obtain the standard land and cutoff values of the SDQ.

From 2010 to 2012, children reaching 5 years of age in Kanie-cho, Aichi Prefecture, Japan, underwent a health checkup. Of the 888 children for whom parental consent was obtained, 884 responses without missing values (453 boys: 51.2%, 430 girls: 48.6%) were included in the analysis.

SDQ and medical questionnaires for 5-year-old children were sent to the parents with a formal request for approval for the child to participate in the study. Further, the parents were asked to respond to the questionnaire. The Ethics Committee of the Graduate School of Education and Developmental Sciences, Nagoya University approved this study (No.298).

A confirmatory factor analysis using the maximum likelihood method revealed a factor structure almost identical to that of Goodman (JCPP 1997; 38 581-586). Nonetheless, items 3, 10, 11, 13, 14, and 22 showed high loadings on factors different from those in the original version. Similar to the original version, we set our criteria so that Some and High Needs would be approximately 10% each. Furthermore, we calculated the percentage of children who fell into these categories and found that the scores that fell into the Need category differed from those in the previous study(Table 1).

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Although the five-factor structure of the SDQ was generally accepted, as pointed out in previous studies (Matsuishi et al. Brain Dev 2008;30 410-415 : Iida et al. 2014; 33-41), differences in expression between English and Japanese and cultural differences may have influenced the results. Therefore, it is necessary to be careful in interpreting the results. Additionally, the differences in the Need classification indicated that the difficulty level tends to be slightly lower in the 5-year-old children’s health checkups and that boys may be more likely to recognize the “Hyperactivity/inattention” problem. Based on these results, it is necessary to consider more effective ways of using the SDQ in 5-year-old children’s health checkups, such as evaluating the SDQ scores in combination with the actual condition of the children at the time of the checkup.

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MDD is a chronic illness characterized by complex patterns of persistence, remission and relapse. Personality disorder (PD) is a negative prognostic marker MDD and its chronicity, and dynamics of STPD and BPD in adolescence occurs most severely.

The purpose of this study was to study the effect of STPD and BPD on the course of MDD in comparative groups in youth.

Clinical psychopathological interview and follow-up assessment, SCID-II, Hamilton Depression Rating Scale (HDRS). Sample: N=102 male and female with MDD in STPD and BPD into two equal groups of 51 people respectively. MDD was assessed in each of both PD groups in two time frames: current and during depressive the last 12 months in adolescence; three and more years later during adolescence. Outcome predictors included: clinical characteristics of MDD, duration of current episode, relapse rate. The average age of first MDD in both groups was 18.9±3.2 years.

The first MDD with both PD in adolescence characterized by psychopatological variety due to type PD and age factor. Depressive was more variability of affect, and shorter duration (less then 6 months N=28 (55%)) in group BPD as opposed to the sustained mood problems seen in STPD – (6-12 months N=19 (37%); 12 months and more N=21(41%)) with MDD (p=0,004; χ2= 14,997). During the subsequent follow-up assessment among patients with BPD had the highest percent recurrences once every 6 months or more (N=36 (71%)) and those with STPD significantly rarer recurrences, every 6 to 12 months (N=21(41%)), Less than once a year N=17 (33%)), (p=0,001; χ2= 23,252). Diagnosis of PD in adolescence is based on pathological traits, and impairment in the affective disorder is measurement separately. When measuring impulsivity in the BPD group, significantly higher rates BIS-11 scale were noted (74±1) than in the SPD group (61±1).

Diagnosis of PD in adolescence is based on pathological traits, and impairment in the affective disorder is measurement separately. It has been confirmed that PDs are a negative prognostic marker of the manifestation of a MDD in adolescence, and the presence of BPD is a serious prognostic predictor of its persistence.

None Declared

Autism spectrum disorder (ASD) is a disorder with social, communication and behavioral disturbances that start from early childhood. There are many difficulties in diagnosing people with ASD. The diagnostic criteria are in terms of behavior descriptions, and as methods of intervention the most used is the applied behavior analysis (ABA). Although, the treatment of autism is not based on drugs, there are a number of reports that sustains the vitamin supplementation. For example, the deficiency of vitamin D (VD) was often outlined in the serum of the ASD people. Nowadays, zebrafish (Danio rerio) plays an important role in the modeling era; being one of the main organisms used in animal studies.

In this study, we aimed to describe the influence of VD in autistic people, and the possibility of vitamin investigation through animal models studies.

For analyzing this subject specific scientific databases were screened using certain keywords as: ”autism spectrum disorder”, ”vitamin D”, ”treatment”, ”deficiency”,”animal models” and ”zebrafish”. Inclusion criteria were studies that (1) investigated a behavioral intervention, (2) used animal models for ASD modelling, (3) reported vitamin D results, and (4) were published within the last 20 years.

The majority of the studies supported the importance of an adequate level of VD in the body, mainly due to its implication during pregnancy and early brain development. The few existing data bring information about the positive impact of its administration in ASD children; in which a considerable improvement in typical symptoms was observed. For further knowledge about VD activity in ASD it was suggested the animal modelling, especially zebrafish organisms due to its numerous advantages (high similarity of its genome with the human one).

VD deficiency during pregnancy and early brain development is a real risk factor besides genetic predisposition. Moreover, the use of animal models for investigating the effect of VD is required for a better understanding of the vitamin mechanism in ASD people.

Acknowledgement: *R. M.-A. and B. M.-I. are supported by the Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program.

M. Robea Grant / Research support from: Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program., M. Balmus Grant / Research support from: Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program, M. Nicoara: None Declared, A. Ciobica: None Declared

Mental illness is characterized by a major emotional, cognitive, and or behavioral impairment of an individual. It is usually accompanied by distress or functional impairments in important areas.

Mental illness affects 48.9% of the Moroccan population. This makes it a major public health issue but one that is still unrecognized and underestimated in the general population. Because of certain cultural aspects considering mental illness as a taboo or privileging traditional healing.

to evaluate the time between the initial symptomatology and the first psychiatric consultation Identify the course of action to be taken in the face of the first symptoms of the illness; Determine the factors responsible for the diagnostic delay;

We conducted a cross-sectional study to assess the duration between initial symptoms and diagnosis and to identify the responsible factors of diagnostic delay. This study included 200 patients followed at the psychiatry department of the University Hospital Arrazi of Salé, and evaluated by an hetero questionnaire.

The average age of our patients was 29 years, male gender was predominant (84%). The mean diagnostic delay was 46 months. Data analysis showed some significant results: - The Diagnostic delay was longer in male patients. - The diagnsotic delay conditioned response to treatment and therefore the prognosis.

In conclusion, public awareness of psychiatric problems, treatment availability, and educational efforts to overcome the social stigma are essential to reduce diagnostic delay and improve the prognosis of schizophrenia.

None Declared

One of the most common somatic responses of the human body to a mental health issue consists of alterations of the breathing rate. Typically, when an individual is under stress, tends to have a more rapid shallow breathing - instead of resorting to the diaphragm to help the air in and out the lungs, ends up conducting a thoracic breathing, leading to extended fatigue or dizziness.

The aim of this project is to assess the accuracy and efficacy of measuring the breathing rate through abdominal breathing movements, via the smartphone’s sensors, and applying it to personalize a digitized diaphragmatic breathing strategy. The main hypothesis under testing is that the digitization of this strategy with the personalization to the subject’s own response is efficient as a valuable tool for mental health coping.

A tool was developed and integrated with a mobile app that aggregates mental health coping strategies, based on the digitalization of positive psychology techniques. The tool included the diaphragmatic breathing exercise and the personalization to the user through biofeedback. Such biofeedback was based on the user’s abdominal movements and directly impacted the course of the strategy. The tool is under testing, counting so far with 25 subjects resident in Portugal.

The usability and effectiveness metrics of the solution will be assessed on the first contact of the subject with the app, and segmented by different subject profiles. Mental health metrics will also be assessed, namely anxiety levels - using the smartphone sensors and standard psychiatric scales. The results will be compared with a control group, in which the subjects will only perform the self-assessment, without using the breathing exercise.

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We have yet to draw conclusions from the project; however, we aim to achieve the first results in due time.

None Declared

Four cases are presented who debut with depressive episodes and after close follow-up, are diagnosed and treated for Alzheimer’s disease

The aim of this case series is to give a brief review of the depressive prodrome of dementia.

Four women, aged 67-77 years, treated on an outpatient basis, consulted for depressive symptoms. In addition to affective symptoms such as apathy, lack of interest, sadness, increased emotional lability and anhedonia, all three reported cognitive impairment. In their follow-up after two years, they became progressively more dependent on their partners, with more memory lapses, forgetfulness and progressive loss of higher cognitive functions. With the progression of cognitive impairment, anxious symptoms have become increasingly present.

The mean age of the patients is 70 years. Two of them had an insidious onset of depressive symptoms, while the other two had a psychotic onset of depression. None of the patients had no previous history of depression. All four were started on antidepressant treatment with little response. Following the diagnosis of cognitive impairment, treatment was started with rivastigmine, with an adequate response.

Dementia and depression are very common in the elderly. It appears that up to 40% of patients with dementia have depressive symptoms. It appears that depression in old age may actually be a prodromal symptom of dementia.

None Declared

Late-life depression (LLD) is currently a hot topic for neuroimaging studies, while an increasing number of imaging modalities are now available for the characterization of brain structure and function. Changes in brain volumes, including hippocampal volume, have been observed in LLD, although results are inconsistent. Vascular lesions are more consistently associated with LLD and may constitute factors of poor prognosis. More recent MRI modalities, including fMRI and DTI, also show interesting results, notably to assess treatment response in LLD. Molecular Imaging also has the potential to improve our understanding of the pathophysiology of LLD, using imaging such as PET-FDG and Amyloid PET. Finally, there are emerging studies with novel neuroimaging modalities such as Ultrasound to measure subtle mechanical properties in the brain of patients with LLD. Finally, we contend that neuroimaging has the potential to provide markers for the identification of subcategories of LLD (vascular depression, amyloid depression, etc.) as well as prognostic values and markers for treatment response.

None Declared

Sleep related sexual behaviors or sexsomnias are unconscious behavioral activities that occur during sleep (e.g. parasomnias). Behaviors could range from sexual vocalizations, orgasms, sexualized movements, masturbation, or full sexual intercourse with a subsequent amnesia. Early epidemiological studies showed a prevalence of 7.1%, with a male predominance. While intended as a rare condition, leads to important physical and psychological consequences for both the patient and their bed partner. For our knowledge this is the first case of sexsomnia reported in Portugal.

To report the clinical and psychosocial impact of a Sexsomnia case in a young woman which was misdiagnosed with depression.

Patient´s clinical files consultation and literature review using Pubmedâ and the keywords: sexsomnia.

A 18-year-old female referred to a psychiatric consultation to be assessed and treated from a diagnostic of depressive disorder. This was a young woman with a previous history of sleepwalking during childhood, with no recurrent episodes since adolescence. A familiar positive history for sleepwalking was confirmed (mother). She reported the beginning of her sleep related sexual behavior six months before the consultation, conflicting with the moment in which she started pharmacological therapy for Chron Disease, diagnosed at that time.

After she slept with her boyfriend, she was told by him about the recurrence of masturbatory activity during sleep. These episodes were told to occur as often as 1 to 2 times a night, shortly after falling asleep, with posterior amnesia for the event.

As for medical or psychiatric history, only Chron’s disease is highlighted, being under control with azathioprine. Likewise, he took 1mg of melatonin/night.

Pittsburgh Sleep Quality Index at presentation was 7/21 and the STOP-Bang questionnaire revealed a low risk of Obstructive Sleep Apnea.

A Type I Polysomnographic study was performed revealing decreased sleep efficiency and fragmented sleep presenting an alternating cyclic pattern. The existence of significant respiratory events during sleep, as well as periodic movements, was excluded.

Cognitive behavioral therapy by means of highlighting the need of improvement on sleep hygiene measures was prescribed and the dose of melatonin was increased up to 3mg. Despite the good clinical response, the patient discontinued the melatonin treatment mainly due to familiar and personal reasons and failed to comply with the prescribed hygienic measures, with a further worsening of the clinical condition.

This particularly challenging case representing the emerging medicolegal issues and psychosocial aspects related with the still poorly understood sleep disorders like sexomnia, shows up how much awareness is required from psychiatric team members to better assist and refer patients, promoting both an assertive diagnostic and an effective management.

None Declared

Schizophrenia is a severe mental illness but especially important in terms of its impact on the subject. The stigmatization of these patients is major, leading to a significant decrease in their quality of life. This is partly due to the media coverage of the rare cases of hetero-aggression.

The aggressiveness of schizophrenic subjects remains poorly known and little studied.

The objectives of our study are to determine whether the prescription of second-generation antipsychotics is associated with lower levels of aggression than the prescription of first-generation antipsychotics and to identify aggravating factors.

Materials and methods: We used an anonymous questionnaire based on, in addition to individual status and conditions, a self-administered questionnaire to assess the degree of aggression (the Buss and Perry Aggression Questionnaire (BPAQ)).

Our study demonstrated superiority of second-generation antipsychotics in preventing aggression in subjects with schizophrenia, as well as an association between increased aggression and low insight, low compliance and low social support. In addition, younger age, male gender, and lower education were associated with increased aggression.

The prevention of aggression would then begin with the management of psychotic symptoms and comorbid disorders, as well as work on the compliance and insight of these patients. However, the aggressive dimension persists in some of them.

None Declared

The COVID-19 pandemic has strongly impacted mental health outcomes of healthcare workers (HWs). In spite of the large literature reporting on Post-Traumatic Stress Disorder (PTSD) symptoms, only a few studies focused on potential positive aspects that may follow the exposure to the COVID-19 pandemic, namely post-traumatic growth (PTG) among HWs.

In a large sample of Italian HWs, we aimed to investigate the prevalence of PTSD, its correlates and whether PTG dimensions independently affect the risk of PTSD during the first COVID-19 wave.

An online self-report survey was submitted to HWs throughout physicians’ and nurses’ associations, social networks and researchers’ direct contacts, between April 4th and May 13th, 2020. Sociodemographic data, information about possible COVID-19 related stressful events, Impact of Event Scale-Revised (IES-R) and PTG Inventory-Short Form (PTGI-SF) scores were collected. IES-R and PTGI-SF scores were compared between subjects based on main sociodemographic, work- and COVID-19-related variables using the Student T-test or the one-way ANOVA where appropriate. Post-hoc comparisons were conducted using the Tukey test. Participants with total IES-R score >32 were assigned a provisional PTSD diagnosis and binary logistic regression analysis was conducted to investigate the contribution of each variable to the provisional PTSD diagnosis.

Out of 930 respondents, 256 (27,1%) reported a provisional PTSD diagnosis. Female sex (p<.001), separation from cohabiting family (p<.001), family members infected with (p<.05) or deceased due to (p<.05) COVID-19, increased workload (p<.05), relocation to a different work unit (p<.05) and unusual exposure to sufferance (p<.001) were significantly associated with higher IES-R mean scores. The median PTGI-SF score was 24. Factors associated with greater mean PTGI-SF scores were female gender (p<.001), being a nurse (p<.05), being older than 40 years (p<.05), and increased workload (p<.05). The logistic regression model showed that previous mental disorders (OR=1.65; 95% CI= 1.06-2.57) working in medical (OR=2.20; 95% CI=1.02-4.75), or service units (OR=2.34; 95% CI=1.10-4.98) (compared to frontline unit), relocation to a COVID-19 unit (OR=1.90; 95% CI=1.06-3.36), unusual exposure to sufferance (OR=2.83; 95% CI=1.79-4.48) and exposure to a traumatic event implying threat to self (compared to other work-related events) (OR=2.07; 95% CI=1.10, 3.89) significantly increase the risk of receiving a provisional diagnosis of PTSD, while the availability of personal protective equipment (OR=.61; 95% CI=.40-.94) and moderate or greater scores on PTGI-SF, particularly in the spiritual change domain (OR=.552; 95% CI=.35-.85), were found to be protective factors in relation to the PTSD diagnosis.

Our results shed light on possible protective factors against PTSD symptoms in HWs facing COVID-19 pandemic.

None Declared

Mixed states in bipolar disorder (BD) are characterized by the simultaneous occurrence of both manic and depressive features. Growing evidence suggests that they are associated with longer duration of illness, increased relapse risk, and higher prevalence of comorbidities. Suicide risk among BD patients is up to 20–30 times greater than in the general population, although there is not a univocal consensus in whether mixed states should be considered as a high-risk state for suicide.

The objective of this study was to identify whether depressive and hypo/manic episodes with mixed features, are associated with more frequent suicidal behavior or ideation when compared to pure hypo/manic and depressive ones. We hypothesized that suicidal ideation or behavior would be more common in those experiencing mixed symptoms. We subsequently also tested whether gender or bipolar subtype moderated the relation between mood and suicidality.

In a naturalistic study, 903 adult BD outpatients participating in the Stanley Foundation Bipolar Network were followed longitudinally across 14,213 visits for 7 years. The scores at the Inventory of Depressive Symptomatology–Clinician-Rated Version (IDS-C) and at the Young Mania Rating Scale (YMRS), administered at each visit, were used to define the mood episode. Given partial overlap of items between these scales, analyses were also conducted by removing overlapping items. The presence of suicidality was evaluated through the 18th item of the IDS-C (Suicidal Ideation).

During the observation period, up to 60.7% of subjects had at least one visit with suicidal ideation or behavior, broadly defined as a score ≥ 1 at the 18th item of the IDS-C. The distribution of suicidality among visits in different mood states is reported in Figure 1 (N° of visits in which suicidality was detected by mood state at the time of visit). Depressive symptoms were associated with suicidal ideation and behavior either during mixed depression and hypo/mania (p < 0.0001). Hypomanic or manic symptoms appeared to be related to suicidality only during hypo/mania, either pure or mixed (p 0.007). When overlapping items between the two psychometric scales were removed results seemed to confirm these hypotheses. Moreover, male gender appeared to have a protective role against suicidal ideation when hypo/manic (p 0.002).

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The primary role of depressive symptoms in predicting suicidal risk was confirmed by our results, which however suggest that mixed symptoms relate to suicidal ideation and behavior more intensely than pure hypo/manic symptoms. More importantly, hypo/manic symptoms did not appear to have a protective role during mixed episodes. Future studies considering also deaths by suicide are required in order to better clarify the role of mixity on suicidality.

None Declared

By the decision of the Polish Government, all persons arriving in the territory of the Republic of Poland after the commencement of the Russian aggression against Ukraine have free access to public psychiatric assistance, including reimbursement of pharmacological treatment on the same terms as Polish citizens. According to the UHNR data over 4 million displaced people, refugees, came to Poland so far and some of them benefited from such help.

Displaced individuals suffer from the consequences of traumatic events, exhibit psychological problems or develop mental disorders, including post-traumatic stress disorder, depressive and anxiety disorders or relapses of psychotic episodes.

The lecture will present data from the Interdisciplinary War in Ukraine Research Laboratory by pointing out the most important problems faced by Ukrainian refugees in Poland, why they chose Poland when escaping the war, how they evaluate Polish help, what their integration in Poland looks like. The survey also measured the level of war trauma (RHS-15). The results of the analysis show that most refugees present post-traumatic stress disorder symptoms (76 %), while only 0.15% of this population was treated in public psychiatric facilities.

Mental healthcare services are suddenly faced with major challenges and need to develop or expand strategies to address them. The Polish Ministry of Health prepared and started implementation of a reform of the mental health care system for adult as well as children and adolescent psychiatry. This fundamental reform should comprise three main actions, i.e. integration of mental health services into primary healthcare; establishment of community psychiatric services together with the provision of inpatient services in general hospitals; and limitation of the role of mental hospitals to specific tasks only (long-term or specialist treatment).

None Declared

Despite the fact that, age is a strongest know risk factor for onset of dementia, and developing countries are projected to have highest number of ageing population, few national dementia strategies have been put in place to address this impending scourge. In 2017, World Health Organization(WHO) released and called for countries to adapt and contextualize the Global Action Plan on the Public health response to dementia, few Sub-Saharan countries have slowly adopted plan. The outcome of the unprecedented increase populations with dementia will be immense. The substantial increase in morbidity and mortality pose a threat to the over stretched health care system and undermine the potential to achieve sustainable development goal (SDGs).

Understading the implementation of Global Action Plan on the Public health response to dementia in the developing countries

This paper is a view of published and grey literature relevant to Global Action Plan On the Public Health Response to Dementia (GAPD) in sub-Saharan Africa. The overall approach to the review had an exploratory and inductive focus. Articles were categorized around a guiding conceptual framework. Like; A description of structural arrangements and content of national dementia strategy development and normative underpinnings within policy frameworks

Nearly all countries within the SSA hadn’t developed the national dementia strategy plans. Countries like South African, Ghana, Kenya and Ethiopia had drafts of national dementia strategy, though not yet operationalized. Few countries highlighted some of the parallel targets of GAPD within their national mental health policy and strategy, but it was not comprehensive. Countries where Civil societies that advocate/champion dementia activities were strongly presently were more likely to possess a draft of GAPD.

Although there some initiatives for different countries to develop national strategy for dementia plans, there are gaps in the extent of engagement of different stakeholders and how these strategies will be operationalized may limit the impact on addressing the escalating burden of dementia in Sub-Saharan Africa.

None Declared

Psychiatric diseases are often accompanied by medical comorbidities, and cardiovascular system disease is one of the most important causes of death in bipolar disorder (BD) and schizophrenia (SCH) [1]. The QRISK3 algorithm calculatesa person’s risk of developing cardiovascular disease over the next ten years and it has been used in psychiatric research in recent years [2].

In this study, we aimed to evaluate the relationship between cardiovascular risks (by using QRISK3 algorithm) and treatment options in patients of BD and SCH.

Thirty-six patients with bipolar disorder and thirty-two patients with schizophrenia recruited between the years 2016-2022. All of the patients were treated with long-acting injectable (LAI) antipsychotics. Sociodemographic information, clinical features and medical treatment agents of individuals were recorded. The risk of development of cardiac disease of the patients were evaluated by the QRISK3 algorithm. Descriptive and regression statistical analysis was performed with Statistical Package for the Social Sciences (SPSS).

More than half of the patients were male (n= 39, 57.4%) and single (n= 40, 58.8%). The mean duration of education was 9.2 ±3.5 years and the mean age was 39.7 ±11.9 years of the patients. Nearly half of the patients had a diagnosis of BD (n= 36, 52.9%) while others had SCH (n:32, 47.1%). Most of the patients were treated with LAI of aripiprazole (n= 36, 59.2%) and the rest of them were treated with LAI of paliperidone (n= 32, 40.8%). When demographic and clinical data of BD and SCH patients were compared, there was no significant difference in terms of age. However, SCH patients had a longer disease duration (t= 2.56, p= 0.013) and more hospitalization (t= 3.35, p= 0,002) than BD patients. Our findings showed positive correlations between age (r= 0.74, p<0.01), duration of disease (r= 0.57, p< 0.01), and duration of LAI use (r= 0.55, p< 0.01) with QRISK. A regression analysis to examine related factors associated with QRISK found that having a diagnosis of schizophrenia (β= 0.27, t= 2.58; p= 0.01) and a long disease duration (β= 0.67, t= 6.50, p< 0.01) were associated with the development of cardiovascular disease. However, there was no relationship between LAIs (paliperidone vs aripiprazole) used in the treatment and QRISK.

The significant correlation found between duration of disease and QRISK -that indicate the risk of development of cardiac disease- confirming the progressive nature of the BD and SCH. Moreover, the significant correlation between SCH and QRISK suggests that SCH is a chronic and severe disease that causes more cardiac dysfunction than BD. However, we could not find a significant difference between LAIs in terms of QRISK, these results can be changed by evaluating other variables such as comorbidities, other medical treatments and physical activities in future research.

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Psychiatry has been diagnosing its pathologies through the evaluation of the symptoms reported by patients, relying on a few complementary exams to exclude organic causes. Studies about transcranial magnetic stimulation and electroencephalography (TMS-EEG) are bringing, from a clinical point of view, crucial information to characterize the different pathophysiological biomarkers of the psychiatric diseases, leading not only to the evolution of diagnosis, but also to an improved, more individualized treatment.

Characterizing the state of the art of TMS-EEG and its use in psychiatric diagnosis and treatments of different diseases.

We undertook a narrative literature review by performing a search on PubMed for English-written articles from the last 10 years. The query used was “TMS-EEG”; “TMS-EEG” AND “Schizophrenia” OR “Major Depressive Disorder” OR “Bipolar Disorder”.

Transcranial magnetic stimulation (TMS) is a safe and reliable method of non-invasive brain stimulation that allows for the local activation of cortical areas through electromagnetic induction. When combining this method with electroencephalography (EEG), it enables the underlying mechanisms of brain diseases.

TMS is a powerful therapeutic technic in Major Depressive Disorder (MDD). The literature refers to an enhanced N45 and N100 amplitude, which indicates a baseline cortical inhibition that can indicate a depressed state, which can be used as a clinical biomarker to evaluate TMS treatments.

In Schizophrenia (SCZ), TMS-EEG reveals a decreased cortical inhibition and excitation. Indices of inhibition and excitation reductions were also related to cognitive deficits.

The current studies regarding Bipolar Disorder (BD) are not so consistent, revealing that there are shared neural pathways with MDD and SCZ. This is a pathology often misdiagnosed with MDD, so biomarkers would help to diagnose BD earlier and improve its prognostic.

TMS-EEG can be used to provide more accurate neural targets, leading to more powerful and personalized interventions in psychiatric disorders, as well as more accurate diagnoses.

As for future studies, it would be relevant to assess not only TMS treatment effects, but also pharmacological results in these different pathologies.

None Declared