As part of the intervention, patients with severe schizophrenia who are cared for in psychiatric rehabilitation units need psychological treatments. However, there is great variability within the psychotherapy alternatives that are proposed for rehabilitation in schizophrenia, and it is necessary to know which are the most efficient interventions in order to prioritize their inclusion in intervention programs.

To know the level of evidence of the existing psychotherapy alternatives for the rehabilitation treatment in schizophrenia through the systematic review of recently published studies.

Consecutive systematic searches in the scientific literature were used in a sensitive and specific way, aimed at identifying the existence of documents in databases and clinical practice guidelines based on evidence of psychological treatment in schizophrenia. Psychosocial and social approaches and family members interventions were excluded, and the search was limited to the last 5 years. The PICO format has been used, and a subsequent critical reading using the AGREE II tool, considering the inclusion criteria of presenting a score >60% in 4 domains.

The following interventions have been found to be therapeutically effective: Level 1B (Early intervention in Psychosis; Patient and Family psychoeducational intervention; Basic ando social skills training; Social cognition and Metakognition training; Cognitive Remediation; Cognitive Behavioral Individual Therapy; Assertive Community treatment; Supported employment). Level 2B (Family Problem Solving Therapy, Dynamic Psychotherapy; Cognitive Behavioral Group Therapy); Level 2C (Horticultural, Art, Music, Animals Therapies).

Several psychotherapy alternatives are proposed for rehabilitation in schizophrenia, with known level of evidenca in order to prioritize their inclusion in intervention programs.

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Chronic mental illnesses can significantly impact an individual’s quality of life and lead to functional disabilities. Scientific interest in overall quality of life and health-related quality of life has been gradually increasing, especially in the context of chronic diseases where the relationship between patients’ long-term functionality and symptom development is not always linear.

Our research aimed to investigate the factors influencing subjective-objective well-being and in patients diagnosed with schizophrenia and schizoaffective disorder. Specifically, we examined the effects of anticipated discrimination on patients’ quality of life, satisfaction with health care, and overall functionality.

We recruited 25 patients from Semmelweis University Department of Psychiatry and Psychotherapy in Budapest, Hungary. To be eligible, patients had to meet the diagnostic criteria for schizophrenia or schizoaffective disorder according to DSM-5, cooperate with pharmacotherapy, and meet remission criteria (Andreasen et al., Am J Psychiatry 2005; 162 441-449). We collected socio-demographic data and clinical history, utilized the Mini International Neuropsychiatric Interview (M.I.N.I.) and the Positive and Negative Syndrome Scale (PANSS) to identify our clinical sample and assess the severity of symptoms. Objective and subjective functionality and well-being were measured using the Lancashire Quality of Life Profile (LQoLP). Self-reported medication adherence were measured with Morisky Medication Adherence Scale (MMAS-8). Additionally, we assessed anticipated discrimination (QUAD), and satisfaction with healthcare (CACHE).

Our findings have unveiled a cross-sectional association between higher self-reported medication adherence and improved quality of life among patients with schizophrenia. Moreover, increased adherence levels, as well as greater satisfaction with healthcare, were linked to enhanced objective and subjective functionality and overall well-being. Additionally, the anticipation of discrimination was found to be associated with reduced quality of life and functionality.

The overall quality of life and objective-subjective functioning in patients diagnosed with schizophrenia and schizoaffective disorder can be influenced by various factors. Further research is needed to gain a better understanding of the factors associated with higher quality of life in patients.

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Microdosing psychedelics has garnered considerable attention within both nonprofessional circles and the scientific community in recent years. This method involves taking small, non-hallucinogenic doses of substances like LSD or psilocybin over weeks or months, purportedly to enhance specific behaviors, emotions, or address psychiatric conditions.

Exploring these assertions is crucial given the potential therapeutic value of microdosing, especially in conditions that respond positively to full psychedelic doses, such as depression. The full psychedelic experience might not always be suitable due to various factors like age, capacity to consent or comprehend the experience (e.g., dementia), or individual personality traits that might hinder surrendering to the experience. Microdosing could potentially serve as a maintenance therapy post-full dose administration, aiding specific psychological or biological processes during therapy or therapeutic exercises.

Recent studies in healthy individuals highlight that small psychedelic doses have nuanced effects on pain perception, mood, neuroplasticity, sleep duration, brain connectivity, and default mode network synchronicity. However, some parameters show null effects after both single and repeated administration.

Our survey research uncovered that individuals with ADHD reported symptom relief through microdosing, deeming it more effective than their conventional treatments. Subsequently, we conducted a naturalistic study following individuals with ADHD across a 4-week microdosing period. Our findings indicated a reduction in symptoms over time, an increase in trait mindfulness, and a decrease in neuroticism compared to baseline. While these results are intriguing, they necessitate validation in a clinical trial. We have recently concluded such a trial and are currently analyzing the data to further explore these effects.

K. Kuypers Grant / Research support from: The author is a principal investigator on a research project that is sponsored by Mindmed, a company that is developing psychedelic medicines.

Visual hallucinations are a relatively common neurological complaint. Peduncular hallucinosis (PH) stands out as a distinct entity, characterized by complex visual hallucinations resulting from structural lesions in the brainstem or diencephalon.

We aim to provide an overview of the clinical features, etiological factors, and management strategies associated with PH, incorporating a unique case study.

Clinical case report and brief literature review.

Clinical Characteristics: PH is marked by detailed, colorful, vivid, and occasionally emotionally charged visual hallucinations. These hallucinations encompass people, animals, or objects and may be mistaken for reality. While primarily visual, they may occasionally involve other sensory modalities. Crucially, patients with PH maintain insight, distinguishing it from primary psychotic disorders.

Etiological Factors: PH is most commonly associated with structural brainstem lesions, particularly in the midbrain. Potential instigators encompass ischemic strokes, vascular anomalies, tumors and infections. Disruption of the reticular activating system in the brainstem is implicated in the pathogenesis. Advanced imaging techniques have unveiled cases with subtle presentations, broadening our comprehension of PH.

Pathogenesis: PH may involve the disturbance of serotonergic inhibitory pathways and the reticular activating system. A plausible link with hypnagogic hallucinations hints at a mechanism related to rapid REM sleep transitions.

Case Report: Mr. J., a 30-year-old patient, suffered recurrent mesencephalic strokes attributed to Sneddon’s syndrome, ADA-2 deficiency, and protein C deficiency, leading to malacic lesions in the hemimesencephalon and right hemipons. He experienced complex visual hallucinations, primarily geometric patterns and animals, mainly at night. Importantly, he maintained insight into their hallucinatory nature. Mr. J. also had diplopia, visual impairment, recurrent headaches, and left hemiparesis.

Reactive anxiety and depression due to functional loss followed his recurrent strokes. Initially, antipsychotics were used to manage sensory-perceptual disturbances, but were later discontinued due to reduced interference with daily functioning. Antidepressant and psychological therapy was continued throughout the follow-up to address mood symptoms.

Peduncular hallucinosis is an intriguing phenomenon characterized by complex visual hallucinations. Understanding its clinical features, etiology, and possible mechanisms is essential for accurate diagnosis and management. This case report emphasizes PH’s clinical aspects and the importance of a multidisciplinary approach, including pharmacological intervention and psychological support. Understanding its features, causes, and management is essential for accurate care. Further research is needed to improve our comprehension and optimize treatment strategies.

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Anorexia nervosa (AN) is a widespread chronic mental disorder with severe negative medical and social consequences. Treating patients with AN is a complex and time-consuming process, as persistent forms are often encountered. The studies’ results indicate a possible influence of psychoemotional state and/or existing psychopathological manifestations in parents on AN development.

To investigate the clinical and psychopathological characteristics of parents of patients with AN based on the study of emotional regulation, alexithymia, depression, and anxiety.

The study population (N=110) consisted of fathers (N=47 (42.7%)) and mothers (N=63 (57.3%) of patients with AN. The mean age was M=44.90 (SD=5.9; SE=0.567). All participants completed the emotional regulation scale (DERS), Toronto Alexithymia Scale (TAS-26), Hospital Anxiety and Depression Scale (HADS).

According to DERS: “rejection” - 21.86 (SD=5.675; SE=0.541); “goals” - 19.13 (SD=2.028; SE=0.193); “impulse” - 24.17 (SD=4.908; SE=0.468); “awareness” - 21.93 (SD=1.999; SE=0.191); “strategies” - 30.75 (SD=2.173; SE=0.207); “clarity” - 18.58 (SD=1.486; SE=0.142). The sum was 136.42 (SD=8.119; SE=0.774). The TAS results of the study group were 80.45 (SD=13.699), which characterizes the average personality type as alexithymic. According to HADS, the average values were distributed: the anxiety scale M=7.96 (SD=1.347) the depression scale M=7.95 (SD=1.442). These indicators can be considered as the extreme limit of the norm or subclinically expressed anxiety and depression. The next step was to find statistically significant relationships between the DERS methodology and the HADS and TAS for the study group. According to Spearman’s correlation coefficient, there is a direct stable relationship between the variables “anxiety” and “impulse” (r=0.257), awareness (r=0.255), and the total score of emotional regulation according to “DERS” (r=0.246); A direct correlation was found between the indicators “depression” and “rejection” (r=0.151), “goals” (r=0.233), “awareness” (r=0.138); Alexithymia, in turn, has a direct correlation with the “goals” scale and an inverse correlation with the “strategies” scale (r=-0.141)

Parents of patients with AN have various manifestations of psychoemotional disturbances, namely subclinical levels of depression and anxiety, high levels of alexithymia, and emotional regulation problems. The correlation analysis showed that the anxiety score for parents of patients with AN is higher if difficulties with impulse control, emotional awareness, and general emotional regulation are problematic. Depressive tendencies are also associated with the subjects’ rejection of emotional reactions and problems with goal-directed behavior. The inverse correlation indicates that the higher the index of alexithymia, the less limited access to emotion regulation strategies, and vice versa.

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Understanding coronophobia, or the heightened fear and anxiety related to the COVID-19 pandemic, involves assessing physiological, cognitive, and behavioral measures.

We aimed to develop a Greek version of the Coronavirus Anxiety Scale (CAS), the Obsession with COVID-19 Scale (OCS), and the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), to identify groups that appear vulnerable to this form of pandemic-related anxiety.

We conducted a cross-sectional online study from February to April 2021 in Greek-speaking people living in Cyprus. Participants completed sociodemographic questions and questions related to COVID-19, the CAS, OCS, and the CRBS. All three scales are rated on a 5-point scale, from 0 (not at all) to 4 (nearly every day). For CAS, a score ≥ 9 indicates probable dysfunctional coronavirus-related anxiety, for OCS a ≥ 7 score indicates probable dysfunctional thinking about COVID-19, and for CRBS score ≥ 12 suggests above-average reassurance-seeking activity.

A total of 405 adults (66.4% women) from Cyprus participated in this study. The results of this study demonstrate that these Greek adapted measures have adequate reliability (Cronbach’s alphas >0.70) and factor structure (exploratory and confirmatory factor analysis support). However, only the CAS demonstrated both convergent and divergent validity. Education personnel, housekeepers, and older adults were also found to have higher coronavirus anxiety relative to their counterparts.

The findings of this research support the use of these coronaphobia scales in Cyprus and other Greek-speaking populations. Assessing the potential for fear-driven behaviors may be of great benefit to both clinicians and researchers, helping to identify individuals at risk, adapt interventions, and improve our understanding of the psychological consequences of surviving a public health emergency.

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Mental pain is a transdiagnostic symptom, predictive of suicide and reported as a critical outcome by patients. A previous systematic review of epidemiological and clinical research has shown a lack of consensual definition of mental pain in clinical research and high heterogeneity across the different measurement instruments of mental pain. Up today there is no systematic review synthetizing all published biological investigations on mental pain.

This study aims to map the field of biological investigations of mental pain in human to identify what and how biomarkers are investigated with a meta-research approach, by providing a critical appraisal of the terms and definitions of mental pain, the studies’ hypotheses, the experimental paradigms used to induce or mimic mental pain and the measurement instruments used to measure mental pain.

We conducted a systematic review (compliant with PRISMA guidelines) of all primary research reporting to investigate candidate biomarkers of mental pain in human subjects as stated by the authors. We searched from inception to June 23rd, 2022, the 3 databases MEDLINE, Web of Science and EMBASE. We extracted the study characteristics (e.g., year of publication, population, etc.), the terms used for meaning mental pain, the definition of mental pain, the method to induce mental pain and its rational, the hypotheses and aims, the measurement instruments of mental pain, the candidate biomarkers, and their method of investigation. We performed descriptive statistics of the sample’s characteristics and the extracted data, a qualitative analysis of the definitions, hypothesis, aims and experimental paradigms, and a data visualization linking candidate biomarkers, experimental paradigms, and their investigation methods.

The search retrieved 5685 papers of which we included 72 primary research publications constituting 78 distinct research studies. Only 37.5% of studies reported a definition of mental pain. 11.5% of studies did not show a measurement instrument of mental pain. The Cyberball (a social exclusion paradigm) was the most frequently used paradigm in experimental studies (62.7%). The cingulate cortex was the most frequently investigated biomarker category (15.3% of all candidate biomarkers), with fMRI as the most frequent investigation method (53.7% of all investigation methods).

The field of biological investigations on mental pain shows a marked heterogeneity of definitions, terms, hypotheses, experimental paradigms, and measurement instruments, with an over-representation of the construct of social pain and the Cyberball. These could compromise the comparison and combination of studies results in evidence synthesis and their translation into clinical practice.

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The COVID-19 pandemic involved stringent social restrictions, a surge in mortality, and significant economic consequences, affecting age groups differently and leading to increases in loneliness and mental health problems, particularly depression, which was already very common before the pandemic.

Analyse changes and related factors of the relationship between loneliness and depression by age group from (1) before to the COVID-19 outbreak, (2) during the pandemic, and (3) after the last state of emergency. Moreover, we aim to (4) evaluate the effect of social support to alleviate feelings of loneliness and improve the course of depression.

We used data from three different cohorts, all representative of the Spanish adult population. (1) We longitudinally analysed the association between loneliness and depression with a sample interviewed before (N = 1,880) and during (N = 1,103) the pandemic. We used mixed-models to study changes in major depressive disorder (MDD) by age group and regression models to quantify the association between age and potential mediating effects. (2) We analysed data of 2,000 adults during the pandemic. Several regression models were constructed to assess the impact of pre-pandemic mental disorders on the main association by age group. (3) Out of those 2,000 participants, 1,300 were interviewed 9 months later, to determine group-based loneliness trajectories and its associated risk factors. (4) We analysed the relationship between loneliness, social support, and MDD over a 7-year period (N=404 individuals aged 50+ having MDD). We tested cross‐lagged panel models using structural equation modelling.

During the pandemic the probability of having MDD increased significantly among younger individuals, and was partly explained by loneliness, low resilience, and worsened economic situation. Loneliness was associated with more depressive symptoms, and this association was stronger in younger adults without pre-pandemic mental disorders and in older adults with them. At the end of pandemic, three courses of loneliness were detected: invariant low loneliness (42.6%), decreasing medium loneliness (51.5%), and fairly invariant high loneliness (5.9%). Risk factors for worse trajectories were being younger, female, not married, and, notably, having pre-pandemic mental disorders. Among individuals with depression prior to the pandemic, lower social support predicted higher subsequent levels of loneliness, resulting in an increase in MDD recurrence.

Strategies to decrease the impact of loneliness on depressive symptoms should consider individuals mental health background, address social determinants, and adopt an age-driven perspective.

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Pregnancy and postpartum is an important life event associated with profound physiognomic and psychosocial changes affecting the female body in all its physiological, psychic and affective reality. It might influence the sexual function in expectant mothers.

To investigate the relationship between the body satisfaction and perception and the sexual function among pregnant and postpartum women.

It was a cross-sectional study established over a period of 3 months from the June 1st, 2023 to August 31, 2023. This study focused on a population of pregnant and postpartum women recruited from outpatient consultations and inpatient of the obstetric gynecology department at the university hospital of Gabes. We used a pre-established sheet exploring socio-demographic data, medical and gyneco-obstetric history, the body mass index (BMI) and informations concerning the marital relationship and the woman’s sexual activity. We administered the validated Arabic version of the Arizona Sexual Experiences Scale (ASEX) to assess sexual functioning and we used the body satisfaction and global self-perception questionnaire (QSCPGS) to explore the body satisfaction and perception.

Fifty-eight women were included. The average age was 35.6±5.5 years; they were from an urban origin in 75%. They were pregnant in the first, second and third trimester in (15.6%, 15.6% and 25% respectively). They were in postpartum in 43.8% of cases with a cesarean delivery in 73.3% and breastfeeding in 56%. All women reported being on good terms with their spouses and satisfied with their sexuality. The usual frequency of sexual relations was (1/day: 22.6%, 1/week: 74.2%, 1/month: 3.2%) and 25% reported wanting to reduce the frequency. The mean ASEX score was 13 ± 4.3 and 47% of the sample had sexual dysfunction. For the total score of the QSCPGS, we observe a mean value of 33 ±28.3, which means that our sample has a good level of positive body satisfaction and self-perception. The mean value of the “body satisfaction” factor is higher (23.7 ± 10.4) than the mean value of the “self-perception” factor (11.4 ± 14.3). The mean value of BMI was 28.74 ± 4.4 wich means an overweigh. We found a significant association between the “body satisfaction” factor and the sexual dysfunction (p=0.03), insufficient lubrication (p=0.01) and difficulty reaching orgasm (p=0.001).

We found that body and physical changes among pregnant and postpartum women can negatively affects their body perception and it might deteriorate its global sexual function. Further researches are recommended to study other potential factors affecting sexual function during this period.

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Traumatic exposure is a common global problem across nations. It is currently well established that childhood trauma is associated with increased risk for psychopathology transdiagnostically, with children having experienced trauma being twice as likely to develop a mental health condition compared to those who have never experienced trauma. According to population-based studies, this heightened risk for the emergence of mental health disorders persists throughout adolescence and adulthood. The risk for psychopathology seems to be most marked in children exposed to interpersonal violence (child emotional and physical abuse, neglect, sexual violence). In this presentation, we will summarize the results of an increasing number of published studies that have examined the mechanisms underlying vulnerability to psychopathology following childhood trauma and protective factors that buffer this risk. Specifically, we will highlight the role of emotion dysregulation and interpersonal difficulties, related to disrupted threat processing following trauma exposure, in mediating the impact of trauma on internalizing and externalizing symptoms. Research studies have also identified protective factors accross the lifespan that might mitigate these outcomes, including social support and emotional skills building. Based on this review, we will suggest a conceptual transdiagnostic and biopsychosocial model of risk and resilience, which can provide opportunities and targets for early interventions and treatment, at the primary and secondary healthcare levels, as well as the social, public health and community levels. Our model is based on a socioecological and multisystemic paradigm of risk and resilience, where resilience is conceptualized as an interaction between individuals and resourceful environments and communities.

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Bipolar disorder (BD) is a recurrent disorder, causing functional impairment and raised mortality, particularly due to suicide. However, the difficulty in predicting suicidal behaviors relies in the lack of clear biomarkers.

Machine learning (ML) has emerged as a promising tool to enhance suicidal prediction. However, most ML studies focused on lifetime attempts, without having a predictive time window, and did not employ time-dependent variables. Moreover, most studies lie on cross-sectional databases, without including more than one time-point.

First, we aimed to predict 12-months suicide attempts in a naturalistic sample of BD patients, using clinical and demographic data.

Second, we aimed to improve the prediction by including information from intermediate visits (1, 3, and 6 months), mimicking more closely the clinician’s way of thinking and the multiple observations a patient receives.

A sample of 163 BD patients (53% females, mean age 44.7, SD 15.3) were recruited.

Based on EHR, 56 clinical and demographic features were extracted, including hospitalizations, suicidal behaviors lifetime and in the last 12 months, along with comorbidity, family history, work, and therapies. Patients were followed up for 12 months.

Support Vector Machine (SVM) was used to differentiate subjects who attempted suicide versus those who did not in a 12-month time window, within a repeated nested Cross-Validation. The SVM was optimized weighting the hyperplane for uneven group sizes.

Then, we repeated the analysis including information from intermediate visits (1, 3, 6 months after the first contact). For each visit, we created a composite score based on current therapy, new admissions, and ER presentations. To avoid circularity, all the information (ER, admission etc.) related to a suicide attempt were not included.

During the 12-months follow-up, 9.8% of patients attempted suicide. The results from the 12-months suicide prediction model obtained an Area Under the Curve of 0.71(with a Balanced Accuracy (BAC) of 68%).

After incorporating the composite scores based on intermediate visits in the model, the prediction raised to an Area Under the Curve of 0.78 (BAC 73%), suggesting that including intermediate visits is a valid method to improve prediction.

The features that contributed the most to the prediction were the composite score at 6-month visit, lifetime number of suicide attempts, suicide attempts in the last 12 months, substance of abuse (other than cannabis), and antipsychotics.

ML proved a good prediction accuracy for suicide in a 12-months time window, and the prediction was improved by including data from intermediate visits. The model showed the importance of time-dependent features, such as attempts in the last 12 months. Our analysis might help in identifying early clinical risk factors and underlies the importance of multiple evaluations in populations at risk.

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Human functioning in the physical, emotional, psychological, and social arenas is improved by contact with animals.

This study aimed to explore the affective relationship of older adults with their pets during the COVID-19 pandemic; and to assess how the affective relationship with pets contributed to older adults’ mental health.

This qualitative study included 176 participants aged 65-88 years from Portugal, the United Kingdom, and Spain. All interviews went through content analysis.

Findings indicated five themes: (1) Meaningful Emotional Relations (86%); (2) Intimacy with Partners (68%); (3) New Emotional Connections (61%); (4) Sensory Stimulation (55%); and; (5) Physical Enjoyment (23%). As for the second objective, three main themes emerged from the content analysis: (1) Decreasing Depressive and Anxiety Symptoms (73%); (2) Easing Feelings of Loneliness (68%); and (3) Reducing Mood Swings (43%).

The affective relationship between older adults and their pets was relevant during the COVID-19 pandemic, since it allowed for solidifying affection relationships with their partner and creating new ones. Additionally, it contributed for deepening the affective relationship with themselves, in terms of sensory stimulus, physical touch and physical pleasure. Owning a pet, was important for improvement in mental health symptoms, associated to depression, anxiety, and mood swings.

Keywords: Affective relationship; animal companionship; COVID-19 pandemic; mental health; older adults; pets.

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Psychotic disorders are strongly linked to a higher risk of mandatory hospitalization, often affecting men more, though some studies report the opposite. Recent investigations also show a higher rate of involuntary admissions in younger individuals. Knowledge in this area is still limited despite extensive research.

Analyze whether there is an association between sex and age with involuntary admissions of individuals with psychotic disorders.

Retrospectively, 254 people with psychotic disorders admitted between 2018-2023 to the adult psychiatric inpatient unit at Hospital Universitari Germans Trias i Pujol were selected, collecting their nature of admission, sex, age, and discharge diagnosis. Comparisons between voluntary and involuntary admissions, with respect to sex and age variables, were conducted using independent sample t-tests, Mann-Whitney U tests, Fisher’s exact test, and chi-square tests. A logistic regression model was used to identify variables significantly associated with mandatory admission.

In both the male and female groups, there were no statistically significant differences in terms of the mean age at admission (p = 0.162) or the nature of admission (p = 0.586) (Table 1). When analyzing the voluntary nature of admission based on age and sex, statistically significant differences were only found in the female group (p = 0.01), resulting in a 9.18 year age difference among those admitted voluntarily (Table 2). The model that best predicted the probability of involuntary admission in individuals with psychotic disorders included the sex variable (OR = 4.88) and the interaction between sex and age (OR = 0.97) (Table 3).Table 1:

Differences between sex regarding voluntariness of patients with psychotic disorders.

Young women with psychotic disorders face a higher risk of involuntary admissions, emphasizing the need for gender-specific strategies to improve care of these patients.

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There are numerous structured group psychological treatments (GPT), especially in the cognitive behavioral paradigm, which have proven effective. In these TPG, strategies, guidelines, knowledge, etc. are worked and, in many cases, homework is prescribed as an integral part of the treatment. A group context is also generated where people relate, generally with a similar culture, ages, mental health states and life problems

Elucidate which group therapeutic factors (GTF) are valued as most important by patients in their psychological improvement process. Know what our patients consider has helped them most in their GPT, whether the GTF or the content of the therapy (CT), conceptualized as the set of guidelines, knowledge, strategies, exercises and learning carried out with the therapists intrasession and with the material provided intersessions

A total of 36 patients(mean age=51.04 (9.21)); 69.44% women (n=25); with main diagnoses (77.77%, n=28) of adaptive disorder, 6 patients of major depression (16.66%) and 2 unspecified anxiety disorders (5.55%) are included in GPT based on acceptance and commitment therapy (ACT) of Hayes’s (2012) for primary care patients, and on a treatment protocol developed in our clinical health psychology section (Segú et al. PaP 2023; 25 6-18) in long covid patients

Patients are recruited and cared for in the collaboration program with the primary care centers (CPPC), n=22(61.11%), and 12 patients (38.89%) diagnosed with long covid in the specialized post-covid unit of internal medicine, and treated in the clinical health psychology section on the Hospital Clínic of Barcelona (HCB)

Post-treatment evaluation is carried out using the GTF questionnaire, based on Yalom’s Q-short(1985), validated with 11 items, adapted to Spanish (Ribé et al. RAEN 2018; 38(134) 473-89). Patients rate from 1 to 10 how much they consider each FTG has helped them in their improvement process

The relevance of the GTF are: Altruism(8.16), catharsis(7.61), cohesiveness(7.94), corrective recapitulation(6.15); socialization techniques (6.41); self-awareness of reality(6.65); imitative behavior(6.43); participated information(6.69), instill hope(6.39); interpersonal learning (7.07), universality(8.27).

Regarding the other objective, 44.44%(n=16) consider the GTF more important than the content of the therapy in their improvement; 36.11%(n=13) equal importance; 13.88%(n=5) plus the CT and 2 consider that none of it has helped them (5.55%). Total importance CT(7.18/10) and GTF(7.44/10). The perceived help in their improvement process in the GPT(CT + GTF)=7.61/10.

In two structured group treatments, based on ACT, a greater percentage of patients value that the GTFs have helped them more in their improvement process than the CT. The GTFs considered most relevant were universality, altruism, cohesiveness and catharsis.

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Modern authors characterize hyperthymic individuals as eloquent, humorous, self-confident, optimistic, energetic, liberated, sexually active, constantly planning and implementing their plans. Four or more of the listed characteristics indicate the individual’s involvement in the circle of hyperthymic people. Statistical data on the prevalence of hyperthymic is scarce, which is due to rare requests for help and the diagnosis of this condition not as a disease, but within the framework of characterological traits. Attempts to classify hyperthymics have been made more than once, but previously none of the authors divided them according to the presence of side character traits in the personality structure.

To establish psychopathological types of hyperthymic individuals in whom affective states were formed.

The sample consisted of 50 patients (42 women, 8 men) who were on inpatient or outpatient treatment at the clinic since 2019 to 2022. Patients were examined by clinical-psychopathological, clinical-anamnestic methods due to the presence of a phase affective state.

Four types of hyperthymic personalities have been identified: anxious-hyperthymic, hysterical-hyperthymic, schizoid-hyperthymic and standard hyperthymic. Anxious-hyperthymic type, 20% (n=10) characterized by a combination of increased activity, sociability with such traits as suspiciousness, perfectionism, meticulousness, exactingness, concern for one’s health and the desire to maintain a healthy lifestyle. Hysterical-hyperthymic type, 46% (n=23) includes both hyperthymic and hysterical traits in the form of increased emotionality, egocentrism, drama, and desire for recognition from others. In addition, patients in this group are characterized by increased concern about their appearance (bright clothes, makeup, tattoos). Schizoid-hyperthymic type, 10% (n=5). In addition to increased activity and emancipation, patients in this group are prone to fantasizing, overvalued hobbies, sthenicity, emotional poverty and rationalism. Standard type, 24% (n=12) are characterized by the presence of typical hyperthymic traits - optimism, energy, constant desire for productive activity, success in the chosen profession, rapid career growth, sociability, openness.

Hyperthymic individuals with the development of affective phases are heterogeneous in their psychopathological structure and have features of the pathocharacterological structure that make it possible to distinguish anxious-hyperthymic, hysterical-hyperthymic, schizoid-hyperthymic and standard types. The developed classification of hyperthymia reveals the predominance of the hysterical-hyperthymic type (46%).

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Forensic psychiatric services address the therapeutic needs of mentally disordered offenders in a secure setting. Clinical, ethical, and legal considerations underpinning treatment emphasize that the Quality of Life (QOL) of patients admitted to forensic hospitals should be optimised.

This study aims to examine changes in the QOL in Ireland’s National Forensic Mental Health Service following its relocation from the historic 1850 site in Dundrum to a new campus in Portrane, Dublin.

This multisite prospective longitudinal study is part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST). Repeated measures were taken for all inpatients in the service at regular six-monthly intervals. The WHOQOL-BREF questionnaire was offered to all inpatients and an anonymised EssenCES questionnaire was simultaneously used to measure atmosphere in the wards. Data were obtained at five time points for each individual patient and ward. WHOQOL-BREF ratings were obtained across five time points with comparisons for four time intervals, including immediately before and after relocation. For 101 subjects across the four time intervals, 215 sets of data were obtained; 140 before and 65 after relocation with 10 community patients who did not move. Using Generalised Estimating Equations (GEE) to correct for multiple comparisons over time, the effect of relocation, with community patients as a control, was analysed by ward cluster and whether patients moved between wards. Observations were categorised according to security level — high dependency, medium secure, rehabilitation, or community — and trichotomised based on positive moves to less secure wards, more secure wards (negative moves), or no moves.

The hospital’s relocation was associated with a significant increase in environmental QOL (Wald X2=15.9, df=1, p<0.001), even when controlling for cluster location, positive and negative moves. When controlling for ward atmosphere, environmental QOL remained significantly increased after relocation (Wald X2=10.0, df=1, p=0.002). EssenCES scores were obtained within the hospital for three time points before relocation and two time points afterward. No significant differences were found in the three subscales before and after the relocation. All three EssenCES subscales progressively improved with decreasing security level (Patient’s Cohesion: Wald X2=958.3, df=1, p<0.001; Experienced Safety: Wald X2=152.9, df=5, p<0.001; Therapeutic Hold: Wald X2=33.6, df=3, p<0.001).

The GEE model showed that the hospital’s relocation improved self-reported environmental QOL. The cluster location made significant differences, as expected for a system of stratified therapeutic security, with a steady improvement in scores on all three atmosphere subscales.

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Emergency psychiatric care, unplanned hospital admissions, and inpatient health care are the costliest forms of mental health care. According to Statistics Canada (2018), almost 18% (5.3 million) of Canadians reported needing mental health support. However, just above half of this figure (56.2%) have reported their needs were fully met. To further expand capacity and access to mental health care in the province, Nova Scotia Health has launched a novel mental health initiative, the Rapid Access, and Stabilization Program (RASP).

This study evaluates the effectiveness and impact of the RASP on high-cost health services utilization (e.g. ED visits, mobile crisis visits, and inpatient treatments) and related costs. It also assesses healthcare partners’ (e.g. healthcare providers, policymakers, community leaders) perceptions and patient experiences and satisfaction with the program and identifies sociodemographic characteristics, psychological conditions, recovery, well-being, and risk measures in the assisted population.

This is a hypothesis-driven program evaluation study that employs a mixed methods approach. A within-subject comparison will examine health services utilization data from patients attending RASP, one year before and one year after their psychiatry assessment at the program. A controlled between-subject comparison will use historical data from a control population will examine whether possible changes in high-cost health services utilization are associated with the intervention (RASP). The primary analysis involves extracting secondary data from provincial information systems, electronic medical records, and regular self-reported clinical assessments. Additionally, a qualitative sub-study will examine patient experience and satisfaction, and examine health care partners’ impressions.

The results for the primary, secondary, and qualitative outcome measures to be available within 6 months of study completion. We expect that RASP evaluation findings will demonstrate a minimum 10% reduction in high-cost health services utilization and corresponding 10% cost savings, and also a reduction in the wait times for patient consultations with psychiatrists to less than 30 calendar days. In addition, we anticipate that patients, healthcare providers, and healthcare partners would express high levels of satisfaction with the new service.

This study will demonstrate the results of the Mental Health and Addictions Program (MHAP) efforts to provide stepped-care, particularly community-based support, to individuals with mental illnesses. Results will provide new insights into a novel community-based approach to mental health service delivery and contribute to knowledge on how to implement mental health programs across varying contexts.

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Sleep disturbance, particularly insomnia, is prevalent across various mental health disorders. While it is a common sign in mood disorders, emerging evidence suggests that insomnia might act as a precursor or an early sign of psychosis. Our case report and literature review emphasize the importance of evaluating sleep disturbances in the diagnosis and management of mental disorders.

• - To explore potential neurobiological underpinnings linking sleep disturbances to psychosis onset.

• - To advocate for the importance of early identification and intervention for sleep disturbances in the broader context of preventing or managing psychotic disorders.

We present a case describing a young patient’s first episode of psychosis, which was masked by an initial presentation of insomnia. Additionally, we conducted a review of the relationship between sleep disturbances and psychosis, with a comprehensive literature search from Pubmed, Scopus and psychINFO.

A 20-year-old African-American male with a history of poor sleep was initially diagnosed with Major Depressive Disorder. He was treated with Bupropion, Quetiapine, and Trazodone. However, he later presented with worsening depression, odd behavior, and signs of disorganization, suggestive of a psychotic episode. After switching his medication to Risperidone 4mg twice daily, the patient’s sleep and other symptoms markedly improved. Through our literature review, we identified that sleep disturbances, especially insomnia, can be a risk factor for developing psychosis. While a cross-sectional study recorded one-fourth of their study population experiencing First Episode Psychosis (FEP) with clinical insomnia, another study reported close to 80% of their study sample with early psychosis suffering from a minimum of one sleep disorder; insomnia and nightmare disorder being the most frequent. A large sample longitudinal analysis lasting one year also observed patients with sleep disorders to be twice at risk of onset and persistence of psychotic episodes. A growing body of evidence also suggests that structural brain abnormalities and neural development alterations in the early stages of psychosis may lead to sleep disturbances and subsequent psychotic symptoms. Findings suggest that thalamic dysfunction may in particular contribute to sleep spindle deficits and altered EEG microstate dynamics. These deficits are unrelated to antipsychotic medication exposure, and are also not observed in patients with other psychiatric illnesses.

While the correlation between sleep disorders and psychosis has been well-established for decades, very limited literature is available on the role of sleep in FEP. Recognizing and treating sleep disturbances is pivotal in managing psychiatric disorders, including psychosis. Thus, a comprehensive evaluation of sleep issues in patients presenting with psychiatric symptoms is imperative for accurate diagnosis and management.

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Nonsuicidal self-injury (NSSI) is a self-damaging behavior with typical onset in early adolescence, and shows greater prevalence in females. NSSI is defined by recurrent episodes of intentional self-inflicted damage to body tissue, without suicidal intent. These recurring self-inflicted injuries are done by the indivuduel to relief oneself from negative feelings, to resolve interpersonal difficulties, or to induce positive feelings.

NSSI in DSM-5. has been included among the conditions in need of further study.

NSSI can be interpreted as a maladaptive coping mechanism that can be regarded as an emotional dysregulation. Adverse childhood experiences including physical abuse, neglect or sexual abuse are the strongest predictors of the NSSI. Research has repetitively found strong associations between NSSI and identity diffusion and/or distorted personality traits.

The aim of our study was to assess the association between childhood traumatization, personality characteristics including stages of identity development, and self-injurious behavior among female adolescents that experience difficulties with emotional regulation.

We compared our results to a Hungarian normative sample. The sample consisted of inpatients adolescents, age between 14 and 18, with a diagnosis consisting of „Emotional disorders with onset specific for childhood” or „Mixed disorders of conduct and emotions” with chronic nonsuicidal self-injurious behavior.

Childhood traumatization was measured with the short version of Childhood Trauma Questionnaire (H-CTQ-SF). Identity development and identity diffusion were measured with the Assessment of Identity Development in Adolescence Questionnaire (AIDA). Temperament and character factors were measured with the Junior Temperament and Character Inventory (JTCI).

Adolescent patients with NSSI reported severe and multiplex childhood traumatization. These patients scored higher on novelty seeking and harm avoidance and scored lower on the persistence, self-directedness, and cooperativeness factors in the JTCI. These results were compared with the Hungarien normative sample. Adolescents scored higher on the Discontinuity and Incoherence scales of the AIDA.

Our preliminary results suggest that childhood traumatization predicts self-injurious behavior in adolescent females. Additionally, we have found associations between signs indicative of personality disorder, including lower level of self-cohesion, self-integration and self-directedness.

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In this section, the speaker will present the results from a recent longitudinal study performed by the work group, in which a cohort of 265 patients admitted with a manic episode were followed up during three years after hospital discharge to identify acute readmissions due to affective relapses. The study of different sociodemographic and clinical variables potentially implicated in a higher risk of readmission over three years is presented, including adherence to treatment, substance use, number of previous episodes, family history, predominant polarity, treatments used and number of visits to the Emergency Department.

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