The aging population in the developed world has implied increasing age diversity in the workforce of organizations. Consequently, mutual perceptions about one’s co-workers and age discrimination is becoming increasingly important.

This study aims to explore how perceptions about older workers’ work (un)adaptability, work effectiveness and workplace age discrimination vary according to participants’ psychosocial factors, such as age group, gender, education level and work sector.

This study included a sample of 453 workers in Portugal, diverse in terms of age, gender, education level and work sector. Four different instruments were used: (a) a sociodemographic questionnaire; (b) an older workers’ Work Adaptability scale; (c) an older workers’ Work Effectiveness Scale and; (d) the Workplace Age Discrimination Scale (WADS).

Middle-aged and older participants perceive older workers as more adaptable than younger participants. The oldest group of participants perceives older workers to be more work-effective and experience the highest levels of age discrimination in the workplace, when compared to the other age groups. Also, participants with lower levels of education tend to perceive higher levels of workplace age discrimination, when compared to participants with high school and higher education.

Generational perceptions in the workplace are perceived by workers differently, hence organizations should implement age management strategies to address age discrimination, particularly due to the increasing proportion of older workers.

None Declared

CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is a cerebrovascular disease, tht appears in 1.98/100,000. It´s caused by a mutation of the Notch3 gene and is characterized by accumulation of granular osmiophilic material in the middle layer of the small and median sized cerebral arteries.

Sypmtoms are migraine, recurrent cerebral ischemic episodes, dementia, neuropsychiatric disorders (anosognosia, character disorders, apathy and cognitive impairment). It usually appears between 30-60 years, although there is an important variability. There is no curative treatment, only palliative.

Clinical review of anosognosia and its presence in CADASIL disease.

Clinical case and literatura review.

We presented the clinical case of a 68-year-old man, who was diagnosed with CADASIL after a stroke 3 years earlier. In his family, his brother was diagnosed also with CADASIL. The patient had previously presented disturbances in impulse control (hyperorality) and important executive failures. He currently presented anosognosia, deficits in verbal memory, spatial perception and executive functions, in addition to behavioral alterations and apathy. Due to these deficits he was prohibited from certain activities (driving, hunting).

The patient was not aware of these deficits and becouse of his “no knowledge of his illness”, he disagreed with these prohibitions, so he showed rage and anger at the impotence of not understanding why certain actions are prohibited.

In the consultation, mnesic errors and in naming objects were also objectified, for which it was recommended to carry out cognitive stimulation on a daily basis. In addition, he presented failures of sphincter incontinence, especially of urine and occasionally also of the anal sphincter. He had previously had episodes of myoclonus or fasciculations.

A genetic study by massive sequencing confirmed the heterozygous presence of the pathogenic variant c.1819C>T p.(Arg607Cys) in the NOTCH3 gene, a CADASIL disease.

The anosognosia that many patients with CADASIL disease present constitutes a problem because it contributes to the delay in consultation and, therefore, the delay in the adequate diagnostic approach, therapeutic possibilities and family genetic counseling. Due in part to anosognosia, CADASIL is considered an underdiagnosed entity. Due to the lack of awareness and the consequent lack of recognition of the deficit, these people are often seen as stubborn and difficult to deal with by people in their immediate environment.

In addition, there is general difficulty in the rehabilitation process, since patients do not think the neccesity to be treated. This can generate frustration and despair both in their relatives and in the health personnel.

For all these reasons, both in anosognosia and in CADASIL disease, adequate psychological support is needed for both those affected and their families.

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One of the great challenges still to be achieved in schizophrenia is the development of a staging model that reflects the progression of the disorder. The previous models suggested have been developed from a theoretical point of view and do not include objective variables such as biomarkers, physical comorbidities, or self-reported subjective variables (Martinez-Cao et al. Transl Psychiatry 2022; 12(1) 1-11).

Develop a multidimensional staging model for schizophrenia based on empirical data.

Naturalistic, cross-sectional study. Sample: 212 stable patients with Schizophrenia (F20). Assessments: ad hoc questionnaire (demographic and clinical information); psychopathology: PANSS, CDS, OSQ, CGI-S; functioning: PSP; cognition: MATRICS; laboratory tests: C-Reactive Protein (CRP), IL-1RA, IL-6, Platelets/Lymphocytes (PLR), Neutrophils/Lymphocytes (NLR), and Monocytes/Lymphocytes (MLR) ratios. Statistical analysis: Variables selection was performed with an ad hoc algorithm developed for this research. The referred algorithm makes use of genetic algorithms (GA) to select those variables that show the best performance for the patients classification according to their global CGI-S. The objective function of the GA maximizes the individuals correct classification of a support vector machines (SVM) model that employs as input variables those given by the GA (Díez-Díaz et al. Mathematics 2021; 9(6) 654). Models performance was assessed with the help of 3-fold cross-validation and these process was repeated 10,000 times for each one of the models assessed.

Mean age(SD): 39.5(13.54); men: 63.5%; secondary education: 59.50%. Most patients in our sample had never been married (74.10%), and more than a third received disability benefits due to schizophrenia (37.70%). The mean length of the disease was 11.98(12.02) years. The best SVM model included the following variables: 1)Clinical: number of hospitalizations, positive, negative, depressive symptoms and general psychopathology; 2)Cognition: speed of processing, visual learning and social cognition; 3)Functioning: PSP total score; 4)Biomarkers: PLR, NLR and MLR. This model was executed again 100,000 times applying again 3-fold cross-validation. In 95% of the algorithm executions more than a 53.52% of the patients were classfied in the right CGI-S category. On average the right classification was of 61.93%. About specificity and sensitivity the average values obtained were of 0.85 and 0.64 respectively.

Our staging model is a robust method that appropriately distributes patients according to the severity of the disorder. Highlights the importance of clinical, functional and cognitive factors to classify patients. Finally, the inflammatory parameters PLR, NLR and MLR have also emerged as potential biomarkers for staging schizophrenia.

None Declared

Although cognitive impairment is a core symptom of schizophrenia related to poore outcome in different functional domains, it still remains a major therapeutic challenge. To date, no comprehensive treatment guidelines for cognitive impairment in schizophrenia are implemented.

The aim of the European Psychiatric Association (EPA) guidance paper was to provide a comprehensive meta-review of the current available evidence-based treatments for cognitive impairment in schizophrenia, structured into three sections: pharmacological treatment, psychosocial interventions, and somatic treatments.

Based on the reviewed evidence, the EPA guidance recommends an appropriate pharmacological management as a fundamental starting point in the treatment of cognitive symptoms in schizophrenia. Among psychosocial interventions, cognitive remediation and physical exercise are recommended for the treatment of cognitive impairment in schizophrenia. As for cognitive remediation, some variables have been confirmed as core elements for treatment effectiveness.

The dissemination of the EPA guidance paper may promote the development of shared guidelines concerning the treatment of cognitive functions in schizophrenia, with the purpose to improve the quality of care and to achieve clinical recovery in this population.

None Declared

The concept of social vulnerability arises in the individual-collective relationship and points to changing social conditions, built on the basis of power relations. In this context, vulnerability can be directly related to the deterioration of social and civil rights, resulting in the weakening of individuals’ citizenship. On the other hand, vulnerability can also lead to the deterioration of mental health. Stigma and discrimination generate low self-esteem, decreased self-confidence, reduced motivation, and less hope for the future.

This study aimed to explore the perceptions and experiences of vulnerability from the perspective of vulnerable people and identify strategies they used to reduce vulnerability.

This study employed a qualitative descriptive design. Using a purposeful sampling method, data were collected in April 2022. The following criteria were applied in the selection process: (1) adults with a personal sense of vulnerability or the experience of being vulnerable; and (2) understanding the Portuguese language and having reflective capacity.

A total of 12 respondents (6 male; 6 women) participated in study, mostly of middle-age. The manifestations of vulnerability reported by participants included being homeless, being a migrant, having an infectious disease, being drug dependent, experiencing a process of loss and grief and living socioeconomic difficulties. The data was summarized in terms of three major themes: (1) Conceptions about vulnerability, (2) Barriers imposed by vulnerability, and (3) Strategies for dealing with vulnerability. “Three subthemes were identified within the first theme: ontology condition that spreads, being alone “without network” and being exposed to external pressure (others). In the second theme, there were also three subthemes: discrimination/stigma, difficulties in social reintegration, and “my condition is difficult”. Lastly, in the third theme, we found four subthemes: the ability to ask for help/seek support, motivation, and commitment to behavioural change, not exposing others to the same risks, and ignoring the disapproving look of others” (Laranjeira et al., 2022, p.5).

Our findings demonstrated that vulnerability is a dynamic process of being exposed to circumstances that influence individual outcomes. However, there is a conceptual gap: vulnerability is regarded negatively, but vulnerability also has the capacity to shift life priorities for the better.

Laranjeira C., Piaça I., Vinagre H., Vaz AR., Ferreira S., Cordeiro L., Querido A. (2022). Vulnerability through the Eyes of People Attended by a Portuguese Community-Based Association: A Thematic Analysis. Healthcare. 10(10):1819. https://doi.org/10.3390/healthcare10101819

None Declared

Stress is inextricably linked to mental well-being while stressful events remain a major contributor to many common psychosomatic disorders. Traumatic events are universal stressors. Only some individuals participating in stressful events do not develop full-blown post-traumatic stress disorder (PTSD) but many of them manifest psychosomatic symptoms with a strong psychological component

The current study compared the severity of somatization, anxiety, depression, and distress in medical university students who were exposed and in those who were not exposed to a traumatic event.

Data were collected from 594 students of different faculties of the Poznan University of Medical Sciences in Poland. Participants were asked whether or not they had experienced any psychological trauma events and were asked to rate the intensity of psychosomatic symptoms they manifested. The data was collected using the Posttraumatic Diagnostic Scale (PDS) questionnaire and The Four-Dimensional Symptom Questionnaire (4 DSQ).

The study found that 78% of study participants experienced a traumatic event while 15% of them reported moderate and severe PTSD symptoms. 45% subjects reported moderate or high stress levels, 23% subjects reported symptoms of depression while 30% reported symptoms of anxiety. The analysis also demonstrated 26% of students participating in the study reported somatic symptoms.

In the subgroup of study participants with trauma history trauma sufferers, 36% subjects declared they experienced a one-time event, 23% subjects experienced trauma event twice while others experienced trauma ≥three times. The number of traumatic events was positively associated with the number of PTSD symptoms and severity of psychosomatic manifestations such as stress, depression, anxiety and somatization. In addition, the study analyzed whether traumatic events resulted from conscious and intentional harm by others. In this respect, 16% of subjects declared they participated in an event that was consciously and intentionally caused by others (e.g., battering or abuse). Students who experienced traumatic events related to intentionally harming another person were characterized by a greater severity of depression.

Study indicates that experiencing traumatic events is associated with a greater severity of a range of psychosomatic symptoms.

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

Aripiprazole is a newer atypical antipsychotic with a favorable side-effect profile, especially a low propensity to result in metabolic syndromes.It is effective at treating bipolar disorder, the positive symptoms of schizophrenia and has the potential to treat negative and cognitive symptoms.

However, prior studies suggested that aripiprazole seem to be associated to a risk of inducing certain impulse control behaviors, such as uncontrollable gambling, hyper sexuality, as well as compulsive eating.

We proposed to assess the evidence for compulsive eating associated with the use of aripiprazole.

We report a rare case of new onset aripiprazole induced compulsive eating behavior in a patient with bipolar disorder. Then, we conducted a literature review using“PubMed” database and keywords “Aripiprazole”, “Impulse Control Behaviors”, “Compulsive Eating”.

He was a 21-year-old patient, diagnosed with bipolar 1 disorder. He was prescribed Aripiprazole, after a neuroleptic malignant syndrome induced by haloperidol (which was prescribed during the first episode psychosis).

One month following the treatment initiation, the patient complained of eating excessively. He was not able to control his eating and gained 30 Kg over the period of 4 months. Metabolic assessment showed a hypercholesterolemia.

Aripiprazole is a promising novel antipsychotic in mental diseases. However current evidence associates compulsive behaviors like eating with the use of Aripiprazole, probably due to the drug affinity to 5-HT receptors. More studies are needed to confirm this rare side effect.

None Declared

Substance use continues to be an important problem among mental health patients either as main diagnosis or as comorbidity. Acute care visits, including emergency department visits and hospitalizations, related to substance use disorders (SUD) are increasing and can be opportunities to engage individuals to get proper treatment (Suen LW et al. J Gen Intern Med 2022; 37(10):2420–2428).

Both mental disorders and SUD lead to subsequent chronic physical conditions, premature death, suicide or overdose (Bennett AC. Public Health Rep 2019; 134(1):17-26) that can be accidental or not.

24% to 32% of patients with Substance Induced Psychosis develop later a schizophrenia spectrum disorder or bipolar disorder (Starzer MSK et al. Am J Psychiatry 2018;175(4):343–350) leading to a chronic use of medication and, in several instances, to a necessity of psychiatric in-patient treatment with long hospital stays and high readmission rates (Khan S. Health Reports (2017) 28(8)3-8).

Our goal was to analyze if substance use is associated with higher psychiatric hospitalization rates.

An independent-samples t-test was run to determine if there were more hospitalizations among patients with substance use. Afterwards, the Cohen’s D was calculated to measure the effect size and to see the magnitude of the experimental effect.

A sample of 2604 in-patient treatment episodes was used. The sample had 1696 female patients, 908 male patients and 823 patients had substance use. We found that patients with substance use had a statistically significant higher hospitalization rate (6.82±5.27) than the ones without it (5.32±4.84), t(1483)=6.945, p<0.001. Cohen’s effect size value (d=.30) suggested a small practical significance.

Our findings go mainly accordingly the literature; we found a significant effect of drugs on readmission rates (Böckmann V et al. Front Psychiatry 2019; 10:828) but we might have thought it would be bigger. That could be explain by undiagnosed substance use (refusal to admit the use, drugs not detected on lab tests, not requesting toxic lab tests) or higher sample percentage of confounding comorbid diagnoses.

However, is undoubtable the several risks that drugs bring to our health and so the authors aim to raise awareness among the medical community to the importance being alert for signs of use or psychiatric symptoms to avoid reaching a no turning point. It’s known that doctors frequently fail to diagnose SUD in hospitalized patients and given the linkage between use of certain substances and particular medical reasons for admission, it would be well-advised to search for SUD in certain admission diagnoses (Weintraub E et al. Am J Addict 2001;10(2):167-77). Knowledge of substance use behavior may help reducing relapse rates and to reduce the risk of developing a SUD (Andersson HW et al. Nordic Journal of Psychiatry, 75:3, 160-169).

None Declared

Suicide is a complex problem in which individual, family social factors are interrelated. The 1997 Asian financial crisis caused a major economic crisis in Korea, and Korea received bailout support from the International Monetary Funds(IMF) from December 23, 1997 to August 23, 1997.

This study aimed to investigate the relationship between the suicide rate of children and adolescents who grew up during this economic crisis in Korea.

Suicide rates are calculated according to gender, region, and age of 5 years (10-14 years old, 15-19 years old, 20-24 years old) using suicide death data from the Korea National Statistical Office from 2000 to 2017. The cohort of interest in the study is the group that was in childhood and early adolescence between 1997-2000 and corresponds to 1986-1995 in terms of birth year. Cohorts are divided into 1986-1989 (G1), 1990-1992 (G2), and 1993-1995 (G3) according to birth year. These groups were 8-14 years old for G1 and 5-10 years old for G2, 2-7 years old for G3 during 1997-2000, during the economic crisis. The Age-Period-Cohort analysis and linear mixed-effects regression models are used and the moderating effect on region and age is also analyzed.

The 10-24 year-old suicide rate was higher in males than females, in older age groups, earlier in birth years in the birth cohort, and in rural than urban areas. Suicide rates between the ages of 20-24 years were particularly high among men living in rural areas. During the national economic crisis, the suicide rate was higher among adolescents than preschoolers (G3 < G1) (p<0.001), and this trend was observed for both men and women. However, the main effect of the cohort was not observed at a statistically significant level.

The national economic crisis has a negative impact on the mental health of children and adolescents, and it is more negative for adolescents than for children, which can increase the suicide rate between the ages of 20-24.

None Declared

It is known that the restrictions and clinical changes experienced during the pandemic period have negative effects on the care and treatment of psychiatric patients. However, insights on how the pandemic environment and the approaches of healthcare professionals serving during the pandemic affect the care and treatment of patients at risk of suicide are insufficient.

This ethnographic study aimed to identify the approaches of psychiatric nurses in managing suicide risk during the pandemic period in relation with their work environment.

This ethnographic research design used a sample of 13 psychiatric nurses in a psychiatric clinic in Ankara. Data were collected with in-depth interviews, participant observations and observant participations. Data were obtained from a total of 612 hours of observation and 13 planned nurse interviews. Data were analyzed using qualitative thematic analysis.

The emergent main theme from data analysis is explained under the title of “The risk of loss of inauthenticity in suicide risk management”. “Risk of loss of inauthenticity” means the fact that the individual suicidal risk factors and differences of the patients cannot be perceived/assessed by the nurses.

Supposing all patients having the same suicide risk level by psychiatric nurses caused insensitivity to risky patients in the care process. Nurses’ inadequate approach to patient personality disorder and limited social interactions due to the pandemic atmosphere made it difficult for nurses to have knowledge and understanding of how patients cope with suicidal ideations. These findings show the importance of the use of valid and reliable scales with risk formulations and the significance of triage in crisis periods such as current pandemic. In addition, creating available online consultancy service alternatives may have an important role in the management of suicide risk for patients who are disturbed by long-term hospitalization. Also these findings may contribute to the creation of qualified care and treatment guidelines on suicide risk management for crisis periods.

None Declared

We introduce and present a psychotherapic technique initiated by Wilhelm Reich (1897-1957) in the 1920’s and thereafter expanded and refined with essential contributions by Elsworth Baker among others. We outline its theory and technical foundations and also provide an epistemologic interpretation of its peculiar body-mind representation based on character- and muscular armoring as a reaction to suffering; armoring of the ocular segment in the etiology of Bleuler’s schizophrenic splitting; and finally the consequences of armoring on the energetic functions as the logical development of Freud’s theory of libido, with significant theoretic, therapeutic and nosologic consequences.

The goal of my presentation is to avoid extinction of a valuable technique for future psychiatrists; moreover, to catch the interest of young collegues to a technique that integrates Bleuler’s psychiatric discovery with Freud’s psychoanalytic contribution and demonstrates that the old nosology and theoretical achievements in the psychic field were not as obsolete as today many think.

Research, book summaries, practical experience

Poster presentation

Poster presentation

None Declared

Eating disorders (ED) historically been adressed as illnesses that only affect young adolescent females. ED’s in males have been documented in literature as early as the 1960’s; yet men continue to be under represented on research on the topic. For decades, the Diagnostic and Statistical Manual of Mental Disorders (DSM) perpetuated the invisibility of males by including amenorrhea as a diagnostic criterion. It was not until 2013 that male inclusion was endorsed thorught the removal of that criterion. It is estimated that one in four people affected with and ED is male.

It is estimated that one in four people affected with and ED is male. The proportion of males reporting lifetime prevalence of Binge eating disorder (BED) was far greater than for Anorexia nervosa (AN) or Bulimia nervosa (BN); the female versus male ratio of BED prevalence was 3:1. AN is the most life-threatening ED, but is least frequently seen in male populations; researchers suggest this is because most men are not interested in the emaciated, thin look.

This poster aims to recognize the presence of ED’s in males and raise awareness on this topic.

Case report and literature review

We present the case of a 50-year-old man with long-standing AN, who had never undergone mental health follow-up. He is referred to psychiatrist by his primary care provider (PCP) due to depressive symptoms. His medical history included vitamine D insufficiency and osteoporosis. At the age of 19 he was obese (BMI 35) and from the age of 23 he started to present dietary restriction after a social event. He had never self-induced vomiting, use of laxatives, binge eating or compulsive exercise. He reported no history or current substance use disorder. BMI at first consultation was 17,6 and showed fear of weight gain. Antidepressant therapy was started and patient was referred to a specialized therapist, nutritionistand nurse.

Overall, the findings demand clinicians develop awareness about ED in males to advance illness management and enhance long-term prognosis. In our case, the delay in receiving treatment has probably led to greater morbidity and chronicity. PCP’s play a key role in detection of ED’s as the often act as a first point of contact for men accesing the health care system. While assesing and ED, the PCP should include general questions on eating habits in their intake interview. Once an a ED is suspected, the first few minutes of the encounter are crucial to gain trust and buy-in from the patient. Once buy-in from the patient is gained, a complete physical exam and diagnostic work-up is required. Priority referrals to the following professionals are critical: psychiatrist, therapist, dietician or nutritionist, and ED specialist if available.

None Declared

Studies reported an initial decrease in the number of presentations and incidence of self-harm in young people during the pandemic. As the pandemic progressed young people may have experienced increased levels of distress, contributing to worsened mental health. There is a need for mental health services to evaluate the presentations of young people presenting to the Emergency Department (ED) so that services can meet the needs of young people.

To examine the mental health presentations of young people (aged 16-25) to the ED and how this may have changed since the start of the pandemic.

This study reviewed all 16–25-year-olds presenting to the Mater Misericordiae University Hospital (MMUH) who were triaged with a mental health issue in a 2 month period (September-October) over three years – 2019 (Period A), 2020 (Period B), 2021 (Period C). Approval for this service evaluation was granted by the Clinical Audit and Effectiveness Committee at the MMUH.

Of 232 presentations across all periods, there was no significant difference in the number of presentations in each study period - Period A (n=76), Period B (n=79) and Period C (n=77). In all three periods, most presentations occurred out of hours (A: 57.9% [n=44]; B: 74.7% [n=59]; C: 68.8% [n=53]) statistically significant (p=0.034) from before (A) to during the pandemic (B and C). Out of hours arrival by ambulance was most common in in Periods A and B (45.5% and 55.9%). Over all three periods discharge home was the most frequent outcome of assessment (A: 69.7% [n=53]; B: 70.9% [n=56]; C: 76.6% [n=59]). Overall, there was a decrease in self-harm presentations over the period (A: 47.4% [n=36]; B: 41.8% [n=33]; C: 40.3% [n=31]). The percentage of presentations with self-laceration increased during the pandemic (A: 33.3% [n=12]; B: 39.4% [n=13]; C: 48.4% [n=15]). There was a significant increase in attendees who were already taking psychotropic medications (p<0.001).

The findings suggest that the majority of 16–25-year-olds present out of hours and do not require admission. Although the number of presentations remained similar, the increase in out of hours presentations and arrivals by ambulance in Period B may reflect increased distress in the initial stages of the pandemic, and restricted access to services. The higher rates of medication prescribing suggests that these young people are already receiving health care, but that their needs are not being fully met. Mental health services should be designed to provide access to mental health care out of hours when young people are most likely to require them.

None Declared

On January 7, 2020, the Chinese authorities identified a new type of virus from the Coronaviridae family as the causative agent of an outbreak of pneumonia of unknown etiology, which has been named SARS-CoV-2. The disease caused by this new virus has been named by international consensus COVID-19. The WHO recognized it as a global pandemic on March 11, 2020. The Government of Spain declared the State of Alarm on March 13.

Hospitals have had to reorganize their consultation areas and emergency rooms to carry out security measures and prioritize the care of patients with COVID-19. All this has had repercussions on the closure of Psychiatric Day Hospitals and outpatient consultations, carrying out fundamentally telephone or telematic follow-up.

The objective of the study was to analyze the characteristics of admission during the year after the 2020 pandemic compared to the similar period in 2019.

An observational study of retrospective characteristics of patients admitted to a hospitalization unit during the year 2020 after the pandemic will be carried out compared to the year 2019 of the same period. Demographic and clinical variables are included in the study.

During the period after the 2020 pandemic, a total of 135 patients were admitted, with a mean age of 42.8 years, 65 of them women and 70 men. With a diagnosis at discharge of 48% of Psychotic Disorder, 17% of Bipolar Disorder, 11.1% of other affective disorders (T. depressive, adaptive, dysthymia) 14% of Personality Disorder, and 17% of others. Compared to the same period of the previous year, the number of admissions decreased by 98 patients (42%), including the severity of the clinic, with 36% of the total admissions being psychotic disorders.

It can be concluded that the number of hospitalizations has decreased due to the patients’ fear of being admitted and therefore being subject to infection, and the higher percentage of psychotic and affective pathology because these patients are more serious, making home containment impossible.

None Declared

The new coronavirus pandemic has brought the issue of life quality to the forefront. Among HIV-infected patients, life quality may be associated with fear of death.

The study aimed to investigate the life quality and death fear among HIV-infected patients during the pandemic second wave in Russia.

The data were collected from February to July 2021 using a Google form that we developed. Fifty-nine patients living with HIV participated in the study. We used the WHOQOL-BREF to examine the quality of life and the Fear of Personal Death Scale to explore fear of death. Both questionnaires were adapted for use in Russia.

We found the following mean values for the domains: “physical and psychological well-being” — M = 21.39±3.61; “self-perception” — M = 17.51±2.28; “microsocial support” — M = 9.15±2.94; “social well-being” — M = 24.81±5.33. We found that physical and psychological well-being were associated with the transcendental consequences of death (rxy = 0.274, p < 0.05), self-perception with body consequences (rxy = -0.304, p < 0.05) and fear of forgetting (rxy = -0.287, p < 0.05), and social well-being with body consequences (rxy = -0.310, p < 0.05).

Life quality is related to intrapersonal, interpersonal, and supra-personal dimensions of death fear during the second wave of the pandemic among patients living with HIV. Such fact may indicate possible psychotherapeutic targets when working with this group of patients.

None Declared

The effects of the COVID 19 pandemic manifests in all segments of society, and they have special impact on the vulnerable population of persons with mental disorders. After two years of pandemic, the vaccines against COVID 19 are still the most important strategy against infection, disease, transmission and reinfection.

The aim of our research was to compare the attitudes of different subcategories of people with mental disorders towards vaccination and to discover potential factors that could participate in the decision-making process.

The research was conducted in the outpatients population, from January to March 2022, in Special Hospital for Psychiatric Disease Kovin, Serbia. All patients included in the research signed a voluntary consent to participate in the research. The data was collected from a self-assessment questionnaire, consisted of 4 segments: sociodemographic characteristics, a set of questions related to the COVID pandemic, history of influenza vaccination and attitudes towards vaccination.

The questionnaire included 147 people, 50 of whom were the control group of health professionals employed in SBPB “Kovin”, while in the subgroup of 97 respondents there were 49 people with a diagnosis of one of the non-psychotic disorders and 48 people with a diagnosis of one of the psychotic disorders. In the total population examined, the percentage of vaccinated was 53.97. In the population of persons with mental disorders, this percentage was lower compared to the control group. The results indicated that there is no statistically significant difference in attitudes towards vaccination in relation to the level of education. People who have been vaccinated are also people who would accept vaccination if another pandemic were to occur. In the unvaccinated subgroup, the greatest concern is vaccine safety. This group of respondents did not significantly differ from the vaccinated when it comes to fear of COVID 19 infection and concern about possible illness of family members.

The research showed that slightly more than half of the examined population of persons with mental disorders who use the services of the psychiatric dispensary SBPB “Kovin” were vaccinated.

There is no statistically significant difference in the vaccination status against COVID 19 infection in the subcategories of persons with non-psychotic and psychotic symptoms. In the unvaccinated category, concerns about vaccine safety are a significant cause of vaccine refusal. Such preliminary results indicate the need to raise awareness and provide contoured, timely information and education regarding the pandemic of persons with mental disorders. Promotion of mental health and finding appropriate strategies in the provision of services to persons with mental disorders is one of the key tasks of the psychiatric service.

None Declared

Another pandemic besides COVID-19 stalks the land. This one takes a heavy toll on the young.

Suicide occurs throughout the lifespan and is the second leading cause of death among 15-29 years old globally.

The objective of this review is to highlight for another tragic pandemic, with main emphasis on the preventable character.

Data was obtained through an internet-based literature review, using the research platform Pubmed and the World Health Organization website. Seven articles from the last two years were included.

Improved surveillance and monitoring of suicide attempts and self-harm is a core element of suicide prevention and desirable worldwide.

A public health surveillance system based on medical records would provide and disseminate data that would guide and prioritize the best interventions in each context and contribute to an effective overall suicide prevention strategy.

Close to 800 000 people die due to suicide every year, which is one person every 40 seconds.

According to current data, for each adult who died by suicide there may have been more than 20 others attempting suicide.

Effective and evidence-based interventions can be implemented to prevent suicide and suicide attempts.

None Declared

In recent years, mental health professionals have faced a lot of difficulties and challenges in their work and often need the help of colleagues themselves.

To study the specifics of self-reflection of mental health professionals in different years (January 2020 - October 2022)

Since 2002, Institute of Integrative Family Therapy has been using an approved registration card, which is filled in and handed over after completion of work by all specialists working with families. The maps contain sections describing the progress of work, hypotheses, system parameters of the family, features of the state of the specialist and clients, and so on. We conducted a content analysis of the cards: in 2020, 531 cards were considered, in 2021 - 390, in 2022 - 464 cards.

There are differences in the subjective assessment by specialists of their condition over the years. In the description for the section “Themes and questions in family work that elicited strong emotional reactions from the therapist(s”), professionals began to mention their reactions of fear and confusion more often than before. So, in 2020, fear was mentioned by 4 and confusion by 17 specialists, in 2021 - by 5 and 16, in 2022 - by 36 and 121, respectively. In the section related to the reasons for changing the working (systemic) hypothesis, specialists changed the hypothesis more often (in 2020 - in 53 cases, in 2021 - 40, in 2022 - 98). “The degree of satisfaction of the specialist (-s) with the results of working with the family (in points from 1 to 10, where 1 - absolutely not satisfied, 10 - satisfaction exceeded all expectations" was assessed in 2022 by specialists lower than in previous years: the average value in 2020 - 8.8; in 2021 - 8.9; in 2022 - 6.2.

Supervision, as a form of professional growth and support from a more experienced colleague, is becoming an indispensable component of the work of a specialist helping families in 2022. Assistance in overcoming “dead end” and advising difficult cases due to the experience of the supervisor, on the one hand, allows specialists to understand the situation, offer alternative hypotheses, teach new interventions, on the other hand, it helps the supervised colleague to reflect on the case, analyze its “blind” zones, understand mistakes and summarize the unique experience gained in the psychotherapy of a “difficult” patient.

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Adequate sleep quality and quantity are essential for optimal occupational and psychological health as well as cognitive function. In up to 78% of adults with ADHD, several sleep disorders are associated.1,2 These include delayed circadian rhythm, insomnia, sleep-related movement and breathing disorders and altered sleep duration.3,4 Such sleep problems have consequences in the family and somatic health spheres. In the workplace, adult ADHD coupled with untreated sleep disorder leads to significant occupational impairment. Low employment status, unpredictable behaviour, relationship difficulties, mood lability, risk of injury and accidents are all described as potential associations, with far-reaching consequences. When ADHD is coupled with sleep disorders, cognitive performance deteriorates further and sickness absence is more common. The clinical presentation of the sleep disorders commonly associated with ADHD will be described in detail. State-of-the-art therapeutic interventions will be dicussed based on clinical experience and research findings from our Expertise Centre.

Wajszilber D, Santiseban JA, Gruber R. (2018). Sleep disorders in patients with ADHD: impact and management challenges. Nat Sci Sleep,14;10:453-480.

Van Veen MM, Kooij JJ, Boonstra AM et al. (2010). Delayed circadian rhythm in adults with attention-deficit/hyperactivity disorder and chronic sleep-onset insomnia. Biol Psychiatry. 1;67(11):1091-6.

Wynchank D, ten Have M, Bijlenga D et al. (2018). The association between insomnia and sleep duration in adults with attention-deficit hyperactivity disorder: results from a general population study. J Clin Sleep Med, 14(3):349–357.

Fayyad J, Sampson NA, Hwang I et al. (2017). The descriptive epidemiology of DSMIV Adult ADHD in the World Health Organization World Mental Health Surveys. Atten Defic Hyperact Disord, 91:47-65.

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