Schizophrenia is a chronic disease that deteriorates the functionality of patients, especially when raising a family and caring for children. We are interested in analyzing the characteristics of mothers and fathers diagnosed with schizophrenia and their degree of global activity when switching from oral treatments to injectable treatments.

1 To evaluate the quality of life and functional level of mothers with schizophrenia treated with quarterly paliperidone palmitate. 2. To compare the quality of life and functional level when switching from oral treatment to long-acting injectables.

Participants were 3 mothers and 3 fathers, 33-40 years old, with a diagnosis of schizophrenia in monotherapy who changed treatment with monthly paliperidone palmitate to quarterly paliperidone palmitate LD IM (525 mg/every 12 weeks). Retrospective data collection. QLS quality of life scale.

Six patients were included, caregivers of 1 child (80%), 2 children (20%) who met the inclusion criteria and completed the questionnaires. After its application and correction by means of non-parametric tests (N<30). During oral treatment, scores are observed in the QLS questionnaire of: intrapsychic functions mean 34.2, interpersonal relationships mean 19, instrumental role mean 8, daily activities mean 8. After 12 months of treatment with intramuscular paliperidone palmitate (injectable every 12 weeks ) scores were obtained: intrapsychic functions mean 36, interpersonal relationships mean 23, instrumental role mean 15, daily activities mean 11. A better functioning of the patients was observed in the instrumental categories and daily activities. As well as the patients referred better adherence to treatment.

In our experience, injectable long-acting Paliperidone Palmitate every 12 weeks is associated with the perception of a better quality of life in parents with schizophrenia and increases administration facilities as well as planning in their daily lives.

None Declared

Catatonia is a complex psychomotor syndrome that often goes unrecognized and, consequently, untreated. Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications. Benzodiazepines and electroconvulsive therapy (ECT) are the most widely studied treatment methods. However, no uniform treatment method has yet been brought forward and no previous attempts to treat catatonia on a patient suffering concomitant major depressive disorder (MDD) with NMDA receptor antagonists have been documented so far.

To describe the unknown and novel management of catatonia and MDD with intranasal esketamine, a NMDA receptor antagonist.

A 55-year-old woman with a diagnosis of long-standing recurrent major depressive disorder who was admitted to the psychiatric inpatient unit of UniversityHospital Marqués de Valdecilla (Santander, Spain) suffering a complex catatonic, mutative state framed on a severe MDD. Different ineffective therapeutic interventions were deployed during the course of her illness. After failing to improve under conventional pharmacological treatment and ECT, and given the complexity of peripheral venous access on this patient (which disabled the option for iv ketamine use), we decided to initiate compassionate treatment with intranasal esketamine.

Intranasal esketamine was effective in the resolution of patient’s complex catatonic state. Clinical response from catatonia was observed after 6 intranasal esketamine administrations (2-week follow-up), reaching full catatonia and MDD remission after 12 sessions in absence of significant adverse events

Esketamine showed promising effectiveness for the treatment of catatonia in the context of MDD, although further research on this topic is needed.

None Declared

Suicide in older people is a critical public and mental health issue which requires attention, given that the ageing population is increasing.

Multiple factors, including biological, psychological, and social stressors increase suicidal susceptibility. Unfortunately, elderly are more susceptible to these, such as psychiatric disturbances, physical comorbidities, prior suicide-related behaviours, lack of social support, grief, and increased difficulty in problem-solving

In order to review the risk and protective factors, assessment and prevention of suicide in older adults.

Bibliographic research through PubMed and Web of Science.

Older people can be subdivided into three age groups (from “young old” at 65 years old to “oldest old” after 85 years of age), with suicide being more prevalent in the oldest-old, and overall in men above 75 years old.

Previous psychiatric background, suicidal attempts, substance abuse, poor physical health or disability, family psychiatric history, low social support or isolation, and finantial stress most frequently predispose to suicidal ideation, suicide attempts or death by suicide in this community.

Besides this, ageing relates to a tendency to cognitive impairment, which affects coping mechanisms, leading to deficits in reasoning and decision-making under stressful circumstances during depressive episodes. This can mediate suicidal ideation and associates to greater lethality methods. Geriatric suicidal attempters have been shown to have greater degrees of cortical and subcortical cerebral areas, including the frontal, parietal and temporal regions, as well as significant loss of volume in the dorsomedial prefrontal cortex, insula, midbrain, cerebellum, lentiform nucleus and putamen. Abnormalities in these regions can impair executive and cognitive function, attention, problem solving and ultimately be responsible for suicidal behaviour.

On the other hand, there are suicide protective elements such as physical and cognitive fitness, quality of life and life satisfaction, marital status, religiousness and social support. A prompt identification of modifiable risk factors and strengthening the protective ones by health professionals can reduce this prospect.

Suicidal ideation in older people is a multifactorial public health concern given the very high frequency of completed suicides in this population. Therefore, it is urgent to review and further research to build more effective suicide prevention strategies.

None Declared

The last decade has seen an enormous expansion on our knowledge of the human gut microbiome and its importance for human physiology. The gastrointestinal inhabitants have taken centre stage as regulators of the bidirectional gut to brain communication. The gut microbiota is not only critical for metabolism, glucose homeostasis and body composition, but increasing evidence is demonstrating the significant effects of the gut microbiota on mood and mental wellbeing and its role in the development of affective disorders, such as anxiety and depression, and other neuropsychiatric conditions. Studies in the field of nutritional neuroscience and nutritional psychiatry are now increasingly including the gut microbiota as a key factor mediating the impact of diet on central nervous system function. Accumulating evidence from cell-based in vitro studies, animal models and preclinical intervention studies are linking the gut microbiota to the effects of diet on brain function, but the precise mechanism are still not fully understood and studies have had limited translation to human intervention studies. Overall, the increase in our understanding of interconnectedness of the gastrointestinal microbiota of human health and disease, has led to a strong focus on the development of microbiota-targeted strategies to influence all host physiological responses, including those that can modulate central nervous system function. In this talk, I will provide an overview of the most recent advances in the nutritional psychiatry–microbiome field, highlighting significant opportunities for future research.

None Declared

Around 2010, the number of hikikomori cases increased rapidly. Hikikomori is a global problem that characterizes the current era, and has become an increasingly deep-rooted social issue that affects the younger generation, especially during the coronavirus disease-2019 (COVID-19) pandemic. In our previous comparative study of adolescent hikikomori between Japan and France (Hamasaki et al. BMC Psychiatry 2022; 22, 477), we investigated its psychopathology, including potential cultural influencing factors. The study showed no difference in terms of psycho-behavioral characteristics of hikikomori between Japan and France. However, the sociocultural factors that make hikikomori more severe differed between the two countries, i.e., in Japan: lack of communication between parents, in France: lack of communication between the family and the community.

Since these differences in sociocultural factors are closely related to the social context in which the mothers were placed, the factors in terms of maternal gender issues were examined, along with reviewing previous studies.

Statistical data from the “Global Gender Gap Report 2022” of the World Economic Forum, the “Towards real gender equality 2021” of the Ministry of Gender Equality, Diversity, and Equal Opportunities of France, the “Women and Men in Japan 2020” of the Gender Equality Bureau, Cabinet Office, Government of Japan, and other sources were evaluated. Further, previous literature on the family environmental factors of hikikomori were reviewed.

An absent father, a subsequent mother-child closeness and over-interference, and the inhibition of children’s independence, have been repeatedly mentioned in studies as factors leading to hikikomori. The time spent on housework and childcare by Japanese men is at the lowest level globally (Japan’s gender gap index ranks 116th out of 146 countries, the lowest among the seven major G7 nations). In Japan, where generally little cooperation exists between parents, particularly in those families where communication between parents is self-rated as relatively poor, the above factors may surpass the threshold for triggering hikikomori. In France (ranked 15th in gender gap index), the isolation of mothers and children from society is an important factor associated with hikikomori. Adequate social participation of the mother may be a protective factor against hikikomori.

Gender gap-related issues among mothers may be involved in the root of the hikikomori problem. Hikikomori has emerged from various socio-familial factors. Further studies are warranted to determine the causal relationships of these factors with the onset and severity of hikikomori.

None Declared

Seasonal affective disorder (SAD) is a type of depression that comes and goes in a seasonal pattern. Symptoms of SAD can include: a persistent low mood, a loss of pleasure or interest in normal everyday activities, irritability, feelings of despair, guilt and worthlessness, feeling lethargic (lacking in energy) and sleepy during the day, sleeping for longer than normal and finding it hard to get up in the morning, craving carbohydrates and gaining weight, difficulty concentrating.

The purpose of this study was to evaluate the response to different therapeutic interventions of seasonal depression

Α biographical review was performed using the PubMED platform. All relevant articles were found using the keywords: seasonal affective disorder, treatment, and winter depression.

The main treatments are: lifestyle measures – including getting as much natural sunlight as possible, exercising regularly and managing your stress levels, light therapy – where a special lamp called a light box is used to simulate exposure to sunlight, talking therapies – such as cognitive behavioral therapy (CBT) or counseling, antidepressant medicine – such as selective serotonin reuptake inhibitors (SSRIs)

Light therapy can be a very effective treatment for SAD, with most seeing an improvement of symptoms within the first week. A powerful lamp that replicates natural light, high-quality light boxes are recommended as they allow patients to spend a shorter time (up to 30 minutes at a time) using them.

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In the past two decades, social media has become the central way for many people, organizations, institutions to communicate and share opinions, ideas, and information. A young individual on average spends 2-3 hours on social media, engaging in 6-7 applications, which has also dramatically increased during/and after the pandemic. So far, there has been increasing evidence that social media influences behavior, including its own use. It has also been related with aggression towards self and others, and especially suicidal behaviour related (positively and negatively) with social media use has received growing academic and public interest. Excessive use of social media or addiction, exposure to negative content, stalking, cyberbullying and cybervictimization are among concepts which have an influence on (self-)aggressive behavior. Research has shown that adolescents are more vulnerable to cybervictimization than adults, and female adolescents, who spend more time on social media than males, are even more vulnerable, resulting in depressive and in some cases, suicidal ideation. Individuals in marginalized groups might also be more prone to be affected by excluding discourse or discriminatory posts. On the other hand, social media could serve as a coping mechanism given the possibilities for instant support from online networks, availability of psychoeducational resources and mental health related scientific content. Few meta-analyses in the field indicate the need to systematize sampling and data collection; while each pointing to the heterogeneity of the impact of social media. In this talk, the correlates of social media will be reviewed, and possible mental health-promoting approaches will be discussed.

None Declared

Dr. Pereira-Sanchez, Founder and Executive Director of the World Network of Psychiatric Trainees (WNPT) and responsible for the WNPT Human Rights Curriculum Initiative, will present an overview of the same, which aims at understanding the current state of human rights education for psychiatric trainees across the world and at partnering with relevant organizations to develop international standards on the topic. The talk will highlight pilot results and achievments of the initiative and invite feedback, discussion, and further collaboration.

None Declared

The First Episode Psychosis (FEP) Inpatient Unit is specialized in early assessment/intervention in patients with Psychotic Disorders. Duration of Untreated Psychosis/DUP has a key role in the prognosis of those patients. Longer DUP is associated with poorer treatment response and greater risk of relapse. Some studies also suggest an association between DUP and the severity of negative symptoms, but further research is needed.

The objectives of this study were to analyze the relationship between DUP and psychotic symptoms, duration of admission, medication, and quality of life, after inpatient intervention.

This is a retrospective study of a cohort (N=25) admitted to the unit. Sociodemographic and clinical variables (number of days of hospitalization, DUP, and Defined Daily Dose/DDD of antipsychotics) were evaluated. Psychometric instruments (PANSS/Positive and Negative Syndrome Scale and WHOQOL-BREF/World Health Organization Quality Of Life) were applied at admission and at discharge. We used a Spearman correlation test to measure the degree of association between the variables.

Longer DUP correlated with more days of hospitalization, higher negative PANSS scores, and poorer social relationships domain of the WHOQOL at admission (p<0.05). At discharge, DUP presented positive and significant correlations with all subscales of the PANSS (positive, negative, and general; p<0.05) and DDD (p<0.01).

Our results are in line with the current literature on DUP, showing it leads to a worse prognosis, with a more severe clinical course, with the need for extended hospitalizations, a worsening of social relationships, and a higher dosage of medication.

Thus, DUP may be a potentially modifiable prognostic factor. It is possible that FEP patients with negative symptoms dominance may have a more insidious onset and, therefore, the search for treatment may be delayed. Conversely, if there is a mechanism by which DUP influences the symptom profile, its knowledge may lead to a better understanding of psychosis and improved treatment options.

Importantly, DUP showed stronger correlations with the severity of the clinical picture at discharge than at admission, suggesting that longer untreated psychosis may also predict poorer treatment response.

None Declared

Psychotic experiences (PE) are strongly associated with non-suicidal self-harm (NSA). NSA are present throughout life, but are more frequent during adolescence and young adulthood. Early psychotic episodes (PEP) are a particularly vulnerable group compared to later phases of psychosis psychosis.

Analyze risk factors for suicide attempts and NSA, in order to improve early detection and prevention of suicides in adolescents and young adults with PD

Review in the literature of the different risk factors associated with parasuicidal behaviors in early psychosis

• • Presence of positive psychotic symptoms: auditory hallucinations, Delusional ideation.

• • Social isolation

• • Longer duration of untreated psychosis.

• • Comorbid symptoms: irritability, depression, anxiety, psychotic distress, insomnia.

• • Traumatic events in childhood

• • Difficulty in regulating emotional, impulsivity and sensitivity to reward.

• • Consumption of substances.

• • Psychosocial stress.

We consider essential the inclusion of early intervention programs aimed at the prevention of suicide and NSA, evaluating all risk factors for suicide and NSA among individuals with a PEP and high-risk mental states.

Initial assessment and ongoing assessments of suicide risk and parasuicidal behaviors, positive psychotic symptoms, depression, and the other related risk factors mentioned are required. Integrating trauma management into PEP care is critical.

Bibliography:

1.- Honings S, et al. Psychotic experiences and risk of self-injurious behaviour in the general population: a systematic review and meta-analysis. Psychol Med. 2016;46(02):237–51. doi: 10.1017/S0033291715001841

2.- Honings S, et al. Psychotic experiences and incident suicidal ideation and behaviour: Disentangling the longitudinal associations from connected psychopathology. Psychiatry Res. 2016;245:267–75. doi: 10.1016/j.psychres.2016.08.002

3.- Nishida A, et al. Risk for suicidal problems in poor-help-seeking adolescents with psychotic-like experiences: Findings from a cross-sectional survey of 16,131 adolescents. Schizphr Res. 2014;159(2–3):257–62. doi: 10.1016/j.schres.2014.09.030 39.

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Shared decision making (SDM) is a health communication approach focusing on patient-clinician interactions around treatment decisions, with the goals of improving clinical and functional outcomes and providing personalized care. Moreover, decision making may need to be negotiated between, and communicated to, multiple health and social care practitioners, as well as patients and their social networks (SNs). The skills for sharing and discussing personal information with patients, and their SNs, can be hard to embed in mental health services. Compared to physical health, SDM in mental health is characterized by inconsistent definitions, models, and measurement, and evidence for the effectiveness of SDM interventions is inconclusive. Therefore, there is a need to define what is considered an effective SDM approach in mental healthcare, and to determine the core elements and steps required for its successful implementation in mental health populations.

To better understand the concept and role of patients’ social networks in treatment decision-making in mental health.

A two-phase process (compliant with the International Patient Decision Aid Standards) will be used to develop the first polyadic SDM measure of patient experience to support a wide range of models of mental health care. The new measure of patient experience will focus for the first time on the patient’s perception of individual qualities/behaviour of a patient, clinician, caregiver, and their interaction. Phase I of this thesis involved reviewing the existing SDM interventions and SN interventions in mental health, as well as reviewing the existing instruments used to measure SDM in mental health research and practice. Phase II will involve developing and revising the new measure of SDM using stakeholder feedback in an iterative process. Stakeholders will include patients, their caregivers, and clinicians recruited from community mental health services in England.

To define SDM and the most relevant aspects of it, data from the literature review and exploratory focus groups will be evaluated together. A pool of draft questions will be generated, covering all aspects of the identified themes. These questions will be further refined following discussions with people with lived experience of mental illness (i.e., peers) and academics who have the relevant expertise in SDM and psychometric measure development. This will establish content validity and ensure wording clarity, to be accessible for all English language requirements.

The new SDM measure will ensure effective evaluation of SDM experiences of people with mental illness. It will be an important step forward in advancing the study and application of SDM in mental health care. It will lay the foundation for further research into the needs of patients and their SNs regarding SDM in mental healthcare.

None Declared

Primary insomnia is frequently present in the general population, with epidemiologic research reporting prevalence values from 10% to as high as 60%. Chronic insomnia is associated with a significant impact on professional, academic, and daily life functionality, and it also may be responsible for decreasing the quality of life. Multiple generations of drugs for insomnia have been launched in clinical use in the last decades, but each class of pharmacological agents has its shortcomings (i.e., low efficacy, risk of addiction, diurnal sedation, risk of falls and fractures, etc.). Initially, research on orexin receptor antagonists has been considered with enthusiasm, due to these agents’ low risk of adverse events and good safety profile in the medium and long term.

To assess the evidence supporting the efficiency and safety of orexin receptor antagonists in the treatment of insomnia.

A literature review was performed through the main electronic databases (PubMed, Cochrane, Clarivate/Web Of Science, and EMBASE) using the search paradigm “primary insomnia” AND “orexin receptor modulators”. All papers published between January 2000 and September 2022 were included.

Suvorexant is a dual antagonist of orexin 1 and 2 receptors (DORA), FDA-approved for the treatment of insomnia, both for difficulties in falling and staying asleep. Daridorexant is another DORA, approved by FDA and EMA for the same indications as suvorexant, but EMA considers „additional monitoring” necessary for this drug. Lemborexant is a DORA approved for use in US and Japan, while vornorexant, which is included in the same class, is under development for the treatment of insomnia and sleep apnea (in phase 2 and 1 clinical trials, respectively). Almorexant is a DORA that was discontinued from clinical research due to hepatic safety concerns. Seltorexant is an orexin 2 receptor antagonist (SORA2) explored in phase II trials for the treatment of insomnia. Somnolence and fatigue are the most frequently reported adverse events of DORAs, but sleepwalking and sleep driving, sleep paralysis, or hypnopompic and hypnagogic hallucinations have been described in clinical studies. Seltorexant was associated with somnolence, headache, and nausea.

Dual antagonism of orexin 1 and 2 receptors is a mechanism that produced three currently available drugs for insomnia, and other clinical applications of these agents are still under investigation. At least one other agent from this class is under investigation, therefore the potential clinical utility of DORAs is far from being exhausted. Also, the selective orexin 2 receptor antagonism could be a promising mechanism of action for the treatment of insomnia.

None Declared

Borderline personality disorder (BPD), also known as emotionally unstable personality disorder is a severe disorder of emotional regulation. In people with BPD, mood swings are extreme, relationships are uncertain, and emotions are difficult to control, suicide and self-destructive behaviors are extremely common. medical treatment can certainly reduce the symptoms and suffering of people with BPD, but it is still not enough. The treatment is mainly based on psychotherapy especially Dialectical behavior therapy (DBT) focuses on the concept of mindfulness, or paying attention to the present emotion.

To assess the current level of evidence for mindfulness in BPD.

a systematic review was performed using the database PubMed / Medline, using the following keywords: “MCBT”; “DBT”; “Mindfulness Therapy”;” BPD”; “Borderline personality”.

Research shows that the mindfulness therapy approach teaches skills for controlling intense emotions and reducing self-destructive behaviors. Decentering appears to play a crucial role in the treatment as a primary mechanism of action in this therapy.

results suggest that the Mindfulness therapy is a main component for BPD treatment.

None Declared

There are currently no diagnostic or treatment-guiding biomarkers for major depressive disorder (MDD). Microribonucleic acids (miRNA) may facilitate understanding the reorganisation of gene expression networks in MDD. Identifying miRNA and target mRNA pathways that contribute to MDD may open new therapeutic avenues, such as inhibiting endogenous miRNA or administering exogenous miRNA.

This study investigates how miRNAs can clarify the molecular mechanisms of MDD by comparing the miRNA levels in the blood serum of patients with MDD and healthy individuals. The study also investigates the discriminative ability of miRNAs to distinguish between depressed patients and healthy controls.

Sixty depressed patients were matched with 60 healthy controls based on age, gender, ethnicity, and years of education. The severity of depression was measured using the Hamilton Depression Rating Scale, and venous blood was collected for miRNA profiling. Using the QIAGEN Ingenuity Pathway Analysis, networks were constructed to identify the biological pathways associated with MDD influenced by the differentially expressed miRNAs. Analyses of the receiver operating characteristic (ROC) were performed to examine the capacity of miRNAs to distinguish between depressed and healthy individuals.

Six miRNAs (miR-542-3p, miR-181b-3p, miR190a-5p, miR-33a-3p, miR-3690, and miR-6895-3p) were significantly down-regulated in untreated depressed patients compared to healthy controls. miR-542-3p has experimentally validated mRNA targets predicted to be associated with MDD. ROC analyses determined that a panel containing miR-542-3p, miR181b-3p, and miR-3690 distinguished between depressed and healthy individuals with an area under the curve value of 0.67.

Specific miRNAs, including miR-542-3p, miR181b-3p, and miR-3690, may be biomarkers with targets implicated in the pathophysiology of depression. They could also be used to distinguish accurately between depressed and healthy individuals.

None Declared

The sudden and large-scale Russian invasion of Ukraine has caused significant stress not only in Ukrainians but also in citizens of countries which have received the largest numbers of refugees.

The aim of the current study was to identify stress, resilience, and self-efficacy levels, as well as to examine the relationships between these variables, in a sample of women from Ukraine, Poland, Slovakia, and Romania during the third month of Russian aggression on Ukraine.

The study involved measuring a sample of Ukrainian (N = 82), Polish (N = 102), Slovak (N = 79), and Romanian (N = 42) women using the Perception of Stress Questionnaire, the Brief Resilience Scale, and the Generalized Self-Efficacy Scale in May 2022.

The results showed that during the third month of Russian aggression on Ukraine, stress levels and its components (emotional tension, external stress, and intrapsychic stress) were the highest among Ukrainian women and the lowest among Polish women. The sense of self-efficacy was the lowest among Ukrainian women and highest among Polish women, while resilience was the lowest among Ukrainian women and the highest among Slovak women.

Women from Ukraine reported being in the worst mental state compared to the rest of the sample. Moreover, a path analysis of the measured variables points to a multifaceted relationship between stress, resilience, and self-efficacy among women from Ukraine, Poland, Slovakia, and Romania during the third month of the Russian invasion.

None Declared

Every year at least one million people die by suicide, with major depressive disorder (MDD) being one of the major causes of suicide deaths. Current suicide risk assessments rely on subjective information, are time consuming, low predictive, and poorly reliable. Thus, finding objective biomarkers of suicidality is crucial to move clinical practice towards a precision psychiatry framework, enhancing suicide risk detection and prevention for MDD.

The present study aimed at applying machine learning (ML) algorithms on both grey matter and white-matter voxel-wise data to discriminate MDD suicide attempters (SA) from non-attempters (nSA).

91 currently depressed MDD patients (24 SA, 67 nSA) underwent a structural MRI session. T1-weighted images and diffusion tensor imaging scans were respectively pre-processed using Computational Atlas Toolbox 12 (CAT12) and spatial tract-based statistics (TBSS) on FSL, to obtain both voxel-based morphometry (VBM) and fractional anisotropy (FA) measures. Three classification models were built, entering whole-brain VBM and FA maps alone into a Support Vector Machine (SVM) and combining both modalities into a Multiple Kernel Learning (MKL) algorithm. All models were trained through a 5-fold nested cross-validation with subsampling to calculate reliable estimates of balanced accuracy, specificity, sensitivity, and area under the receiver operator curve (AUC).

Models’ performances are summarized in Table 1.Table 1.

Models’ performances.

Overall, although overcoming the random classification accuracy (i.e., 50%), performances of all models classifying SA and nSA MDD patients were moderate, possibly due to the imbalanced numerosity of classes, with SVM on FA reaching the highest accuracy. Thus, future studies may enlarge the sample and add different features (e.g., functional neuroimaging data) to develop an objective and reliable predictive model to assess and hence prevent suicide risk among MDD patients.

None Declared

Ganser syndrome is described as a dissociative disorder not otherwise specified in the DSM-IV, and is not currently listed in the DSM-V.

It is a rare condition, with transient Vorbeireden as the central symptom. This means the patient responds to questions with an incorrect answer, but by the nature of the answer reveals an understanding of the question posed.

This disorder was first described by the German psychiatrist Sigbert Ganser in 1898.

Analyze case reports published in the available literature and intelligibly characterize their clinical presentation and dissect the etiopathogenesis of the disease.

Data was obtained through an internet-based literature search, using the databases PubMed, Cochrane Library and NCBI. The World Health Organization was also utilized. Seven articles from the last four years were included.

The core clinical features of this syndrome are approximate answers, clouding of consciousness, somatic conversion symptoms and hallucinations. However, they are all not needed for diagnosis.

The basic underlying etiology of Ganser syndrome is still unknown. Debates over the factitious versus psychiatric versus organic origin of the symptomatology are common in the literature.

No reliable epidemiological data can be established.

The condition is a rare, probably dissociative, with transient Vorbeireden as the central symptom.

Although the research interest in dissociative disorders, the etiopathogenetic models remain hypothetical. Detailed imaging, neuropsychological and neurological data are required.

None Declared

The COVID-19 pandemic has disrupted mental healthcare delivery in many countries. The restricted access to psychiatric services and double disasters (pandemic and earthquakes) coincided in Croatia, potentially placing people with severe mental illness (SMI) in a very vulnerable position.

The aim of this study was to examine the changes in substance use in people with SMI in the first and the second COVID-19 wave and co-occurring earthquakes. The secondary aim was to explore whether the type of treatment (community mental health teams (CMHT) vs. treatment as usual) influenced those changes.

This study was nested within the RECOVER-E project (LaRge-scalE implementation of COmmunity based mental health care for people with seVere and Enduring mental ill health in EuRopE, Horizon 2020 research and innovation programme, grant agreement No 779362). The study involved 90 participants with SMI assessed at two time points: in May/June 2020 (during the first COVID-19 wave and after Zagreb earthquake) and in December 2020/January 2021 (during the second COVID-19 wave and after Petrinja earthquake). The changes in the use of psychoactive substances (alcohol, cannabis, other drugs, sedatives) were assessed using self-reported survey.

The increase in tobacco smoking behavior and the use of sedatives was observed in both COVID-19 waves in people with SMI. No increase was reported in cannabis and other drugs use, while less than 5% of participants reported increase in alcohol consumption. Not receiving CMHT service predicted the increase in sedative use.

Ensuring accessible mental health care provided by CMHT is recommended for counteracting the negative effect of external stressors (such as pandemic and co-occurring earthquakes) on the increased substance use among people with SMI.

S. Levaj Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., S. Medved Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., J. Gerlach: None Declared, L. Shields-Zeeman Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., F. Bolinski Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., Z. Bradaš Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., Z. Madžarac Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., I. Rojnić Palavra: None Declared, M. Rojnić Kuzman Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362.

Freelancing can be analyzed through psychological prism of escapism, through the desire not to be involved in the systems of inflexible social ties that are accepted in group (career, family, classical education, etc.)

Freelancers have a non-standard self-attitude and self-description, which indicates their “isolation” from the real social world by these people.

Quantitive (Spyrman’s criteria and corellations) and qualitive analisys ( semi-structured interviews). N = 300, residents of ussia and Austria.

The hypothesis was rejected that freelancers do not have career and personal orientations, in contrast to individuals who are not prone to this type of career choice. The absence of a connection between goal setting and downshifting was revealed based on the analysis of the author’s questionnaire for goal setting.

The hypothesis was empirically confirmed that freelancers have more pronounced indicators such as global self-attitude, self-esteem, self-sympathy, expected attitude from others, self-confidence, self-acceptance in the affective component of the self-concept, in contrast to people choosing the traditional career path.

Freelancers have a less pronounced indicator of self-accusation, in contrast to people committed to careerism.

None Declared

One fairly common side effect of psychopharmaceuticals is sexual dysfunction. They can influence various aspects of sexual function, including lubrication, desire, ejaculation, and orgasmic intensity… This may worsen mental health conditions and make it challenging for patients to adhere to the Treatment. We’ll examine how these drugs affect the area of sexual activity.

To emphasise how different antipsychotics and antidepressants may affect sexual function.

We conducted a narrative review about the available literature on the subject. Articles were selected based on their clinical relevance.

All SSRI antidepressants carry a considerable risk of sexual dysfunction. According to some research, escitalopram and paroxetine may pose the greatest risk among this group. Similar risks of sexual issues exist with SNRIs. Bupropion, on the other hand, has a lot of evidence demonstrating low or no risk. Agomelatine, mirtazapine, and moclobemide also have a minor impact on sexual performance.

Hyperprolactinemia has been specifically linked to sexual impairment in antipsychotic medication, hence antipsychotics that cause hyperprolactinemia such as haloperidol, risperidone, paliperidone, and amisulpride are more likely to induce sexual disturbances. Aripiprazole, quetiapine, and ziprasidone have been demonstrated to be less or not connected to sexual dysfunction.

Although sexual dysfunction is not an unusual side effect of psychiatric medications, it is frequently underdiagnosed. Sexuality needs to be explored by therapists because it may affect patient’s treatment compliance and well-being. It’s critical to understand how each psychotropic drugs can impair sexual function in order to select the best option based on the individual traits of each person.

None Declared