The COVID-19 pandemic has affected the mental health of the global population (Dragioti et al. J Med Virol 2022;94(5):1935-49). The first lockdown brought the hardest and most sudden impact on work, educational, social, and recreational activities. Moreover, the fruition of mental health services was restricted, and non-urgent appointments were delayed or converted into telepsychiatry. Thus, it was reasonable to hypothesize different trends of urgent consultations regarding mental health.

To detect quantitative and qualitative changes in patients presenting to our Emergency Departments (ED) during the early phase of the pandemic compared to the previous year.

We conducted a retrospective, multicenter study in Venezia (historical center, mainland) through systematically reviewing the psychiatric consultations in our ED, during the first 16 weeks since 8-Mar-2020 and the same period of 2019. The protocol was approved by the local Ethics Committee as UPSI-19 (Urgent PSychiatric consultations In COVID-19). The statistical analysis was conducted with the software R; Interval Risk Ratio (IRR) with 95% CI was calculated for absolute frequency, primary diagnosis, leading symptoms, and outcomes of these consultations.

In the early phase of the pandemic, in our ED we assisted to a significant decrease in psychiatric consultations: 372 vs 441, IRR=0.84(0.73-0.96). Data revealed a reduction of referral for suicidal behavior (IRR=0.52(0.33-0.80)) and anxiety symptoms (IRR=0.60(0.42-0.87)). Primary diagnoses of patients were not different between the two periods explored. There was a slight increase in admissions (150 vs 121), and a significant decrease in less severe clinical pictures.

In the timeframe considered, we assisted to a significant decrease in referrals from the ED, possibly related both to fewer non-locals and to less frequent non-severe presentations. Despite the type of patients (for underlying diagnoses) remained unmodified, an interesting reduction of anxiety symptoms and suicidal behavior was noticed. Literature from ED studies during the first wave are consistent with our finding regarding the number of visits; suicide attempts seemed unmodified or decreased elsewhere (Giner et al. Curr Psychiatry Rep 2022;24(1):1-10). Limitations of our study include peculiarities of the Venetian territory, limited sample and time of observation. Future directions encompass the integration with data from the community setting and later developments.

None Declared

Patients with amnestic mild cognitive impairment (aMCI) have a high risk of transition to Alzheimer’s disease. Analysis of potential biomarkers of conversion to dementia in this clinical group is crucial for prognosis and early intervention.

The aim of the pilot study was to compare whole-brain functioning characteristics (fMRI, spontaneous activity and local coherence) in aMCI converters and non-converters to dementia.

Nine aMCI converters to dementia of the Alzheimer’s type (mean age 69.2 ± 8.2; 9 females) and ten aMCI non-converters (mean age 65.9 ± 6.1; 8 females) underwent resting-state fMRI (3T). All patients were followed up for three years. Baseline whole-brain amplitude of low-frequency fluctuations (ALFF) and local coherence (LCOR) were compared between groups (CONN-fMRI toolbox 19.с, https://web.conn-toolbox.org/; p < .001 voxelwise, p(FDR) < .05 clusterwise). Age was included in the analyses as a second-level covariate.

As compared to non-converters, aMCI converters were characterized by higher ALFF and LCOR values in the cluster located in the frontal medial cortex and frontal pole bilaterally.

Frontal medial cortex and frontal pole are involved in a wide range of cognitive functions, including episodic memory and “hot” (motivational) executive control (Rolls. ProgNeurobiol 2022; 217; Friedman, Robbins. Neuropsychopharmacology 2022; 47(1) 72-89). Both increased and decreased LCOR/ALFF values in aMCI converters compared to non-converters were found, although in the other regions (Mondragón et al. Dement Geriatr Cogn Dis Extra 2021; 11(3) 235–249; Khatri, Kwon. Front Aging Neurosci. 2022; 14). It seems reasonable to clarify if the brain functional features revealed in our study are the markers of conversion to dementia in aMCI.

None Declared

Use of lumateperone in reduction of aggression in patients with both autism spectrum disorder and intermittent explosive disorder has not heretofore been described.

Explore the impact of lumateperone treatment for intermittent explosive disorder in autism spectrum disorder.

Case A: An illiterate non-verbal 18-year-old male, presented with history of behavior problems, developmental and intellectual delays. He attended special education programs at school where he had difficulty interacting with peers and teachers. For three weeks prior to presentation, he has displayed more anger and aggression, biting his hands, pounding on the walls and furniture, and screaming.

Case B: This 18-year-old male, presented with a history of hypsarrhythmia, Lennox-Gastaut syndrome, severe developmental delay, deficit in socializing with lack of interaction with others and autism, presented with aggression, agitation, and hostility, banging on walls and furniture and throwing objects. Coincident with this was an increase in frequency of myoclonic seizures occurring up to twenty-five seizures per day followed by a postictal period of shouting and screaming.

Case A: Psychiatric examination: Nonverbal, intermittently grunting and screaming, eyes darting, not responding to verbal commands. Posturing of arms in the air, in a hostile stance. Ten days post starting nightly lumateperone 42 mg, patient was no longer banging furniture nor biting. He remained non-verbal but without screaming and hostile behavior.

Case B: Psychiatric examination: Non-verbal screaming, throwing furniture, hitting walls and uncooperative to verbal commands. One month post starting lumateperone 42 mg nightly, while the seizures persisted, patient’s violent attacks were not severe. Two months later, the aggression was much less severe, that he could attend school. Behavioral problems with aggression would recur an hour before the next evening’s lumateperone dose.

Lumateperone modulates a variety of neurotransmitters including glutamate, functions as a presynaptic partial dopamine agonist and postsynaptic dopamine antagonist, and enhances N-methyl-d-aspartate, an inhibitor of serotonin reuptake (Reddy, 2020), input, on any of these, may be its mechanism of action (Vyas, 2020). Perchance, its action as a 5HT-2A receptor antagonist may be its method of reducing aggression, as has been posited for its anti aggression effect in schizophrenia (Vyas, 2020). Lumateperone impacts on neurotransmitters, including substance P, which modulate aggression (Gretchen, 2020). Alternativity ASD correlated with dysfunction of Area VIIIA of the right posterior cerebellum and its connection with the left frontal cortex (Heemkerk, 2021). Lumateperone may act to stabilize these areas and thus inhibit aggression (Heemkerk, 2021). In those with aggression associated with ASD and IED, a trial of lumateperone may be worthwhile.

None Declared

Alcohol Use Disorder (AUD) is one of the most significant public health problems in Europe, being highly associated with several medical and psychiatric comorbidities. Sleep disturbances are in this interface and may include insomnia, alterations of sleep architecture and circadian rhythm abnormalities, breathing-related sleep disorders, and sleep-related movement disorders. Also, considering the three stages of the addiction cycle (binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation) and since these domains are reflected in key regions of the brain, it is possible to map these nearly ubiquitous sleep disturbances.

This review aims to summarize the current literature related to the association between sleep disorders and AUD, with a focus on its clinical aspects and neurobiology.

Non-systematic research was made recurring to the PubMed database, with the keywords “alcohol use disorder”, “sleep”, “sleep disorder”. The most relevant articles were selected, focusing on articles published in the last decade.

In patients with AUD, the prevalence of insomnia ranges from 36-91%. A possible mechanism underlies in a mismatch involving maintained activity in wake-promoting structures during non-rapid eye movement sleep (NREM) and a blunted homeostatic drive. On the other hand, alcohol consumption also affects the normal sleep-wake cycle, due to a disruption in the underlying circadian rhythms, a mechanism compassed by the suprachiasmatic nucleus and by photic and non-photic cues. Considering this, it seems highly likely that insomnia and circadian abnormalities may coexist in some individuals. Moreover, AUD is implicated in initiation or worsening of breathing-related events in sleep, especially when having a history of snoring or sleep apnoea syndrome and in period limb movement disorder.

Simultaneously, sleep disorders in AUD can be incorporated into the three-stage addiction cycle. In the binge/intoxication stage, excessive alcohol intake leads to a faster sleep onset but poor sleep quality, explained by the effects on GABAergic systems. During the withdrawal/negative affect stage, there is a decrease in slow-wave sleep and limited rapid eye movement (REM) sleep recovery, which can be explained by the alcohol-positive allosteric modulation of GABAA receptor and other mechanisms. Lastly, during the preoccupation/anticipation stage, the glutamatergic system dysregulation contributes to persistent sleep disturbances, including insomnia, decrease in slow-wave sleep, and an increase in REM sleep.

The knowledge of sleep disturbances associated with AUD has grown and has suggested a bidirectional process that appears to play an essential role in the addiction process. Further studies investigating this association are warranted.

None Declared

Behavioral addictions, also known as non-substance or non-drug addictions, refer to a range of compulsive behaviors that individuals engage in despite the negative consequences that result from these behaviors. Research on behavioral addiction in women has shown that women are at a higher risk for certain types of behavioral addictions, such as shopping addiction and internet addiction, compared to men. Studies suggest that women may be more susceptible to these types of addictions because of social and cultural factors, such as societal expectations of women to be nurturing and caregiving, which may lead them to use these behaviors as a form of coping mechanism. There is also evidence that women are more likely to experience shame and guilt as a result of their addiction, which can make it more difficult for them to seek help and support. Gambling among women has traditionally been less common than among men however, this trend is changing. Survey have shown that the number of women who gamble is on the rise, and that they are becoming increasingly diverse in terms of age, income, social background. Research studies have found that the rate of problem gambling among women is lower than men, but that women tend to develop gambling problems more quickly than men. This is thought to be due to a number of factors, including women’s greater vulnerability to stress and depression, as well as the fact that women are more likely to have a history of trauma or abuse. Overall, research on behavioral addictions among women is still a relatively new field, and there is a need for more studies to be conducted in order to better understand the unique factors that contribute to the development of these types of addictions in women.

None Declared

Medical students have to do multiple tasks as part of their extensive curriculum in order to achieve the proficiencies expected of them. Being overwhelmed creates a time management problem, substance use and a tendency to procrastinate. Therefore, accumulated tasks may generate distress that could result in poor academic performance.

The aim of this study was to investigate prevalence and factors related to academic procrastination in Tunisian medical students.

It was a cross-sectional, descriptive and analytical study conducted among Tunisian medical students. Data were collected through an anonymous online questionnaire, assessing sociodemographic characteristics, the “Tuckman Procrastination Scale” (TPS) and the “Time Management Subscale of the Learning and Study Strategies Inventory” (LASSI-TM).

A total of 133 participants completed the questionnaire. Their mean age was 26 ± 3,8 years, with a sex-ratio (F/M) of 4,5.

The mean LASSI-TM score was 16.69±4.6. Among students, 65.4 % showed deficit in time management.

The mean TPS score was 42.48±7.11. According to this scale, 87.2% of participants were engaged in academic procrastination. TPS score was significantly higher among psychoactive substances users (p=0.004), in those with psychiatric history (p=0.026) and in students with a rank over than 100 (p=0.029). It was negatively correlated with LASSI-TM score (p<0.001; r=-0.706).

Considering the heavy load of work that the students undergo, it would be prudent to arrange for group trainings and workshops that will cultivate students with strategies and skills for effective time management, so that the tendency to procrastinate will be managed and their academic performance would improve.

None Declared

As a result of Russia’s large-scale military aggression against Ukraine, many civilians were forced to leave their homes. Emotional disorders associated with fear for one’s life and relatives, loss of housing, work, and stable social ties are found in the majority of forcibly displaced persons.

The purpose of our study was to study the characteristics and expressiveness of affective disorders in displaced persons as a result of Russian aggression against Ukraine. Studied affective disorders in 24 forcibly displaced females. Age of the surveyed 30-50 years. Contacted with psychiatrist because the insistence of relatives. Patients were not identified and applied earlier about mental disorders to psychiatrists. To quantify anxiety, we used a scale HAM-A.

Clinico-psychopathological.

Affective disorders in the examined patients can be confidently attributed to adjustment disorders. According to the ICD-10, an adaptation disorder (F43.2) was diagnosed. Most of them were dominated by depressive and anxiety-depressive modalities of affective disorders. According to the HAM-A scale, the level of anxiety was 14±2.7. Most patients showed few irritability and anger, which is probably due to the inability to respond to the cause of their troubles and problems. However, some patients (6 people) expressed gloomy irritability, anger (clinical sighnificant) a feeling of hostility towards others. It is necessary to note the undulation of these manifestations, often aggravated under the influence of external factors.At the same time, the immediate environment often suffered, on which all the troubles fell. The behavior of such patients became maladaptive, significantly disrupting communication.

Therapeutic impact on internally displaced persons should be aimed not only at overcoming anxiety and depressive syndrome, but also irritability and anger. This should be taken into account when planning psychotherapeutic programs, it is possible to prescribe normotimics.

None Declared

There are various ways people cope with life events. One can expect generalized positive or negative outcomes across various life domains, called dispositional optimism. This can be explained by attribution theory: how people explain past events, their causations, and outcomes. Understanding attribution styles is important to help people reframe current circumstances and improve mental wellbeing. Our hypothesis is that people of different religious groups may exhibit various levels of optimism and pessimism based on their values, teachings, and practices. Previous research has found that people of Christian faith, or those with a religious faith in general, look to their religion as a way of coping during life adversities. Certain religious practices such as prayers and Church gatherings have been found to improve mental health through increasing dispositional optimism. While the relationship between religiosity and mental health has been previously examined in different religious populations, there are few studies that focused on comparing this relationship across religions.

The objective of this scoping review is to understand the link between religiosity and mental health, focusing primarily on how people of the Christian religion demonstrate dispositional optimism or pessimism when coping with adverse life events, compared to other religious groups or atheists.

This scoping review included original peer reviewed study articles that studied mental health in terms of dispositional optimism or pessimism in people of Christian religion compared to other religious groups. This review used online databases, Ovid MEDLINE and PsycInfo, and used extraction tables to analyze the results of past research.

The results of this scoping review revealed that people of Christian religion, especially those high in religiosity, use their religion as a method of coping. This population also showed higher dispositional optimism compared to atheists or those that believe in other religions. However, when compared to other religions such as Buddhism and Muslim, Christian populations showed lower dispositional optimism.

It is evident that religious involvement is linked to aspects of mental health, but comparing the effects of different religions is still a topic of exploration that can be investigated further to allow deeper understanding of their similarities and differences, as well as the mechanisms by which religion can affect mental health. In this review, a gap in the body of knowledge regarding the relationship between religion and pessimism was revealed. Future research directions could include examining whether dispositional pessimism varies across religious groups, as it does not necessarily have a perfectly inverse relationship with optimism.

None Declared

Attention Deficit Hyperactivity Disorder (ADHD) and Dyslexia are among the most frequent developmental disorders in school-aged students, and both often cause an impact on scholar reading performance. Therefore, it is fundamental to trace the differential profile in reading performance in such diagnoses. Competent reading occurs through the interaction of several cognitive processes, such as decoding, fluency, and oral and reading comprehension, that should be assessed in an evaluation.

The study aimed to characterize the performance of students with ADHD and dyslexia.

We assessed 25 adolescents, aged between 11 and 14 years old, from 6th to 9th year of middle school of public and private schools in Brazil, divided into two groups: the group with ADHD (16 students) and the group with dyslexia (9 students). The diagnoses were established by a multidisciplinary center and there were no comorbidities for any case. The instruments used were: Comprehension Test of Words and Pseudowords II (TCLPP II) to assess decoding (indicate if the word is correct or incorrect); Reading Fluency Test (TFL) to assess fluency in single words and in text reading; Cloze Reading Comprehension Test (TCCL) to measure reading comprehension; and the WISC vocabulary subtest to assess auditory comprehension.

Non-parametric analyzes revealed statistically significant differences in measures of textual comprehension, especially in the tasks that involved decoding and fluency processes, evidencing superior performance of the group with ADHD in these tests. Participants with dyslexia had a significantly higher performance in relation to the number of word omissions, that is, they had lower omission errors. There was no significant difference between groups in auditory comprehension.

A differential profile was found in reading performance, consistent with the cognitive deficits classically pointed out in the literature for each diagnosis: phonological deficits in dyslexia, with problems in decoding and fluency; and attentional deficits in ADHD, with omission errors. In the comprehension measures, dyslexic group had significant lower performance than ADHD in the Cloze Reading Comprehension Test, but there was no difference in the Vocabulary subtest-WISC. An explanatory hypothesis is that, to understand the text, it is necessary to recognize the words previously, whereas, in the WISC, it is not necessary to read, since the questions are oral. These results corroborate the hypothesis that deficits in reading comprehension in dyslexia are more related to difficulties in word recognition and fluency skills than in general listening comprehension.

Financial support: CAPES Proex [grant 0426/2021, no. 23038.006837/2021-73]; CNPq [grant 310845/2021-1]

None Declared

Early life stress (ELS) associates with unfavourable outcome in Major depressive disorder (MDD) and treatment-resistant depression (TRD). Trauma-focused psychotherapy benefits TRD patients exposed to ELS. Epigenetic processes are altered in stress-related disorders, but few studies show epigenetic signatures associated with trauma.

We performed an epigenome-wide association study (EWAS) to explore the relation between methylation changes in TRD patients characterized for recent and ELS and trauma-focused psychotherapy outcomes.

Thirty TRD patients participated. They underwent psychotherapy, from which 12 cognitive behavioural therapy and 18 Eye Movement Desensitization and Reprocessing (EMDR). We used validated interviews and questionnaires for symptom evaluation and stress exposure. Patients were evaluated at T0 (baseline), T8 (end of psychotherapy), T12 (follow-up) and T26. Methylation was profiled with Illumina Infinium EPIC array for T0, T8 and T12. Methylation levels were quantified after quality control and normalization using ChAMP R package. We tested the association between B-values for each CpG site (each probe set) and each phenotype/condition using a linear model approach (with paired values) as implemented in the Limma R package. P-values were adjusted using Benjamini & Hochberg method. Probe sets were considered significant with an adjusted p-value q ≤ 0.05. CpG site annotation was performed using IlluminaHumanMethylationEPICanno.ilm10b2.hg19 R package (hg19 genome reference).

Association analyses between baseline methylation levels and emotional abuse resulted in two significant probe sets annotated in SLCO4A1 (p=1,72E-08; q=0,008), involved in sodium independent transmembrane substrate transport, and GPNMB (p=1,53E-07; q=0,022), involved in cell differentiation. Associations between baseline methylation levels and physical abuse resulted in one significant probe set annotated in DDIT4L (p=4,77E-08; q=0,035), involved in cell growth.

In longitudinal analyses, association between T0-T8 methylation levels and response at T8 resulted in two significant probe sets annotated in PLEKHB1 (p=3,54E-08; q=0,013), involved in cell differentiation, and NUDT4P2 (p=1,34E-07; q=0,032). Longitudinal T12-T0 EWAS analyses in patients undergoing EMDR resulted in 44 significant probe sets annotated in genes, highlighting MAD1L1 (p=6,28E-07; q=0,035), involved in cell division, and TNFAIP3 (p=3,00E-06; q=0,045), which regulates immunity.

We identified epigenetic signatures of ELS in TRD patients, suggesting that ELS may modulate the intensity of epigenetic alterations. Longitudinal methylation analyses along psychotherapy showed significant genes in relation to response, especially for patients undergoing EMDR. Some genes are associated with post-traumatic stress disorder (MAD1L1) and anxiety disorders and MDD (TNFAIP3).

None Declared

Pregnancy is an important life event, involving body and mind transformation as well as brain reorganization. ADHD dimension is an additional aggravating factor, albeit poorly studied in the literature, in patients with mental health disorders in the peripartum.

The purpose of this study was to evaluate the correlation among ADHD dimension, trauma in childhood, and anxiety-depressive symptomatology to assess whether the ADHD dimension may affect the quality of life of peripartum patients, and to identify vulnerability factors and self-harm risk.

The sample included 74 women aged 21-46 years, recruited from Sant’Andrea Hospital in Rome between 2015 and 2019. All recruited women were administered the following scales: Adult ADHD Self Report Scale (ASRS), Edinburgh Postnatal Depression Scale (EPDS); Childhood Trauma Questionnaire (CTQ), Perceived Stress Scale (PSS); Minnesota Multiphasic Personality Inventory (MMPI). Statistical analysis was performed by Pearson’s correlation with SPSS software to verify the presence of linear relationships (p<0.05) among theADHD dimension, assessed by the ASRS scale, and the other psychopathological dimensions.

The sample was divided into two groups depending on the results of ASRS: 26 patients were positive for at least one of the ASRS scale items, while 48 patients were negative. The groups did not statistically differ in socio-demographic variables examined. The medium score at EPDS was 15,11 (± 8,43). It was found that the severity of ADHD dimension directly correlated with the duration of mental symptoms in peripartum (r=0.324;p=0.013), with the total CTQ scale score (r=0.342; p=0.004), with emotional abuse detected by CTQ (r=0.415; p<0.001), with emotional neglect detected by CTQ (r=0.291; p=0.014) and with perceived stress detected by PSS scale (r=0.456; p<0.001). Furthermore, we identified a correlation between self-injurious ideation and ADHD symptomatology (r=0.269; p =0.049) evaluating the item 10 of EPDS.

The severity of ADHD traits directly correlates with the symptomatology and duration of mental disorder in peripartum. Specifically, ADHD patients who develop anxious-depressive symptoms are more likely to have experienced emotional abuse and emotional neglect in childhood.

None Declared

The peculiar requests of postgraduate teaching could affect the students’ lives, predisposing them to mental disorders and suicide risk (e.g. Abreu et al., 2021). The Interpersonal Psychological Theory of Suicide (IPTS) (Joiner, 2005) is a model that has proved useful in explaining this risk.

We analyzed risk factors associated with current suicidal ideation (SI) and history of suicidal planning and/or suicide attempt (SP/SA) in a sample of 97 Italian residents in psychological (n= 17, 17.5%) and medical and health care area (n=80, 82.5%) (mean age 29.18±3.25 SD).

Socio-demographic, psychological (i.e. State-Trait Anxiety Inventory, Beck Depression Inventory – II; BDI-II, Rosenberg Self-Esteem Scale, Reasons For Living Inventory; RFL, Psychache Scale, Mental pain questionnaire; MPQ, Visual Analogue Scale - VAS - on mental pain, Acquired Capability for Suicide Scale-Fearlessness About Death) psychosocial (i.e. Interpersonal Needs Questionnaire; INQ, UCLA Loneliness Scale Version 3, Multidimensional Scale of Perceived Social Support; MSPSS) and somatic pain features (i.e. VAS, Pain Vigilance and Awareness Questionnaire; Self-Awareness Questionnaire; SAQ) were collected through an online questionnaire. We compared residents with SI vs No SI and residents with SP/SA vs No SP/SA and the emerged significant variables, have been inserted in logistic regression models with stepwise method, backward elimination.

The presence of depression (BDI-II), low reasons for living (RFL), psychological pain (Psychache Scale and MPQ), interoceptive awareness (SAQ), Thwarted Belongingness (TB, INQ subscale), loneliness (UCLA) and low perceived social support (MSPSS) were associated with both current SI and history of SP/SA. Concerning regression models, TB (INQ) increased the likelihood of SI while Survival and Coping Beliefs (RFL subscale) reduced it. The model explained 49% of the variance of SI by correctly predicting 88.7% of SI cases. Perceived social support (MSPSS)reduced the likelihood of current SP/SA levels while interoceptive awareness (SAQ) increased it. This model explained 40% of the variance of SP/SA by correctly predicting 82.5% of suicide risk cases.

We have identified risk and protective factors for suicide, consistent with the IPTS, which can orient the prevention, evaluation and clinical treatment of residents.

None Declared

Recent studies proved that academic procrastination is a very common pervasive problem that has a negative impact on general well-being, causing distress, anxiety, remorse and unhappiness. It could also result in poor academic performance and negatively affect students’ satisfaction with themselves and their academic life.

The aim of this study was to explore the influence of self-esteem and self-efficacy on academic procrastination among Tunisian medical students.

We conducted a cross-sectional, descriptive and analytical study among medical students from Tunisia. Data were collected through an anonymous online questionnaire, exploring sociodemographic characteristics, the “Tuckman Procrastination Scale” (TPS), the “Rosenberg’s self-esteem scale” (RSES) and the “General Self-Efficacy Short Scale” (GSESS).

A total of 133 participants completed the questionnaire. Their mean age was 26 ± 3,8 years, with a sex-ratio (F/M) of 4,5. Among them 87.2% were engaged in academic procrastination, 57,1% showed low self-esteem and 55,6% perceived themselves as non-effective.

GSESS score were higher among males (p=0.019)

TPS score was negatively correlated with RSES score (p<0.001; r=-0.372). RSES score was positively correlated with GSESS score (p<0.001; r=0.44).

No relationship was proved between TPS and GSESS.

Even though procrastination is most of the time considered as a maladaptive and detrimental behavior with a psychological cost, some authors consider it acting in a beneficial way, as it reflects self-reliance, autonomy and self-confidence knowing that they are able to finish their task in time. As a result, procrastination is linked to feelings of superiority and it should be recoined as “purposeful delay”.

None Declared

In the past few years, there has been a considerable amount of evidence that cannabis use can cause structural and functional brain abnormalities.Structural imaging studies of cannabis users have revealed reduced prefrontal cortex volumes and white matter damage that may be involved with impulsivity.Objectives: To Determine the level of dependence on cannabis among cannabis users consulting the detoxification center of Sfax, Tunisia To assess in addition the impact of cannabis on impulsivity and motor control.

This is a cross-sectional, descriptive and analytical study that was conducted over a period of 13 months between September 15, 2020 and October 1, 2021 among cannabis users consulting the detoxification center of Sfax, Tunisia.A short form of the Barratt Impulsiveness Scale (the BIS-15) and a Cannabis Abuse Screening Test (CAST) were used to assess impulsivity and to determine cannabis abuse.Results: Thirty Eight cannabis users agreed to participate in this study. The distribution of CAST scores showed that 36 users (94.7%) had problematic cannabis use at the time of the study. The mean BIS 15 score was 38.2. In our sample, The level of impulsivity was highest in people with a high level of cannabis dependence. A higher level of impulsivity was found in younger subjects. However, a greater level of impulsivity was found in subjects with a lower socio-economic level. Concerning employment status, unemployment was significantly correlated with a higher level of impulsivity.

Impulsivity is often associated with a variety of problematic behaviors such as aggressive behavior, smoking, drug abuse, pathological gambling or compulsive buying.

A higher frequency of cannabis use and earlier age of onset use have been shown to be associated with the highest rates of impulsivity.

Therefore, cannabis addiction represents a real public health problem, both because of the serious complications and heavy repercussions that it causes.

None Declared

Worldwide, annually more than 800,000 suicides occur. In the Netherlands, suicide rates rose from 8.6 per 100,000 in 2007 to 11.4 per 100,000 in 2016. Rates in the province of Noord-Brabant were consistently higher than the national average. Noord-Brabant is a province in the south of the Netherlands covering an area of over 4700 km2 with 2.5 million inhabitants. Although Noord-Brabant has five specialised mental healthcare institutions (SMHIs), and 90% of suicides are deemed related to mental disorders, 60% of those who died by suicide did not receive mental health treatment. However, with good access to treatment, suicide could be preventable.

To evaluate whether the systems intervention compared to the regular care approach led to a reduction in suicides in Noord-Brabant. We aimed to attain a reduction in suicides of at least 20%.

Co-design and development of a digital monitoring system and decision aid. Stepwise implementation per subregion of the systems intervention by the five specialized mental healthcare institutions (SMHIs) and their chain partners. Pre-post analysis for the whole province (Exact Rate Ratio Test, Poisson count).

The SUPREMOCOL systems intervention consisted of four pillars, which were all supported by a digital decision aid and monitoring system. This was provided via a desktop computer with a secured login. The data were kept on a secured encrypted server. The number of professionals accessing the system was limited to two per SMHI or other chain partner. They could only see patients in their subregion, not in the whole of the province. The pillars of our systems intervention for suicide prevention are:

1. Swift identication of people at risk for suicide by triage on the spot after a non-fatal suicide attempt.

2. Provision of swift access to specialised mental health care for those at risk

3. Accommodating transitions in care following a collaborative care approach

4. Prevention of suicidal attempts after discharge or treatment dropout by 12 months telephone follow-up.

Suicide rates dropped 17.8% (p=.013) from baseline (2017) to implementation in 2018 and 2019. This is a significant reduction (p=0.043) compared to the non-significant drop in the rest of the Netherlands. Suicide rates dropped further by 21.5% (p = 0.002) in 2021.

Noord-Brabant also dropped in the relative rank of the number of suicides, from second place in 2015 to third in 2018.

During the SUPREMOCOL systems intervention, over a period of 4 years, there was a sustained and significant reduction of suicides in Noord-Brabant. We attained a reduction of 21,5% in total. Noord-Brabant dropped in the relative rank of the number of suicides, from second place in 2015 to third in 2018. This is a result that warrants further research and implementation into system interventions for suicide prevention with digital support such as SUPREMOCOL.

C. Van Der Feltz-Cornelis Grant / Research support from: The Netherlands Organisation for Health Research and Development, I. Elfeddali: None Declared, M. Metz: None Declared, S. de Jong: None Declared, M. Bakker: None Declared, C. van Nieuwenhuizen: None Declared

During the COVID-19 pandemic, care for the elderly in the community was greatly limited. Accordingly, the demand for alternative community care have increased to cope with changing situations.

In this study, we tried to find out whether the companion robot improved mood state and related problem in depressive or isolated community dwelling elderly

For 186 community dwelling elderly who have received social welfare service due to depression or social isolation, we provided companion robot that could support their daily living. The robot was equipped with special program that could recognize and respond to the participant’s own emotion. It was part of behavioral activation techniques which is one of powerful treatment for depression. The self-report questionnaires were used to measure changes in cognitive function, depression, suicidality, loneliness, resilience and satisfaction of life. Outcomes were measured before using companion robot and after 3 months, and we compared them.

The elderly using companion robot for 3 months showed improved cognitive function (45.7% to 30.1%), depression (p<0.001), suicidality(p<0.001), and loneliness (p=0.033) in the self-report questionnaire. Resilience(p=0.749) and satisfaction of life (p=0.246) were also improved but not reached significance.

Image:

Image 2:

Image 3:

These findings showed that the use of companion robot with emotional recognition coaching program could help improve depression, cognitive function, loneliness and suicidal ideation. In particular, this effect was also useful for those who were diagnosed with depression. Also if we can put more techniques of behavioral activation programs into robot, it could be useful in community care for depressive and isolated elderly.

None Declared

Bladder cancer, which is primarily a non-muscle invasive bladder cancer (NMIBC), is prevalent worldwide and its incidence is increasing. NMIBC shows a high recurrence rate of 50-70%, and in 25% of cases, progresses to muscle-invasive disease (Saginala K et al. Med Sci 2020; 15) (Fernandez-Gomez, J et al. J Urol 2009; 182(5) 2195-2203). Frequent recurrence and consecutive medical interventions in patients with NMIBC lead to psychological problems such as anxiety, fear of recurrence, depression, and stress, resulting in reduced quality of life (Chung et al. Support Care Cancer 2019; 27(10), 3877-3885). It is expected that the increased accessibility and convenience of mobile health (mHealth) will be effective in providing a mobile-based psychological intervention program to promote the mental health of patients with NMIBC.

This study aims to develop a mobile-based mental health improvement program for NMIBC patients, design a protocol for evaluating feasibility, and provide preliminary evidence of the efficacy of the developed program.

The program content was developed based on the results of a needs assessment conducted among patients with NMIBC through a cross-sectional study. The draft program was prepared by referring to the guidelines of the National Comprehensive Cancer Network and publications of the International Continence Society. Based on the developed draft, two professors of nursing, a professor of counseling psychology, a registered nurse, and a counseling practitioner verified the validity of the content before finalizing the program. The final version of the developed program consisted of one session on NMIBC knowledge and symptom management and five sessions on mental health improvement. Researchers sent an online link to the YouTube video comprising lecture materials and voice recordings of health professionals weekly using a mobile messenger (Kakao Talk) (Image 1). The topics of each session were as follows: Session 1 (Understanding of bladder cancer and treatment), Session 2 (Understanding and respecting myself), Session 3 (Maintaining reasonable thoughts and positive emotions), Session 4 (Benefits of positive emotions and healthy communication), Session 5 (Living in a healthy way through stress management), and Session 6 (Finding happiness and meanings in daily life).

The protocol for evaluating the feasibility of the developed program is outlined in Image 2.

Image:

Image 2:

The feasibility of the mental health improvement program for patients with NMIBC based on mobile messenger (KakaoTalk) will be evaluated through the developed protocol. Moreover, by introducing a program that reflects the feasibility of test results into practice, the results of this study can contribute to improving the quality of life of patients with NMIBC.

None Declared

Mental health disorders are among the most burdensome health concerns in the world; it affects more than 970 million people in 2019. These disorders deteriorate all aspects of life, especially the professional field, impacting mainly physical capability, daily functioning, and productivity among the working-age population.

To study the socio-professional and medical characteristics of workers with psychiatric disorders and to assess the repercussions of these pathologies on work ability.

A descriptive and retrospective study included all the medical files of workers with psychiatric disorders who were referred to the occupational medicine department at Charles Nicolle Hospital for a medical opinion of fitness for work during the period from January 1, 2014, to December 31, 2020.

The average age of the 224 cases collected was 41.74± [25-60 years] with a sex ratio of 0.67. The average professional seniority was 13.4 years±8.27 years. The most common occupational sectors were health (38.1%) and communication (20.2%). The patients were mainly suffering from either an anxiety-depressive disorder (36.6%) or psychosis (11.6%). These included 21 cases of bipolar disorder, 21 cases of schizophrenia, two cases of chronic hallucinatory psychosis and 3 cases of delusional psychosis. Forty-three patients were fit to continue working, 133 patients were fit with restrictions and twenty-six were unfitted to work.

A professional reclassification was recommended for 37 patients in positions with a lower mental load. One employee suffering from advanced schizophrenia was offered early retirement on grounds of disability. Permanent unfitness was pronounced in 11.6% of cases.

The impact of mental disorders on cognitive abilities can be so significant as to result in temporary or permanent unfitness for work. However, the decision of medical fitness for work for the same psychiatric pathology may vary from one individual to another and from one workstation to another.

None Declared

The Positive and Negative Syndrome Scale for Schizophrenia Autism Severity Scale (PAUSS) scale can be derived from the Positive and Negative Schizophrenia Syndrome Scale, enabling an assessment of psychotic and autistic dimensions with a single tool.

The aim of the study was to investigate the prevalence of autistic traits and the diagnostic, developmental, clinical, and functional correlates of this phenotype in a sample of early-onset psychosis (onset before age 18 years; EOP).

Prospective observational 2 year- follow-up study in a sample of young people with a first-episode of EOP. Demographic, perinatal, developmental, cognitive, clinical, and functional data were collected. PAUSS total scores and socio-communication and repetitive behaviors subscores were calculated. We used the proposed cut-off points for adult populations to define prevalence of autistic traits (PAUSS≥30). Subgroups of patients with and without autistic traits were identified based on the total PAUSS terciles. We used the Cronbach’s alpha test to assess the PAUSS internal consistency. Linear mixed models were performed to compare changes in PAUSS during follow-up between diagnostic subgroups [i.e., non-affective psychosis (including schizophrenia and schizophreniform disorder), affective psychosis (including bipolar disorder, schizoaffective disorder and major depressive disorder with psychotic features), and other psychosis (including brief psychotic disorder and psychosis not otherwise specified)]. Developmental, clinical, and functional variables were compared between subgroups with and without autistic traits with logistic regression analysis.

248 patients with PIT were included (age 15.69 ± 1.86 years, 38.65% female). The prevalence of autistic traits in EOP was 7.04%, with significantly higher prevalence in the group of patients with non-affective psychosis (15.20%) than in other diagnostic groups. PAUSS scores significantly decreased over time, with no significant differences in the trajectories of the total PAUSS and its subscores among the three diagnostic subgroups during the 2-year follow-up. The PAUSS showed good internal consistency at all visits (Cronbach’s alpha > 0,88). Patients with autistic traits presented longer duration of untreated psychosis, longer duration of the first inpatient admission, poorer social adjustment in childhood, poorer functionality, greater clinical severity, and poorer response to treatment during follow-up than patients without autistic traits.

The PAUSS is an easy-to-apply tool that can be useful to differentiate psychosis subgroups with worse prognosis.

J. Suárez Campayo: None Declared, L. Pina-Camacho: None Declared, J. Merchán-Naranjo: None Declared, C. Ordas: None Declared, V. Cavone: None Declared, R. Panadero: None Declared, G. Sugranyes: None Declared, I. Baeza: None Declared, J. Castro-Fornieles: None Declared, E. de la Serna: None Declared, C. Arango Consultant of: Acadia, Angelini, Gedeon Richter, Janssen Cilag, Lundbeck, Minerva, Otsuka, Roche, Sage, Servier, Shire, Schering Plough, Sumitomo Dainippon Pharma, Sunovion and Takeda, C. Diaz Caneja Grant / Research support from: Exeltis and Angelini

In the 20 years since a review by McCarthy (2001) on the presentation of Post-traumatic stress disorder (PTSD) in people with intellectual disability (ID), the understanding of trauma disorder has increased.

Diagnostic criteria for ID will be presented to set the context. A brief summary of the key literature over the past twenty years will be discussed focusing on the presentation of PTSD in people with ID including the use of ICD-11 criteria. Evaluated tools available to assess the impact of life events and trauma for use in people with ID will be outlined including treatment options. The presentation of trauma disorder will be illustrated through a case study.

Psychiatrists need to be aware that a history of trauma may be an underlying factor in the presentation of people with ID to psychiatric services.

McCarthy J (2001). Post-traumatic Stress Disorder in People with Learning Disability. Advances in Psychiatric Treatment; 7, pp. 163-169.

None Declared