Inhalants are volatile psychoactive compounds whose effect varies from disorientation, excitement, euphoria to hallucinations. Different opinions have been raised concerning the relationship between inhalant use and psychosis and several publications have studied the incidence of psychotic disorders in the context of inhalant use. These studies concluded that using inhalants was independently associated with the development of psychosis

our aim is to determine the demographic and psychiatric profile of inhalant users previously hospitalized in our department

This is a retrospective descriptive study carried out by analyzing hospitalization records in the addictology department of the psychiatric university hospital Ar-Razi in Salé over a period of one year (from August 2020 to August 2021). The diagnoses are established according to the DSM 5 diagnostic criteria.

Seventeen patients, inhalant users, were recruited after chart review, including 5 women and 11 men (68.7 %). The average age was 24.7 years (16; 41). The majority of the patients were single (81.2%), 62.5 % had a secondary education and 62.5 % were unemployed.

The psychiatric evaluation showed that 87% of these patients had a history of incarceration, 50% had a diagnosis of schizophrenia, 12.5% had bipolar disorder and 14.2% had a cluster B personality disorder (DSM 5).

The average age of onset of the addictive disorder in this population was 14.4 years and the entire sample was polyaddictive.

More than half of our sample had psychosis associated with their inhalant use disorder. these results are consistent with literature data.

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Aggression and negative behaviours are used to be present in individuals with bipolar disorder, who are sensitive to life events. Thus, many studies investigated the emergence of impulsivity and aggression in the developmental process and revealed its relationship with childhood adversities.

The aim of this study was to determine the relationship between childhood trauma and aggressive behaviour in euthymic patients with bipolar disorder.

It was a cross-sectional descriptive and analytical study involving patients diagnosed with bipolar disorder and followed in the psychiatric department at the University Hospital ofSfax (Tunisia).

All subjects completed the Childhood trauma questionnaire (CTQ) and the Buss–Perry Aggression Scale (BPAS). Euthymiawas defined as a score on the Montgomery-Åsberg Depression Rating Scale (MADRS) not higher than 14 and by a score on theYoung Mania Rating Scale (YMRS)not higher than seven.

We included 35 patients. Their mean age was 46.69 ± 12.01 years with a sex ratio (M/F) =0.45. Most of them lived in urban areas (91.42%) and had a moderate socioeconomic level(88.57%).

The most frequent trauma type was physical neglect with 74.28%, followed by emotional abuse (42.85%), emotional neglect (42.85%), physical abuse (37.14%) and sexual abuse (31.42%).

The mean score of CTQ was 58.57 ±9.51. Theaverage total score of BPAS was 82.26 ±14.57.

The mean scores of subscales of BPAS were 25.49±4.59 for physical aggression, 13.74±3.51for verbal aggression, 19.14±6.22 for anger and 23.89±5.57 for hostility.

A statistically significant and positive correlation was determined between CTQ and BPAS (p=0.011). The score of BPAS was significantly correlated with physical abuse (p=0.003) and physical neglect (p=0.014).

The relationship between CTQ and BGHA scores suggests the possibility that childhood trauma may be one determinant of aggression in patients with bipolar disorder. Considering the childhood trauma history in the evaluation of these patients may prevent their aggression and thus their psychosocial functioning.

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Mental health issues of the health care workers (HCW) are often overlooked. It’s often presumed that situations like COVID are handled well by this group of population and hence their own mental wellbeing is ignored and neglected.

The objective of this study was to evaluate the depression and anxiety levels in healthcare workers who were on COVID duty.

This study was performed over telephonic interview of all the healthcare workers who were performing COVID duty from March 2021 to December 2021. Hospital Anxiety and Depression Scale (HADS) was administered. Various factors influencing the presentation were then analyzed.

Over 534 healthcare workers were screened for psychiatric symptoms. About 76 fulfilled HADS criteria. 7.86% (42) scored above the anxiety cut off point and 6.36% (34) scored above the depression cut off point. About 373 (69.85%) expressed concerns about their safety and security as they were staying away from their families and about 469 (87.8%) expressed concerns about uncertainties about duty patterns.

Health care workers should be screened for psychiatric illness if they are in constant stress. They should be well trained to carry out COVID duties which will reduce the anxiety about the duty patterns. Better awareness about COVID 19 may lead to decreased levels of anxiety and depression.

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Researches has shown that a subset of the autism spectrum disorder (ASD) population presents with immune dysregulation. Based upon the immunological abnormalities, various treatment modalities have been applied to children with ASD. One immunomodulatory treatment that has been studied in ASD is intravenous immunoglobulins (IVIG).

This report is based upon two hypotheses: autism etiology may be closely related to neuroinflammation; and, an effective treatment should restore the individual’s comminication skills. In this report, we present two cases who were diagnosed with ASD and received IVIG treatment.

Case A is a 5-year-old female patient who was diagnosed with ASD at the age of 3. The second case, B is a 9 -year-old male patient who is a 7th grade student and was also diagnosed with ASD at the age of 3. The first patient’s autism symptoms was noticed by her family at the age of 2. Although she had the ability to coordinate eye contact, understood simple commands, she was observed to lose all her acquired developmental skills one by one at around 18-24 months. Towards the age of 3, stereotypical movements such as turning around and flapping wings, started. Similarly, the second patient’s acquired skills were lost around at the age of 2-3, after having recurrent infections. Based on deficits in social‐emotional reciprocity, deficits in nonverbal communicative behaviors used for social interaction and restricted/repetitive patterns of behavior, both patients were diagnosed with ASD. Considering that autoimmune mechanisms may have been affected in ASD, IVIG treatment was initiated at 1 g/kg/month. Case A received IVIG once in a month, total 5 infusions had been applied. Case B received total 12 infusions with the same protocol. Treatment response was assessed with the Childhood Autism Rating Scale (CARS).

In these two ASD cases which were treated with IVIG ,a subjective partial reduction in autism symptoms and an objective decrease in CARS scores were detected. Current evidence suggests that there are various factors contributing to the development of autism and different combinations of these aspects give rise to different variations of some ASD subtypes. Recent studies in this field indicate a possible connection between the immune system impairments and ASD. This report, therefore, provide support for the notion that at least a subset of children with ASD might have immune abnormalities and may respond to the immune modulating effect of IVIG therapy.

Although, autoimmune or inflammatory etiologies may not explain the majority of cases of autism, it might at least be useful to understand some. Further studies with larger number of patients should be conducted about the use of IVIG in selected patients with ASD.

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Chronic renal failure is a public health issue. It leads to a degradation of physical integrity, hormonal disorders and a great psychological impact, which can lead to sexual disorders.

The aim of this study was to identify risk factors of sexual dysfunction in patients on dialysis and renal transplant patients.

This is a cross-sectional survey conducted in nephrology department of Sahloul teaching hospital (Sousse) and Fattouma Bourguiba teaching hospital (Monastir) over two-month period. Patients on dialysis and renal transplant patients were included. Sexuality was assessed by FSFI and IIEF 15

This study enrolled 137 patients (99 patients with chronic renal failure and 38 renal transplant patients). The incidence of erectile dysfunction of men on dialysis was 57% and was associated to a decrease in testosterone level (11%) and an increase in LH level (50%). Its main risk factors were age (p=0.000), the duration (p=0.009), the cardiovascular diseases (p=0.03), the anxiety (p=0.000), the depression (p=0.000) and the different aspects of erectile dysfunction (p=0.000. In women on dialysis, the most common sexual disorder noticed was sexual arousal disorder (78.8%).

In the transplant, erectile dysfunction was found in 18.2% of transplant men and was associated to age was a predictive factor (p=0.03). In women, orgasm and desire disorders were the most common (69%).

Renal transplantation improved erectile dysfunction in men with IIEF score rising from 14 to 27 (p=0.021). It also improved sexual life in women: increase of desire (p=0.042) and orgasm scores (p=0.034).

Sexual disorders remain common in patients on dialysis and with renal transplant. Their management requires a systematic screening to improve patients’ outcome

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According to current diagnostic systems, affective symptoms do not represent a fundamental criterion for the diagnosis of DD. However, numerous studies have highlighted frequent comorbidity between DD and Mood Disorders and have elucidated the importance of the affective state in the development and persistence of delusions. Thus, some factor analysis studies have identified the existence of a depressive dimension in DD, suggesting a substantial psychopathological heterogeneity in DD. However, these important affective features have not evaluated from a phenomenological point of view and in their relationship with delusions.

The aim of the present study is to investigate the relationship between personality, trait affectivity and severity of delusions in patients with Delusional Disorder (DD).

Thirty-two outpatients affected by DD were administered the Structured Interview for DSM-IV-TR Personality Disorders (SIDP-IV), the Pathological Narcissism Inventory (NPI), the Positive and Negative Affect Schedule (PANAS) and the Psychotic Symptom Rating Scale (PSYRATS). Next, we analysed the prevalence of personality disorder in our sample of patients with DD and studied the correlations between the severity of delusions and the different affective variables. Finally, we obtained a multivariate explanatory model of the severity of the delusions.

The severity of delusions was directly associated with “Grandiose Fantasy” item of narcissistic personality and inversely related with the feelings of shame, fear and guilt. In the multivariate model, the feeling of shame was the only independent variable capable of accounting for the severity of the delusions, that, in in DD patients, would lie on an affective core of shame.Table 2.

Pearson correlation coefficient

The severity of delusional beliefs in DD patients would lie on an affective core of shame upon predisposing personality traits. These findings could help to develop a psychotherapeutic approach for delusional patients focused in the feeling of shame.

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For a very long time, anthropologists and psychiatrists have studied how the symptomatology of mental diseases varies among cultures. Different social environments approach depression in different ways, and cultural practices and meanings influence how it develops. Culture also affects how symptoms are felt and described, how treatments are chosen, how patients and doctors interact, how likely it is that certain events, like suicide, will occur, and how professionals behave. As a result, all of these circumstances must be taken into consideration when approaching the diagnosis and management of depressive disorders. To illustrate the above, we present the case of a 31-year-old man, originally from Nigeria, who was admitted to the hospital after a suicide attempt by precipitation onto the subway tracks.

(1) To describe the clinical particularities of this case, focusing on the diagnostic difficulties we faced derived from intercultural contrasts (2) To review cross-cultural differences in the symptomatology and its implication on severity of depressive disorders.

A review of the patient’s clinical history and complementary tests performed was carried out. Likewise, a bibliographic review of the available scientific literature was also performed in relation to transcultural depressive experiences and its severity.

There is little evidence in favor of a direct link between sociocultural factors and severe depression, but we reviewed the arguments that look significant for further research. Depressive illnesses are found in all societies and their symptomatic expression varies culturally, particularly in terms of somatization and delusional ideas. Similarly, the social and individual representations of the disease depend on the culture, and some conceptual models can increase the effects of stigmatization. These cross-cultural variations could influence the care-seeking process and therefore modulate the evolution of the disease in the sense of greater severity.

All societies experience depressive disorders, which exhibit symptoms that vary culturally, especially in terms of somatization and delusional beliefs.

The care-seeking process is affected by cross-cultural differences, and as a result, the disease’s progression may also be modulated in terms of increased severity.

When we ignore cultural factors in understanding, assessing, and treating depression, we are contributing to misdiagnosis and errors in patient management.

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Non-suicidal self-injury (NSSI) – the deliberate, self-directed damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned – is a highly prevalent phenomenon in adolescents and young adults. Motivation for the NSSI is known to be heterogenous in different patients. However, biological and especially genetic markers associated with different motivation for the NSSI have not been studied to date. One of the possible candidates are mu- (OPRM1) and kappa-opioid receptor (OPRK1) genes, since opioid system is known to be involved in the NSSI. Another perspective candidate is the DCC gene, encoding the netrin 1 receptor, which plays vital part in the formation of the prefrontal cortex.

We conducted a pilot cross-sectional study to test the impact of the rs1779971 OPRM1, rs6473797 OPRK1 and rs8084280 DCC gene polymorphisms on the characteristics and motivations for the NSSI in young adults.

28 patients of European ancestry with NSSI (89,3%; n=25) women, median age (Q1-Q3) – 23 (21,25-25) years) were included in the pilot sample. The majority of the sample had a diagnosis of bipolar disorder (78,6%; n=20). Characteristics and motivation for the NSSI were measured by the Inventory of Statements about Self-Injury (ISAS). The Childhood Trauma Questionnaire (CTQ) was used to control for adverse childhood experiences, a potent environmental factor, associated with NSSI. Genotyping was performed using RT-PCR. The genetic effect was evaluated using the dominant model. For statistical analysis multiple linear regression with the presence of minor alleles, different types of childhood trauma, diagnosis, age and sex as factors and ISAS scores as dependent variables were used.

Multiple linear regression showed that minor C allele of rs6473796 OPRK1 gene polymorphism was associated with an increase of the “Affect regulation” (B=2,23; CI95% [0,39–4,06]; p=0,022), “Anti-dissociation” (B=3,31; CI95% [0,18–6,44]; p=0,039) subscales of ISAS scores. Moreover, the minor T allele of the rs8082480 DCC gene polymorphism was associated with a decrease of the “Affect regulation” subscale score (B=-1,74; CI95% [-3,30 – -0,18]; p=0,032).

To our knowledge, this is the first study on the genetic markers of motivations for NSSI. Our pilot results showed that, controlling for diagnosis, age, sex and childhood trauma, OPRK1 and DCC gene polymorphisms may be associated with the heterogeneity of motivations for NSSI. However, these results require confirmation on the larger samples.

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: Occupational justice (OJ) regards the human right to be engaged in meaningful life occupations (work, leisure, learning, house management etc.). It highlights the idea that all society members should be able to actively participate in all occupations as equals. Yet, people with mental health problems remain at the margins of society and struggle to fully participate in life activities. At the same time, such participation has been shown to lead to better functional abilities, higher quality of life, and better illness management among this population. It provides routine, connectedness, belonging, purpose, and identity. Moreover, impaired occupational participation due to mental health problems has resulted in functional impairment, symptomatic deterioration, loss of social roles, and a reduced sense of competence. Despite the importance of such participation, it is unclear in many mental health rehabilitation service organizations how to design policies that will achieve better occupational participation for their consumers.

To better understand the OJ concept and to create a conceptual model pertaining to the challenges and solutions, which may serve policy makers as a theoretical basis for enhancing OJ based policies.

We conducted a qualitative phenomenological study that included in-depth interviews with mental health rehabilitation consumers, to identify their experiences and perceptions in relation to OJ and focus groups with rehabilitation employees and managers. Data analysis was a multi-staged process using a systematic and inductive procedure.

Based on our analysis, the three key themes clarifying the interviewees’ experiences with the OJ concept were a) the importance of and barriers for achieving meaningful participation, b) the required resources for implementing OJ, and c) principles for practice. These elements comprise a holistic OJ construct, affording a practical understanding of what a service that implements OJ means. Such a service would use the resources and practices discussed in this study and address meaningful participation as the desired outcome to achieve.

Unlike other forms of justice, OJ emphasizes the need for flexible and tailor-made services that address the consumer’s changing needs and circumstances. It considers the consumers’ role as active rather than passive service recipients. Recently, the fields of health and rehabilitation have increasingly acknowledged the importance and applications of involving consumers. Their genuine involvement would enhance OJ and provide a basis for more accurate assessments and customized interventions.

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Paraneoplastic syndromes (PNS) can be expressed with a wide variety of neurological and psychiatric symptoms: alterations in consciousness, cognition, behaviour, mood or perception. Testicular tumours have been related to different expressions of PNS, but, to date, no relationship with bipolar disorder has been described.

On the other hand, the relationship between SARS-CoV2 infection and subsequent affective conditions has also been recently described. Between 30-40% of people affected by the infection present symptoms of depression in the following months.

To describe a case of a 17-year-old patient with an atypical onset of bipolar disorder a few months after a SARS-CoV2 infection and a few months before a testicular germ cell tumour was detected.

Description of a clinical case, its differential diagnosis and the literature review associated.

This is a 17-year-old adolescent with no previous psychiatric history, who is referred to a day centre after committing a suicide attempt. The patient presented an average premorbid functioning. Stands out, a SARS-CoV2 infection 3 months before the onset of symptoms. He presents repeated and self-limited episodes (maximum 3 weeks) of major depressive symptoms: autolytic ideation, hypothymia, asthenia, clinophilia, isolation, anhedonia, mutism, psychomotor retardation, lack of hygiene, hyporexia, hypersomnia; that alternates with periods of stability and with others of symptoms of hypomania (sudden improvement in mood, increased activity and plans), also lasting a few days. Paradoxic response to treatment with antidepressants, presenting irritability and exacerbation of suicide ideas. Good tolerance and response to treatment with low doses of aripiprazole and quetiapine. The patient was diagnosed as type II bipolar disorder with rapid cycling.

A few days after definitive diagnosis, a testicular germ cell tumour was detected, for which he had to undergo surgical intervention and chemotherapy treatment. At this point, it is suggested that the symptoms could be included in a paraneoplastic condition prior to the tumour. Months after the remission of the cancer, the patient does not present symptoms of relapse or metastasis, but mood swings persist, of lesser intensity, every few weeks. Treatment with lamotrigine was started at increasing doses, with good response and tolerance from the start.

The onset of mental health disorders in adolescents can be complicated by the non-specific or atypical early or prodromal symptoms. This degree of complexity increases when somatic pathologies coexist and even more if those pathologies have yet to be fully understood and studied, such as paraneoplastic syndromes or SARS-CoV2 infections. It is necessary to continue investigating the interrelationship between somatic and psychiatric conditions in order to provide more specific and rapid clinical responses.

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Behavioral addictions are a growing problem in the society. Digital technologies are used by people of different ages, and their number is increasing every year. The precise reasons for the development of addictions remain unknown. In the case of behavioral addictions, especially Internet addiction, the significance of personality traits and behaviors predisposing an individual to addiction, such as depressiveness, anxiety, hostile attitude, aggression, impulsiveness, psychotic behaviors, shyness and self-esteem disorders, are emphasized. Personality predispositions play an essential role in Internet addiction.

The aim of this study was a general assessment of the level of Internet addiction with regard to personality traits according to the Big Five model by Costa and McCrae among women from the West Pomeranian Voivodeship.

The study involved 556 women, whose average age was 34 years and who met the inclusion criteria: female sex, age of 18 years or above, place of residence in the West Pomeranian Voivodship, an informed consent for participation in the study, and completion of the set of questionnaires. The study was conducted using a diagnostic poll method with a questionnaire technique. To carry out the analysis both author’s own and standardized tools were used: the author’s questionnaire covering socio-demographic data, the NEO-Five Factor Inventory which assesses the levels of personality traits, and the Internet Addiction Test used to measure behaviors and characteristics related to compulsive use of the Internet.

Most (70.9%) of the women were average users of the Internet, 25% of respondents were at risk of addiction, and the least numerous group of women (4.1%) was addicted to the Internet. Conscientiousness negatively correlated with Internet addiction (r = -0.22; p < 0.001; R2 = 4.9%). Openness to experience was conducive to Internet addiction (r = 0.15; p < 0.001; R2 = 11.1%). A positive link between neuroticism and Internet addictions was established (r = 0.33; p < 0.001; R2 = 11.1%). No significant relationships between Internet addiction and extraversion (r = 0.03; p = 0.45) as well as agreeableness (r = -0.07; p = 0.10) were demonstrated.

The type of personality of the studied women implicated relationships to Internet addiction. Neuroticism might be a personality trait that particularly predisposes to an increased risk of Internet addiction. Openness to experience was conducive to Internet Addiction. Low levels of conscientiousness more often become addicted to the Internet.

None Declared

Patients hospitalized in the case of COVID19 have had to face a complex and potentially very stressful situation. In this context a screening program for psychological distress in patients with COVID19 is necessary.

To screen for post-traumatic stress disorder post COVID19 and to identify the epidemiological and clinical factors correlated with this disorder in post COVID19 patients.

A descriptive and analytical cross-sectional study that took place during the period from 1st March to 15th May 2021 with 154 patients who were hospitalized at the COVID19 unit at Hedi Chaker Hospital Sfax.

We used a pre-established form to record sociodemographic, clinical and therapeutic data. The post-traumatic stress disorder was assessed by the “Impact of Event Scale-Revised”.

The mean age was 66.62 ± 13.34 years with a male predominance of 60.4%. In our sample, 77.9% of the patients had a somatic history, of which hypertension was the most frequent pathology (46.1%). The average length of hospitalization was 9.5 days ± 6.3. The form was considered severe in 27.9 cases.

According to the IES-R scale, twenty-one patients (13.6%) had post-traumatic stress disorder, with a predominance of women (57.1%).

A significant association was found between marital status and post-traumatic stress disorder. Thus, married or widowed patients are more likely to develop PTSD.

In the present study, we did not find statistically significant associations between the clinical characteristics of the disease (severity of the disease, length of hospitalization, functional signs) and post-traumatic stress disorder.

Psychological support interventions in surviving patients of COVID 19 is necessary aiming to increase resilience, manage coping strategies and decrease the deleterious impact of the pandemic on mental health.

None Declared

Bpolar disorder (BD) is a severe and chronic psychiatric disorder it is the sixth leading cause of disability among all illnesses worldwide. With regard to causes of premature mortality, patients with BD are at very high risk of suicide. Whereas risk factors for suicidal behaviors are multiple and complex, hopelessness appears to be a major independent risk factor for suicidality in BD. Compelling evidence has also demonstrated that BD is frequently associated with circadian rhythms alteration, contributing to its vulnerability, pathogenesis, and manifestations. in particular in the desynchronization of sleep and social life, has been associated with the severity of BD. Indeed hopelessness has never been studid in relation to circadian rhythms in BD

To examine the role of chronobiological rhythm alterations in suicidal ideation and behaviors and its relation with hopelessness.

One hundred twenty-seven patients (77 females, mean age of 47.4 ± 12.5 years) with a major depressive episode and bipolar disorder (BD) type I or II (according to Structured Clinical Interview for DSM-5 assessment) were recruited in 2019 and assessed for depressive and manic symptoms (Beck Depression Inventory-II, Young Mania Rating Scale) and with the Biological Rhythms Interview of Assessment in Neuropsychiatry, Beck Hopelessness Scale, and Scale for Suicide Ideation. Univariate regression and mediation analyses were performed.

Forty-one patients (32.3%) showed clinically significant suicidal ideation and were more frequently affected by BD type I (P = .029) with mixed features (P = .022). Compared to nonsuicidal individuals, they had significantly more depressive symptoms (P = .019), higher emotional component of hopelessness (P = .037), and higher dysrhythmicity of sleep (P = .009), activities (P = .048), and social life (P = .019). Passive and active suicidal ideation and suicidal plans were best predicted by dysrhythmicity of sleep and social life. Dysrhythmicity of sleep and social life mediated the direct effect of depressive symptoms on passive and active suicidal ideation and also of active ideation on suicidal plans. The emotional component of hopelessness was related to dysrhythmicity of social life and mediated its effect on suicidal plans (P = .010).

Chronobiological alterations directly contributed to passive and active suicidal ideation and to suicidal preparation, with a key role of circadian rhythm alteration of sleep, activities, and social life. Chronobiological alterations also impacted the emotional component of hopelessness, hence indirectly contributing to suicidal ideations and plans. These findings call for the systematic screening of these dysrhythmicity dimensions when considering suicidal risk in individuals with BD.

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The ASD Day Therapeutic Unit of the HUMT is an interdisciplinary reference center specialized in ASD, for the care of children and adolescents with this pathology, that offers care by programs with the aim of achieving functionality altered.

The main objective of this study is to know the clinical characteristics of the patients admitted to our center and to offer preliminary data on the functional improvement achieved in a pilot program that works by processes.

This is a prospective clinical study of patients with ASD, treated at the ASD Day Therapeutic Unit of the HUMT since februay 2022 till nowadays. We compare the clinical improvement and functionality acquired through the evaluation through various scales: Conners scale, SRS, BRIEF and CBCL.

Our sample is made up of 19 patients with ASD who are admitted to the HUMT ASD Day Hospital. 13 belonged to the intensive care program, 5 to recovery of low-functioning functionality, and 1 to the differential diagnosis program. 84.21% (n=16) have preserved cognitive capacity. The median age is 13.1 years. 73.7% of the sample are men.

We observed that 89% of patients admitted to our unit presented comorbid symptoms with ADHD. more than 78.9% present isolation, anxiety/depression, altered thinking and attention difficulties. 13/19 present a SEVERE RANGE OF AFFECTATION upon admission, in social area. Facing discharge, the CBCL shows us a general improvement in behavior and comorbidity in the total scale.

The SRS shows us an improvement in social awareness, social communication, social motivation, repetitive behavior and stereotypes and in the total score.

Specific interventions in social skills, autonomy, social understanding, daily routines, and sensory integration in patients with ASD improve core symptoms, as well as associated behavior.

Specific interventions and working on social relationships during admission improve comorbidity derived from ASD.

More studies are needed to specify the most efficient interventions to improve the quality of life in children and teenagers with ASD.

None Declared

Penal coercive measures (e.g., detention) seriously interfere with the individual’s fundamental rights (especially the right to liberty). It is necessary to have proper guarantee mechanisms to protect an individual against the arbitrariness of decisions made in this regard. It is especially significant in the case of people with mental disorders (MD). This group of entities may not be able to take intended legal actions to protect their rights and, thus, requires enhanced legal protection. The effectiveness of legal solutions depends on the appropriate terminology. Vague, ambiguous, or archaic terms pose a risk of over-interpretation and create an area for abuse. An example of such solution is art. 5(1)(e) of the European Convention on Human Rights (ECHR) allows deprivation of liberty for “the person of unsound mind.”

The study aims to analyze the concept of “person of unsound mind” appearing in the ECHR and to define its semantic scope in relation to mental disorders. This procedure aims to determine whether the status of a person of unsound mind is the same as the status of a person with MD - both in legal and medical contexts.

The study consists of two stages. The first stage included the narrative review of the literature by searching the PubMed and Google Scholar databases with the keywords “unsound mind” and “person of unsound mind”. The second stage included the analysis of the European Court of Human Rights judgments relating to art. 5(1)(e) of ECHR, collected in the HUDOC database. Forty-four articles and 128 judgments met inclusion criteria and were included for further analysis.

The study shows that the concept of a “person of unsound mind” is primarily indefinite. The term does not correspond to the current standards of medical terminology. It relates to mental disorders but has a narrower scope. The term “unsound mind” refers only to “true mental disorder”, which is of that kind or degree that warrants compulsory confinement. To be considered a “true” mental disorder has to be of a certain severity. This term should be interpreted narrowly, but there are no grounds to limit its scope to psychotic disorders only. However, including some non-psychotic disorders in its scope may be questionable (e.g., antisocial personality disorder).

The structure of art. 5(1)(e) ECHR does not comply with the current medical terminology standards. This inconsistency in terminology and primary indefinite character of the “unsound mind” may implicate a lot of difficulties in precisely defining its meaning and scope of use in individual cases. It is dangerous from the perspective of the personal liberty of people with MD. This term should be replaced with the term “mental disorders,” the meaning of which is well-established in medicine.

None Declared

Substance abuse is a common problem associated with significant morbidity and mortality, but is often underdiagnosed and unrecognized in geriatric patient populations.

to determine the prevalence of substance use disorders geriatricic inpatient population.

Data from 2010 to 2020 were retrospectively reviewed from a clinical database. 148 admissions of patients older than 60 years were identified. Descriptive statistics were used to group patients with and without a diagnosis of substance use, which included intoxication, withdrawal, abuse, dependence, and substance-induced disorders.

There were 148 hospital admissions for patients over 60 years of age, with a mean age of 72.38 ± 5.64 years and a mean length of stay of 13.91 ± 14.15 days. Of all admissions, 44% (n=64) were associated with at least one substance use diagnosis. In this group of 64 patients, the most frequently used substance was tobacco with associated disorders ( 65% N=42). The prevalence of other substance use diagnoses was as follows: sedative-hypnotic abuse/dependence 32% (N=21), cannabis abuse 10% (N=6), alcohol-related disorder 12.5% (N=8). Compared with patients without a substance abuse diagnosis, these patients were significantly younger, had shorter lengths of stay, were less likely to be readmitted, and were more likely to be single men

Given the inherent difficulties in diagnosing substance use disorders and the retrospective nature of this study, the true prevalence of substance use disorders in elderly psychiatric inpatients is likely higher than found. Cross-sectional or cohort studies are more appropriate to shed light on this condition.

None Declared

On average, thirty percent of patients in internet based treatments do not complete the treatment program. The majority of studies predicting adherence have focused on baseline variables. While some consistent predictors have emerged (e.g. gender, education), they are insufficient for guiding clinicians in identifying patients at risk for dropout. More precise predictors are needed. More recently, studies on prediction have started to explore process variables such as early response to treatment or program usage.

To investigate:

1. i) How much variance in adherence is explained by baseline symptoms and sociodemographic variables?

2. ii) Can we improve the model by including early response and program usage as predictors?

3. iii) What is the predictive accuracy of the most parsimonious regression model?

Data will be extracted from the Danish ‘Internetpsychiatry’ clinic, which delivers guided internet based cognitive behavioural therapy for depression. Sociodemographic data is collected upon application, and symptoms of depression and anxiety are measured at the start of treatment. Further, symptoms of depression are measured between each session of the online treatment program. Early response to treatment will be conceptualized as the individual regression slope of depression scores for each patient, during the first four weeks of treatment. Program usage data will be collected from the online treatment platform (e.g. number of words per message to therapists, time spent on each session during the first four weeks, number of logins during the first four weeks).

Predictors for adherence will be examined in a hierarchical logistic regression. Models will be compared using ANOVA. The most parsimonious model will be determined using the Aikake Information Criterion. Receiver operating characteristic curve analyses will be used to classify the accuracy of the model.

Analyses have not yet been conducted. Results will be available for presentation at the conference.

Determining more accurate predictors for adherence in internet based treatments is the first step towards improving adherence. Research findings need to be translated into clinically useful guidelines that may inform clinical decision making. Findings from this study could potentially be implemented as a system that monitors patients’ program usage and symptom development and signals therapists if a patient is at risk for dropout.

None Declared

Non-suicidal self-Injury (NSSI) and suicidality are common reasons for emergency presentations in child and adolescent psychiatry (1). NSSI is defined as intentional destruction of one’s body tissue without suicidal intent and has a prevalence rate in adolescents of approximately 30–40% in clinical samples (2). Suicide prevalence is around 24–33% (3).

There are many factors leading to suicidal or self-harming behavior. A prior history of self-injurious behavior is one of the strongest predictors of future suicidal behavior, both cross-sectionally and longitudinally (6) . Additionally, longitudinal studies have found that a previous suicide attempt increases the risk of a future suicide attempt threefold.

Suicide and NSSI have a significant impact on families and communities. Hence, considerable required clinical attention is warranted to develop preventive strategies.

The aim of this study is to investigate the prevalence of non-suicidal self-Injury (NSSI) and suicidality among children and adolescents presenting in emergency department of the tertiary psychiatric services and to study their demographic and clinical characteristics.

This is a retrospective cross-sectional analytical study included all children and adolescent patients attended the emergency department at Sultan Qaboos University Hospital between June 2021 to March 2016. The data was collected using the hospital´s electronic database to retrieve the medical records of children and adolescents who visited the emergency department. Patients who were 18 years of the age or younger were included in the study. The included patients must had been evaluated by psychiatrist during their presentations in the emergency department.

During the 63 months of observation, 114 patients attended the emergency department and required psychiatric evaluation, 44.7%(n=51) of patients presented with NSSI and/or SA. The mean age was 15.7. 80.4%(n=41) were females while 19.6%(n=10) were males. 37.3% had a primary diagnosis of major depressive disorder (MDD) and 21.5% had comorbid medical illness. 44% of suicidal attempts were with drug overdose, mostly paracetamol overdose, while the most used method for NSSI was cutting the body with a razor, 57%.19 patients had a primary diagnosis of major depressive disorder, 17 patients had no clear diagnosis at presentation.22% of the patients had other medical comorbidities, 5 patients with epilepsy. 51% of the patients had positive family history of mental illness.

Considering that NSSI and suicidality were found to be the main reasons for presenting to a child and adolescent emergency psychiatric service, it seems crucial for physicians at PEDs to provide proper crisis intervention and referral to mental health services when appropriate. Early identification of risk factors is highly recommended.

None Declared

Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system that is associated with a range of devastating symptoms including fatigue. In addition, the accumulation of disability that occurs in most MS patients can have a detrimental effect on their quality of life.

To assess fatigue and quality of life in patients with MS.

Descriptive cross-sectional study that interested MS patients referred to the occupational pathology consultation of Charles Nicolle Hospital, during the period from 1 July 2020 to 30 September 2022. The data collected concerned socio-demographic and occupational characteristics. The impact of MS on quality of life was studied using the SF-12 quality of life scale. Fatigue was assessed by the Fatigue Severity Scale (FSS).

Twenty-six cases of MS were identified. The mean age was 38 ± 9 years with a sex ratio (M/F) of 0.3. The average occupational seniority was 11 ± 8 years. The health sector was the most represented (23%, n= 6) followed by the transport sector (19%, n= 5). The main occupations were manual workers (31%), drivers, and administrative agents (19% each). The occupational constraints were physical in 44% of cases and psychological in 24% of cases. Fourteen patients (87% of the cases) lost their jobs because of the disease. The decision on occupational fitness was definitive incapacity in 44% of cases. The mean FSS score was 4±1.74. Sixteen patients (62%) had moderate fatigue (FSS 36-52), eight patients (31%) had mild fatigue (FSS <36) and two patients (8%) had severe fatigue (FSS >52). In addition, the mean scores for the physical and mental components of perceived health were estimated to be 37.04±7.67 and 44.93±7.23, respectively. The mean global score (SG) of SF12 was 40.98±7.23. The majority of patients (92%, n=24) had an average quality of life (SG- SF12 between 30 and 60) and two patients (8%) had a poor quality of life (SG <30).

The impact of MS on the socio-professional quality of life of patients was noted in the majority of cases. It is therefore imperative to improve the care of our patients on both the physical and psychological levels.

None Declared

Obsessive–Compulsive Disorder (OCD) is a disabling and chronic illness defined by the presence of obsessions and/or compulsions. Recently it has been proposed that the perinatal period may act as a trigger in this disorder, leading to its onset or exacerbation.

Variations in pregnancy-related hormones are believed to be one of the main etiological theories for the development of perinatal OCD (pOCD). Perhaps for that reason research has been almost exclusively focused on the development of this disorder in mothers. We aim to investigate pOCD in fathers.

A non-systematic review was conducted via electronic searches of PubMed. The keywords used were “Perinatal”, “Father”, “OCD”, “Obsessive-compulsive disorder”.

Unwanted intrusive thoughts are experienced with a similar prevalence in mothers and fathers. The same seems to be true regarding compulsions. However, it does appear that mothers are more distressed by these symptoms, which tend to be baby-related, usually concerning themes of suffocation, accidents or contamination. It is hypothesized that this seemingly different impact is related to the fact that mothers are more often the primary caregivers than fathers, thus feeling more distress because they are imbued with a greater responsibility. Accordingly, pOCD symptoms tend to be more severe in fathers who consider their baby-related obsessions meaningful, often confusing them as a desire to carry out such thoughts. These findings are consistent with the Cognitive-Behavioral Theory of OCD, highlighting that purely biological theories for the development of pOCD might not suffice.

Research indicates a similar presence of OCD symptoms in postnatal mothers and fathers, although it seems that mothers may experience more distress. Underlying dysfunctional beliefs seem to be responsible for the negative appraisal of these symptoms, predicting the development of the disorder in question. Further research of pOCD should seek to better characterize the onset or exacerbation of this disorder in fathers.

None Declared