Smoking is highly prevalent in patients with mental health disorders and although most literature describes the physical health impact of smoking, there is little which addresses the poverty and social consequences associated with nicotine addiction. In 2022, Ireland’s HSE (Health Service Executive) published clinical guidelines, regarding smoking cessation in healthcare settings, with special attention to mental health settings.

The aim of this study was to assess the current prevalence of smoking among inpatients in a psychiatric unit with a “Tobacco Free Campus” policy in place, and the associated patient factors. We also assess the efficacy at which mental health professionals are addressing smoking in this setting.

We performed a cross-sectional analysis of all patients admitted to the inpatient psychiatric unit on a single date. All inpatients were interviewed using a standardised format to ascertain smoking history and employment status. Case records were examined to record diagnoses and assess the patient’s inpatient care plan, nursing admission proforma and medical admission proforma. Medication charts were examined to ascertain whether Nicotine Replacement Therapy (NRT) was prescribed to those identified as smokers. Using Microsoft Excel, we analysed the smoking behaviours data gathered, and the identification of smokers and their orientation to the Tobacco Free Campus policy, on admission.

Of the 51 inpatients, 78% (n=40) had an Axis 1 diagnosis according to the DSM-4, 72% (n=37) were unemployed and 67% (n=34) were receiving Social Welfare. 57% (n=29) of inpatients were current smokers. 63% (n=25) of smokers had an Axis 1 diagnosis, 51% (n=19) were unemployed and 53% (n=18) were receiving Social Welfare. Since admission, 52% (n=15) of smokers have been smoking more, and 48% (n=14) have been spending more money on tobacco. 7% of smokers (n=2) started smoking on the unit. 50% (n=9) of smokers receiving Social Welfare were smoking more, with the majority in receipt of long-term disability allowance (n=7). Only 10% (n=3) of smokers were prescribed NRT, with only 1 patient taking NRT. 90% (n=26) of smokers did not have smoking addressed in their care plan. 38% (n=11) had a fully completed smoking history in the nursing admission, while only 14% (n=4) had one in the medical admission.

Despite a Tobacco Free Campus policy, smoking continues to be highly prevalent in an inpatient psychiatric setting. Smoking was particularly prevalent in patients with Axis 1 diagnoses, and in the unemployed. A large proportion increased their smoking on admission, and their expenditure on tobacco. More can be done to identify smokers on admission so as to promote quitting, and in turn, reduce the social consequences related.

None Declared

Schizoaffective disorder (SAD) is a nosographic entity characterized by an association of schizophrenic symptoms with thymic episodes. Addictive substance abuse behaviours precede or appear concomitantly with thymic and/or schizophrenic symptoms for the majority of patients.

The objective of our work was to specify the sociodemographic ,clinical and therapeutic characteristics of this population and to compare them to a group of schizophrenic patients who do not use cannabis.

This is a retrospective descriptive study of patients with Schizoaffective Disorder (SAD) meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, 5th Version (DSM-5), hospitalized between January 2015 and December 2021 in the psychiatry department of the EPS Tahar Sfar Mahdia.

Our sample was composed of two groups: A first group formed by patients with a positive toxicological assessment to tetra-hydro-cannabinol (n=14) and a second group witha negative toxicological assessment (n=36). In SAD subjects using cannabis, the average age at first hospitalization was younger (27.5 years) than in the other groups, hospitalization was earlier (27.27 vs 33.58; p=0.04), the duration in number of days of hospitalization was greater (29.33 vs. 24.67; p=0.02) and they had required during their hospital stay a higher dosage of antipsychotics in equivalent doses of chlorpromazine (723 vs 603; p=0.04). There was a significant difference (p ≤ 0.04) in the psychometric scales (BPRS, SAPS and SANS) in favour of patients who did not use cannabis.

The deleterious psychic effects of chronic cannabis use have long been suspected for a long time. Patients followed for SAD present more frequently than the reference population addictive behaviours towards cannabis which is associated with many negative events affecting clinical symptomatology, evolution, prognosis and therapeutic response.

None Declared

Metabolic syndrome and other cardiovascular risk factors are highly prevalent in people with mental severe illness (Sun & Jang, 2020).Metabolic disorders in people with schizophrenia increase their risk of developing cardiovascular disease, consequently reducing their life expectancy by approximately 10 to 25 years (Heald et al., 2017)In part these cardio-metabolic risk factors are attributable to unhealthy lifestyle, including poor diet and sedentary behaviour.Lifestyle interventions (diet, increased physical activity) are the first-line treatments to decrease that risk.

Our objective is to carry out a prospective study on the application of a program of healthy habits in outpatients unit

Patients with mental severe illness were recruited at a mental health center in the Hospital Clinic of Valencia. Inclusion criteria: age from 18 to 65 years and diagnosis of severe/persistent mental illness Exclusion criteria: acute illness, were not understanding Spanish, not be able to read and understand questionnaries. We included following data: sociodemographic data and aspects of the health behaviors, anthropometric measurements and analytical with hemogram and biochemistry pre and post-intervention. All subjects gave informed consent for participation in the study.

We included 12 patients, but only 9 completed the full program. Average baseline data suggests that participants were at increased health risk when entering the program.At the end of the program, differences were observed: a reduction in glucose profile, a reduction of an average of 3.33 kg from the initial weight and a reduction of 10 points in blood pressure.

This real world pilot trial evaluate of a health promotion intervention targeting physical activity and healthy eating in mental health care using a specific programme.

None Declared

Recent reports confirmed that more than 22% of adult world population are suffering from addiction. Tobacco and alcohol use remain the most prevalent addictive behaviors reported in Tunisia. The management of addiction is a multidisciplinary team concept. This entity may be underdiagnosed due to perception default at the first line of management.

The aim of this study was to identify the limiting factors for addictive behavior approach in general practitioner (GP) clinic.

Recent reports confirmed that more than 22% of adult world population are suffering from addiction. Tobacco and alcohol use remain the most prevalent addictive behaviors reported in Tunisia. The management of addiction is a multidisciplinary team concept. This entity may be underdiagnosed due to perception default at the first line of management.

The aim of this study was to identify the limiting factors for addictive behavior approach in general practitioner (GP) clinic.

A cross-sectional study involved 84 GPs in the city of Monastir, Tunisia. Self‐reported questionnaire was designed to survey the prevalence of patients with detectable addictive behavior among the outpatient GP clinic visitors.

The participation rate was 93.3% (84/90). The prevalence of addictive behaviors was variable (38-59.5%). Tobacco use was the most common addiction (91.7%). More than seventy percent of questioned GPs were regularly consulting patients with known addictive behavior. The diagnosis was incidental in 7% of cases. Sixty percent of patients had predisposing factors for addiction. Diagnostic with screening difficulties for addictive behavior were independently related to doctor’s age >40 (OR = 6.51; p = 0.005), exercise in private clinic (OR= 6.46; p=0.004). Thirty-three percent of GPs were more involved in addiction monitoring. The use of assessment scales was noted in 15%. Young physician age (OR=5.20; p=0.002) and the absence postgraduate diploma in addictology (OR=9.66; p=0.01) were significantly associated addiction management avoidance.

This study aimed to assess of the attitude of GP in Monastir city regarding the addictive behaviors of their patients. The diagnosis and the management of addiction is not standardized for these health practitioners and this will not contribute to the battle against this social entity.

None Declared

Violence is a common behavioral and health concern among adolescents, aged 12 to 18 years old. In fact, aggressiveness may result in severe outcome in a critical age characterised by biological, psychological, and social changes. Schizophrenia is a severe and chronic condition, with elevated level of aggressiveness. Since unaffected biological relatives of schizophrenia patients share similar though less severe neurocognitive and behavioral abnormalities seen in their affected relatives, they are at increased risk of violence mainly during adolescence. However, studies including adolescents with schizophrenia first degree history are scarce.

The aim of this survey was to evaluate the aggressiveness among unaffected adolescents with fist degree family history of schizophrenia and in a control group of adolescents with no family psychiatric history.

In this purpose wo conducted a case-control cross sectional study in Razi hospital during three months: from July to September 2022. Unaffected adolescents aged 12 to 18 whom first-degree relatives were diagnosed with schizophrenia according to DSM-5 criteria were included. Adolescents with psychiatric conditions or medical affections associated with psychiatric presentation were not included. Control group was selected amongst the population. Sociodemographic data were collected on a preestablished questionnaire and the following scales were used: The Life History of Aggression LHA, an 11 items self-reported tool, in the Arabic version, The Aggression Questionnaire AQ which is a 29 items self-reported scale in Arabic version. Written informed consent was obtained from the legal tutor of each adolescent.

Results of this survey are ongoing.

Results of this survey are ongoing.

None Declared

Postictal Psychosis of Epilepsy (PIPE), part of the group collectively known as Psychosis of Epilepsy, is characterized by an onset of confusion or psychotic symptoms within one week of apparent normal mental function. PIPE has been argued to be underdiagnosed in the clinical population, perhaps due to a failure to recognize the temporal relation between the seizure and the psychotic episode.

To explore the concept and management of post ictal psychosis.

We present a clinical case and a review of the literature concerning post ictal psychosis.

We report the case of a 36 year old woman with focal refractory epilepsy after a likely episode of limbic encephalitis in 2015. Cognitive and psychiatric sequelae in the form of depressive symptoms, in treatment with neurology and psychiatry since 2021. One previous episode of psychotic symptoms during seizures. Worsening of seizure frequency since march of 2022 with apparent normalization (absence of seizures after dose reduction of eslicarbamazepine and introduction oflamotrigine) for about four days before being hospitalized in the neurology unit due tobehavioral abnormalities. During psychiatric exploration, the patient showed signs of partial clouding of consciousness with manierisms, ecopraxias and ecolalias; verbigerance in the form of the neurologist’s name and bizarre movements like looking behind suggestive of sensoroperceptive disturbances. The symptomatology resolved itself during the following week after treatment with diazepam.

Finally, a narrative review concerning the case was also performed; with particular emphasis on antipsychotic drugs with low risk of lowering seizure threshold (such as risperidone or aripiprazole) as the recommended treatment.

Our findings point to the relevance of Postictal Psychosis of Epilepsy as a clinical entity. Further studies on pathogenic mechanisms and therapeutic management are required.

None Declared

Drawing represents mainly a motor activity of expression. Drawing represents a form of non-verbal language that is very important both cognitively and affectively. Therefore, it allows to hypothesise and evaluate the degree of neurodevelopment of individuals as well as their level of interaction with the environment.

Family sketches can be evaluated in a projective, neurocognitive and affective way to provide insights on the attachment system, degree of bonding, communication, social and affect interaction as well as difficulties or problems that have motivated emergency consultation.

This study evaluate the possible correlation between family dysfunction and irritability as cause of request of consultation in an emergency department of mental health in child & adolescents through the analysis of family drawings.

This is a retrospective, observational study of correlation between the reasons of emergency consultations, dysfunctional irritability and family difficulties represented through family drawing. It is based on a randomised sample of 30 reports of emergency appointments of children between 8 to 13 years old that have been examined in the Child & Adolescent Psychiatry Emergency Department at the Pitié Salpêtrière Hospital during two years for Emotional or Irritability dysfunction.

An adaptation of both Goodenough-Harris Drawing projective test and Corman test were used to evaluate findings from family drawings as well as neurocognitive parameters of drawing technics, sociodemographic dates, cognitive level and family dysfunction.

The degree of cohesion, identification and devaluation of adult figures have been important elements of interpretation in irritability dysfunction and family drawings.

The family environment could be a factor in the interpretation of chronic irritability and its manifestations on the child’s family drawings establish a clear correlation.

The adapted assessment of the family drawing could be an important tool in the nosological exploration of children’s mental health in emergency, especially on relational systemic representation and symbolization.

None Declared

A mature and fulfilling sexuality is based on appropriate sexual education. The message must be adapted to the level of knowledge and practices of young people. Old studies dating back more than 15 years have been published.

The objective of this study is to assess adolescents’ knowledge and attitudes about sexuality.

This is a descriptive cross-sectional study conducted among 80 adolescents using an anonymous online questionnaire.

The average age of the participants was 18 years old 45% had had at least one sexual intercourse, they are mostly male. Only 9% had used a method of contraception. Most of them had heard of contraceptive techniques. Young age, male gender, lack of dialogue with parents, low socio-economic status and lack of sex education were significantly associated with a low level of knowledge about sexuality.

The results show that adolescents had risky practices with a lack of information. More studies are needed to approve these results and improve sexual health of these teenagers thanks to targeted sensitization.

None Declared

ADHD is a neurodevelopmental disorder that occurs in childhood and can persist in adulthood in a percentage of cases ranging from 15% to 70% (Cheung, C. H. et al. J. Psychiatr. Res. 2005; 62, 92–100). In these cases, if not treated, ADHD symptoms can cause severe dysfunction (Biederman, J., et al. Am. J. Psychiatry 2000; 157(5), 816–818) often leading to misdiagnosis.

The aim of this case report is to describe the clinical picture of a 26-year-old boy with ADHD and the consequences deriving from the missed diagnosis of the disorder during childhood.

We report a case of undiagnosed and untreated ADHD and the ensuing consequences.

G.V. is a boy who came to our attention complaining about a vague depressive symptomatology. After psychopathological examination we detected mood instability, with the alternance of phases characterized by deep despair and melancholy and phases of agitation with internal tension and generalized anxiety. He reported a tendency to act on an impulsive basis and an occasional abuse of cocaine together with a daily abuse of high doses of Alprazolam. During the past years the boy had been visited by several psychiatrists who made various diagnoses (borderline or avoidant personality disorder, cyclothymic disorder) and prescribed various drugs but none of these were able to stabilize the psychopathological condition. The clinical history revealed the presence of a pervasive picture of inattention and hyperactivity since childhood which had heavily conditioned the patient’s functioning over time. The inattentive pattern has persisted unchanged over the years, while the hyperactive one has improved leaving room for a stable sense of internal tension and generalized anxiety on which mood fluctuations are cyclically inscribed. A diagnosis of ADHD, combined presentation type, was made by using the DIVA-5. The patient was first prescribed lithium, which was subsequently replaced with valproic acid. After mood stabilization and the reduction of anxious symptoms prolonged-release methylphenidate was added to therapy, obtaining resolution of the clinical picture.

Almost all adults with ADHD exhibit a lifelong pattern of frequent mood swings and irritability. Given that many mental health practitioners are unfamiliar with emotional lability in adult ADHD, a bipolar, or cluster B/C personality disorder is more likely to be considered as the cause of the mood swings (Fayyad, J. et al. BJPsych 2007; 190, 402–409). An accurate collection of clinical history can guide the diagnosis and help to address adequate treatment.

None Declared

Nowadays the disorders of Mental sphere are still the clinically significant disturbances in an individual’s cognition, emotional regulation, and behaviour. They are usually associated with distress or impairment in important areas of functioning. In recent years, more than 280 million people were living with depression, including 23 million children and adolescents. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Heart failure (congestive heart failure) is the leading cause of hospitalization in people older than 65. Soluble ST2 is regarded as a key molecule regulating immune system as well as cell proliferation. Elevated serum concentrations of soluble ST2 have been reported in patients with neuropsychiatric disorders, suggesting pathophysiological roles of soluble ST2 in behavioral phenotypes.

measurement of the amount of ST2 molecule levels in the blood of patients with depressive disorders and comorbid heart failure.

there were examined 180 patients with depression of varying severity together with the syndrome of HF of ischemic genesis, FC II-IV (NYHA). Depressive disorders were diagnosed and determined using the Hamilton Depression Rating Scale (HDRS) with the result in 20 and more points. Transthoracic echocardiography was performed; the plasma content of soluble ST2 (sST2) and the titers of the N-terminal fragment of the brain natriuretic peptide (NT-proBNP) in the blood were determined by ELISA. Statistical analysis was performed using the standard software package “Statistica for Windows 12.0” (StatSoft, Tulsa, OK, USA).

The average age of the examined patients was (69.33 ± 10.44) years; among them - 64 women (35.5%). It was found that the levels of soluble ST2 and NT-pro-BNP in the blood of patients with depressive disorders and HF decreased with prescribing of 3 months therapy of multimodal antidepressant. After the treatment using vortioxetine, the majority of patients with HF and depressive disorders of moderate intensity - 111 (61.6%) people –noted a reduction in symptoms of both depression and heart failure. Univariate correlation analysis showed a direct relationship between soluble ST2 levels in the blood of the examined patients and the reduction of depressive symptoms (rs= 0.33; p = 0.041); blood content of NT-pro-BNP (rs = 0.51; p = 0.015); resting heart rate (rs = 0.31; p = 0.011) and feedback from LV EF (rs = -0.39; p = 0.043).

Patients with depressive disorders and concomitant heart failure that are treated with multimodal antidepressants (vortioxetine) are more likely to have decreased levels of soluble ST2 molecule in the blood, that explain the anti-inflammatory together with anti depressive effect of this medication.

None Declared

Within the theories that explain tooth grinding are dental factors, skeletal malocclusions, occlusal anomalies and defective reconstructions, however, there would be psychological factors that explain this phenomenon.

The aim of the study is to evaluate anxiety, depression and coping responses in university students who self-report clenching or grinding teeth.

Design: Non-experimental, cross-sectional, and quantitative.

Sample: University students (n=25) aged between 18-25 years (mean: 25.3; SD: 2.39), purposive sampling. Participants completed a self-reported questionnaire reporting teeth clenching/grinding habits.

Instruments: Standardized instruments were used, such as the State Trait Anxiety Inventory (STAI), Beck’s Depression Inventory (BDI) and Coping Strategies Scale Modified (CSS-M).

Procedure: First, the study was disclosed, the participants were informed and signed informed consent. They were asked to complete an instrument on teeth grinding/clenching habits and if it was fulfilled, it was included in the study and the psychological evaluation instruments were administered.

Data analysis: An analysis was made using descriptive statistics.

The STAI results showed a high Anxiety-State in all the participants and the Anxiety-Trait had a prevalence of 92.3%. Regarding the levels of depression, it was evidenced that 7.7% presented moderate depression and 31.6% showed mild symptoms.

The most used coping strategies were problem solving (87.2%), positive reappraisal (74.4%) and religious support (71.8%), while the least used were seeking professional help (92.3%), waiting (76.9%), aggressive reaction (74.4%) and expression of coping difficulty (71.8%).

University students must cope with an academic load that exceeds their capacity to face academic challenges (Wikes et al., 2019). This demand causes significant discomfort that increases emotions with a high negative charge and favors the appearance or intensification of mental health problems, such as chronic stress, anxiety, depression, nervousness and behavioral disorders.

None Declared

The neurobiological underpinnings of negative symptoms in schizophrenia remain unclear. Previous studies have revealed that in schizophrenia, the anticipatory component of the hedonic experience (anticipatory anhedonia, failure to anticipate reward or pleasurable experiences) is more markedly impaired than the consummatory aspect of pleasure (consummatory anhedonia, in the moment experience of pleasure during pleasurable situations). Several neuroimaging focused on reward prediction deficit have shown dysfunctions in the neuronal circuits that sustain these processes in patients, but findings have not been consistent.

The current study aimed at investigating the impairment of reward anticipation in subjects with schizophrenia (SCZ) during the “Monetary Incentive Delay task” (MID task), employing the topographic analysis of event-related potentials (ERPs) with EEG recordings. Furthermore, the associations with negative symptoms and anticipatory and consummatory hedonic experience were investigated.

EEG data were recorded in thirty SCZ and twenty-three matched HC, during the MID task in which reward and loss cues (incentive cues of positive and negative value) of different magnitude, as well as neutral cues were presented. Anticipation and experience of pleasure were measured by the Temporal Experience of Pleasure Scale (TEPS), while negative symptom dimensions by the Schedule for the Deficit Syndrome (SDS). For the EEG data analysis, the topographic analysis of variance (TANOVA) that uses the global field power of difference maps was used to evaluate between-group differences in scalp topography. Correlation analyses between hedonic experience, negative symptoms and ERPs were performed.

The TANOVA interaction effect (group x cue) was significant in the time window between 140.6 and 195.3 msec after cue presentation (p<.05). Post-hoc analysis showed that significant differences in topography were observed for the reward condition (p=.0006) but not for the loss one (p=.6732) between SCZ and HC. Finally, a significant correlation (p<.01) between t-maps values obtained in the same time-frame and the anticipation of pleasure scores was detected, while no significant correlations were found with the experience of pleasure scores or the severity negative symptom.

SCZ are unable to integrate the incentive magnitude and reward value of future events in the context of their ongoing task. Topographic abnormalities in ERP could be traced already during early stages of reward processing and were associated with anticipation of pleasure, but not with the experience of pleasure or the avolition, suggesting that these constructs might be partially separate.

None Declared

The emergence of new psychoactive substances (NPS) has had a substantial impact worldwide. NPS mimic the effect of “existing” drugs and are specifically manufactured so that the new substances fall out of regulatory frameworks. Although the structural changes might be minimal, NPS often have marked differences in potency and subsequent harm.

The population of the Azores archipelago has been particularly affected by the rapid growing and changing nature of this phenomenon, mainly caused by the introduction and spread of the “newly” synthetic cathinones as a inexpensive and easily available street drug.

Before any educational, public health and socioeconomic policy changes be proposed to accurately tackle the problem, the basic step of knowing how these substances have been affecting their users, specially their neuropsychiatric effects, must be taken.

This project aims to characterize the neuropsychiatric side effects caused by the acute intoxication of NPS with a psychostimulant profile, namely synthetic cathinones.

Description of the neuropsychiatric symptoms of intoxicated users of stimulant NPS that present to non-governmental organizations specialized in addictions and also to the psychiatry emergency department in Sao Miguel - Azores.

Review of the forensic records of the deaths by suicide in 2021 in Sao Miguel, looking for evidence of recent abuse of NPS or previous history of “NPS use disorder”.

Non-systematic review of the recent and relevant scientific literature on this topic.

The desired effects are increased energy, mood enhancement, euphoria, mental clarity, improved concentration, improved sociability, increased talkativeness, empathy inducing effects, amplification of sound and colour and prosexual effects. Nevertheless, in the case of intoxication, the frequent neuropsychiatric side effects tend to be agitation, agressiveness, irritability, altered consciousness, brief psychosis with paranoid delusion, visual and auditive hallucinations, transient mania, enhanced sensorial experiences, headaches, dizzyness, seizures, confusion and amnesia. Usually, the acjute intoxication period tend to be followed by a “crash” with depression, craving, anxiety, panic, suicidal ideation and behaviours. A third of the deaths by suicides in Sao Miguel Island in 2021, 7 out of 21, were in stimulant NPS active or recent users.

Review of the neuropsychiatric effects of New Psychoactive Substances with a psychostimulant profile. Further studies of this population of synthetic cathinone users in the Azores are due, namely studying their socioeconomic background, looking for risk and protective factors, and also the long-term side effects.

None Declared

Major depressive disorder (MDD) is characterized by both clinical symptoms and cognitive deficits. Prior studies have typically examined either symptoms or cognition correlated with brain measures, thus causing a notable paucity of stable brain markers that capture the full characteristics of MDD. Brain controllability derived from newly proposed brain model integrating both metabolism (energy cost) and dynamics from a control perspective has been considered as a sensitive biomarker for characterizing brain function. Thus, identifying such a biomarker of controllability related to both symptoms and cognition may provide a promising state monitor of MDD.

To assess the associations between two multi-dimensional clinical (symptoms and cognition) and brain controllability data of MDD in an integrative model.

Sparse canonical correlation analysis (sCCA) was used to investigate the association between brain controllability at a network level and both clinical symptoms and cognition in 99 first-episode medication-naïve patients with MDD. The potential mediation effect of cognition on relationship between controllability and symptoms was also tested.

Average controllability was significantly correlated with both symptoms and cognition (rmean=0.54, PBonferroni=0.03). Average controllability of dorsal attention network (DAN) (r=0.46) and visual network (r=0.29) had the highest correlation with both symptoms and cognition. Among clinical variables, depressed mood (r=-0.23) , suicide(r=-0.25), work and activities(r=-0.27), gastrointestinal symptoms (r=-0.25) were significantly negatively associated with average controllability, while cognitive flexibility (r=0.29) was most strongly positively correlated with average controllability. Additionally, cognitive flexibility fully mediated the association between average controllability of DAN and depressed mood (indirect effect=-0.11, 95% CI [-0.18, -0.04], P=0.001) in MDD.

Brain average controllability was correlated with both clinical symptoms and cognition in first-episode medication-naïve patients with MDD. The results suggest that average controllability of DAN and visual network reached high associations with clinical variates in MDD, thus these brain features may serve as stable biomarkers to control the brain functional states transitions to be relevant to cognitions deficits and clinical symptoms of MDD. Additionally, altered average controllability of DAN in patients could induce impairment of cognitive flexibility, and thus cause severe depressed mood, indicating that controllability of DAN may be a potential intervention target for alleviating depressed mood through improving cognitive flexibility in MDD.

None Declared

Video gaming is an extremely popular leisure activity, with over two billion users worldwide (Newzoo, 2017).

Nevertheless, excessive video game playing exposes to potential dangers. The WHO reminds us that “every gamer should be aware of the time spent on games, especially if their daily activities are affected, as well as any physical or psychological, social and health changes that could be attributed to gaming behaviour.”

The aim of our study is to analyse the frequency of video game use, and to determine its relationship with psychological and social functioning and academic performance.

A cross-sectional study was conducted in the child psychiatry department at Arrazi Hospital in Salé among adolescents aged between 10 and 17 years.

For this, we used:

• - A hetero-questionnaire on socio-demographic characteristics, reasons for gambling, type of gambling, satisfaction, self-esteem, ability to make friends and degree of social support, and school results

• - The DSM 5 criteria proposed in the appendix for the research

• - The K-SADS

Socio-demographic data

• - Our study was carried out on a sample of 57 adolescents aged between 10 and 17 years, with an average age of 13.47.

• - There was a predominance of males:

Boys: 87.5 , Girls: 17.5

All the adolescents are in school:

Social functioning and academic performance

• - 54.4% reported having both real and virtual friends, 29.8% specified that all their friends are virtual, And 15.8% noted that they have no friends

• - Academic decline was noted by the parents of 61.1% of adolescents Psychological functioning

• - 68.4% reported low self-esteem

• - 31.6% reported being dissatisfied with their lives

• - 0.5% met the diagnostic criteria for video game addiction

Our study finds that problematic video game use is related to male gender, low academic performance, difficulties with social interactions and also low self-esteem and satisfaction.

Screening for psychiatric co-morbidities and vulnerability factors is essential for the management of this type of pathology.

None Declared

The National School of Rehabilitation, Integration and Recovery in Mental Health was established in 2011 at Ono Academic College. Its operation is supervised and funded by the Department of Rehabilitation in the Mental Health Division of the Israel Ministry of Health. The School offers courses for a broad variety of mental health professionals and others involved in the mental health field (service users and family members) to promote professional competencies, social cohesion, learning from experience, and to advance mental health rehabilitation. In recent years, the School has become increasingly involved in multiculturalism, providing special courses and workshops for both the Palestinian-Arab and ultra-Orthodox Jewish sectors in Israel. The School is based on the belief in the ability of service users to recover, integrate, and live meaningful lives in the community. This belief is consistent with values of the recovery approach (Slade et al., 2017). The School is constantly in dialogue with the community, and provides training for interventions that promote recovery, as well as social cohesion in the field of psychiatric rehabilitation.

To describe the process of foundation, implementation, and outcomes of the unique model of the School; to discuss the multicultural and social opportunities and challenges; to portray major elements of the school methodology and practice.

Work model presentation through qualitative analyses of social and academical processes, alongside quantitative descriptive data.

Every year, 700 students from various helping professions in the field of psychiatric rehabilitation study at the School, as well as service users. The school operates as a bridge between academy and the field and encourages learner and staff diversity, joint learning, and discourse. Over 30 courses are conducted annually including evidence-based intervention courses such as IMR, and training courses such as knowledge by experience, supervision, rehabilitation coordinators, etc. In addition, unique courses are given, such as eating disorders, DBT, and social cognitive intervention training with multicultural adaptations. Lastly, the school offers consultation in implementing interventions within services.

The working model of the School operates under the framework and values of recovery, social integration and cohesion, and multiculturalism. To this day, the School offers courses, symposiums, conferences, and professional publications, to educate for values of recovery and community inclusion, alongside improving the quality of services.

None Declared

Research investigating interventions for problematic usage of the Internet (PUI) remains at an early stage but is steadily developing. In terms of therapies assessed through randomized clinical trials, literature suggests that cognitive behavioral therapy may be the most effective intervention but definitive statements as to its benefits need more testing. In relation to pharmacological treatments for PUI, studies have largely examined the efficacy of agents such as antidepressants and stimulants with a potential therapeutic effect of escitalopram, bupropion, methylphenidate, and atomoxetine. Another emerging form of potentially useful treatment involves non-invasive neurostimulation techniques such as transcranial magnetic stimulation and transcranial direct current stimulation. These interventions are thought to mediate their effect in PUI via stimulation of cortical brain cells and modification of their related functions. In summary, although the limited available treatment evidence includes some promising findings, there is a need for higher-quality research to develop best practice guidelines and determine cost-effective options in PUI treatment. The presentation will provide a state-of the-art overview in the field of therapeutics for PUI.

B. Dell’osso Grant / Research support from: LivaNova, Inc., Angelini, and Lundbeck

Understanding the psychological meanings of a rigorous protocol for introducing a drug to patients is a challenge of emotional management for clinical professionals. Clozapine is an effective drug for patients with schizophrenia resistant to treatment with first and second-generation antipsychotics. This medication has agranulocytosis as an important side effect. The medication protocol requires frequent blood draws to monitor any effect on blood cells. Investigating patients’ emotional perceptions about the experience with this procedure was the triggering question of our study.

To interpret emotional/symbolic meanings attributed by patients with schizophrenia to the protocol of introduction of clozapine in follow-up at a specialized university service.

Clinical-qualitative design of Turato. Semi-directed interviews with open-ended questions in-depth were conducted face-to-face with participants using clozapine. Closed sample by the theoretical information saturation criterion described by Fontanella. Data were treated by Faria-Schutzer’s Clinical-Qualitative Content Analysis, employing psychodynamic concepts of the theoretical framework of Medical Psychology.

From the analysis of nine patients, three categories emerged: 1) “Anyway, I come here to stay alive”: frequent blood collections of the protocol seem to have a good impact on patient’s adherence to treatment; 2) To re-signify a psychiatric illness: the protocol reinforcing an embodiment of a medical diagnosis; 3) “It is a very big precaution”: the protocol as real and emotional support to deal with the possibility of serious side effects.

Although blood collection is a repetitive experience for patients, such a routine does not mean that the procedure brings symbolizations that are more charged than the disease itself. Patients can benefit from the commitment to attend blood collection frequently, as it removes them from possible social isolation, allowing social interaction; it brings the perception of emotional security due to the commitment to the clinical team. These benefits can lead the patient to develop new meanings for their life condition. Future qualitative research can be conducted to study the meanings of medical protocols in other diagnostic situations.

None Declared

There is evidence that anxiety and depressive symptoms may lead individuals to under-estimate their own sleep quality, particularly among younger subjects (aged <45 yrs).

The aim of this study was to investigate the discrepancy between objective and subjective measurements of sleep quality in a sample of healthy control subjects (HCs) with no Axis I mental disorders, and the possible impact of panic-agoraphobic spectrum symptoms.

A total of 117 HCs (65 males and 97 females; Age: 35.3±14yrs) were evaluated by the: Panic Agoraphobic Spectrum-Self Report (PAS-SR), to investigate panic spectrum; the Pittsburgh Sleep Quality Index (PSQI) and actigraphy, respectively for the subjective and the objective sleep efficiency (SE) measures. Groups were divided according to the congruence between SE-actigraphic vs SE-PSQI (“Accurate”, “Underestimate”, “Overestimate”), establishing as a threshold an SE>85% as a measure of good SE. Regression analyses were conducted to assess the association between PAS-SR domains and the discrepancy between objective and subjective measurements, controlling confounding factors such as age, gender and BMI

Since our data showed that a low sleep quality was associated with a greater age and that higher PAS-SR scores were associated with younger age, we used a sub-sample of 117 participants with age <45 years and comparing the 3 groups of subjects created on the basis of the discrepancy: Accurate, N = 74 (63.2 %), “Overestimate group”, N= 23 (19.7 %), “Underestimate group”: N=20 (17.1 %), we found a statistically significant difference among groups in the PAS.SR separation anxiety domain (p value=0.032), with a multinomial regression model confirming this domain contributed significantly to the differentiation between the three groups with higher symptoms being associated with a higher probability of belonging to the “underestimate” group.

Our results suggest that the discrepancy between objective and subjective sleep efficiency measurements in HCs could be affected by panic spectrum symptoms, particularly separation anxiety.

None Declared

A well-established principle is that informed consent is an obligatory requirement for any medical intervention; a patient’s decision-making capacity to consent is a requirement for legally valid consent. Some individuals may be unable to give valid informed consent due to their limited mental capacity. In such cases, laws permit substitute decision-making and involvement of the patient as far as possible (Art.6, Oviedo Convention). National laws of European countries allow persons with mental health problems to be deprived of their liberty and undergo involuntary treatment, namely treatment without a patient’s informed consent, in certain circumstances. Procedural safeguards must be secured, and a court must review its lawfulness (FRA, 2012). The legality of involuntary treatment is highly debated by various audiences (CRPD committee, CoE bodies). In Latvia and other countries, the requirement to assess a person’s decision-making capacity in the application of involuntary treatment is not required.

This study was conducted to reveal the role of a person’s decision-making capacity to consent to the treatment of mental disorders in cases where involuntary treatment was approved by courts.

A retrospective case law study method was applied. Anonymised decisions of Latvian courts at www.manas.tiesas.lv in cases of involuntary treatment in Latvian adult psychiatric hospitals since 2010 were collected and analysed. The content of decisions concerning persons’ decision-making capacity and applicable legal regulations were studied.

The case law revealed that the decision-making capacity had not been addressed regularly and in detail. Latvian law does not require an assessment of capacity, and as a result, the courts do also not require any data. Some elements of decision-making abilities, such as the limited ability to comprehend or process information, are mentioned in the decisions of courts.

There is a need to address the significance of decision-making capacity in the application of patients’ rights law in clinical and legal settings when involuntary treatment is suggested or applied. There is a need to amend the laws justifying the limitations of patients’ rights, particularly concerning involuntary treatment.

This paper has been prepared within the research project “Towards a human rights approach for mental health patients with a limited capacity: A legal, ethical and clinical perspective”, No. lzp-2020/1-0397 and the project “Strengthening of the capacity of doctoral studies at the University of Latvia within the framework of the new doctoral model, identification No.8.2.2.0/20/I/006”

None Declared