The process of integrating technology into mental health pathways represents a social transformation that we are gradually getting used to. But does it represent a valid alternative to face-to-face care processes? In this paper we will consider telesychology as a tool for treating anxiety and depression and its validity. Anxiety and depression are harmful to individuals, suffering from these disorders, their caregivers, and the economy. Remote delivery of psychotherapy has been established as a viable alternative to traditional in-person psychotherapy for treating anxiety and depression. However, literature comparing and evaluating the variety of remote delivery modalities of psychotherapy has not yet been integrated.

This review examines the efficiency – to - practice and the limits of e-therapy and its mediums: telephone, video, and online-administered psychotherapy, for treatment of anxiety and depression.

A comprehensive literature search, conducted using PubMed and PsycINFO included systematic reviews, randomized controlled trials, and cost-analysis studies focused on a remote delivery method of e-psychotherapy for anxiety and depression

Overall, interventions delivered through telephone, video, and online modalities, have generally demonstrated good efficiency in treating anxiety and depression; also comorbid with other disorders. The literature also suggested that telehealth psychotherapy is accessible, convenient, and cost-effective.

In evaluating the reviews on the databases, it also emerged that among the many psychological therapies for anxiety disorders, delivered digitally (CBT, Attention bias modification, Exposure therapy, Applied relaxation, Bibliotherapy, Psychodynamic therapy, Mindfulness, Behavioral stress management, Counseling), the best digital therapy is internet-based cognitive behavioral therapy (iCBT), in particular for Social Anxiety Disorder (SAD).

Despite this, overall, the efficiency and practical benefits of remote psychotherapy interventions in treating anxiety and depression across a diverse range of patient groups suggested that it is an appropriate alternative for those who cannot access in-person psychotherapy.

Further research evaluating the efficiency and practical benefits of e-psychotherapy for anxiety and depression is much needed for patients with limited access to in-person psychological care. Moreover, it remains to evaluate the maintenance of therapeutic gains after the end of the treatments.

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

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.

None Declared

Research suggested that psychosis and mental illness-related experiences can be extremely traumatic, and that psychosis could theoretically also lead to posttraumatic growth (Mazor et al., 2019; PTG). The promotion of PTG may contribute to the treatment of people who experienced massive traumas such as people with severe mental illness (SMI). Psychotic symptoms are a common feature of SMI, and individuals who have experienced psychosis are also more likely to have been exposed to trauma and are more vulnerable to developing posttraumatic symptomatology (Ng et al., 2021). Negative symptoms such as amotivation could also contribute to the traumatic experiencing of psychosis (Mazor et al., 2016). Amotivation is specifically relevant to the possible traumatic sequelae of psychosis (Mueser et al., 2010). Alongside the adverse consequences of psychopathological symptoms is the unique outcome of coping with adversity (Tedeschi & Calhoun, 1995)- PTG. Two important factors that contribute to PTG is coping self-efficacy (CSE), and meaning making (Mazor et al., 2018). We investigated the possibility of PTG in individuals with SMI, through the mediating effect of CSE and meaning making.

Recent research has shown high rates of exposure to trauma among people with SMI, and that psychosis and mental illness-related experiences can be extremely traumatic. While some develop PTSD, it has been noted that some may also experience PTG. However, few studies have examined PTG in this population.

121 participants were recruited from community mental health centers and administered trauma and psychiatric questionnaires. Study protocol was approved by the University of Haifa ethics board.

High levels of traumatic exposure were found in the sample. Furthermore, we found that people who endured psychosis can experience PTG, which was mediated by meaning making (MLQ) and CSE. Psychotic symptoms were found to be a major obstacle for PTG, whereas negative symptoms were found to have the potential to lead to PTG when mediated by meaning making and CSE.

Mediation analyses for the dimensions of PANSS, MLQ total, CSE total, and PTGI total (N=121)

The portrayed research provided preliminary evidence for the potential role of meaning making and CSE as mediators of PTG in the clinical, highly traumatized population of people with SMI who have experienced psychosis.

None Declared

Excessive mind wandering is a common feature of ADHD in adulthood also referred to as mental restlessness and ceaseless mental overactivity. ADHD is a predisposing factor for many psychiatric symptoms, especially negative emotions such as depression and anxiety. Rumination is thought to be a mediator for depression in individuals with ADHD. The above-mentioned mental processes may reduce the ability of individuals with ADHD to be mindful.

This study investigates whether the mentation processes (excessive mind wandering, rumination, mindfulness) mediate the relationship between ADHD symptoms and anxiety, and depression in adults with ADHD.

Medication-free 175 individuals with ADHD who were referred to the Adult Neurodevelopmental Disorders Clinic, Department of Psychiatry, Selçuk University were invited to the study. After initial diagnostic examination including The Structured Clinical Interview for DSM-5 (SCID 5), all participants completed a test battery that included a sociodemographic form, the Adult ADHD Severity Rating Scale, the Hospital Anxiety Depression Scale, the Mind Excessively Wandering Scale, the Ruminative Response Scale, and the Freiburg Mindfulness Inventory. The data of 159 patients whose ADHD diagnosis was confirmed, who did not have any mood episodes and psychotic symptoms at the time of inclusion of the study, and who filled out the forms completely, were included in the analysis. The study was approved by the Selçuk University Local Ethics Committee.

Participants ages ranged from 18 to 39 (mean of 22.93 ± 4.36), and 57.2% (n = 91) were women. Also, their 48.6% (n = 77) reported that they alcohol use, and 21.1% (n = 34) had substance use history. According to SCID 5 interview, participants 64.2% had comorbid psychiatric conditions. Pearson correlation analysis revealed that ADHD symptoms, rumination, excessive mind wandering, anxiety, and depression scores were significantly positively correlated with each other, but all were negatively correlated with mindfulness. Linear regression analysis showed mindfulness association with rumination, excessive mind wandering, anxiety, and depression scores, but not with ADHD symptoms. Thereupon, a conducted mediation regression analysis showed that ADHD symptoms indirectly worsened depression and anxiety through increased rumination and excessive mind wandering, and decreased mindfulness ability (Figure 1).

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Adults with ADHD have distressing mentation patterns which worsened their anxiety and depression. Mindfulness-based cognitive behavioral therapy modalities may help improve excessive mind wandering and rumination in ADHD. Our findings should be warranted in future studies of functional brain connectivity patterns that may serve as a mentation endophenotypes in ADHD.

None Declared

The COVID-19 pandemic has produced negative mental health outcomes, which were more prominent in vulnerable communities, such as Fort McMurray (FMM), the community that experienced prior similar disasters.

This study aimed to examine the likelihood and correlates of anxiety symptoms among FMM residents, during the COVID-19 pandemic.

A cross-sectional online survey questionnaire was applied between 24 April and 2 June 2021, at FMM community to gather a set of data, including sociodemographic, COVID-19, and clinical information. Generalized anxiety disorder was the main outcome of the study, and was measured using GAD-7 scale.

Overall, 186 individuals completed the survey (response rate 74.7%). Most of the respondents were females (159, 85.5%); above 40 years (98, 52.7%); employed (175, 94.1%); and in relationship (132, 71%). The prevalence of moderate-to-severe anxiety was (42.5%, 71) on GAD-7 self-reported scale. Subscribers who reported that they would like to receive mental health support; have received no family support since COVID-19 declaration; and have lost their job during the pandemic were all more likely to report moderate-to-severe anxiety (OR = 3.39; 95% CI: 1.29-8.88), (OR = 4.85; 95% CI: 1.56-15.03), and (OR = 4.40; 95% CI: 1.01-19.24), respectively.

Anxiety levels were high among FMM residents, compared to levels before COVID-19. Clinical and social factors related to the COVID-19 pandemic significantly predicted likely anxiety among Fort McMurray population. It is imperative to mobilize resources to support vulnerable communities during the COVID-19 pandemic.

None Declared

Despite its well-known acute and long-term harmful effects on a person’s mental health and well-being, alcohol remains the most commonly used psychoactive substance among adolescents after tobacco products in many countries.

We aimed at studying the prevalence of alcohol use, and identify associated factors in Tunisian high school adolescents.

We used national data from the 2021-Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD). Based on a clustered two-stage stratification sampling method, a representative sample of teenagers aged 16 to 18 years, was selected. Data collection was performed using a self-administered standardized questionnaire, assessing socio-demographic characteristics and risky behaviours, and including questions about alcoholic beverages patterns of use. Binary logistic regression model was used to assess associated factors and adjusted Odds Ratios (AORs) were presented with 95% confidence intervals (CI). Cspro software was used for data entry and all statistical analysis were performed with STATA software.

A total of 6201 adolescents with a mean age of 16.8 years and a sex ratio female/male of 1.5 were enrolled.

Lifetime prevalence of alcoholic beverages consumption was 8.0%, 95% CI [7.0, 9,1] (n=6196). The prevalence of alcohol consumption during the previous year and month were 5.1 % and 1.7% respectively. Cocktails and beer were the most frequently consumed beverages.

Prevalence of alcohol use was significantly associated with tobacco, cannabis and e-cigarettes use (AOR 9.5, 6.0 and 1.9 respectively; p≤10-3), a higher frequency of nights spent away from home, school absenteeism for non-medical reasons and enrolment in the private sector.

Alcohol intoxication was reported by 2.9% of respondents during their lifetime.

Early onset was reported by 17.2% of respondents for alcohol use and 10.1% for alcohol intoxication.

Although the prevalence of alcohol use was relatively low among Tunisian adolescents compared to European adolescents, early onset- indicating an increased risk of developing an alcohol use disorder- warrant the implementation of primary prevention interventions through mental health promotion and life skill trainings to halt these trends and avert the raising burden of morbidity and mortality attributable to alcohol use.

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

The effects of antidepressant and antipsychotic medications in the perinatal period in both mothers and children have been a subject of interest for many decades. Risks and benefits should be considered according to the illness stage, trimester of pregnancy/ postpartum period, and neonatal outcomes.

Our goal was to summarize the knowledge about the use of antidepressants and antipsychotics in the perinatal period. To illustrate the complexity of treatment decisions with clinical reports.

Review: A narrative review was carried out using the PubMed database including papers published in 2022. Evidence about the risks and benefits of using antidepressants and antipsychotics in the perinatal period is presented. Search terms: antidepressants OR antipsychotics AND (perinatal OR pregnancy OR postpartum).

Case reports (5 clinical scenarios): (1) pre-pregnancy counselling, (2-4) first-, second- and third-trimester of pregnancy, and (5)postpartum/breastfeeding.

Review: (1)Depression/antidepressants. Treating maternal depressive symptoms is associated with a lower risk of pregnancy complications. Although placental passage of sertraline is low, drug monitoring is recommended. Antidepressant use in pregnancy is associated with preterm delivery and low weight at birth. (2)Psychosis/Antipsychotics. Antipsychotic intrauterine exposure is not significantly associated with increased risk of major congenital malformations. Minimum effective doses are recommended.

Case reports. (1)Pre-pregnancy counselling. Schizoaffective disorder receiving perphenazine, quetiapine and lithium. (2)First-trimester pregnancy. Discontinuation of treatment in major depressive disorder. (3-4)Second/third trimester. Occurrence of anxiety symptoms in posttraumatic stress disorder. (5)Postpartum/Breastfeeding. Discontinuation of antidepressants.

Shared decision-making models for antidepressants and antipsychotics prescription represent patient-centered approaches to be recommended in perinatal period.

None Declared

Adolescence is the period when many mental disorders have their peaks of onsets. Investigation into adolescent mental health problems and their risk factors is required, but there has been few prospective cohort studies on adolescent mental health.

This study aimed to prospectively reveal the developmental trajectory of physical and mental health in adolescence, and to investigate factors associated with the trajectory.

We launched a prospective cohort study (Tokyo Teen Cohort: TTC) on general population of adolescents at three municipalities in metropolitan area in Tokyo, Japan. Using the resident register, we recruited 10-year-old children from the community between 2012 and 2015. The second, third, and fourth wave of data collection were conducted at 12, 14, 16 years of age, respectively. We collected multidisciplinary data including mental health by self-report questionnaire and home-visit interview. Further, we have launched two subsample studies which focus on biological measures such as brain MRI, EEG, and sex hormones. TTC is based at three research institutes, and ethics approval has been granted by all of the three institutions.

A total of 3171 children participated the TTC. Of those, 3007 children participated in the second wave of data collection (follow-up rate: 94.8). The third and fourth wave of data collection were completed and more than 80% of children continued to participate in TTC. More than 300 children participated in the two subsample studies. More than 30 papers were already published, and many national/international research collaborations have started.

The fifth wave of data collection at 20 years of age is being currently conducted. Further national/international collaborations are expected to examine cultural effects on mental health of adolescents.

None Declared

In patients with schizophrenia, numerous studies have shown a relationship between negative symptoms and cognitive deficits (both neurocognition and social cognition deficits) and a similar impact of these domains on different clinical features such as onset, course and prognostic relevance. However, this relationship is still today subject of scientific debate.

The aim of the present study is to conduct a systematic review of the literature on data concerning the relationships between neurocognition and social cognition deficits and the two different domains of negative symptoms ̶ avolition-apathy and expressive deficit.

A systematic review of the literature was carried out following PRISMA guidelines and examining articles in English published in the last fifteen years (2007 - March 2022) using three different databases (Pubmed, Scopus and PsychINFO). The included studies involved subjects with one of the following diagnoses: high risk of psychosis, first episode of psychosis, or chronic schizophrenia. Other inclusion criteria of the reviewed studies included: evaluation of at least one neurocognitive or social cognition domain and at least one negative symptom using standardized scales; analysis of the relationship between at least one neurocognitive or social cognition domain and a negative symptom.

Databases search produced 8497 results. After title and abstract screening, 395 articles were selected, of which 103 met inclusion criteria. The analysis of retrieved data is still ongoing. Preliminary evidence highlighted: a correlation between social cognition and negative symptoms, in particular with the “expressive deficit” domain; a positive correlation between the severity of negative symptoms and that of neurocognitive deficits (in particular with the “processing speed” domain); an association of verbal working memory deficits with alogia and anhedonia.

The study of the relationship between negative symptoms, neurocognitive deficits and social cognition could contribute to the understanding of the aetiology of psychotic disorders and therefore to the identification of therapies for the improvement of overall functioning and quality of life. The studies analysed so far show some interesting associations between cognition and negative symptoms, but the presence of often inconsistent results, partially attributable to the different conceptualizations of the various domains of negative symptoms adopted, hinders the generalization of the results.

None Declared

Adverse childhood experiences are common and have been linked to a number of physical illnesses, as well as socioeconomic problems. Moreover, it has been proven that ACEs can increase chances of people showing criminal behaviour. The question arises whether people with ACEs also have an increased chance of joining extremist groups or violent gangs.

The aim of this systematic review is to measure the ACE rates in violent extremists and gangs and to establish whether there is a pattern linking ACEs to violent extremist organizations and gangs.

The following databases were searched to retrieve relevant studies: the ProQuest Social Science database, Pubmed, Scopus. Eligible studies were articles of any study design that reported ACE rates in either extremists or gang members. Data was extracted and organized into a table and a quality assessment was performed using standardized tools (CASP and NHLBI). A narrative synthesis of the evidence was conducted. A meta-analysis could not be performed due to the heterogeneity of the studies.

22 studies (eight on extremists and fourteen on gang members) were included. The studies varied in terms of research design, sample size, location and measured ACEs. Quality also varied across the studies. The prevalence rates were heterogenous and ranged from 0% to almost 100%.

Physical abuse was the most addressed ACE (5 studies on extremists and 11 on gang members). Sexual abuse was the second most explored ACE (4 studies on extremists and 9 studies on gang members). Neglect and caregiver loss were also common ACEs, while the other ACEs were less represented in the two subpopulations. A comparison between the two subpopulations was difficult due to the differences in the studies.

While overall ACE rates were high in the two groups and some ACEs were salient in the two subpopulations, quality of evidence varied across the studies. No solid ACE pattern across the studies could be found. Moreover, there were only two prospective studies on gang members and none on extremists, so a causal relationship between ACEs and involvement in violent gangs or extremist organizations could not be established. Future research should concentrate on studies of this design, as well as on improving the quality of the evidence.

As ACEs are extremely common, researchers should also look beyond them when searching for causes of extremism or violent gang membership. Other negative events (bullying, racism) should also be explored.

None Declared

Coronavirus disease 2019 (COVID-19) modify voluntary admission rates to psychiatric wards in the early phases following pandemic onset. Older patients have higher COVID-19 distress scores because elderly people are at risk for COVID-19 infection.

The present investigation aimed at admission rates of elderly patients to a General Hospital Psychiatric Ward during the lockdown due to the COVID-19, compared to similar periods of 2018 and 2019.

Anonymized data on psychiatric admissions (n=55) from one general hospital psychiatric ward have been obtained and analysed. We compared admission characteristics between April and June of 2018 and 2019 with the same period of 2020 (lockdown).

During the COVID-19 lockdown, a significant reduction in psychiatric hospitalizations of older patients (aged >65 years) was observed in the lockdown (69.2%; χ2=4.823,df=1,p=0.028) in contrast with young patients (26.7% reduction). There was a reduction of 14% in admission due to suicidal behaviour (IRR = 0.57; 95% CI: 0.11-2.75; p=0.48), 25% in depression (IRR = 0.28; 95% CI: 0.64-1.25; p=0.09) and 50% in psychotic disorders (IRR = 0.33; 95% CI: 0.07-1.48; p=0.15). There was none admission by dementia during the lockdown.

Changes in the number of psychiatric admissions, particularly for older patients, were observed during the COVID-19 lockdown. During this period, their fear levels could modify their psychiatric admission rates. We suggest that the decrease of psychiatric admissions in the elderly was due to fear of contagion in hospitals.

None Declared

As the founder of modern psychology as a discipline Wilhelm Wundt came up with the theory of tridimensional feeling (Wundt. Grundriss der Psychologie 1922; Leipzig), which has evolved over time with different theories and is thought to be essential for human survival. A feeling is the conscious awareness of the emotion itself. Feelings are personal and biographical, emotions are social, and affects are impersonal.

We intend to understand how emotions can be explained through theories since the beginning of the modern psychology.

We performed a review of the published literature on the subject using Pubmed. We conducted a search using ‘feeling’ , ‘emotion’ and ‘affect’ as keywords.

Although there are many theories on emotions they conclude that for centuries emotions have various functions and they help us survive. In order to explain this we can make use of biopsychosocial perspectives.The history of study of feeling began with Wundt’s theory of tridimensional feeling and later on different theories such as structuralism, functionalism, evolutionary perspective, behaviorism and nowadays most famous theory neuropsychoanalysis were proposed. Affect can be described as the individual’s ability to participate in stimuli, events, memories and thoughts with an emotional response, on the other hand feelings are the subjective complements of sensations but do not originate necessarily from a sense organ. Moreover, emotion is the reflection of a feeling.

Based on our research, we conclude that for almost over a century there are still theories being developed on feelings and in this matter biopsychosocial perspective has a critical role on its advancement. Are emotions just telltale signs of homeostasis, as Damasio points out? (Damasio & Carvalho. Nat. Rev. Neurosci 2013; 14(2), 143–152.) Apart from their physiological functions, can there be emotions that were once experienced and then suppressed and pushed into the unconscious? If we explain the unconscious only with the functioning of procedural memory in accordance with the current findings of neuroscience, then some changes are needed in our understanding of psychotherapy and especially transference. Because “is the thing that helps change in psychotherapy, the expression of an idea, the verbalization of the experiences, or an emotional/affective exchange between the psychotherapist and the patient?” We must find the answer to the question. It is hoped that neuroscience in general and neuropsychoanalysis in particular will reach new findings and explanations on these issues in the near future.

None Declared

The treatment of the person with alcohol dependence allows the possibility of a self-determined alcoholic abstinence and reducing the consequences associated with alcohol-related problems at a personal, family, work and social level.

It is important to develop therapeutic strategies that complement the different approaches in the treatment of people with alcohol dependence, enabling them to use effective coping strategies that facilitate the maintenance of their self-determined alcohol abstinence.

In recent years, scientific evidence has emerged that justifies the adoption of mindfulness-based protocols as a complement to various treatments, both for the prevention of relapses and as a treatment enhancer.

To train people with alcohol dependence to use Mindfulness;

To promote psychological well-being and positive emotions;

To reduce anxiety;

To evaluate the effectiveness of a Mindfulness-based intervention program.

The Mindfulness-based intervention program was developed with 2 groups of people hospitalized for the treatment of alcohol dependence (the institution’s treatment protocol is comprehensive and based on self-determined alcohol abstinence). The 1st G (pilot) - 6 people; 2nd G - 5 people), total of 11 participants; 4 sessions (each group), duration 45-60 minutes.

The selection criteria of the participants were evaluated in an interview and defined as follows: being in the first week of the treatment program; self and allo psychic orientation; reduced to moderate anxiety (Zung Self-Assessment Anxiety Scale - EAAZ); existence of motivation for change.

Participants gave informed consent.

In the global assessment used instruments: Psychological General Well-being Scale for the Portuguese population (BEP); Short Version of the Portuguese Scale of Positive and Negative Affect (PANAS-VRP) in the first session (before intervention). In the last session (after the intervention), in addition to the BEP and the PANAS-VRP, the EAAZ was also used.

At the end of each session, an evaluation was carried out using a grid built for this purpose.

As for the general psychological well-being, the BEP, only one participant (pilot group) had a final score lower than the initial one.

With regard to PANAS-VRP, in both groups, there was an increase in positive affection and a reduction in negative affection at the end of program implementation.

With regard to the EAAZ, 7 participants showed a decrease in anxiety after the intervention.

The evaluation grid of each session revealed good participation, good adhesion and positive evaluation.

It is concluded that after the implementation of the Mindfulness-based intervention program there was: an increase in well-being (the higher the score, the greater the state of well-being); increase in positive affection (which remained or increased); decrease in negative affection and decrease in the level of anxiety.

None Declared

The University Clinic of Skopje – Skopje was part of two Horizon 2020 projects – IMPULSE and RECOVER-e that finished in December 2021. The advances in the field of community mental health in the capital of Skopje, the idea to combine the best aspects of the aforementioned projects and the need of continual implementation and research on an evidence-based community-based service delivery model for recovery-oriented care led to this study which aims to improve functioning, quality of life, and mental health outcomes for people with severe and enduring mental ill health, such as schizophrenia, bipolar disorder, severe depression.

The objectives of the study are: - to design, implement and evaluate recovery-oriented care for people with severe mental illness in community settings using a psychosocial digital intervention - DIALOG+;- to recognize the value of experiential knowledge through inclusion of peer experts as members of community mental health teams;- to develop scale-up plans for national decision-makers, as informed by the intervention’s implementation and impact, for sustained implementation and scale up after the research study’s timeline.- to improve the conditions of people suffering from psychotic disorders and to overcome financial barriers encountered in the treatment of psychotic disorders in N. Macedonia.

DIALOG+ represents an affordable and effective intervention which has already demonstrated positive outcomes in previous research. This study involves the use of the DIALOG+ intervention during home visits, so that patients themselves can decide which aspects of their life that they would like to discuss and work on improving. DIALOG+ lets them rate 12 domains that are related to quality of life, such as physical health, relationships and employment. Patient decide which of these they would like to discuss in detail during the meeting. There is then a 4-step approach to help improve this aspect of their life, using the principles of solution-focused therapy. Researchers will collect information about demographic characteristics, quality of life, and symptoms in patients taking part in the study through the administration of questionnaires and clinical scales.

The study is still in phase of completion. The results will be shown at the EPA Congress 2023.

Having the previous positive outcomes from IMPULSE and RECOVER-e, with this combined approach we expect even more improvement in functioning and better quality of life in patients suffering from severe and enduring mental ill health.

None Declared

The COVID-19 pandemic is a healthcare crisis, with unprecedented impact on healthcare services, notable morbidity and mortality of the public and healthcare workers, economic impact and significant psychosocial impact. Besides, this pandemic has had a profound negative effect on the mental health of people worldwide, particularly among those who are faced with combating the virus.

The aim of this research was to examine the impact of the COVID-19 pandemic on healthcare workers’ mental health (HCWs), as they are on the front line of the pandemic.

An internet-based questionnaire was created including the following scales: (1)Posttraumatic Stress Disorder Checklist (PCL-5), (2) Secondary Traumatic Stress Scale (STSS) (3) Quality of Professional Life (ProQOL) (4) Post-Traumatic Growth Inventory, (PTGI), (5) Brief Resilience Scale (BRS), (6) Brief Orientation to Problems Experienced Inventory (Brief Cope)], (7) Self-Compassion Scale (SCS-SF). It was distributed to 120 Greek health professionals, including nurses, doctors, midwives and physiotherapists.

Most of the participants were female with an average age of 46 years. HCWs had low levels of both primary and secondary traumatic stress . They presented post-traumatic growth in the dimension of relationship with others. They used predominantly the coping strategies of positive reframing, acceptance of the situation, venting, and instrumental support.

Females had statistically significant higher levels of post-traumatic growth, better quality of life, and used more positive coping strategies compared to males. Humor and acceptance were coping strategies used mainly by physicians. Nurses and midwives had worse quality of professional life potentially due to increased workload. HCWs with more functional ways of coping were more resilient and seemed to have better quality of life, such as higher compassion, satisfaction, lower burnout, and lower post-traumatic stress.

The experience of the COVID-19 pandemic highlights the need to implement some strategies to protect health care workers’ mental health and to take extensive prevention measures in highly stressful situations.Further research is needed to clarify the long-term negative and positive psychological effects of the pandemic on healthcare personnel’s mental health.

None Declared

Although in many countries in the meantime more women than men choose medicine and later psychiatry for their training, key positions in hospitals and research are still mainly held by men. The professional career of women is impeded not only by institutional, but also by psychological barriers such as gender role behavior and gender role stereotypes. Mentoring can help young women to overcome these barriers.

But usually mentoring starts too late. As studies have shown, important decisions about future career steps are taken already towards the end of medical studies. Therefore, gender sensitive teaching and mentoring should start already at university and should not only address young women, but also young men as potential partners and future colleagues - especially regarding their gender role behavior and stereotypes. Mentoring programs considering gender-specific needs should be implemented in the regular teaching during medical studies and in psychiatric training.

Furthermore, women should be coached during their further career steps since there is not only a “glass ceiling” that excludes young women from achieving leadership roles. When they finally have achieved such a role, women often face further difficulties stemming from gender stereotypes and traditional gender roles.

University teachers and employers should be addressed, as well as politicians. Otherwise, psychiatry not only loses a great potential of talents, but might also miss the chance of reforms towards a more gender-sensitive psychiatry and psychotherapy.

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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.

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Due to the exacerbation of psychotic processes in acute psychiatric services, patients may exhibit risky behaviors for themselves and others. Especially, psycho-motor agitation seen in schizophrenia may result in some harmful behaviors towards him/her self or other individuals in patient. Physical restrain, or chemical restrain with psychotropic drugs can be used for ensuring the safety of the patient with a tendency toward violent behavior and to prevent harm to himself and others. These restrain methods are usually applied when they showed aggressive or violent behaviors, that is after the observed warning signs or real violent behaviors.There is no system that can evaluate and notice agitation or tendency of violence before the obvious behaviors. By using a wearable sensor system to be able to measure some biological change and to evaluate of the sensors’ ability to obtain quantitative and objective data may help the health professionals to prevent the damage in advance.

The aim of this pilot study was to evaluate the changes in measurements of the four wearable sensors which applied to persons with schizophrenia.

Ten patients who restrained in the observation room, selected for this pilot study. On the first day (13:00), which meets the criteria for inclusion in the study and the end of the insulation process (the COVID test result is negative), the first measurement was before the noon treatment. The patients’ second measurements were taken on the day they switched from parenteral to oral treatment. For measurement, the sensor circuits developed at the Physiological Analysis and Wearable Systems Research Laboratory of Koç University were connected to various parts of the body to collect the non-invasive data detailed below. In addition, including the clinical status of the patient in the experimentation process, and a positive-negative syndrome scale was also used. The data from the patient was obtained under the supervision of the clinical chief nurse for 10 minutes. Sensors were electrocardiogram (ECG) photoplethysmogram (PPG), seismocardiography (SCG), body temperature.

Since some recording errors observed in two patients’ records, the data of eight patients were evaluated. Aside from one of the eight patients evaluated, the signal deviation and strength of other patients’ data increased in general. This result imply that signal deviations and strengths may be reduced during the psychomotor agitation. These deviations may suggest that this sensor system is capable to evaluate some biological changes in patients.

Considering the results of the pilot study, it is planned to carry out future studies with a larger sample size and longer records. With these studies, it is thought that psychomotor agitation in patients can be determined in an objective and measurable way without risk.

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