In 2016, the International Olympic Committee (IOC) preliminarily recognized cheerleading as an Olympic sport. In this regard, the participation of Ukrainian cheerleaders in the 2024 Olympics in Paris is quite likely. The athlete’s performance depends on both physical and psychological factors. Human behavior depends on interaction with other people. Empathy is based on social interactions and is defined as understanding, awareness, sensitivity, and the ability to experience the feelings, thoughts, and experiences of another person. There is little research on the impact of empathy on individual athlete and team performance and performance. Psychological training in sports involves a significant amount of work with the athlete, in particular on the part of the coach: the formation of personality and interpersonal relations, the development of sports intelligence, mental functions and psychomotor qualities, etc.

The purpose of the study was to determine the level of empathy among cheerleading coaches.

The following research methods were used to realize the goal of the work: 1) theoretical analysis and generalization of literary sources and Internet data; 2) observation, questionnaire, interview; 3) method of expert evaluations; 4) method of diagnosing the level of empathy; 5) methods of non-parametric statistics.

According to the general (total) indicator of empathy, the vast majority of cheerleading coaches (n=18) fell into the group with a reduced level of empathy, which is generally characteristic of coaches of some other team sports. According to the results of the research, the following features were revealed regarding individual trends in the structure of empathy of the subjects. In particular, the lowest number of points for coaches was found on the scales “Rational component of empathy”, “Identification abilities (ability to imitate)” and “Intuition”.

The data of the conducted research show that the vast majority of the surveyed coaches are characterized by a reduced level of empathy. The most pronounced components of empathy, according to the obtained results, were such components of the coaches’ personality as penetrating abilities (ease of establishing communicative ties), emotional sensitivity and instructions that promote or hinder empathy.

None Declared

Early-onset schizophrenia (EOS) is a relatively uncommon disorder with psychotic symptoms emerging before 18 years of age. Although still under debate, EOS may be a more severe disorder relative to adult-onset schizophrenia (AOS), with worse prognosis. Cognitive deficits are a core feature of schizophrenia, accounting for a large part of the detrimental effect of the disorder and may reflect underlying neurodevelopmental disturbances. Some but not all previous studies show that the magnitude of cognitive deficits, including intelligence quotient (IQ), in patients with schizophrenia is dependent on the age of onset.

We aimed to assess IQ in adult patients with EOS and AOS, and healthy controls. We hypothesized that patients with EOS would show lower IQ than those with AOS, and both patient groups lower IQ than HC.

We included 136 adult patients with EOS (mean age: 24.7 (7.7) years, mean duration of illness: 9.3 (8.5) years, 50% women), 382 patients with AOS (mean age: 32.4 (9.5) years, mean duration of illness: 5.7 (6.6) years, 40.1% women) and 896 adult healthy controls (mean age: 33.2 (9.2) years, 47.1% women). We assessed current IQ with the Wechsler Abbreviated Scale of Intelligence (WASI) which yielded verbal (VIQ), performance (PIQ) and full-scale IQ (FIQ) scores. In a post-hoc analysis, we estimated premorbid IQ using the National Adult Reading Test (NART). We applied analyses of covariance (ANCOVAs) to investigate the putative differences in IQ scores and IQ change between patients with EOS, patients with AOS and healthy controls.

In sex-, and age-adjusted models, FIQ and PIQ, but not VIQ, were significantly lower in EOS than in AOS (p=0.03, p<0.001 and p=0.428, respectively) (Image). Patients with EOS had fewer years of education than patients with AOS (p<0.001); the PIQ but not the FIQ difference between EOS and AOS remained significant after adjustment for education years (p=0.016 and p=0.333, respectively). Both patient groups had significantly lower IQ scores than healthy controls (Image). Further, patients with EOS and patients with AOS did not significantly differ in estimated premorbid IQ (109 and 110 units, respectively, p=0.092), whereas patients with EOS had a significantly larger estimated IQ decline after the disease onset compared to patients with AOS (12 and 9 units decline, respectively, p=0.015).

Image:

Our findings show that adult patients with EOS have significantly lower PIQ and FIQ scores, and significantly larger IQ decline after the disease onset, but not lower premorbid IQ, compared to patients with AOS. The adolescent onset of psychotic symptoms is linked, as expected, to fewer total years of education, which appears to explain the lower FIQ but only partially the lower PIQ in EOS, which may thereby be linked to the disorder per se.

T. Calkova: None Declared, L. Mørch-Johnsen: None Declared, R. Elle Smelror: None Declared, K. Nordbø Jørgensen: None Declared, S. Cervenka: None Declared, K. Collste: None Declared, A. Vaskinn: None Declared, A. Margrethe Myhre: None Declared, O. A. Andreassen Consultant of: HealthLytix, Speakers bureau of: Lundbeck and Sunovion, T. Ueland: None Declared, I. Agartz: None Declared, D. Andreou: None Declared

There is a paucity of population-based longitudinal studies examining the associations between childhood behavioural problems and alcohol use disorders in later life.

This study aimed to examine the association between hyperactivity/inattention problems in early adolescence and the risk of alcohol use disorders in young adulthood.

We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based prospective cohort based in Bristol, United Kingdom. Hyperactivity/inattention problems at 11 years of age were measured using the Strengths and Difficulties Questionnaire (SDQ). Logistic regression analyses were used to examine associations. E-values (E) were calculated to estimate the extent of unmeasured confounding.

Hyperactivity/ inattention problems in early adolesce were associated with a 1.75-fold increased risk of any alcohol use disorders (OR = 1.75, 95% CI: 1.20-2.56; E= 2.90, CI: 1.69) and a 4-fold increased risk of severe alcohol use disorders at age 24 (OR = 4.35, 95% CI: 2.00 – 9.47; E= 8.17, CI: 3.58). We also found a 2.09 (OR = 2.09, 95 % CI: 1.24-3.53; E= 3.60, CI: 1.79) and 1.63-fold (OR = 1.63, 95% CI: 1.07 – 2.49; E= 2.64, CI: 1.34) increased risk of alcohol dependence symptoms and alcohol abuse symptoms at age 24 in offspring who had hyperactivity problems at age 11, respectively.

Hyperactivity/ inattention problems in early adolesce were associated with an increased risk of alcohol use disorder symptoms in adulthood, even when controlling for conduct problems. Associations did not appear to differ by gender and unmeasured or unknown confounders were unlikely to alter the observed associations.

None Declared

Early detection and intervention are critical for improved outcomes in mental disorders, and this is particularly true for bipolar disorders. Understanding the risk factors involved in the onset of the disease and the subsequent relapses and recurrences may lead to better results as regards to functional outcomes, which are the most relevant for patients and their significant others. This presentation will review those factors and discuss which ones can be used as targets for early intervention. It has been argued that, most often, early intervention comes late, and it is therefore paramount to build on strategies aimed at effective detection of people at risk and situations that may lead to recurring episodes of illness. Treatments not only aimed at treating symptoms, but at improving illness trajectories are necessary, and pharmacological formulations and interventions improving treatment adherence are particularly relevant to avoid interruptions of effective therapies.

E. Vieta Grant / Research support from: Boehringer-ingelheim, Compass, Janssen, Lundbeck, Novartis, Consultant of: AB-Biotics, AbbVie, Adamed, Angelini, Biogen, Boehringer-Ingelheim, Celon Pharma, Compass, Dainippon Sumitomo Pharma, Ethypharm, Ferrer, Gedeon Richter, GH Research, Glaxo-Smith Kline, Janssen, Lundbeck, Medincell, Merck, Novartis, Orion Corporation, Organon, Otsuka, Roche, Rovi, Sage, Sanofi-Aventis, Sunovion, Takeda, and Viatris

Contemporary children practically live in cyberspace, constantly using various devices,and many of them have an addiction that leads to violations of their mental and physical formation.

Based on the mental and the physical examination of children suffering on cyber addiction with the sings of clinical manifestations determine the targets and form of ccmbined correctional rehabilitation system.

The clinical investigation based on psychiatric examination with the narrative motivation interview,psychological examination by Eysenck “extra/introversion”test and physical examination with special attention to the musculoskeletal system.

The randomized investigation of childhood population was performed.198 children of different age (7 – 14 years old) were examined.72 (36.4%) of them showed significant signs of cyber addiction with a narrowing of interests, a reduction in social ties, and a decrease in school performance. They spent from 3 to 10 hours on gadgets per day.140 (71%) of them, also showed signs of fubbing, that is, the priority of telephone communication over direct communication with the interlocutor.The significant results of Eysenck test examination were following: 126(64%) of them were introverts and 72(36%) of them were extraverts. During the physical examination,91 (46%) of these children had different spine and musculoskeletal disturbances.In the group of addictional children the vast majority of subjects, 87%, have characteristic defects of the musculoskeletal system. The most symptomatic in the diagnosis of cyberaddiction and phubbing of school-age children are: round back, stooping, scoliotic posture and types of lateroflexion.The severity of cyber addiction and the degree of musculoskeletal disorders were inversely proportional. The results served as the basis for the development of a combined system of psycho-physical rehabilitation. The psychotherapy based on CBT according to A. Beck, modified for children’s in concordance with specialized program “Vertebra-Dinamik” to correct defects of the musculoskeletal system. The basis of the corrective “Vertebra-Dinamik” technique includes a comprehensive approach to the use of isometric and statodynamic exercises of moderate intensity with elements of relaxation. Approbation of the developed system showed its high( 80%) and moderate(20%) efficiency.

To successfully overcome cyber addiction and its negative consequences, the most optimal system is the complex application of psychotherapeutic and physical rehabilitation methods.

None Declared

Most mental disorders, when examined individually, are associated with an increased risk of cardiometabolic complications. However, these associations might be attributed to a general liability toward psychopathology or confounded by unmeasured familial factors.

To examine whether the associations between psychiatric diagnoses and increased risk of cardiometabolic complications are attributable to a general liability toward psychopathology, or confounded by unmeasured familial factors.

We conducted a cohort study in Sweden and identified all individuals and their siblings born in Sweden 1955-1962 with follow-up through 2013. After excluding individuals who died or emigrated before 1987, the final sample consisted 672 823 individuals. We extracted ICD-coded diagnoses (recorded 1973-1987) for ten psychiatric conditions and criminal convictions when participants were aged 18-25 years, and ICD-coded diagnoses (recorded 1987-2013) for five cardiometabolic complications (obesity, hypertensive diseases, hyperlipidemia, type 2 diabetes mellitus, and cardiovascular diseases) when the participants were 51-58 years old. Logistic regression models were used to estimate the bivariate associations between psychiatric conditions or criminal convictions and cardiometabolic complications in individuals. A general factor model was used to identify general, internalizing, externalizing, and psychotic factors based on the psychiatric conditions and criminal convictions. We then regressed the cardiometabolic complications on the latent general factor and three uncorrelated specific factors within a structural equation modeling framework in individuals and across sibling pairs.

Each psychiatric conditions significantly increased the risk of cardiometabolic complications; however, most of these associations were attributable to the general factor of psychopathology, rather than to specific psychiatric conditions. There were no or only small associations between individuals’ general psychopathology and their siblings’ cardiometabolic complications, suggesting that the associations were not attributable to genetic or environmental confounding factors shared within families. The same pattern was evident for the specific internalizing and psychotic factors.

Individuals with mental disorders in early life had an increased long term risk of cardiometabolic complications, which appeared attributable to a general liability toward psychopathology. Sibling analyses suggested that the elevated risk could not be attributed to confounds shared within families.This highlights the importance of transdiagnostic and lifestyle based interventions to reduce the risk of cardiometabolic complications, particularly in patients with several mental disorders.

None Declared

The health impact of the COVID-19 pandemic has been widely recognized in both physical and mental health. Relatively little attention has been paid to patients with delusional disorder (DD).

Our goal was to synthesize the known mental and physical health consequences of the COVID-19 pandemic in patients diagnosed with DD.

A systematic review was carried out using the PubMed and Scopus database (2019-October 2022) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Search terms: “delusional disorder” or “delusional disorder” AND “COVID-19 OR SARS-CoV2.” Inclusion criteria: 1)DD according to DSM/ICD, 2)languages: English, French, German and Spanish, 3)studies reporting health consequences of COVID-19 pandemic. From a total of 615 records, 6 were included: meta-analysis (n=1), cross-sectional studies (n=2), retrospective study (n=1), case reports (n=2).

A full third of patients with psychosis (including DD) presented with increased psychiatric symptom severity, reportedly activated by increased daily life stress. Suicidal behavior was reported in a previously undiagnosed DD patient in association with a worsening clinical picture. Perhaps surprisingly, admissions for DD in 2020 were lower than in 2019. The duration of hospitalization was, however, longer. There was a report of new onset DD with delusional material centred on COVID. There was also a report of COVID-19 symptoms being more severe in DD patients than in the larger community.

Health emergencies affect the seriously mentally ill more than other community members. Awareness and outreach can help to maintain treatment adherence and minimize risk of psychotic exacerbation.

None Declared

Serotonin syndrome is a potentially life-threatening condition due to increased serotonergic activity in the CNS. Its most well-known causes are the ingestion of large amounts of serotonergic drugs or the inappropriate combination of two or more serotonergic antidepressants. Rarer causes of serotonin syndrome have been reported in the literature.

The aim of this paper is to highlight, through case presentation, rarer causes of serotonin syndrome.

Case presentation (woman, 39 years old) who was hospitalized with clinical presentation of Serotonin syndrome, after pharmaceutical self-poisoning with a large amount of quetiapine (>20g). The search of the case data (clinical and paraclinical examination findings) was performed from the medical records and files of the 3rd Internal Medicine Clinic and the Liaison Psychiatry Department of our hospital. A literature search of similar cases (through PubMed) was performed.

A patient with a history of mood disorders, under treatment with venlafaxine, lamotrigine, quetiapine and aripiprazole, was admitted to the hospital ICU due to a decreased level of consciousness (GCS 11/15). Ingestion of approximately 100 tablets of Quetiapine 200mg was reported. The patient developed upper and lower limb myoclonus, supraventricular tachycardia (130bpm), nystagmus, bilateral mydriasis with normal photomotor reflexes, increased tendon reflexes, excessive sweating, upper limb muscle rigidity and abdominal flatulence with the presence of loud bowel sounds. Gastric lavage was performed and admission to the Internal Medicine department followed. Intravenous diazepam was administered, 30mg on the 1st 24 hour period and 20mg on the 2nd, with gradual tapering. From the very 2nd 24 hour period of hospitalization, her clinical condition showed significant improvement, with complete remission of symptoms and recovery of a satisfactory level of consciousness.

Serotonin syndrome can be effectively treated if early recognition of symptoms is made. Clinicians should be particularly alert and suspect the possibility of serotonin syndrome in a patient with compatible symptoms by clinical examination, especially in case of overdose of a drug, with or without a serotonergic mechanism of action.

None Declared

The existence of a clinical entity on the spectrum of mood disorders characterized by the occurrence of manic episodes without major depressive episodes (Unipolar Mania, UM) is largely debated. Although not classified nosologically, the studies exploring this topic have suggested that UM might differ from bipolar disorder with a manic-depressive course (md-BD), in terms of several clinical characteristics. Individuals with UM might represent a subpopulation with specific clinical profiles and unmet care needs, requiring personalized treatments, as compared with those suffering from md-BD.

To identify clinical factors associated with UM, as compared with md-BD.

We performed a systematic review and meta-analysis of observational studies according to the MOOSE guidelines. We searched for articles indexed up to July 2022 in the main electronic databases. We conducted random-effects meta-analyses of the association between UM and relevant correlates, using odds ratio for categorical variables and standardized mean difference for continuous variables.

Based on data from 21 studies meeting the eligibility criteria, we found that individuals with UM, as compared with md-BD, were more likely to be males (p = 0.007) and to have an earlier age at onset (p = 0.020). Moreover, UM was significantly associated with a higher number of hospitalizations (p < 0.001), the occurrence of psychotic features (p < 0.001), as well as hyperthymic temperament (p = 0.012). Finally, subjects with UM were less likely to report a family history of depression (p = 0.006) and a personal history of suicide attempts (p < 0.001).

Our work supports the hypothesis that UM might represent a distinctive diagnostic construct, with peculiar clinical correlates. Additional research is needed to better differentiate UM in the context of affective disorders.

None Declared

Clinical evidence supports the interaction between genetic predisposition and environmental stressors on the emergence of positive psychotic symptoms. Childhood trauma might be a modifiable risk factor among adults with serious mental illness.

The aim of our study was to investigate associations between childhood trauma (physical abuse, sexual abuse, emotional abuse, emotional neglect, and physical neglect) and symptoms of schizophrenia.

We included in our study 33 stabilized inpatients with schizophrenia at the Psychiatry C department at University Hospital in Sfax-Tunisia.

Data on Sociodemographic and clinical variables were collected from medical records.

Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). We used the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to evaluate childhood trauma experiences.

Our sample was exclusively composed of men with an average age of 35 years and 4 months.

The majority of patients were unemployed (75.8%). Only 6.1% of them were married.

Among the patients included in the study, 15.2% of our patients were illiterate. The majority of subjects were treated after a period of untreated psychosis (65.5%).

The analysis revealed that 42.4% of our patients experienced childhood adversities with mean CTQ-SF total score 35.48 (SD=9.44)

We found that positive and general psychopathology schizophrenia symptomatology were correlated to Childhood abuse (0.03; 0.004), emotional abuse (0.009; 0.004), physical neglect (0.02; 0.01), and emotional neglect (0.01).

In addition, our analysis showed that only emotional abuse lead to more negative schizophrenia symptomatology (p=0.009).*

Several studies have shown an association between childhood trauma and specific symptoms of psychosis. Therefore, Childhood trauma should be considered and inquired about in the course of clinical care of schizophrenia patients.

None Declared

Addiction Liaison Pychiatric Units are frequently requested by other medical services due to the high prevalence of medical pathologies in substance use disorders. We intend to know patient’s characteristics in order to improve the approach.

To describe patient characteristics of all medical request to the Addiction Liaison Pyshicatric Unit from January 2010 to December 2022.

Study data will be obtained from all patients that were referred to the Addiction Liaison Psychiatric Unit to assess addictive disorders and withdrawal symptoms related to drugs during 12 years in Hospital del Mar (Barcelona, Spain). Demographics and clinical data (substance use, medical comorbidity and dual diagnosis) were obtained.

The results will be presented as soon as all data is obtained. We will explore COVID-19 pandemic implications.

None Declared

Anxiety and depressive disorders are major public health problems associated with multiple adverse occupational outcomes, including unemployment, reduced productivity, and absenteeism.

To study the socio-professional and medical characteristics of workers with mixed anxiety -depressive disorders and to evaluate their impact on work ability.

A descriptive and retrospective study conducted in the occupational medicine department at Charles Nicolle Hospital, involving all the medical records of workers suffering from mixed anxiety –depressive disorders that were referred for a medical opinion of fitness for work from January 1, 2014, to December 31, 2020.

The study included 62 females and 20 males diagnosed with mixed anxiety-depressive disorders with a mean age: 41.4± 8 years. The average professional seniority was 12.8 years±7.8 years. The most auspicious occupational sectors for these disorders were health (41%) and communication (30%). Most of these workers (62%) were fit for work with professional restrictions (10 workers to positions with a lower mental load and 20 exclusions from night shift work), though 12% were declared unfit for work temporarily. Twenty-one workers were fit to continue working and one worker was unfitted to work.

The overall prevalence of mixed anxiety –depressive disorders was found to be significantly elevated in female patients (p: <0.001).

The decision of medical fitness for work among workers with psychiatric disorders considers their physical and mental capacities as well as the conditions in which the work is carried out, aiming to annihilate the risk of psychic imbalance. Thus, an adjustment of workstations can be an important determinant in the prevention of psychosocial risks.

None Declared

Prolactin adenoma, called “prolactinoma” is a benign neoplasm, it is the most common secreting pituitary tumor, and represents up to 40% of all pituitary adenomas. More than 90% are small intrasellar tumors which rarely increase in size.

the problem of management lies in how to stabilize the patient on a psychiatric level without increasing the level of prolactin.

We report the case of a young woman who presented a comorbid schizophrenia with a prolactinoma. We will try through this clinical vignette to study the different pillars of management of such pathologies.

At the same time, we did a literature review. The main search engines used were Pubmed, medline, and Science Direct. The keywords Prolatinoma schizophrenia olanzapine

This is Mrs. N. Q., 39 years old She is single, an engineer but currently without a profession, from an average socio-economic level of a teacher father and a housewife mother. She is the 3rd of his siblings of 6 . She is currently hospitalized at Ar-razi Tanger hospital for treatment of decompensation of her chronic psychotic disorder. The patient would have been born following a premature delivery of 34 weeks. For her antecedent, she was followed for asthma since her childhood. Her mother and her maternal grandfather would have been psychotic. The history of the disease dates back to 2017. The patient suffered from headaches resistant to any treatment. The patient would have consulted a neurologist. Magnetic resonance brain imaging would have been requested, which objectified at the left latero-pituitary level a lesional process of 7 mm discretely intense in T2, hypo-intense in T1 and not enhanced by Gd reflecting a pituitary micro adenoma. The patient was put on Cabergoline (Dostinex®). So the psychiatric symptomatology dates back to the end of 2019, by behavioral problems, social withdrawal, she will have stopped all professional activity. At the same time, she will have stopped all medication (Cabergoline). In 2020, the patient would have been hospitalized for the first time at the Ar-razi Tangier psychiatric hospital. The diagnosis of schizophrenia was retained according to the DSM 5 criteria. After a stay of 5 weeks, the patient would be stabilized on olanzapine 20mg/d. Currently, and following non-compliance with treatment (because of adverse effects such as amenorrhea and galactorrhea), the patient has returned, suffering from a relapse, justifying her second hospitalization. During his stay, a check-up would have been requested to show hyperprolactinemia 3 times normal. We therefore switched to Aripiprazole.

We have proposed an approach to the management of patients with comorbid schizophrenia and prolactinoma, an approach that balances the benefits and risks of managing the psychiatric stability of the patient on antipsychotics with the management of prolactinoma and symptoms. of hyperprolactinemia.

None Declared

Insomnia is a prevalent global health problem that affects 11.7% - 36% of the population (Grewal et al. Clinical Handbook of Insomnia Int 2017; 13 - 25). It is a risk factor for depression, poor quality of life, and accidents. Increasingly, insomnia has been identified as a suicide risk factor (Lin et al. BMC Psychiatry 2018: 18; 117) We present a case report of a 43-year-old male patient with insomnia-induced suicidal ideation (SI).

1. 1. Learn the mechanism of insomnia-induced SI

2. 2. Understand the current insomnia treatments

3. 3. Discuss the possible mechanism of ECT treating insomnia-induced SI

A 43-year-old single male with past psychiatric diagnoses of social anxiety, borderline personality disorder, chronic SI, and severe recurrent depression was admitted to inpatient due to intractable SI from insomnia. He failed trials on SSRIs/SNRIs, bupropion, trazodone, lithium, vortioxetine, quetiapine, zolpidem, and ketamine. The patient was initiated on electroconvulsive therapy (ECT) three times a week with 20mg vortioxetine and 100mg quetiapine for sleep initiation.

After 6-sessions, the patient’s mood, affect and sleep had improved considerably, and his suicidal ideations resolved. The patient was discharged with outpatient follow-up and ECT as rescue therapy. His sleep gradually improved to 4-6hrs/night and his mood was back at baseline.

ECT is an effective treatment for refractory insomnia-induced SI, likely due to persistent REM suppression and reduced dendritic arborization and excitatory synapses in the amygdala (Doghramji et al. Sleep 2000; 23 - S16 - S20; Lahmeyer et al. Sleep Respiratory 1989; 18 346). Possible mechanisms for insomnia-induced SI include impaired decision-making, abnormalities in 5-HT function, or HPA dysfunction leading to a hyperarousal state and cortisol release (Chatzittofis et al. Euro Neuropsychopharmacology 2013; Elmenhorst et al. Sleep 2012; 35 1615 - 1623; Keilp et al. Psychol Medicine 2013; 43 539-551; Novati et al. 2008 Sleep; 31 1579 - 1585). Current insomnia treatments address underlying medical/psychological problems and non-pharmacologic and pharmacologic strategies. The predominant non-pharmacologic approach is Cognitive Behavioral Therapy Insomnia (CBT-I), such as relaxation techniques, sleep hygiene education, cognitive structuring, and sleep restriction (Rossman et al. American Journal of Lifestyle Medicine 2019; 13 544 - 547). Pharmacologic options include benzodiazepines, non-benzodiazepine hypnotics, tricyclic antidepressants, trazodone, and antihistamines (Saddichha et al. Annals of Indian Academy of Neurology 2010; 13 94-102). ECT should be strongly considered for the treatment of refractory insomnia-induced SI, and its early application may avoid rapid deterioration improving the quality of life.

None Declared

Professional attitudes and ethics skills of physicians are influenced in part by the lessons of medical training. Still, few medical schools and postgraduate training programs introduce a formal curriculum. There is also the hidden curriculum which is influenced by instructions that are implicitly learned by observation of others, the cultural climate, and the social norms. The hidden ethics curriculum in psychiatry resident programs was investigated with qualitative interviews. Patient autonomy (consent for admission, coercive treatments) and ethical problems that arise during the management of difficult patient populations (medical ills, substance users, and frequent fliers) were the most common themes. Psychiatric residents perceive a need for more education on ethical issues. The speaker will present the available knowledge on psychiatry residents’ perspectives and the current programs addressing ethics training. This talk is hoped to elicit discussion in preparation for future action and inform a roadmap for addressing ethics training and subsequent educational events during psychiatry undergraduate and postgraduate education.

None Declared

48-year-old man from Spain who lived with his wife until he got divorced 4 months before starting the follow up in Mental Health. The debut was in September 2021 with a hospitalization in the Brief-acute hospitalization unit due to florid psychotic clinic-

He consumed several drugs in his twenties (cocaine, marihuana and heroin IV) and was diagnosed of HIV at the age of 29. He abandoned the use of drugs after the diagnoses and keep good adherence to the antiretroviral treatment (Abacavir + Lamivudine +Efavirenz).

At the age of 46 (January 2020), he was successfully transplanted a kidney. Afterwards, he started taking inmunosupresor medication to avoid transplant rejection

At the few months of the transplant and the beginning of the inmusosupresor medication, the patient became more irascible with moments of remarkable disinhibition and progressive abandon of the work obligations.

In January of 2021, he got divorced after months of difficulties with his wife, married 28 years before, due to the mentioned problems as well as moments of bizarre and disorganized conducts and suspicion towards his wife with probable delusional jealousy. He, therefore, lost his job, hose and marriage and started taking drugs again after 17 years of abstinence.

He was hospitalized in e Brief Acute Inpatient Unit in September 2021 with distrustful and hypervigilant attitude- He was suffering from delusional ideation of harm and persecution with high distress and emotional repercussion. He also presented disorganized conduct and probable auditory hallucinations. He was positive to amphetamines and cocaine After 3 days without consuming; there was no remission of the clinic.

Discussing the association between the initiation of inmunsupresor medication and the beggining of psychotic clinic

First psychotic episode (FEP) has a likely consequence of the initiation and maintenance of Tacrolimus -due to a kidney transplant- with the concomitant abuse of amphetamines and cocaine as a trigger factor.

The psychotic clinic progressively remitted in one week after the administration of 3 mg/day of risperidone.

The antiretroviral treatment was changed due to the poor adherence during the disorganization period. The tacrolimus was not removed because of the good response to the neuroleptic and the risk of transplant rejection

The patient started with prodromic symptoms of psychosis at the time he began with the inmunosupresor medication. Progresively, the psychotic clinic worsen wit the consequence of a biographical break with the consequence of a divorce, therlost of work and home and a drug relapse.

There is evidence of the association between psychotic episodes in people with no psychiatric history and the inmunosupresor medication for the kidney transplant (Above all, tracolimus). This case remarks the need of an exhaustive medical anamnesis in the diagnosis of psychiatric pathologies.

None Declared

Depression is the disease with the greatest burden of disability. Despite pharmacological options, up to 30% of depressions are considered resistant to treatment (RTD). Theta burst transcranial magnetic stimulation (TBS) on the dorsolateral prefrontal cortex allows the application of shorter protocols and with longer-lasting effects than conventional TMS. Its implementation in the Public Health System requires the design of efficient, cost-effective and accessible protocols for patients.

The objective of this project is to assess the efficacy and safety of two intensive and spaced protocols (unilateral and bilateral) of 1800 pulses TBS compared to sham stimulation in outpatients with unipolar and bipolar TRD in a public hospital.

This project is the 1st double-blind placebo-controlled RCT with TBS in Spain. It is now in the recruitment phase. Patients receive a total of 22 sessions of 1800 pulses in 6 weeks: 5 days/week the 1st and 2nd weeks (10 sessions) and 3 sessions/week the following weeks (12 sessions). Patients are randomized into three groups: i) bilateral, ii) left unilateral, and iii) sham. The main variable is the change in the HDRS-17 score at the end of treatment compared to baseline. The results were analyzed with a general linear model of HDRS, using time as the intrasubject factor and randomization group as the intersubject factor, using resistance to treatment (Maudsley Score) and diagnosis (bipolar, unipolar) as covariates.

Preliminary results from 13 participants (nbil=4, nuni=4, nsham=5) reveal a significant effect of (group x time) on HDRS change (p= 0.020) with no influence of Maudsley Score or diagnosis. The bilateral group presented a greater decrease in the HDRS with a mean difference of 4,38 points [CI95% 0,17-8,58), (p=0.043)] with respect to the unilateral group and a difference of 8.23 [CI95% 4,24-12,21)(p =0.001)] compared to the sham group.Table 1:Sample description. Data shown are means and standar deviations. In bold significant diferences p<0,05.

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The results demonstrate the preliminary efficacy of intensive TBS protocols relative to sham.

None Declared

Congenital muscular dystrophies (CMDs) represent a heterogeneous group of early-onset muscle disorders presenting primarily with hypotonia and delayed motor development. Several genes are known to be responsible for CMDs, including the LAMA2 gene, involved in merosin-deficient type 1A (MDC1A), and the FKRP gene involved in muscular dystrophy-dystroglycanopathy type B5 (MDDGB5). These two forms of CMD are autosomal recessive and are each characterized by the presence of a mutation with a founder effect in South Tunisia. Cognitive development associated with the founder mutation in the LAMA2 gene (c.8007delT) is often conserved, whereas in the founder mutation of the FKRP gene (c.1364 C>A), motor impairment is associated with intellectual disability (ID).

To compare the psychological impact of motor impairment in children presenting these two forms of CMD and their families.

The study consisted of a survey of parents of children with a confirmed diagnosis of MDC1A (5 from 3 unrelated families) or MDDGB5 (3 from 3 unrelated families). The correspondent founder mutation was already identified in the homozygous state by targeted sequencing. Participants’ parents completed the Parent Strengths and Difficulties Questionnaire (SDQ), a behavioral screening tool designed for children aged from 2 to 17 years. The SDQ assesses emotional symptoms, behavior problems, hyperactivity, and peer relationships; The SDQ Impact Supplement assesses the impact of all these children’s difficulties on their families.

The average age of the children was 4.95±3.92 with two children who were not assessable by the SDQ (age< 2 years). Unlike children with MDC1A, ID has been reported in all children with MDDGB5. The mean SDQ total score for children with MDC1A was 11, whereas the mean score for children with MDDGB5 was 14.875, reflecting greater difficulty for children with MDDGB5. The family impact score was higher in families with children with MDDGB5 than in children with MDC1A (10,5 vs 7), which may be due to the burden of management of the ID associated with the motor impairment. The more pronounced difficulties associated with MDDGB5 are likely to be related to the associated ID. Whereas in MDC1A, the difficulties observed are related to the direct impact of the motor impairment. The presence of cognitive disorders associated with a motor deficit aggravates behavioral adaptation and makes the management of these children more difficult.

In the absence of a comparable study in the literature, the present is conducting future studies on the behavioral profile of children with CMD to obtain a better understanding of their difficulties in everyday life and to develop interventions adapted to their families

None Declared

Evidence shows that racism can have a negative effect on mental health in the lived experiences of Black people and People of Colour. In critical theory discourse including postcolonial and decolonial approaches, racism is suggested to be an everyday phenomenon. Additionally, racism specifically targets the perceived cultural and phenotypic foreignness of Black migrants and migrants Of Colour, as well as the ascribed migrant status attributed to the perceived foreignness of racialized persons who do not actually have any direct migration experiences.

The stigma associated with severe mental disorders such as psychosis has historically been applied to Black people and People of Colour who have been engaged in anti-racist activism as a form of punishment and social control. Higher incidence rates of psychosis in racialized communities have frequently been conceptualized as cultural differences in family composition and levels of expressed emotion in families. The objective of this study is to sensitively investigate psychosis as a potential mental health consequence of racism.

The incidence rates of psychosis - positive symptoms, negative symptoms, non-affective psychosis disorders and first episode psychosis - among migrants by country of migration were compiled in an umbrella review, which offers a summary of meta-analyses. Quantitative research has the limitation of enabling the observation of patterns but not allowing an understanding of the reasons behind them to be theorized through the data. Therefore, qualitative methods complement the quantitative data. Twenty people of diverse genders who self-identified as Black people or People of Colour in Berlin were interviewed about their experiences of racism and sexism and about how those experiences affected their mental health.

The umbrella review found an association between migration and psychosis, with migration from the Caribbean and African countries showing the strongest correlation. A constant comparative analysis of the qualitative data suggests that racism contributes to the emergence of a subclinical psychosis symptomatology profile that consists of a sense of differentness, negative self-awareness, paranoid ideation regarding general persecution, and self-questioning with self-esteem instability.

The findings are interpreted as a situational diagnosis, as coined by the psychiatrist and political philosopher Frantz Fanon in the seminal book ‘Black Skin, White Masks’ (1975). The findings are also contextualized within a critique of institutional racism, both historically and currently, and within an intersectional discussion of the need for structural competency and the provision of safety for racialized groups in clinical settings.

None Declared

Knowledge about concurrent substance use and other risk behaviors - as well as their determinants - in the general population is insufficient.

To investigated socio-demographic, health status, and lifestyle determinants of habit-forming risk behaviors among French men and women.

We analyzed data collected in 2021–2022 from 32,622 participants (74.5% female; mean age=57.9±14.2 years) of the NutriNet-Santé web-cohort who had completed the Alcohol Use Disorders Identification Test, the 12-item Cigarette Dependence Scale, the modified Yale Food Addiction Scale 2.0, and the Internet Addiction Test. Using established cutoff values, participants were first split into 2 groups (Yes/No) for each risk behavior (alcohol use disorders, nicotine dependence, food addiction, and Internet addiction) and then placed into 3 groups (no risk behavior, 1 risk behavior (reference), and ≥2 risk behaviors) before fitting polytomous logistic regression models according to sex.

Younger age (Odds Ratio: ORmale=2.07; ORfemale=2.04), self-perceived poor health (ORmale=2.06; ORfemale=1.61), having obesity (OR=1.56; ORfemale=1.30), lack of affection during childhood (ORmale=1.56; ORfemale=1.39), and a lifetime prevalence or medication use for a mental disorder (ORmale=1.73; ORfemale=1.38) were significantly associated with having ≥2 versus 1 habit-forming risk behavior in both sexes (all p<0.05). Results for experiencing current financial difficulties (ORfemale=1.34), self-perceived poor dietary quality (ORfemale=3.23), being underweight (ORfemale=1.58) and overweight (ORfemale=1.30) were significant only in females (all p<0.05). The same factors plus current e-cigarette use (ORmale=0.54; ORfemale=0.77) in both sexes, having a higher educational attainment (ORfemale=0.75), being physically active at work (ORfemale=0.78) in females were inversely associated with having none versus 1 risk behavior (all p<0.05).

To our knowledge, this is the first study to explore determinants of concurrent habit-forming risk behaviors among men and women in a large, population-based study. The findings could serve as impetus for future research in this domain and ultimately help guide addiction prevention efforts.

None Declared