Reviewing the histories of patients with childhood and adolescent schizophrenia, on numerous occasions, traumatic factors with great emotional and social impact are observed, such as situations of mistreatment, abuse and emotional deprivation, where help is requested but resources are scarce and the approach is limited without work in network.

1. Analysis of the consultation pathways in adolescents with severe psychiatric and socio-familial symptoms and the time delay in optimal guidance. 2. Evaluate the services involved. 3. Evaluate the clinical control of treatment with aripiprazole.

Retrospective observational analysis, 5 months, of prodromal symptoms of childhood psychosis and help-seeking pathways in a 13-year-old adolescent, as well as a description of the pharmacological approach and professional teams involved.

A 13-year-old adolescent who went to the emergency room with her mother for ingesting anti-cockroaches with self-inflicted intent. Reviewing his medical history, 4 serious autolytic gestures were detected in the last 2 months. Referred to Mental Health who did not attend.

On clinical examination, florid psychotic, with perplexity, self-reference, ideation of harm, language and behavioral disorganization. Auditory and kinesthetic hallucinations. A situation of neglect of the minor and abuse by the parents is detected; the risk had not been previously reported. Oral aripiprazole (up to 15 mg/day) was prescribed with good tolerance and progressive improvement in symptoms.

We worked jointly with Social Services, the Juvenile Prosecutor’s Office, Education and the hospital Psychiatry unit. In some of the resources the situation was already evident, the scope of their action was limited and delaying attention for months.

Based on cases like this, we ask ourselves if psychiatrists are sensitized to the comorbidity of serious mental pathology and the existence of risk situations in minors and if they are oriented toward multiprofessional management. Networking provides us with an early diagnosis, improving the therapeutic approach.

None Declared

A new approach of social therapy for criminal offenders was applied in Penalty Facility in Niš, Serbia. It is based on three month peer-training focusing on recognizing of triggers for anger, understanding emotional manifestation and learning socially acceptable ways of anger expression.

To estimate how the impact of pear-based training influences the level of agression of criminal offenders in prison settings.

One hander and six prisoners were randomly assigned to program. The six previously educated inmates trained the participants through 12 work-shops. An independent professional evaluated change in aggression levels after training using Buss&Perry Aggression Scale. We compared subgroups with shorter versus longer sentences pre and post training using Student’s t test. And univariate logistic regression analysis for impacts of sociodemographic variables on aggression scores.

We found a significant higher scores of anger (6.6 ± 4.7 & 11.8 ± 4.2, p=0,043) hostility (15.5 ± 8 & 20.1 ± 6.5, p=0,029) and total aggression (32 ± 14 & 48 ± 21, p=0,023 in subgroup with longer sentences at baseline. After training anger (12.4 ± 4.8 & 15.5 ± 5.6, p= 0,0167), physical aggression (14.6 ± 51. & 17.2 ± 5.6 ,p=0,024) and total aggression score (55.5 ± 14.1 & 68.2 ± 18, p=0,0152) remained higher in the group with sentences more than five years. Lower education level is associated with undesirable outcome-higher level of aggression after training.

Three months training was not sufficient for adopting skills for better control of aggressive behavior in criminal offenders never the less the length of the sentences.

None Declared

Extreme eating and weight conditions (EWC) are a construct that emerges as a dimensional and theoretical model that identifies individuals who exhibit inappropriate eating behaviours and abrupt weight fluctuations. According to this spectrum of EWC, one extreme can be represented by individuals with anorexia nervosa (AN), characterised by excessive food restriction and an extremely low body mass index (BMI), whereas the other end of this continuum is represented by individuals with obesity (OB), characterised by a BMI above 30. In addition to AN and OB, some eating disorders (EDs), namely bulimia nervosa and binge eating disorder, are also part of this continuum, given the high risk of falling into one of the extremes, especially that of higher BMI. Studies have described similar changes at the psychological and neurobiological levels associated with their abnormal eating patterns, delineating vulnerability pathways related to the neurobiological basis.

Based on previous literature, individuals suffering from EWC would show dysfunctional brain activity in regions associated with emotional reward processing and cognitive control compared to healthy controls (HC). Similarly, neuroendocrine alterations in EWC are expected to influence clinical symptomatology. It will also be discussed how impairments in executive function and differential brain activity observed in individuals with EWC may negatively impact their clinical course and treatment outcome.

F. Fernandez-Aranda: None Declared, S. Jimenez- Murcia Grant / Research support from: We thank CERCA Programme/Generalitat de Catalunya for institutional support. This research was supported by grants from Instituto de Salud Carlos III (ISCIII) (FIS PI20/00132) and co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBERObn is an initiative of ISCIII. Additional support was received from the Delegación del Gobierno para el Plan Nacional sobre Drogas (2021I031) and Ministerio de Ciencia e Innovación (grant PID2021-124887OB-I00). Additional funding was received by AGAUR-Generalitat de Catalunya (2021-SGR- 00824), European Union’s Horizon 2020 research and innovation program under Grant agreement no. 847879 (PRIME/H2020, Prevention and Remediation of Insulin Multimorbidity in Europe) and the European Union’s Horizon Europe research and innovation program under grant agreement No 101080219 (eprObes)., Consultant of: FFA and SJM received consultancy and speakers honoraria from Novo Nordisk.

Gestational Loss represents a set of abrupt and unexpected losses throughout pregnancy or after childbirth. Every year, around two million babies die after 28 weeks of gestation, with between 14% and 20% of all pregnancies ending in loss. In most situations, pregnancy loss occurs in a pregnancy without signs of risk or irregularities, something that increases the shock and suffering felt by parents.

The present study aims to understand the relationship between pregnancy loss and parents’ grief experiences after spontaneous abortion, stillbirth or neonatal death with qualitative evidence.

This review followed the principles of PRISMA, and the search was carried out in the Web of Science and Scopus databases, aiming to find relevant articles about parental grief experiences resulting from pregnancy loss, published between 2012 and 2022. After research and analysis Of the studies, 15 qualitative studies were included.

The pain and sadness when experiencing the loss of a child was a common point in all the studies found. In this review, the majority of men revealed a duality in wanting to protect, physically and emotionally, their partner, while experiencing their own grief, something that led to the internalization of their emotions and the minimization of their pain. Grieving fathers and mothers report experiencing this process alone, describing the difficulty in expressing what they feel due to the lack of recognition of the loss. It was found that confrontation with other pregnant women leads bereaved parents to reveal jealousy and shame, as well as feelings of guilt. The farewell rituals, the process of writing and talking about their experience helped the women to not feel so alone and to find a purpose: to transform their pain and help other grieving mothers. Fathers and mothers who experienced pregnancy loss stated that the death of their child provided change and growth.

After Pregnancy Loss, adapting to the new reality is extremely painful, despite the work of mourning being necessary and crucial. This process is a search to integrate and accept the reality of the loss of the baby in a way that has meaning for the mother and father, it is the adaptation to a world without the lost child and to a relationship that had been built during the gestation period, which was violently broken. It is necessary for health professionals to be present and available to address these parents’ fears, provide advice and support.

None Declared

Weight gain, QT interval prolongation, and dyslipidemias associated with the chronic use of some antipsychotic medications can explain a higher prevalence of cardiovascular risk in these psychiatric population. The D’Agostino Index include some factors such as age, total cholesterol, high-density lipoproteins, systolic blood pressure increased, antihypertensive treatment, smoking, and diabetes, to estimate an individual’s risk (low, moderate or severe) of developing a cardiovascular event through a period of 10 years or throughout the patient’s lifetime.

To compare the degree of cardiovascular risk using the D’Agostino Index, among different antipsychotic medications.

An estimation of cardiovascular risk (low, moderate, or high) was performed with the D´Agostino index in a sample of 144 patients (82 men and 62 women) mean age 45,2 +/- 10.13. All patients were treated for at least one year at a therapeutic dose and adhered to their treatment regimen correctly. Subjects with some relevant pre-existing unstable heart disease were excluded. All patients previously provided informed consent and were of legal age. Clinical data on medical history, concomitant medications, and risk factors were collected. A completed physical exam, waist circumference, lab sample, a lifestyle scale, and an evaluation of vital signs in accordance with European Society of Hypertension were evaluated. Statistical analysis was carried out using the statistical software SPSS version 26.0. A significance level α=0.05 was considered throughout the study.

The four most consumed antipsychotics were risperidone 9.72% (n=14), paliperidone 25.7% (n=37), olanzapine 14.6% (n=21), and aripiprazole 34.7% (n=50). Descriptively, it was observed that the drugs most associated with moderate or high risks were paliperidone (37.8%) and olanzapine (33.3%), risperidone (28.6 %). Aripiprazol (22%) was the less associated compound with moderate/high cardiovascular risk.

Subjects treated with olanzapine and paliperidone showed a higher association with cardiovascular risk. Predicting cardiovascular risk could provide individual benefits by enabling lifestyle modifications, pharmacological treatment changes, or closer monitoring to reduce cardiovascular risk.

A. Montejo Grant / Research support from: This study has been funded by the Instituto de Salud Carlos III (ISCIII) through the project PI19/1596 and co-funded by the European Union., C. Bermejo: None Declared, J. Matías: None Declared, T. Martín: None Declared, J. Matías-Polo: None Declared, Y. Santana: None Declared, J. López-López: None Declared, R. de Alarcón: None Declared, J. Acosta: None Declared

Borderline personality disorder is a severe mental disorder characterized by generalized instability of emotional regulation of interpersonal relationships and self-image, and marked impulsivity. Several features of this disorder are likely to be associated with problematic sexual health, such as impulsivity (impulsive sexual behavior), identity disorders (unstable sexual identity) and unstable and intense interpersonal relationships. In addition, childhood sexual abuse and violence are common in people’s histories.

Assessing sexuality in patients followed for borderline personality disorder at Arrazi Salé psychiatric hospital.

This is a descriptive cross-sectional study using a questionnaire including socio-demographic criteria with a questionnaire on sexual behavior in female patients followed for borderline personality disorder at the Arrazi Salé psychiatric hospital. Inclusion criteria: women over 18 years of age diagnosed with borderline personality disorder. Exclusion criteria: psychosis, intellectual disability.

We collected 45 patients with borderline personality disorder. The average age was 22, 80% were single, 58% unemployed, 46% had dropped out of high school. The majority of participants were using psychoactive substances. 25% had attempted suicide. 83% were victims of childhood sexual abuse. The majority were significantly more likely to engage in sexual activity at a younger age than their peers. Over 60% had never used contraception 10% had their first pregnancy at a younger age, with termination. 15% have had genital infections. 53% were attracted to both sexes, and over 66% had more than one sexual partner. Over 73% did not experience sexual satisfaction (sexual satisfaction scale less than 10).

The results indicate that sexuality in patients with borderline personality disorder is present early in the course of the disorder, often at a young age, with significant physical, mental and social consequences. Primary care mental health, sexual health and sexual assault services need to be attentive to the clinical diagnosis of this personality disorder, as the nature of the disorder represents both a risk factor and a health threat.

None Declared

Nurses working in psychiatric departments regularly encounter intricate, stress-inducing, and emotionally challenging situations. The mental well-being of these nurses directly influences the quality of care they deliver.

To assess the prevalence of psychological distress among psychiatric nurses and to identify the socio-demographic and clinical factors associated with it.

Cross-sectional, descriptive, and analytical study conducted over the course of one month from October 11th to November 8th 2023. Participants included were psychiatric nurses working in Razi Hospital, Tunisia. We collected data using pre-established questionnaire which included socio-demographic and clinical data of the participants. The assessment of psychological distress was conducted using the Depression, Anxiety and Stress Scale (DASS-21), validated in Arabic. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) in its 25th version

We collected data from 55 nurses working in Razi psychiatry hospital during the time of the study. Among them, 80% (n=44) were female. Their median age was 35 (Min=25, Max=62). Most of participants were married (81.8%, n=45) and 70.9 (n=39) had kids. In our sample, 5.5% (n=3) and 23.6% (n=13) had respectively personal psychiatric and somatic history. Some addictive behaviors were identified among our participants, especially smoking (14.5%, n=379) and alcohol use (3.6%, n=2).

Regarding working conditions, 81.8% (n=45) were assigned shift work. They worked in the men’s ward (43.6%, n=24), the women’s ward (34.5%, n=19), or in both (21.8%, n=12). Furthermore, 45.5% (n=25) reported witnessing a suicide attempt during their work, and 74.5% (n=41) were victims of aggression, primarily by patients (82.5%, n=33). Sixty percent (n=33) said expressed a desire to transfer.

Moderate to extremely severe depression, anxiety and stress was observed in respectively 34.5% (n=19), 61.8% (n=34) and 36.4% (n=20) of cases.

A significant association was found between stress among psychiatry nurses and personal somatic history (p <10-3). No further links were found between depression, anxiety, stress and other clinical factors.

These results emphasize the difficult working environment within psychiatric settings, emphasizing the critical requirement for specific interventions aimed at improving the mental health and well-being of psychiatric nurses.

None Declared

The Screen for Disordered Eating/SDE was created as a primary care screening method for eating disorders, including binge eating disorder (Maguen et al. 2018). The SDE comprises five items (yes/no answers), extracted from other validated self-reported questionnaires assessing eating psychopathology. Its validity and reliability has proved in a Portuguese psychometric study, that only included woman (Pereira et al. 2022). It psychometric properties have yet to be evaluated in men.

We aim to assess the psychometric properties of the Portuguese version of SDE in males.

Participants were 227 male individuals with a mean age of 30.41 years (±13.96; range: 14-73). They answered an online survey including the Portuguese preliminary versions of the seven-item Eating Disorder Examination Questionnaire/EDE-Q7; the Body Image Concern Inventory/BICI and the Muscle Dysmorphia subscale of the Eating Disorder Assessment for Men/DM-EDAM.

Confirmatory Factor Analysis showed good fit for the unidimensional model (χ2/df=1.483; RMSEA=.0460; CFI=.980 TLI=.961, GFI=.988). Cronbach’s alpha was .621 which although inferior to .7 can be explained by the small number of items and the fact that each one assesses different dimensions. All items contributed to the internal consistency and presented high internal validity. Pearson’s correlations of SDE with BICI (.317) and EDE-Q7 (.361) were significant and moderate. The correlation with DM-EDAM was non-significant, probably due to its focus on muscle dysmorphia, which is not included in SDE’s items.

The Portuguese version of SDE demonstrated adequate validity (construct and convergent) and reliability.

None Declared

Autism spectrum disorders (ASD) is a neurodevelopmental disorder with an estimated lifetime prevalence of at least 1%. Some studies suggest that approximately 60% of children with ASD show emotional dysregulation and 44-86% sleeping disorders.

Studies suggest that cognitive behavioral therapy and animal-assisted therapy AAT can be an intervention strategy to promote emotional and behavioral dysregulation and sleep disturbances.

The purpose of this study was to investigate the effect of a therapy program assisted with dogs (AAT) together with cognitive behavioral therapy (CBT) on behavioral and emotional regulation and sleep disorders in children diagnosed with ASD.

The sample was composed of 24 children between 7 and 10 years old diagnosed with ASD randomized into two groups (CGT group (control group) and AAT + CBT group (experimental group). Inclusion criteria: communication level of simple sentences, mild-moderate difficulties in behavioral and emotional regulation and sleep disturbances. Exclusion criteria: intellectual disability, children with specific dogs phobia. Assessment included ADOS-2, WISC-V, CGAS. dysregulation profile of Achenbach scale and Sleep Disturbance Scale for Children-Bruni. A program of 12 sessions (weekly one-hour sessions) focusing emotional and behavioral regulation and sleep disturbance was designed (Behavior Emotional Sleep Treatment Program. A pre-post evaluation was performed.

Participants were 20 boys and 2 girls (2 participants dropped out), with a mean age of 9. Regarding the socio-demographic and clinical characteristics, no significant differences has been observed between both groups in the global functioning measured with the Children’s Global Assessment scale (CGAS) (p=0.832), nor in the cognitive capacity (QI ) neither in reference to the associated comorbidities (p=0.103) nor in the variable prescription pharmacological treatment (p= 0.142). In emotional self-regulation, a significant improvement in emotional regulation difficulties was observed after treatment in both groups (experimental group: p=0.014; control group: p=0.012). However, the comparison between the pre-post intervention results between groups, regarding the emotional regulation variable, a greater improvement is observed in the experimental group (p=0.013). Significant improvements were also observed in sleep disorders (Bruni scale total score and in the sleep conciliation and maintenance difficulties scale) in both groups.

To conclude, although this is a pilot study with a small sample size and further research is needed, results suggest that a therapy program assisted with therapy dogs and CBT have positive effects on emotional dysregulation and sleep disturbances in children with ASD and offers a possible intervention strategy.

None Declared

Many mental health conditions, including anxiety, mood disorders, and depression, can be effectively treated at a relatively low cost. Exercise interventions can be a therapeutic strategy, but even though exercise has consistently been shown to improve physical health, cognitive function, and psychological well-being, as well as reduce depression and anxiety symptoms, this intervention is often neglected in mental health care services.

The study aims to assess the feasibility of incorporating an Exercise Intervention Program (EIP) as a therapeutic pathway within the Mental Health and Addictions Program (MHAP) in Nova Scotia, as well as to evaluate the effectiveness of the program on mental health outcomes and incremental costs, and the patient acceptability and satisfaction with the program.

This proof-of-concept study has a pragmatic, prospective, controlled observational design with an embedded one-phase qualitative component. Patients with a primary diagnosis of depression or anxiety attending the Rapid Assessment and Stabilization Program (RASP, Halifax, Nova Scotia, Canada) will be offered to receive 60-minute exercise sessions three times per week, per 12 weeks. Patients with similar mental health conditions that have opted to wait for Cognitive Behavioral Therapy (CBT) with the community provider and declined from the EIP will be part of the control group. A certified recreational therapist will conduct the EIP. Participants of both groups (EIP and control condition) will be assessed at baseline and then weekly for four weeks, six weeks and then at 12 weeks post-enrollment. Primary outcomes include differences in the mean change in functional (well-being, resilience, and recovery) and symptom variables (depression, anxiety, and suicidal risk), which will be assessed through online validated scales/questionnaires. Service variables (patient acceptance and satisfaction) and health care utilization (crisis calls, emergency department visits, hospital admissions and readmissions, length of stay for each admission) will comprise the secondary outcomes.

The results of the study will provide information about the effectiveness of EIP in the treatment of anxiety and depression compared to those only wait-listed to receive CBT or counselling from a CMHA provider. The study will also inform about the acceptability and satisfaction of the EIP, as well as the incremental cost-effectiveness of the intervention compared to the control condition.

This proof-of-concept study will demonstrate the effectiveness of EIP as an adjunctive or alternative therapeutic option for the treatment of anxiety and depression in patients seeking mental health support from the MHAP in Nova Scotia.

None Declared

The development of oxidative stress in patients with schizophrenia is associated with changes in the level of activity of antioxidant enzymes. It is likely that catalytically active antibodies (abzymes) can take on these functions. Abzymes are antibodies with enzymatic activity. Catalase and SOD activity of abzymes was previously detected in patients with schizophrenia. But NADPH-dependent peroxidase activity has not been studied. The present work discusses the protective role of abzymes against reactive oxygen species within the pathogenesis of schizophrenia.

The aim of the study was to investigate the NADPH-dependent peroxidase activity of IgG in patients with paranoid schizophrenia in the exacerbation phase and in the remission phase.

A total of 124 patients were examined during the work. Of them, 82 patients with paranoid schizophrenia (F20.0) had a mean age of 33.6±5.12 years (52 males, 30 females), disease duration averaged 8.9± 4.62 years. Patients with schizophrenia included 42 patients with acute schizophrenia and 40 patients with schizophrenia in therapeutic remission. The control group included 42 sex- and age-matched patients. IgG was purified by affinity chromatography on columns with proteinsepharose on an AKTA purifier chromatograph (GE). The homogeneity of isolated IgG preparations was checked by Lemilly electrophoresis in a gradient of 4-18% PAAG. Gel filtration under pH-shock conditions was performed on a Superdex-200 HR 10/30 column. NADPH-dependent peroxidase activity of IgG was determined on a SPECORD M-40 spectrophotometer (Carl Zeiss) at 340 nm by NADPH oxidation in the conjugated glutathione reductase reaction of tertiary butyl hydroperoxide reduction. Statistical processing of data was performed in Statistica 12.0 program.

It was proved that IgG from patients with schizophrenia had NADPH-dependent peroxidase activity, and this activity is an intrinsic property of the investigated antibodies. The NADPH-dependent peroxidase activity in IgG patients in the exacerbation stage was increased 3-fold (p=0.0001) compared to the studied activity in the group of healthy individuals, and it was increased 2-fold (p=0.017) in the group of patients in therapeutic remission compared to the activity in healthy individuals. Also NADPH-dependent IgG peroxidase activity in patients in remission was 1.7 times lower than in patients during the exacerbation period (p=0.012).

It was established for the first time that abzymes from patients with schizophrenia and healthy individuals have NADPH-dependent peroxidase activity and can decompose lipo and hydroperoxides. We hypothesize that these abzymes help cope with generalized oxidative stress. Under the influence of neuroleptic therapy in patients in remission, the level of oxidative stress and NADPH-dependent peroxidase activity of abzymes decrease.

None Declared

Microdosing psychedelics has garnered considerable attention within both nonprofessional circles and the scientific community in recent years. This method involves taking small, non-hallucinogenic doses of substances like LSD or psilocybin over weeks or months, purportedly to enhance specific behaviors, emotions, or address psychiatric conditions.

Exploring these assertions is crucial given the potential therapeutic value of microdosing, especially in conditions that respond positively to full psychedelic doses, such as depression. The full psychedelic experience might not always be suitable due to various factors like age, capacity to consent or comprehend the experience (e.g., dementia), or individual personality traits that might hinder surrendering to the experience. Microdosing could potentially serve as a maintenance therapy post-full dose administration, aiding specific psychological or biological processes during therapy or therapeutic exercises.

Recent studies in healthy individuals highlight that small psychedelic doses have nuanced effects on pain perception, mood, neuroplasticity, sleep duration, brain connectivity, and default mode network synchronicity. However, some parameters show null effects after both single and repeated administration.

Our survey research uncovered that individuals with ADHD reported symptom relief through microdosing, deeming it more effective than their conventional treatments. Subsequently, we conducted a naturalistic study following individuals with ADHD across a 4-week microdosing period. Our findings indicated a reduction in symptoms over time, an increase in trait mindfulness, and a decrease in neuroticism compared to baseline. While these results are intriguing, they necessitate validation in a clinical trial. We have recently concluded such a trial and are currently analyzing the data to further explore these effects.

K. Kuypers Grant / Research support from: The author is a principal investigator on a research project that is sponsored by Mindmed, a company that is developing psychedelic medicines.

In recent years, a global debate has emerged regarding the protection of Internet users from exposure to harmful content. Content moderation is defined as the organized practice of filtering user-generated content posted on internet, social networks, and media to determine the appropriateness of the content for a site, locality, or jurisdiction. The growing volume of this content along with the psychological impact of this activity have promoted the application of automated approaches based on artificial intelligence and machine-learning. However, the changing characteristics of content, as well as the cultural differences that influence its appropriateness, mean that human moderation of Internet content currently continues to exist. Psychological effects of this activity such as symptoms of post-traumatic stress disorder (PTSD) could represent an example of secondary trauma.

Our aim is to describe a clinical case of post-traumatic stress disorder presenting with specific traumatic exposure idiosyncrasy that could lead to a better consequence characterization of a recent social phenomena such as internet content moderation.

We expose the clinical case of a woman with emotional distress who was reffered to our outpatient psychiatric unit in Barcelona in 2022 after five years working as an internet content moderator.

We describe the case of a 35-year-old woman without relevant medical, toxicologic or psychiatric record that presents to our out-patient psychiatric clinic with post-traumatic stress disorder after five years of working as an internet content moderator and being exposed to visual traumatic content such as sexual assault and paedophilia. The clinical presentation consisted with one year of recurrent daily panic attacks, intrusive images about the traumatic exposure, intrusive thoughts, insomnia, vivid nightmares, avoidance of exposure to her son, distrust of the environment and intense fear for her son security. The disorder interfered in her capacity to work. The patient received psychological treatment and ISRS (Sertraline) was prescribed, however only partial response was reached with persistence of the majority of symptoms.

The presented case suggests a temporal and symptom content relationship between the described work exposure and the appearance of emotional distress in a patient without PTSD history. Although previous evidence of secondary trauma in people exposed to indirect traumatic experiences has been reported, for example in healthcare professionals, the exposure to alien trauma through digital exposure as a workactivity is yet to be specifically examined. It is necessary to expand knowledge on the clinical expression of this phenomenon due to the observed recurrence of anxious and depressive symptomatology related to repeated exposure to traumatic content.

None Declared

Mental health problems have increased following the pandemic and are associated with considerable health, economic and societal outcomes, particularly affecting youth. In co-creation with young people several European prevention and early intervention strategies to promote mental wellbeing of youth are currently being developed. The development and implementation of easy-access youth mental services across Europe will be presented and discussed. In addition pilot data of online, hybrid treatment platforms and self-management ecological momentary intervention apps will be presented. Ultimately the aim is: 1) to develop clinical guidelines, best practices, and policy recommendations to mitigate the youth mental health challenges and 2) improve (cost-) effectiveness of early intervention strategies for promotion and prevention in mental health, including enhancing mental health literacy, resilience and self-management, while 3) actively involving young people in the process of these innovative developments. To amplify the reach, campaigns designed in co-creation with young people, to increase awareness, literacy, wellbeing and help-seeking among young people, targeting schools, further-education colleges, universities and other specific settings will need to be developed, specifically paying attention to high-risk groups within this young population, including children of parents with mental disorders, migrants, young people growing up in poverty, those in/leaving care, and the LGBTQ+ community, with coordination across domains: schools, general practitioners, and specialized mental healthcare facilities.

None Declared

Current guidelines for managing antipsychotic-induced hyperprolactinemia recommend the use of aripiprazole, either as a substitute or in combination with the primary antipsychotic. However, there have been reported cases of exacerbated psychotic symptoms when introducing aripiprazole after chronic treatment with another antipsychotic.

We present a case of a patient with unspecified schizophrenia spectrum disorder receiving amisulpride, who developed worsened psychotic symptoms following the introduction of aripiprazole to treat hyperprolactinemia. We also review this phenomenon and its clinical management in the literature.

Clinical case report and brief literature review.

Ms. G, a 54-year-old woman diagnosed with unspecified schizophrenia spectrum disorder, was on amisulpiride 400mg/day and had remained asymptomatic for months. During a follow-up, she complained of mastalgia and had a prolactin level of 71.7 ng/mL. Following clinical guidelines, aripiprazole was added at 10mg/day. Within a month, anxiety and sleep disturbances escalated, followed by the reappearance of psychotic symptoms. Aripiprazole was discontinued, amisulpride reinstated, achieving stability. Subsequently, hyperprolactinemia was managed using metformin.

Antipsychotic-induced hyperprolactinemia is common, especially with first-generation antipsychotics, causing various symptoms in both genders. Long-term consequences may include weight gain, reduced bone density, and potentially increased breast cancer risk, among others.

Aripiprazole is an atypical antipsychotic with a partial agonist effect on dopamine D2 and D3 receptors. This means that aripiprazole will act as a functional D2-antagonist under hyperdopaminergic conditions, but a functional D2-agonist under hypodopaminergic conditions. This property of aripiprazole may contribute to counteract ‘prolactin-raising’ agents, acting as a D2 agonist, potentially reducing prolactin rise.

Chronic use of presynaptic D2/D3 antagonist (amisulpiride) might create a hypodopaminergic environment and hypersensitivity to dopamine agonists, possibly explaining worsened symptoms with aripiprazole introduction.

To prevent adverse outcomes when adding or switching to aripiprazole, gradual reduction of the previous antipsychotic (amisulpride) and high-dose aripiprazole initiation (30-40 mg/day) can help.

Antipsychotic-induced hyperprolactinemia is a serious issue that deserves our attention. While aripiprazole is recommended by several guidelines to treat it, introducing it to patients on chronic antipsychotic treatment may lead to a worsening of psychotic symptoms. Caution is recommended when combining aripiprazole with potent D2 receptor blockers. To mitigate this effect, gradual dose reduction of the previous antipsychotic and high-dose aripiprazole initiation are crucial.

None Declared

Psychotic disorders are significant comorbidities in young people with Autistic Spectrum Disorder (ASD). Evidence suggests that ASD & psychosis present with overlapping clinical features & cognitive symptoms leading to misdiagnosis (Trevisan et al. Front.Psych 2020;11:548). Clinicians encounter diagnostic dilemma during assessment of psychosis in adolescents with ASD.

To discuss the clinical challenges in the assessment & treatment of young people with ASD & comorbid psychosis.

A case report of a young girl with ASD & comorbid psychotic illness.

A young girl with ASD was admitted to CAMHS inpatient Unit with unusual beliefs & perceptual disturbances. She reported hearing the voice of ‘Hydrogis’ who was talking to her about his girlfriend. She made a voodoo doll & tried to set it on fire, as she believed that this would kill the girlfriend. She also heard voices of characters from a TV show, discussing her in third person. She absconded from home due to the distress associated. She attempted suicide by tying a ligature. She was seen responding to external stimuli, laughing incongruously & was thought disordered. Despite never being to USA, she spoke in American accent. She lacked insight & struggled to differentiate reality from fantasy. The aim of admission was to determine if the symptoms were part of ASD or a psychotic disorder. She had medication free assessment but continued to be very distressed. We commenced Aripiprazole which was optimised. She responded well to the treatment & was discharged to the care of Early Intervention in Psychosis team with partial remission of symptoms.

Historically psychotic illnesses & ASD were thought to be closely linked. Research suggest that they are two separate disorders with specific onset, progress, signs & symptoms. ASD might be misdiagnosed as psychosis as difficulties in communication may resemble thought disorder, ‘melt down’ may mimic catatonia & difficulties in recognising others’ intentions may mimic paranoia. Our patient was experiencing first episode psychosis in late adolescence. This age of onset is consistent with research findings. A study to differentiate between ASD & psychosis found that positive symptoms like hallucinations & delusions were suggestive of psychosis while odd emotional gestures, stereotyped speech & restricted interests indicated ASD. Our patient predominantly had positive symptoms of delusions, hallucinations & thought disorder, hence our diagnosis of psychotic episode. In some cases, it is difficult to differentiate childhood fantasies from delusional beliefs (Ribolsi et al. Front.Psych 2022;13:768586). Bleuler explains that children with ASD replace imperfect realities with imaginations & hallucinations but Michael Rutter claims that autistic children lack fantasy. There are varying views on this subject & this is the challenge we faced when treating this young person.

None Declared

Transcendental cinema, distinguished from slow cinema by Paul Schreader, draws on the philosophy of existentialism and depicts the complexity of the human psyche using psychoanalytic tools. We claim that through the use of special procedures, the projection of transcendental cinema essentially becomes a meditation session in the spirit of mindfulness, which has been proven to alleviate and cure more than just neuropsychiatric ailments.

The purpose of this work is to demonstrate the similarity between mindfulness philosophy and transcendental cinema. We believe that the assumptions of both currents are so similar that we can treat the film screening in the category of a meditation session. Thus, we arrive at a situation in which we not only watch the protagonist developing his own consciousness in accordance with the mindfulness philosophy (also following the path of psychoanalysis), but also we, as viewers, develop self-awareness.

We analyze D. Lynch’s Twin Peaks series in accordance with Paul Schrader’s understanding of ‘transcendental cinema’. In addition, we use the scientific achievements of classical psychoanalysts, analyzing the metaphysical world of the characters in accordance with this trend. Using J. Kabat Zinn’s scientific publications, we analyze cinema in terms of a meditation session.

Participation is crucial; in meditation and in the transcendental cinema. Mindfulness means focusing on the emotions and feelings experienced at a given moment, on what comes to us, what we experience. Transcendental cinema using specific formal and narrative tools (e.g. extended scenes, no cuts, etc.) forces us to actively participate. Transcendental cinema fulfills the tenets of mindfulness, and during the screening we undergo a meditation session. What’s more, this style in cinema allows an in-depth exploration of the psyche, it brings us closer to the metaphysical, emotional dimension of humanity what develops in us the ability to understand the psyche of others, as well as our own.

We claim that the similarity between the philosophy of mindfulness and transcendental cinema allows us to treat a film screening as a meditation session. Cinema enriches us not only with knowledge about disorders and the therapeutic process, but is in itself a supportive tool - screening can allow viewers to deepen their awareness and improve their health. What is more, David Lynch’s work brings us closer to exploring the human psyche and the individualization of inner experiences, while also showing us what influence transcendental meditation has on characters and what happens when they undergo a kind of therapy; in the spirit of psychoanalysis or mindfulness philosophy.

None Declared

Electroconvulsive Therapy (ECT) is one of safest and most effective treatments for severe mental illnesses. The ECT Unit of Centro Hospitalar Universitário de Santo António – Magalhães Lemos Hospital (CHUSA-HML) is a reference center for this treatment modality, providing support to the northern region of Portugal.

This study aims to characterize patients undergoing ECT treatment from April to June 2023, at the ECT Unit of CHUSA-HML.

Retrospective study from April to June/2023. Social, demographic, epidemiological and clinical data were evaluated.

Among the 55 patients who were treated there was a predominance in male sex (56%), the average age was 53 years old and only 9 completed higher education. Half of them were in a long-term relationship. Around 67% of patients are retired, predominantly (62%) due to psychiatric disability.

Most patients (78%) were referred through psychiatric consultation and the remainder came from psychiatric hospitalization (only 3 were never hospitalized). 41 patients were under maintenance treatment and 14 under acute treatment. Concerning the type of treatment 30 were submitted to bilateral ECT. For 33% it wasn’t the first ECT treatment. Almost all patients improved their symptoms, only one patient had complications related to the procedure (tooth loss).

According to the international classification of disease (ICD11) the most frequent primary diagnosis was Schizophrenia or Other Primary Psychotic Disorders (58%). Neurodevelopmental disorders and substance use disorders were the most frequently comorbid diagnoses.

The results presented are preliminary, and other data that may be relevant are being collected and processed.

Severe mental illnesses profoundly impact patients, often imposing substantial limitations and suffering. These findings support the safety and effectiveness of ECT as treatment for severe mental disorders. Founding more specialized centers represents an important step toward enhancing mental health treatments. Access to controlled studies is crucial, fostering a deeper understanding of the ECT technique and long-term benefits.

None Declared

The internalized stigma associated with mental illness is considered as an additional burden faced by people with mental disease. Among mental illnesses, schizophrenia is considered as the most stigmatizing.

To Assess the level of stigma in a sample of people with schizophrenia

This is a cross-sectional and descriptive study carried out on 72 stabilized patients followed at the post-cure psychiatry consultation ‘A’ at the CHU Hedi Chaker in Sfax diagnosed with schizophrenia according to the DSM 5 criteria. Socio-demographic and clinical data were collected using a pre-established sheet

We used The Internalized Stigma of Mental Illness (ISMI) scale to assess internalized stigma

The mean age of the patients in our study was 46.83 ± 11.6 years, with a sex ratio (M/F) of 2.

They were single in 48.5%, unemployed in 69.4%. Their level of education did not exceed primary school in 44.4% and their socio-economic level was low in 63.9%. 2% of the patients had no somatic history and 36.1% had a history of attempted suicide.

The median for the total ISMI score was 2.45, which corresponded to the absence of strong stigma. The median of the subscales was distributed as follows: 2 for the level of alienation, 2.28 for stereotype endorsement, 2.4 discrimination experience, 2.36 for social withdrawal and 2.60 for stigma resistance.

In our study, 45.8% of patients reported experiencing high levels of self-stigma (total score>2,5).

Our study found levels of self-stigma in individuals with schizophrenia that align with previous research, suggesting that schizophrenia-related stigma is a global phenomenon unaffected by factors such as origin or ethnicity.

None Declared

A 36-year-old man with a history of cannabis use disorder since age 16, consuming 8-10 units/day, experienced irritability and tremors upon reducing consumption. His psychiatric issues emerged in 2020, marked by anxiety, abdominal pain, and severe vomiting, leading to a dyspepsia diagnosis. Subsequently, he received psychiatric care at CAS Hospitalet, diagnosed with severe cannabis use disorder. No prior inpatient admissions occurred.

Our project aims to show a case report and summarize the available evidence on cannabinoid hyperemesis syndrome (CHS).

In May 2023, he voluntarily sought admission to Barcelona’s “Hospital Sant Pau,” aiming for cannabis detox and treatment of cannabinoid hyperemesis. He’d endured years of intense abdominal pain, nausea, and vomiting, worsening over the last two years, with uncontrollable vomiting hindering daily life. Admission saw reduced cannabis use to 3-4 units/day. Inpatient care revealed anticipatory anxiety, rumination, and somatic anxiety, accompanied by distal tremors and internal restlessness due to abdominal discomfort, partially alleviated by 5-10 mg of diazepam.

Treatment included domperidone 10mg/8h, haloperidol drops (5-10 drops/8h), capsaicin ointment, hot showers, and cryotherapy, resulting in gradual relief from abdominal pain. Moderate cravings for tobacco and cannabis led to acetylcysteine 600mg/12h and gabapentin up to 1200mg/8h. Gastric discomfort with SSRIs led to vortioxetine 10 mg/day, well-tolerated with a positive response. Consultation with the GI department confirmed the treatment’s efficacy, emphasizing cannabis abstinence. Upon discharge, cannabinoid hyperemesis symptoms markedly improved, and the patient was referred to “Hospital de Dia.”

CHS is a cyclic vomiting syndrome, preceded by daily to weekly chronic longstanding use of cannabis that can be difficult to diagnose and treat(1,3,4). It is unique in presentation, because of the cannabis’s biphasic effect as anti-emetic at low doses and pro-emetic at higher doses, and the association with pathological hot water bathing (2). The major characteristics are as follows: history of regular cannabis for any duration of time (100%), cyclic nausea and vomiting (100%), resolution of symptoms after stopping cannabis (96.8%), compulsive hot baths with symptom relief (92.3%), male predominance (72.9%), abdominal pain (85.1%), and at least weekly cannabis use (97.4%)(1). Treatments such as topical capsaicin, haloperidol, benzodiazepines, and propranolol have shown symptom relief (3) whereas opioids should be avoided (4). Cannabis cessation appears to be the best treatment (1,3).

1. 1. Sorensen et al. Journal of Medical Toxicology 13 (2017):71-87.

2. 2. Perisetti et al. Annals of gastroenterology 33.6 (2020):571.

3. 3. Senderovich et al. Medical Principles and Practice 31.1 (2022):29-38.

4. 4. Leu, et al. Journal of Emergency Nursing 47.3 (2021): 483-486

None Declared