Most patients with dementia are treated with irrational polypharmacy, which leads to higher mortality and other negative consequences (higher costs). Nearly 50% of elderly patients take one or more medications that are not medically necessary, which represents another important aspect of medication optimization. Research has established a strong relationship between irrational polypharmacy and its negative clinical consequences, including a negative impact on dementia, especially in patients with excessive polypharmacy (10 or more medications). These patients are underrepresented in the treatment guidelines and randomized controlled trials, although they represent a substantial patient population. The burden of irrational polypharmacy has also been associated with a greater risk of adverse drug events, drug-drug interactions, medication non-adherence and a higher risk of potentially inappropriate medication (PIM) use. Different treatment strategies have been available to reduce irrational polypharmacy in this population. The best intervention for irrational polypharmacy reduction in this population involves an inter-professional approach (collaborative care approach) that often includes special tools, a basic pharmacological approach and collaboration with a clinical pharmacist.

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Patients with an alcohol use disorder frequently relapse after various efforts to quit. Admission to hospital units is a possible start to stop drinking alcohol and reach abstinence. Among the pharmacological strategies to quit this addiction are specific drugs, such as disulfiram or namelfen, which are widely studied. Hospitalized patients frequently initiate these medications to control addiction, but little is known about their efficacy after discharge in this group.

The aim is to determine whether the initiation of treatment with specific drugs for alcohol use disorder could help to maintain alcohol abstinence after admission to a General Hospital Psychiatric Ward. In addition, we want to check those factors associated with a higher rate of relapse in consumption.

We conducted a retrospective cross-sectional study of a group of patients admitted in 2018 to a psychiatric hospitalization ward due to alcohol use disorder and who expressed their desire to stop drinking. At the time of admission, we recorded sociodemographic data, consumption of other substances and alcohol family history. Patients initialized specific treatments to reduce and control alcohol consumption if they wanted. Twenty-four months after discharge, we acquired the number of relapses through new admissions, emergency room visits or outpatient follow-up data.

A sample of 36 patients (28 men) admitted to a psychiatric hospitalization ward was analyzed. At discharge, 17 accepted specific pharmacological treatments to reduce alcohol consumption. After a follow-up period of 24 months, 70.8% relapsed compared to 94.7% who did not accept treatment (χ2=4.001, DF=1, p=0.045, OR=0.13). There were no differences between the two groups in age, gender, amount of alcohol consumed, follow-up modality at discharge or if it was their first detoxification attempt. However, those who did not accept the specific pharmacological treatment consumed other drugs (41.1% vs 5.8%, χ2= 5.888, DF=1, p=0.015), had other history of mental disorder (64.7% vs 23.5%, χ2= 5.845, FD=1, p=0.015) and a higher proportion of relatives with alcohol consumption (81.8% vs 42.8%, χ2= 3.896, FD=1, p=0.048) more frequently. The time (in days) to relapse was faster in this group of patients (200.8 vs 402.7 , Z=-2.5413, p=0.005).

Accepting drug-specific treatment for alcohol use can be helpful for many patients who want to achieve alcohol abstinence. Among the factors that prevent the acceptance of this treatment is the consumption of other substances, comorbidity with another mental pathology and family history, which may involve genetic factors that favour addiction. This group of patients could benefit from a specific pharmacological treatment, although other psychosocial factors may also help.

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Sleep is one of the most important factors for well-being. Numerous studies have linked poor sleep to negative consequences such as depression (Guo et al., 2014), substance use (Comasco et al., 2010), obesity (Wu et al., 2015), and suicidality (Liu & Buysse, 2006). Understanding the causes of poor sleep is an important public health concern. Childhood trauma can have a lifelong influence on mental health and development. However, many examinations of childhood trauma focus on the number of experiences and not the impact of specific experiences. Research has shown gender differences in both insomnia and childhood maltreatment outcomes (Lee et al., 2014); however, less attention has been paid to the potential role of gender in the link between other types of childhood trauma and sleep disturbance.

The goal of the current study is to understand the role of gender in the relationship between childhood traumas and sleep problems among a community sample of emerging adults. This research aims to build on and extend previous work in three different ways: 1) add to the literature on childhood trauma among emerging adults; 2) examine specific types of childhood traumas; and 3) expand the categories to explore the role of some less studied adversities.

The study included a sample of 211 young adults from an urban community. Traumas were measured with the Brief Trauma Questionnaire (BTQ; Schnurr et al., 1999) and sleep was measured with the Pittsburgh Sleep Quality Index (Buysse et al., 1989). Logistic regression was used to calculate odds ratios for the relationship between sleep problems and five traumas (involved in a serious accident, experienced serious injury, violent death of a close family member or friend, witnessed someone’s serious injury or death, and natural disaster).

Results showed that males and females experienced similar rates of trauma. Trauma experienced during childhood was associated with an increased prevalence of poor sleep. In the male model, being involved in a serious accident (OR=1.47), experiencing serious injury (OR=1.24), and experiencing a natural disaster (OR=1.11) were all significantly associated with poor sleep. In the female model, the violent death of a close family member or friend (OR=2.02), witnessing someone’s serious injury or death (OR=1.78), and experiencing a natural disaster (OR=1.69) were all significantly associated with poor sleep.

Traumatic events may impact men and women differently. Women in the study showed greater sleep problems in the wake of childhood traumatic events. They also responded more strongly to events that they saw happening to other people, while men were more greatly affected by things that happened directly to them. Natural disasters are a relatively common event that has a strong impact on sleep. Intervention efforts addressing trauma and poor sleep should be aware of gender differences for greater efficacy.

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Several studies have shown that ketamine, an NMDA receptor antagonist, represents a promising alternative in treating depression and suicide. The intranasal or intravenous use of ketamine, currently used, has limitations in terms of cost and complexity. The subcutaneous (SC) route may be an affordable alternative for the treatment of depression and suicidality.

To evaluate the response of SC ketamine (0,5 mg/kg) applications on depressive, anxiety, and suicide symptoms.

A patient with unipolar depression and suicide attempt was submitted to 3 sessions of SC ketamine (0,5 mg/kg). The applications had 2 days of intervals. Clinical evaluations were measured by BDI, BSI, and BAI. The vital signs were monitored under 2 hours after injections and the potential side effects.

Changes in measurement instruments according to applications can be seen in Tab 1:

The average measurements of vital signs during 2 hours of monitoring for each application can be seen in Tab 2:

The use of SC ketamine showed remission in BDI, BSI and BAI, respectively demonstrated safety in use.

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The prescription of psychotropic drugs is a major health problem , especially in the elderly. In fact, many studies highlight the misuse of psychotropic drugs and in particular the over-prescription of antipsychotics in the elderly which would be deleterious and not indicated.

To evaluate the prescription of antipsychotics in hospitalized elderly people in a psychiatric environment and to compare them with data from the literature.

This is a retrospective descriptive study of patients aged over 65, hospitalized in the psychiatry department between January 2017 and December 2021 and who received first- or second-generation antipsychotic treatment during their hospitalization.

Our sample consisted of 20 patients. More than half of our sample (55%, N=11) had at least one somatic history. More than 20% of subjects, was polymedicated; and for only one patient, the ECG showed an elongation of the space QT counter indicating the use of antipsychotics. The most common diagnosis found was schizophrenia with a rate of 35%,followed by paranoia (20%), and chronic hallucinatory psychosis (15%). More than a quarter of our sample (30%, N=6) received antipsychotic treatment of first generation (AP1G), 10 patients (50%) received antipsychotic treatment of second generation(AP2G) and three patients (15%) received a combination of AP1G and AP2G. More than a quarter of our patients (30%, N=6) reported adverse effects due to neuroleptic treatment.

The results of our study highlighted different indications for which an antipsychotic treatment was prescribed for an elderly person despite a ground often flawed, polymedicated and where the undesirable effects are superimposed.

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With the growing mental health concerns in the United Kingdom, it is undisputable that there will be a need for more mental health professionals, particularly psychiatrists. It has been estimated that there is 1 consultant psychiatrist per 12,567 people in England. The Royal College of Psychiatrists continue to call for a long term plan to address the mental health crisis by investing in psychiatric training and education.

To analyze the socio-demographic profile of doctors in training in psychiatry and change in demand over the last decade (2012-2021)

We carried out secondary review of the state of medical education and practice in the UK in 2021 report. We analyzed reference tables in the report pertaining to doctors in training in psychiatry by age group; gender; by ethnicity; and by place of primary medical qualification. The report included data for the period 2012-13 to 2020-21, which was analyzed. In addition, 5-year (2017-2021) and 10-year (2012-2021) trends were also available and included in our analysis.

While in 2012, there were 1,370 doctors in training in psychiatry, the number had dropped marginally to 1,352 in 2021. While there has been an overall decline of 1.3% in the decade (2012-21), there has been a 11.1% increase (2017-21) in the last 5 years. A big change was noticed with respect to gender. While there were 670 male doctors in training in psychiatry in 2012, the number dwindled to 522 in 2021 (22.1% decline). A deeper analysis of the decline in the male psychiatry trainees reveals that the steepest decline has happened among male international medical graduates (389 to 131 or 58.1% to 25.1%). However, the 5-year trend for male doctors has been more favorable with a 10.6% increase between 2017 and 2021. Among female doctors on the other hand, there was a 18.6% increase from a baseline of 700 in 2012 to 830 in 2021. From an ethnicity perspective, there has been a sharp decline in the proportion of Asian or Asian British trainees, down by 33.9% (555 to 367) between 2012 and 21, compensated largely by White trainees, where a 50.1% increase (511 to 767) has been seen. There has been a significant fall in the proportion of international medical graduates taking up psychiatry training (down 53.5% from 677 to 315) in the UK. This has been compensated by a 58.2% (607 to 960) increase in those who had primary qualification from the UK.

The theme of the 31ST European Congress of Psychiatry: ‘social cohesion, a common goal of psychiatry’ blends well with what is needed in today’s psychiatry teaching and practice in the UK. With the role of culture and society well established in psychiatry, the pursuit for popularizing the profession should not be a ‘one size fits all’ approach but a more targeted approach to ensure that there is greater diversity among the available psychiatrists for patients to choose and benefit from.

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Capgras and Fregoli syndromes are delusional misidentification syndromes, characterized by a belief in duplicates and replacements. Capgras delusion was first described by Capgras in 1923, reporting a belief that a person (usually a close relative) has been replaced by an exact double (imposter). On the other hand, Fregoli Syndrome was first described by Courbon and Fail in 1927, and holds a delusion that a familiar person is disguised as a strange person. Several explanatory models have been hypothesized, through myths, psychoanalytical and psychological interpretations, as well as neurobiological explanations.

Through six different clinical cases and a narrative review, we aim to revisit the concepts of Capgras and Fregoli syndromes, emphasizing their complexity and heterogenicity.

We conducted a non-systematic review of recent evidence on Capgras and Fregoli syndromes and expose exemplary clinical cases.

Capgras and Fregoli syndromes are complex psychotic experiences involving a great number of brain areas, with many heterogeneous clinical manifestations and comorbidities. Even though they were initially encompassed in pure psychotic disorders, today they are mainly understood as neurological disorders, in which the delusion primarily results from organic brain lesions or degeneration. Nevertheless, we present several distinct clinical cases with psychiatric diagnoses that include these curious phenomena: a 39-year-old man with schizophrenia; a 67-year-old woman with late-onset schizophrenia; a 24-year-old woman with schizoaffective disorder; a 48-year-old woman with first episode of acute and transient psychotic disorder; a 76-year-old woman with psychotic depression; and a 25-year-old woman with psychosis and intellectual development disorder.

Our review highlights the complexity of the delusional misidentification syndromes. We expose different patients with different psychiatric diagnosis, showing the diversity of pathologies in which these syndromes can fit. Although they seem to be very common in non-psychiatric disorders, little is known about the prognosis and response to treatment or whether there are systematic differences between delusional misidentification syndromes associated with “functional” and “organic” disorders, which should encourage further studies in order to address this gap and provide appropriate care.

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Although mania is commonly associated with bipolar disorder, it can have many etiologies. Thus, “primary mania” results from bipolar disorder, whereas “secondary mania” results from pharmacological, metabolic, or neurologic causes. Older adults are at risk for secondary mania because of increased medical comorbidities and neurological changes. In one retrospective study of 50 patients with mania who were older than 65 years, it was the first manic episode for 28% of the patients and 71% had a comorbid neurological disorder.

The etiology of mania is important because although acute symptomatic treatment of both primary and secondary mania may be similar, appropriate treatment of secondary mania includes addressing the cause. We present here two case histories of secondary mania in older adults, discuss their presentations and differential diagnosis in turn, and discuss treatment.

We will present a clinical case of a patient. Ms. A, a 63-year-old divorced woman with no prior medical or psychiatric history, was seen for an acute manic episode with mixed features. She was in her usual state of health until 2 weeks before admission, when she presented with a status epilepticus requiring a one-week hospitalization in the neurology département and treated by Carbamazepine. She then developed an abnormally excited and labile mood, motor excitability accompanied by rapid thoughts, with a total loss of desire and pleasure and thoughts of death.

In our study, the patient presented a manic episode with mixed characteristics secondary to a status epilepticus.

The patient was treated both somatically and psychologically, and the evolution was positive. The patient was stabilised after being put on an antiepileptic drug associated with an antipsychotic drug.

In our study, the patient presented with a manic attack with mixed characteristics secondary to a status epilepticus.The patient was treated both somatically and psychologically, and the evolution was favourable. The patient was stabilised after being put on an antiepileptic drug associated with an antipsychotic drug.

Late onset psychiatric disorders often represent a challenge for the psychiatrists as far as the diagnosis and management issues are concerned. The elderly patients have generally been reported to have associated medical, especially neurological illnesses and are also prone to side effects of various psychotropic medications.

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CD is characterized by at least three features: its duration is prolonged, it does not resolve spontaneously and it is rarely completely cured. Approximately 10-15% of young people have CD. Adolescents with CD often have emotional and behavioral problems.

To assess risk factors, derived psychiatric pathologies and coping strategies for a CD diagnosis in adolescence.

An extensive literature review was carried out on the subject in question, extracting information mainly from scientific articles, manuals and books.

The main risk factors are those related with the CD in question, physical sequelae, the need for long-term hospital admissions or the use of drugs whose side effects include affective or behavioral symptoms; those related to the personality traits of the affected child or adolescent. In addition, as far as the family is concerned, the presence of a low level of education, lack of support or communication, as well as the presence of psychiatric disorders or serious medical conditions in parents. Among the most frequent psychiatric disorders associated with CD are affective and anxiety disorders, adaptive disorders, somatoform disorders, eating disorders and behavioral disorders. Whatever the CD is, it generates high levels of stress and uncertainty in the patient and family, which must be dealt together from a flexible perspective, allowing child or adolescent to adapt to the changes, reorganize and facing them with adaptive patterns of behavior. For this, it will be essential to have adequate social and family support with relational style based on communication, trust and acceptance.

In general, both adolescents with CD and their families have an adequate capacity to adapt to the repercussions and effects derived from the disease. Nevertheless, in case of possible emotional difficulties that may appear, a comprehensive and individualized approach to these adolescents and their families is necessary to provide them resources and coping strategies in different areas and contexts in which the disease debuts.The comprehensive therapeutic approach will consist of interventions at the individual and family level. Among the main objectives of these interventions are to achieve acceptance and adaptation to CD provinding adequate psychosocial support to enable them to cope with CD in the best possible way and to detect and address the emotional implications, even coexisting psychopathology.

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The prevalence of alterations of liver function tests in patients with schizophrenia and bipolar disorders is not well known. These alterations are often considered as side effects of medication

Our study aimed to evaluate and compare liver function before and after treatment in patients with schizophrenia (SCZ), schizo-affective disorder (SCA) and bipolar disorder (BD).

This was a prospective study among patients with SCZ, SCA and BD according to DSM-5 criteria. Patients, from the “C” psychiatry department of Hedi Chaker University Hospital in Sfax, were assessed during both acute and remission phases in their illness. The acute phase (T0) assessment was made in drug-free patients from june 2016 to july 2018. As for the remission phase (T1), it was made between november 2019 and march 2020. Blood tests were performed in the Laboratory of Biochemistry at Habib Bourguiba University Hospital in Sfax. Clinical and biological parameters of patients were compared with those of healthy controls. Biological assessment consisted mainly in Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) and Albumine.

Thirty patients were included in our study. Their mean age was 35.83 ± 12.24 years and they were all males. They suffered from SCZ in 33.33% of cases, from SCA in 26.66% of cases and from BD in 40% of cases. Psychoactive substance use was common among 80% of patients. In the remission phase, 90% were polymedicated with use of antipsychotics in 83% of cases and mood stabilisers in 53% of cases. Table 1 shows the evolution of the studied liver function markers in our patients.Table 1:

evolution of some liver function markers in patients

Our results showed an improvement of liver function in patients with SCZ and BD after treatment. This suggests that liver function alterations are due to these diseases rather than the medication.

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Since the start of the COVID19 pandemic, numerous patients have exhibited symptoms related to the viral infection once the acute phase has resolved. The most frequent are fatigue or weakness, cognitive difficulties, insomnia, and anxiety or depression. It has been observed that the persistence of these symptoms is more common in cases of severe infections.

We expose a case that exemplifies it; A 60-year-old man suffering from severe COVID19 infection during 2021, with bilateral pneumonia and secondary pneumothorax. Three months after the acute episode, he continues to present related symptoms, such as dyspnea, asthenia, arthromyalgia, nausea, hyporexia, memory lapses, anxiety and depressive mood with apathy, anhedonia and suicidal ideas.

The patient starts follow-up in Mental Health and antidepressant treatment with Vortioxetine 10mg. In the following months he presented significant improvement consisting in decrease of the asthenia, dyspnea, arthromyalgia and especially in anxious symptoms and depressive mood, disappearing the apathy, anhedonia and suicidal ideation. However, the persistence of memory failures draws attention, which remain in a similar degree or with slight subjective improvement.

The exploration and complementary test were the following:

• - Chest CT: Hydropneumothorax, parenchymal infiltrates, alveolar consolidations, left lamellar pneumothorax.

• - Head CT, complete analysis, microbiological and cytological studies without relevant resolution.

• - Assessment by the Rehabilitation and Neurology service.

This case exposes the existence of a post-COVID syndrome, where the symptoms related to the infection persist, including anxious-depressive symptoms of moderate-severe intensity. The different diagnoses that were considered were the following: Post-COVID syndrome, Adjustment disorder with mixed anxious-depressive symptomatology, Depressive episode.

We consider that in this case and in others that are similar, which are increasingly common in routine clinical practice, the etiopathogenesis of the syndrome is of interest. We found that it is difficult to discern the origin of the symptoms, not being able to differentiate an adaptive difficulty to the infection situation (added to the COVID pandemic context), versus a more organic affectation that improves when receiving pharmacological treatment, as in this case with antidepressants.

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Adolescents represent a vulnerable population, with a high prevalence of mental illness and increased levels of subsyndromal psychological distress. Educational settings are central to the lives of young people, and their potentiality to promote mental health is increasingly recognised. The acknowledged role of peer influence on adolescent behaviours indicates peer-led interventions as a promising avenue of youth mental health support.

The intervention stems from a pilot called The Vineyard Project, which engaged a group of young people with different forms of mental ill-health in local practices of hand-harvesting grape. The pilot was hosted in the region of Langhe (Italy) and was meant to address social anxiety symptoms and poor self-efficacy through the involvement in a culturally meaningful activity within the transformative process of winemaking. The pilot formed the basis of a peer led-intervention in a local Arts high school, aimed to improve mental health knowledge, reduce stigmatising attitudes and promote help-seeking through the mediated connection between students (n = 80) and young people who participated in the Vineyard Project.

Semi-structured interviews with young people participating in the pilot have been conducted and audio-recorded. Interviews explored their experience in the vineyard and its relation with their personal story and the mental health challenges they have been facing. Following a preparatory work with high school teachers, recordings have been anonymized and shared with students to become the object of an art-based workshop.

The practical purpose of the workshop with Arts students was to draw wine labels inspired by their peers’ narratives as they were recorded during interviews. This activity had a double objective: i) to stimulate the ability to listen and foster connection with the experiences shared by young people participating in the vineyard activities; ii) to auction wine bottles labelled by the students to provide financial support for new projects for young people. Feedbacks gathered with students and members of the education community showed that stories shared by participants were considered relatable, experience-near and close to the difficulties that students were familiar with. Consistently with scientific literature on peer support in youth mental health, the intervention showed beneficial effects on the interviewees as well: the opportunity to share their story, making it available to other adolescents who could learn from it and take the project further, stimulated feelings of self-acceptance, personal growth and sense of value.

Emerging results from the Vineyard Project suggest that a dialogue between peers, undertook in a non-medicalised framework, can foster connection and empathy, breaking down taboos about mental health, reducing self-stigma and eventually increasing help-seeking intentions.

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Alzheimer’s Disesase is the most frequent cause of dementia, accounting for approximately 60% of cases. It is characterized by an accumulation of beta amyloid and tau protein in the brain, resulting in the loss of normal brain tissue and cognitive decline, including loss of memory and language. Prior studies have found that this is one of the most feared disorders, possibly because of the associated cognitive decline, our poor ability to prevent and treat the disorder, and its poor prognosis. Prior studies have found different results regarding the importance of age and gender on level of fear.

We wanted to study the fear of obtaining Alzheimer’s disorder in a Norwegian sample and to examine the importance of age and gender.

The Fear of Alzhemer’s Disease Scale (FADS, French et al, Geriatr Psych 2011;27:521-8) was translated into Norwegian for this study, following standard procedures. The questionnaire has 30 items, each responded to on a 5-point likert scale with responses ranging from ‘never’ to ‘always’. The total maximum score was 120 points. Links to the questionnaire were posted on Facebook. Respondents were directed to a site for anonymous and untracable participation. SPSS version 24 was used for statistical analyses. Non-parametrical tests, including the Mann-Whitney U-test, were used to study between-group differences (age below 50/others, male/female).

The FADS score was significantly higher (U=5113, Z=-2.236, p=0.025) in the respondents below 50 years (60.00) than in the others (54.93). The FADS score was not significantly different (U=7513, Z=1.673, p=0.094) between men (56.12) and women (59.67).

We found that the level of fear, on average, was quite high. Those below 50 years were significantly more fearful of the disorder than the older respondents. This might seem counterintuitive, as the disorder is much more common in older people. However, emotional regulation and fear of illness may improve with age (Carstensen et al. Psychol Aging 2011;26:21-33), which might explain our finding. There was no significant gender-related difference in fear of getting Alzheimer’s Disease, which is interesting given that 2/3 of those suffering from the disorder are women. The study was based on a questionnaire posted online, which might have resulted in a bias in participation. Further studies are needed to confirm our findings.

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A septum pellucidum cyst is defined as a fluid collection between the lateral ventricles whose walls have a lateral curvature and are separated by 10 mm or more . Most of these cysts are benign and their clinical significance should be considered as a neurodevelopmental anomaly that may contribute to neuropsychiatric abnormalities . It is often of incidental finding, of little clinical significance. However, an association between this developmental anomaly and a mental disorder, such as schizophrenia and/or intellectual disability, has been reported

The objective of this study is to discuss the relationship between the septum pellucidum cyst and mental disorders, especially schizophrenia and intellectual disability.

We report in this study two clinical cases, diagnosed with schizophrenia comorbid with intellectual disability and in whom brain imaging has objectified a cyst of the septum pellucidum

multiple cases reports of patients with Schizophrenia and/or mental retardation revealed, on brain imaging, significant abnormalities in midline brain regions such as Septum Pellucidum. It is suggested that CSP, particularly if large, should be considered a developmental anomaly that may contribute to neuropsychiatric abnormalities.

Whether the CSP may serve as a risk factor for psychosis or is only a reflection of neuroanatomical changes in individuals with chronic psychotic disorders remains ambiguous. More studies and case reports will be needed to establish the veritable association of CSP and neuropsychiatric disorders in the future, and perhaps to acknowledge the CSP as an early marker and predictor of psychosis.

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Late-onset psychosis appears in people over the age of 40. Some preliminary studies show that LOP has fewer severe positive symptoms, more systematic persecutory delusions, more bizarre-type delusions, less affective flattening, and more social withdrawal than early onset psychosis.

There are some studies that consider late-onset and very late-onset psychosis as prodromes of neurodegenerative disease. There are some differences in neuropsychological profiles and specific cognitive function alterations discovered. More evidence, however, is required to make an accurate diagnosis.

The objective of this study was to reflect the difficulties in differentiating between late-onset psychosis and dementia by reporting the case of a 77-year-old woman who presented with mystical-religious delusions and hallucinations during her hospitalization.

We present the case of a 77-year-old woman who was hospitalized because of a stroke. During her stay, she began receiving follow-up from the mental health team because she verbalized some mystical-religious delusional ideas. During the psychiatric interview, the patient verbalized mystical-religious ideas and oscillated between coherent, organized, and disaggregated speech. No problems were detected with orientation, or florid affective symptoms that could point to a delirium or affective disorder. The premorbid personality was extravagant, with interpersonal difficulties and magical thinking. Nonetheless, she had no prior contact with the mental health system or hospitalization. We could approximate the beginning of the symptomatology at around 60 years old, thanks to her relatives. Prior to this age, she maintained good function by working as a chef on a regular basis. She gradually isolated herself due to her lack of mobility. Similarly, she decreases her self-care activities, begins hoarding items around the house, and gradually develops more psychotic symptoms.A brain scan was performed, and no acute pathology was found. A neuropsychological test was not executed due to a lack of collaboration from the patient.

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This case reflects the complexity of differentiating between dementia and late-onset psychosis. Supplementary testing and follow-up are essential for establishing a diagnosis. Related to that, more research is needed to identify the differential characteristics between the two disorders and the temporal correlation between them.

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Bipolar disorder (BD) is a chronic and disabling disease. Its prognosis is largely conditioned by tretment adherence. The pregnancy and post partum are considered as a period of high vulnerability and risk of relapse. According to the literature, no study has investigated treatment adherence in this population.

The purpose of this study was to compare medication adherence among 3 groups of bipolar patients: in the postpartum period, one year before the conception , and outside the perinatal period. As a secondary objective, we compared intentional and unintentional adherence among these three groups of patients, as well as adherence dimmensions related to behaviors, attitudes and tolerance.

We also studied concerns and perceived need for treatment and the presence of potential confounders.

This is a post hoc study conducted using a research protocol entitled RsBip, (NCT03595670), descriptive, mono-centric and open. Patients with a diagnosis of bipolar disorder established by a psychiatrist, having a pregnancy project, pregnant, or having given birth since less than one year, and their age-matched controls were included in analysis. All the patients are recruited within the expert center for bipolar disorders in the University Hospital of Marseille. Standardized and validated questionnaires such as the MARS, the BMQ and the HADS were used.

112 patients participated in the RsBip study. After exclusion of men, women over 50 years of age and women who did not answer the gyneco-obstetrical history questionnaire, 46 patients with a diagnosis of bipolar disorder were included in our study. Among them, 12 patients had a pregnancy plan within the year, 3 patients were pregnant at the time of inclusion, 8 patients had given birth within the year, and 23 patients constituted the “control” group. The characteristics of the population were similar.

Our main hypothesis was partly confirmed since compliance with treatment decreases in the postpartum period, and more precisely intentional compliance and dimensions related to behaviors and attitudes.

Post-partum period is associated with low adherence in BD. The implementation of a specific therapeutic education for patients and the promotion of a shared medical decision as soon as the pregnancy is planned could be proposed.

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Family members play an important role in the life of many adults with mental disorders and are under considerable amounts of stress that may affect caregiver’s physical health, quality of life and resilience.

The present study aimed to explore the relationship between the perceived stress and the resilience levels among caregivers of patients with mental illness and to identify their associated factors.

This was a cross-sectional, descriptive and analytical study conducted on caregivers of patients suffering from mental illness. It was conducted in the outpatient psychiatry department at the university hospital of Sfax (Tunisia), during september 2021.

We used the Connor–Davidson Resilience Scale to assess resilience and the Perceived Stress Scale (PSS-10) to assess the level of stress. High scores indicate high resilience and perceived

The sample included 34 family caregivers of patients with mental illness. The mean age was 47.47 years (SD=12.4 years) and the sex ratio (M/F) was 1.42.

The mean resilience score of caregivers was 42.85 and the mean perceived stress score was 24.94 (SD=6.36).

The score of resilience correlated negatively with the score of perceived stress among family caregivers (r=-0.751 ; p=0.0001).

The Caregivers with low socioeconomic level were more likely to have a low resilience score (p=0.004) and to have high stress levels (p=0.04).

The level of perceived stress increased significantly in case of long duration of providing care (r=0.697 ; p= 0.001), the presence of stressful events (p=0.029) and the presence of agressive behaviors committed by patients (p= 0.001). However, the level of resilience decreased significantly in those same cases (p=0.001; p=0.002; p=0.0001 respectively)

Our findings suggest that high level of perceived stress among familiy caregivers impact negatively their capacity of resilience. So, interventions targeting stress related to stressful events and violence committed by patients in their family environment should be integrated to increase the caregivers’resilience.

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Evidence-based parent training is a widely recommended in the treatment of ADHD. However, most studies have not tested parent training with clinically referred children and practising clinicians in real-life clinical settings. In this presentation I will present findings from a randomised controlled trial funded by TrygFonden that evaluated the implementation of NFPP in hospital based child psychiatry clinics in the Denmark. The presentation will focus on the many implementation challenges that arose in translating a behavioural intervention from English into Danish. These include cultural adaptations and changes to mode of delivery that were required to ensure Danish parents would be able to engage with and access the intervention. Changes and adaptations were deeply informed by co-production with Danish parents and health care providers to ensure the successful development of NFPP in Denmark, appropriate evaluation, and widespread implementation within secondary care services in Denmark. The presentation will conclude with some preliminary findings from a second study funded by Trygfonden which is seeking to explore barriers to implementation of NFPP within Danish community based child and family services. Again, co-production has been invaluable in guiding the development of NFPP within Danish community care services. Identifying and overcoming barriers in implementation through co-production are essential parts of research needed to close the gap between intervention research and clinical practice

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Attention deficit hyperactivity disorder (ADHD) is a condition that is usually diagnosed in childhood . However studies have shown that there is a propotion of adults with ADHD that did not have the disorder in their early ages and have been diagnosed in adulthood . Symptoms of adult ADHD are often confused with other psychiatric conditions due to the similarities in clinical criteria . Diagnosing Adult ADHD is still challenging due to lack of gold standard instruments , which can interfere with the therapy .

Identify the assessement measures that improve the early diagnosis of Adult ADHD

A systematic literature search was executed using the PUBMED and GOOGLEscholar databases from 2009 to 2022 exploring the different assessement tools of adult ADHD using the keywords : Adult ADHD – Diagnosis issues – Assessement .

Results show diagnosing Adult ADHD can be by using three different assessement methods : clinical interview – ADHD behaviour rating and neuropsychological tests .

Clinical interview has a high sensitivity but low speceficity in diagnosing ADHD in adults .

Harrison and Al showed the CAARS scale appears to have adequate specificity in a young adult population giving it has validity to identify invalid symptom presentation.

The TOVA and the Conners CPT are the two CPTs widely used in ADHD assessment.

It is not clear whether the TOVA or Conners CPT has better diagnostic accuracy .

Cognitive test batteries dont show specific results in identifying ADHD

To sum up , diagnosing adult ADHD is a challenging situation due to the lack of specifity in the assessemnt tools . This work highlights the necessity of further studies to improve the diagnostic process and the ability to create a universal guidelines . That way , early interventions and treatments can take place and avoid the confusion with other conditions .

None Declared

Despite the general awareness of necessity for implementing development of competences in working with LGBTIQ+ people as the obligatory course within the education of mental health professionals, it is still not the educational standard in Croatia.

Within the perspective of the past 20 years, the development of educational programs aiming to develop LGBTIQ+ affimrative and informed practice in the field of mental health care, togeather with the review of the most crucial research results in the field of LGBTIQ+ mental health will be given.

The results obtained from several research on national samples of LGBTIQ+ people, psychology students and psychologists are analysed using mainly qualitative methodology and to the small extent quantitative methodology.

Psychologists are perceived as a profession that respects diversity and actively reduces stereotypes and prejudice but there are still some obstacles to overcome within the profession. In traditional cultures appreciation of human rights of LGBT people is unfortunately not a guiding principle. Research on Croatian university students showed that slightly positive attitudes toward LGBT people were stable and remained unchanged from the 2005 till 2013. Specific attitudes toward human rights of lesbians and gays are ranging from moderately negative to moderately positive. The most frequent forms of discrimination and/or violating human rights of LGBT people are: usage of offensive, humiliating, pejorative and oppressive language, ignoring of LGBT people, attentional exclusion of LGBT people, threatening with physical violence. Stress resilience, social support, and inclusion in the LGBT society are key determinants of different indicators of mental health in this population. Although 64.4 % of transgender participants are highly informed about the new legalization, only 24.5 % are very satisfied with it. Trans-women, in comparison to trans-men, have significantly lower levels of quality of life and experience significantly higher levels of sexual violence. Based on the online research among the professionals from the Croatian national list of experts in thefield of health care of trans people the percieved level of transphobia in sociaty is abowe the average, as well as percieved impact of the COVID- 19 pandemic on acessibility and slowing down of standard diagnostic procedures.

Significant political and social change for sexual and gender minority people in Croatia in the last several years have contributed to a greater public visibility of LGBTIQ+ people. As allies of LGBTIQ+ people and even as belonging to the LGBTIQ+ population, psychologists, psychiatrists and other mental health professionals have the leading role in ensuring that the results of their scientific findings and professional corpus of knowledge have ethical and practical implementation and beneficial impact on society.

None Declared