Results of a randomized controlled trial supported the efficacy of a manualized, Intensive and Brief Psychodynamic Psychotherapy (IBPP) for inpatients with severe depression, but the mechanisms by which the interaction between a psychotherapist and a patient can be involved in a process of change require more direct study.

The study aimed to explore how the psychotherapist and the patient interacted to work through the themes of focalization of their therapeutic work and how their work was part of a potential process of change.

A pragmatic case study was conducted on two cases selected from the umbrella study with one responder and one nonresponder to treatment (response defined as > 46% decrease in depressive symptoms on the MADRS). For each case, the verbatims of 6 sessions were analyzed, focusing on the themes of the IBPP manual.

Two main functions were revealed: 1) “Becoming the subject of one’s depression”, which includes the following themes: i) “Following the Tracks of Pain and Loss”; ii) “Negotiating the Distance to the Cemetery”; iii) “Beginning to Accept”; iv) “Investing in New Projects “; and 2) “Regaining a sense of support” which includes the following themes: i) “Not Being Beaten Down”; ii) “Emptying a Full Closet”; iii) “Fear of Ending Up Alone”. The supportive interactions (regaining a sense of support) were present in a similar way in both cases, whereas the specific interactions (becoming the subject of one’s depression) were more present in the responder case.

In the psychotherapy of inpatients with severe depression, specific therapeutic interventions aiming to mobilize internal processes of symbolization, comprehension, and appropriation are necessary to reactivate a previously frozen mourning process. However, such interventions should be carried out in conjunction with interactions aiming to help the patient regain a sense of support. The central role of interactions that serve to build a therapeutic space and to restore epistemic trust was an unexpected result. It invites psychotherapists to pay particular attention to acknowledging a patient’s melancholic suffering, and to continuously seek to adjust their interventions to foster the continuity of emotional contact and the emergence of a sense of support. Theoretical and clinical implications of these findings will be discussed.

None Declared

The cerebellum has been implicated in cognitive, affective and motor functions, including emotion regulation, executive control and sensorimotor processing. In schizophrenia, cerebellar dysfunction has been associated with treatment resistance and clinical features. However, few studies have been focused on delusional disorder (DD).

Our main purpose was to review the evidence available on cerebellum abnormalities and dysfunctions in patients with DD.

A systematic review was conducted through PubMed, Scopus and ClinicalTrials.gov (inception-June 2022) according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) directives. The following search terms were used: cerebellum OR cerebellar AND (“delusional disorder” AND paranoia). Reference lists from included studies were hand-checked to find other potential relevant papers.

Six studies were included from a total of 119 retrieved records (PubMed: 52, Scopus: 66, ClinicalTrials.gov: 1). Study 1:Patients with DD somatic type (n=14) presented a decreased gray matter volume in cerebellar lobules compared to healthy controls (HC) (n=32, left lobule VIIIa) and non-somatic DD (n=18, lobule V). Cerebellar volumes did not seem to differ between HC and non-somatic DD. Study 2:Abnormalities of voluntary saccadic eye movements, linking frontal and cerebellar functions, were found in DD patients (n=34) compared to HC (n=40). Study 3: Abnormal smooth pursuit eye movements in DD (n=15) compared with HC (n=40) and similar to schizophrenia (n=40). Case reports (n=3): DD associated with Dandy-Walker variant (partial vermian hypoplasia), unruptured intracerebral aneurysm of basilar artery, and megacisterna magna.

Cerebellar deficits in patients with DD has been reported, particularly in those presenting somatic delusional contents.

None Declared

Delusional memories or retrospective delusions have been extensively reported in subjects during or after intensive care stays. In major psychoses, authors have classically observed delusional memories impacting the prognosis and mental well-being.

Our aim was to review the phenomenology, psychological/biological factors contributing to delusional memories in delusional disorder (DD), and potential treatment strategies.

Systematic review using PubMed, Scopus, SciELO and Web of Science electronic databases (inception-September 2022). Search terms: (“delusional memories” OR “retrospective delusions”) AND (“Schizophrenia, Paranoid”) [MeSH]. Studies were included if they reported psychopathology, clinical characteristics or treatment strategies of “delusional memories” in DD. Team members: AGR, JAM, MS, MB, MF, ACP, FD, MVS.

A total of 786 records were retrieved, including six studies. Psychogenesis:A novel cognitive neuropsychological research model (based on hypnosis) in erotomania delusions suggest a potential recall and reinterpretation of delusions beliefs in highly hypnotizable subjects. Biological basis: Frontal lobe (or executive) dysfunction does not seem to contribute to delusional memories in De Clérambault syndrome (erotomania). Phenomenology: 1)General knowledge was essentially intact, while the perceptual characteristics of delusional memories were stronger than real memories. 2)Correlations were found between delusional ideation, positive dimension of schizotypy (r=0.18), and false memories (r=0.27). 3)Jumping-to-conclusions and liberal acceptance bias influence delusional memories. Treatment:Efficacy of 1)Cognitive Behavioural Therapy (CBT) (significant reduction delusions), and 2)Metacognitive control over false memories.

This is the first review exploring the genesis and management of delusional memories in DD. Memory deficits/executive dysfunctions do not seem to be the only cause of this phenomenon.

None Declared

Deficit in Theory of Mind (ToM) is a core feature of schizophrenia (SZ), while adverse childhood experiences (ACEs) can contribute to worsen ToM abilities through their effect on brain functioning, structure and connectivity.

Here, we investigated the effects of ACEs on brain functional connectivity (FC) during an affective and cognitive ToM task (AToM, CToM) in healthy control (HC) and SZ, and whether FC can predict the performance at the ToM task and patients’ symptoms severity.

The sample included 26 HC and 33 SZ. In an fMRI session, participants performed a ToM task targeting affective and cognitive domains. Whole-brain FC patterns of local correlation (LC) and multivariate pattern analysis (MVPA) were extracted. The significant MVPA clusters were used as seeds in further seed-based connectivity analyses. Second-level analyses were modelled to investigate the interaction between ACEs, the diagnosis, and the task, corrected for age, sex, and equivalent doses of chlorpromazine (p<0.05 FWE). FC values significantly affected by ACEs (Risky Family Questionnaire) were entered in a cross-validated LASSO regression predicting symptoms severity (Positive and Negative Syndrome Scale, PANSS) and task performance measures (accuracy and response time).

In AToM, LC showed significant different effects of ACE between HC and SZ in frontal pole, caudate and cerebellum. MVPA showed significant widespread interaction in cortico-limbic regions, including prefrontal cortex, precuneus, insula, parahippocampus, cingulate cortex, temporal pole, thalamus, and cerebellum in AToM and CToM. SBC analyses found significant target regions in the frontal pole, cerebellum, pre and postcentral gyrus, precuneus, lateral occipital cortex, angular gyrus, and paracingulate gyrus. LASSO regression predicted PANSS score (R2=0.49) and AToM response latency time (R2=0.37).

Our findings highlighted a widespread different effect of ACEs on brain FC in ToM networks in HC and SZ. Notably, the FC in these regions is predictive of behavioral ToM performance and clinical outcomes.

None Declared

Older adults with schizophrenia often have multiple chronic conditions, or multimorbidity, yet most prior research has focused on single medical conditions.

To characterize multimorbidity patterns and utilization among older adults with schizophrenia to understand how multimorbidity affects this population and their clinical service needs.

This retrospective cohort study included veterans aged 50 years and older with schizophrenia and followed their comorbid diagnoses and utilization (outpatient, inpatient, and emergency) from 2012 to 2019. Comorbid diagnoses included myocardial infarction, congestive heart failure, stroke, chronic obstructive pulmonary disease (COPD), cancer, dementia, traumatic brain injury, hepatitis C, osteoarthritis, renal disease, chronic pain, sleep disorder, depression, dysthymia, posttraumatic stress disorder (PTSD), general anxiety disorder, alcohol use disorder, other substance use disorder, and tobacco use disorder. Latent class analysis was used to identify latent profiles of psychiatric and medical comorbidity. Chi-square and F-tests were used to assess differences in demographics, comorbidities, and utilization across the latent classes.

The cohort included 82,495 adults with schizophrenia. Three distinct multimorbidity classes were identified: Minimal Comorbidity (67.0% of the cohort), High Comorbidity (17.6%) and Substance Use Disorders and Related Conditions (SUDRC) (15.4%). The Minimal Comorbidity class had <10% prevalence of all comorbid diagnoses. The High Comorbidity class had >20% prevalence of congestive heart failure, COPD, dementia, renal disease, sleep disorder, and depression. The SUDRC class had >70% prevalence of alcohol and drug use disorders and >20% prevalence of COPD, hepatitis C, depression, and PTSD. Although the High Comorbidity class had the highest rates of chronic medical conditions, the SUDRC class had the highest rates of emergency and inpatient medical care and emergency, inpatient, and outpatient mental health care utilization. Comparing across classes, all p-values were <.001 for utilization.

Older adults with schizophrenia are a heterogeneous group with distinct multimorbidity classes and different patterns of utilization. Those with high prevalence of substance use disorders had the highest rates of emergency and inpatient medical and overall mental health care utilization. Tailoring integrated care services to target specific clinical needs could improve outcomes for this population.

None Declared

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

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

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

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

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

None Declared

Psychiatric disorders are often characterised by cognitive impairment. The Screen for Cognitive Impairment in Psychiatry (SCIP) was developed for routine screening of psychiatric patients and is available in several languages.

Using the German version (SCIP-G), 3 studies were conducted: 1. feasibility, reliability, and validity of the SCIP-G were investigated [Sachs et al. Schizophr. Res. Cogn. 2021: 25, 100197], 2. a confirmatory factor analysis was performed [Sachs et al. Schizophr. Res. Cogn. 2022: 29, 100259], and 3. patients with psychotic, bipolar affective, and depressive disorders were assessed before and after standard inpatient treatment including cognitive remediation.

Study 1 included patients with schizophrenia or schizoaffective psychosis and thirty healthy controls matched for sex, age, and education. Data were collected at the Medical University of Vienna, Department of Psychiatry and Psychotherapy. In studies 2 and 3, patients from the Klinik Hietzing, 1st Department of Psychiatry and Psychotherapeutic Medicine, Vienna, Austria, were studied. In study 3, all patients received modern pharmacotherapy plus cognitive remediation using the COGPACK® software package version 6.06; based on the ICD-10 criteria for research, 54 patients received an F2 diagnosis (schizophrenia, schizotypal, and delusional disorders), 39 patients met criteria for bipolar disorder (F30 and F31), and 50 for depression (F32 and F33).

In Study 1, significant differences in cognitive performance were found between patients and healthy controls on both versions of the SCIP. The SCIP effectively discriminated between patients and the control group. In Study 2, a two-factor solution in which the Verbal Learning Test-Immediate Recall subtests, Delayed Recall Test of the VLT, and Working Memory Test loaded on the first factor and the Verbal Fluency Test and Psychomotor Speed Test subtests loaded on the second factor yielded good model fit (χ² = 6.7, df = 3, p = .08, χ²/df = 2.2). In Study 3, SCIP total score showed significant improvement after treatment in all three diagnostic groups (p < .001), with no statistically significant interaction between SCIP total score and diagnostic groups (p = .860).

Our data indicate that the SCIP-G is a valid and reliable instrument for assessing cognitive impairment. Good model fit can be achieved with a two-factor solution for the SCIP. Our study is the first to perform a confirmatory factor analysis with the German SCIP version and to test its dimensional structure with a hypothesis-testing approach. Inpatient treatment consisting of pharmacotherapy and cognitive remediation improved cognitive deficits. This improvement in cognitive performance was observed to a similar extent in patients with psychotic disorders, bipolar disorder, and depression.

None Declared

The main role of prolactin is associated mainly with lactogenesis but additionally it participates in several endocrinological and metabolic processes. The prolactin level may be increased with some antipsychotics such as risperidone, paliperidone, and amisulpride increasing the risk of Bone Mineral Mass (BMM) decrease leading to osteopenia and osteoporosis.

To determine the loss of BMM associated with antipsychotic-related iatrogenic hyperprolactinemia (iHPRL) in a sample of patients suffering of chronic psychotic mental disorder and treated with antipsychotics at least for one year.

A cross-sectional observational and epidemiological study in a sample of 140 patients (males 56.9%; females 43.1%; mean age 48 years), receiving antipsychotics was carried out. After giving informed consent, personal data, prolactin level, antipsychotic use and lifestyle were collected. An evaluation of BMM with a central DEXA Scan was performed. The bone mineral density considering the subject´s age and the peak bone mass in the neck of the femur, hip and in the lumbar vertebrae (L1-L4) was obtained. Inclusion criteria: presence of psychotic disorder, age between 18-65 years and treatment with an antipsychotic at least for one year. Statistical analysis was carried out using the statistical software SPSS version 26.0. A significance level α=0.05 was considered throughout the study.

45 out of 140 patients (32,13%) had some BMM lost (osteopenia). The prevalence of osteoporosis was 5.71% (n=8). The median prolactin level in the sample was 46.1 ng/dL ± 33.1. Patients with hyperprolactinaemia showed a higher frequency of osteopenia/osteoporosis (50% with mild iHPRL and 48% with moderate/severe iHPRL) than those with normal prolactin levels (25.7%). A strong and significant relationship between the presence of osteoporosis and the treatment with risperidone was found (p=0.007).

Osteopenia and osteoporosis are associated with hyperprolactinemic antipsychotic. Risperidone was related with a significant increased osteoporosis risk. The rutinary and systematic control of the BMM is crucial in these patients to avoid progressive bone demineralization. Managing strategies should be individualized to avoid bone demineralization and to preserve physical health.

None Declared

Chronic subclinical inflammation is considered to be an important contributor to the development of schizophrenia. Meta-analyses confirm the presence of higher levels of inflammatory markers in schizophrenia and its prodromal stages compared to controls, however studies differ in terms of associated cytokines. Obesity is a common problem in patients with schizophrenia and, at the same time, it is recognized as a source of subclinical inflammation in the general population.

The aim of the study was to verify if there is an association between the presence of overweight/obesity and higher levels of CRP and IL-6 in various stages of psychotic disorders and if these factors may influence the course of the disease

Study was performed in four study groups: 31 healthy controls (HC), 16 patients with ultra-high risk of psychosis (UHR), 30 with first episode of psychosis (FEP) and 71 with chronic schizophrenia (SCH). The severity of psychopathological symptoms in SCH was assed using the Positive and Negative Syndrome Scale (PANSS). The serum levels of inflammatory markers were measured using sensitive ELISA tests.

Study groups significantly differed in the levels of CRP and IL-6. The presence of overweight/obesity was associated with significantly higher levels of CRP in CON and UHR and IL-6 in CON, FEP and SCH. IL-6 was positively correlated with the severity of positive symptoms in PANSS in SCH, however neither IM or BMI were associated with other psychopathological symptoms or number and frequency of exacerbations in schizophrenia patients.

Overweight/obesity is associated with subclinical inflammation in both healthy controls and patients with various stages of psychotic disorders. Subclinical inflammation may be correlated with the course of the disease, however we did not find any direct associations between overweight/obesity and the severity of symptoms. Further studies are needed to verify, if reduction of BMI would be beneficial in reducing levels of inflammatory markers and alleviating disease course.

This research was funded by the Polish Minister of Science and Higher Education’s program named “Regional Initiative of Excellence” in 2019–2022, grant number 002/RID/2018/2019 to the amount of 12 000 000 PLN, and the National Science Centre, Poland, grant number 2019/03/X/NZ5/00719.

None Declared

Chronic alcohol use is related to alcoholic cerebellar degeneration that is caused by B1 (thiamine) deficiency and associated with the degeneration of Purkinje cells in the cerebellar cortex.

This report aims to present a case with cerebellar ataxia and tremor due to alcoholic cerebellar degeneration that is unexpectedly regressed after starting piracetam infusion treatment in the inpatient Alcohol and Drug Addiction Research, Treatment and Education Center (AMATEM).

We investigated the case prospectively. The patient was informed and consent was obtained.

A 57-year-old, divorced, retired, male with alcohol use disorder for 48 years (mostly high alcohol, cologne for 2 years) presented to our hospital with upper and lower limb tremors and balance problems for 2 years. Neurological examination revealed dysmetria, cerebellar tremor, hypoesthesia of lower extremities, ataxia so he was unable to tandem-walk. CIWA-Ar score:13. The blood test, including hemogram, biochemical, HbA1C, TFT, serum copper and ceruloplasmin levels, results were all normal. Diazepam 50 mg was started and titrated down by 5 mg per day and discontinued, 600 mg parenteral and 250 mg p.o thiamine initiated for 3 days and continued orally, propranolol 20 mg/day and ecopirin 100 mg/day were continued. Cranial CT, cranial MRI, and EMG were ordered.The patient was consulted to the neurologist for movement disorder.

MRI appearance of the cortical sulcus, fissure, cisterna, and cerebellar folia were obvious. The ventricular system was assessed as ecstatic secondary to atrophy. Therefore the alcoholic cerebellar degeneration was diagnosed and increased propranolol to 30 mg/day dose. Furthermore iv infussion piracetam was empirically started at secuencely dose of 60 g/day for 3 days, 45 g/day for 3 days, 30 g/day for 3 days. Upper and lower limb tremor disappeared and ataxa regressed after the treatment was arranged.

Image:

Image 2:

Image 3:

Several authors proposed that serotonergic system among other neurotransmitters in the cerebellum might be affected in ACD. Recent studies investigating the use of buspirone in the treatment of ataxia has showed positive results (1-3).

The mechanism of action of the piracetam is unclear. Supposed that piracetam binds to the polar head groups of membrane bilayers and induces distinct changes in membrane structure. Its actions in the nervous tissue include indirect modulation of several neurotransmitter systems, neuroprotective and anticonvulsant effects and positive influence on neuronal plasticity.

In conclusion, we suggest that high dose piracetam has a potential antiataxic effect in ACD.

Cessation of drinking and nutritional supplementation are the only treatments available for ACD. However, gait does not improve in most patients. Pysical therapy, canes, walkers, and wheelchairs are helpful in maintaining mobility (4). Similarly, we observed that the patient’s need for care has been continuing.

None Declared

People consume and abuse alcohol for varied reasons. Problematic alcohol use is associated with mental and physical health risks, while people exposed to multiple traumas may be more vulnerable to abusing alcohol.

To evaluate the prevalence and predictors of self-reported alcohol abuse among residents of Fort McMurray and explore the correlates of self-reported alcohol abuse with some mental health conditions.

A cross-sectional study adopted an online questionnaire. Sociodemographic data, trauma exposure, and clinical characteristics were collected to identify the predictors of self-reported alcohol abuse. Data were analyzed using SPSS version 25 using cross-tabulations and logistic regression analysis.

Two hundred and forty-nine individuals received the survey link, of which 186 completed the survey, with a response rate of 74.7%. Most participants were females exposed to COVID-19 and either wildfire or flooding traumas. The prevalence of self-reported alcohol was 27.4%. Participants who desired mental health counselling were likely to self-report alcohol abuse (OR=3.017; 95% CI: 1.349-6.750). There was a significant association between self-reported alcohol abuse and self-rated moderate to high depression (X 2 = 4.783; p = 0.033) and anxiety symptoms (X 2 = 4.102; p = 0.047), and suicidal ideations or thoughts of self-harm (X 2 = 13.536; p = 0.001).

Self-reported alcohol abuse is correlated with suicidal ideations, the desire to receive mental health counselling, and anxiety and depression symptoms. Therefore, initiatives to minimize mental health disorders are crucial to reducing alcohol abuse and promoting health among vulnerable populations.

None Declared

Most individuals use cannabis for relaxation and may misuse this substance. Vulnerable communities who have experienced multiple traumas may be predisposed to cannabis abuse. Hence, more cannabis abuse is deserving of more attention.

To determine the prevalence and correlates of likely cannabis abuse among residents of Fort McMurray.

A cross-sectional survey design was adopted, employing an online questionnaire. Data were analyzed with SPSS version 25. Correlation analysis was conducted to assess likely cannabis abuse and its association with other mental health conditions.

One hundred and eighty-sixed out of the two hundred and forty-nine completed the online survey, giving a response rate of 74.7%. The prevalence of self-reported cannabis abuse was 14%. Most of the participants were females (159, 85.5%), owned their houses (145, 78.0%), and 103 (60.6%) reported being exposed to at least a trauma (COVID-19, flooding, or wildfire). Rented accommodation predicted likely cannabis abuse (OR = 3.86; 95% CI: 1.34–11.14), males were more likely to abuse cannabis than the female gender (OR= 6.25; 95% CI: 1.89–20), and participants in a relationship were more likely to abuse cannabis (OR = 6.33; 95% CI: 1.67–24.39). There was a statistically significant association between depressive and anxiety symptoms and likely cannabis abuse.

The study found an association between depression and anxiety symptoms with cannabis abuse among residents of the Fort McMurray population. Sociodemographic characteristics predispose individuals to problematic cannabis use. Vulnerable communities who have endured multiple disasters need psychological care and support to reduce and prevent cannabis abuse.

None Declared

While Smartphone use has been increasing all across age sectors, university students are the largest consumers group of Smartphone services. However, their excessive use or addiction can have harmful effects on the mental and physical health of their users. It is a real public health problem that is growing and affects especially the young population.

We aim to assess the prevalence of smartphone addiction among medical students in Casablanca, Morroco, describe the profile of techno-addictive students (Smartphones) and assess the risk of developing somatic and psychic conditions.

This is a descriptive analytical cross-sectional study, from October 2020 to March 2021, a sample of 878 students of the Faculty of Medicine and Pharmacy of Casablanca, Morocco, including all levels of the academic year 2020/2021. This sample was calculated on the basis of the number of medical students at the Faculty of Medicine and Pharmacy of Casablanca 4095, with an expected prevalence of 51%. Data were collected anonymously through an online questionnaire, constructed of several sections including the SAS-SV scale.

The age of the participants ranged from 17 to 32 years, average age was 22.03 with a M/F ratio of 0.43. Students ranged from first grade to eighth grade, with a majority of Moroccan nationality97.15%. The study revealed a total percentage of addiction of 37.9% for both sexes. Psychic signs such as anxiety, loss of control, disturbance and withdrawal were more frequent than physical signs such as wrist and neck pain. After the analysis of the different results, we come out with the following conclusions concerning the profile of the participants affected by smartphone addiction: Most of them are single94.76%, with a medium socio-economic level 55.5%, with another addiction 31.2%, especially to psychoactive substances,15% with psychiatric history, 45.22%with less than 5 years of smartphone use.Table I:Univariate associations of smartphone use and smartphone addiction.

In conclusion, the present study provides the first insights into smartphone use, smartphone addiction, and predictors of smartphone addiction in young people from Morocco. Future studies should extend this knowledge in order to draw clearer conclusions regarding the disease burden, and why not a more precise long-term exploration of the fate of these students and their later risk in the professional hospital setting seems worth studying.

None Declared

There are serious adverse effects on the physical and mental wellbeing of patients with alcohol use disorders.

It is important to screen and provide brief intervention for these group of patients during their inpatient admission.

Prompt identification and treatment of patients with alcohol use disorders are contingent on the attitudes of healthcare workers towards them.

Non-psychiatric doctors and nurses might respond inadequately due to negative attitudes and beliefs.

We examined the attitudes of non-psychiatric workers in the medical and surgical wards.

The Alcohol & Alcohol-Problems Perceptions Questionnaire (AAPPQ) was administered to 128 doctors and 785 nurses from the medical and surgical disciplines in a tertiary hospital.

75.5% of doctors and 51.9% of nurses endorsed the domain of role legitimacy in the AAPPQ.

However both groups reported low-levels of role-adequacy (combined: 41.2%), role-support (combined: 36.9%), motivation (combined: 36.5%), task-specific self-esteem (combined: 25.1) and work satisfaction (combined: 20.5%) in the AAPPQ.

While non-psychiatric healthcare workers acknowledged the importance to initiating intervention for patients with alcohol-use disorder in daily work, there were low levels of therapeutic commitments towards patients with problematic alcohol-use.

It is vital to introduce in-house programmes to educate, empower and emphasise the importance of therapeutic contact with patients for alcohol intervention.

None Declared

The relevance of behavioral addictions (like gambling or internet gaming disorder) is growing constantly - not only in clinical practice, but also as a topic in addiction research. Furthermore, behavioral addictions were found to share similar neurobiological mechanisms with substance-use disorders like alcohol or drug addiction. Cue reactivity is a well-established concept to study an important concept in addiction: craving, which denotes the strong desire to consume the addictive substance. For instance, images of alcoholic beverages can induce a strong desire to drink alcohol in patients with alcohol addiction, reflected in brain activation in parts of the reward system and regions specifically involved in craving.

In order to extend existing findings to the field of slot machine gambling, we focused on patients suffering from gambling disorder (GD) and who mainly played slot-machines. We investigated neural activation as a response to addiction-related cues (in comparison to neutral cues) using a cue reactivity paradigm.

To that end, participants with a diagnosis of GD (N = 10) and a group of healthy controls (N = 20) viewed pictures of gambling-related cues (slot machines) as well as neutral cues (ticket vending machines), while brain activation was recorded using functional magnetic resonance imaging (fMRI). Direct comparisons of patients suffering from GD with healthy controls were analyzed for the two different image types (gambling-related vs. neutral) separately.

We found stronger activation in the insular cortex for patients with GD only during presentation of the slot-machine images, but not for the neutral cues. Furthermore, for the slot-machine condition also stronger activation in the dorsal anterior cingulate cortex (dACC) and the supplementary motor area (SMA) was documented for the clinical population but not for the healthy controls.

In line with previous findings, the visual presentation of gambling cues led to stronger brain activations in parts of the reward system (dACC) and in the insula, which plays a crucial role in addictive disorders, especially in craving. Our results further add to the notion that brain areas involved in substance-use disorders might also play an important role in behavioral addictions. Specifically, our findings extend existing results to the research field of slot-machine gambling in the context of craving.

None Declared

Patients in psychiatric department, especially in the intensive care unit, often develop delirium syndrome, which leads to a high risk of morbidity and mortality. The etiology is multifactorial. The most common causes are alcoholism and dementia. Pharmacological treatment of delirious syndrome is the most important part of the treatment, which includes various psychopharmaceuticals that are effective both in the treatment of delirium and in improving cognitive functions. Haloperidol is the drug of first choice and from atypical antipsychotics, the most commonly used are risperidone and olanzapine. Benzodiazepines are used in the treatment of delirium tremens.

The objective of the work is to determine the most common cause of delirious syndrome and the treatment of those patients.

We analyzed 52 patients who were treated for delirious syndrome at the Department of Psychiatry , University Clinical Center Tuzla, Bosnia and Herzegovina in the period from January 1, 2019. until June 1, 2022. Data were taken from medical records and the hospital information system.

The total number of patients was 52 and 23 (44.23%) were treated for delirium tremens, and the rest were treated for delirium syndrome of another cause. The most common other causes were dementia in 21 (40.38%) patients, followed by sepsis, infectious syndrome and tumors in 6 (11.53%) patients, and cerebrovascular cause in 2 (3,84%) patient. In a therapeutic approach of delirious syndrome, all patients with delirium tremens were treated with benzodiazepines: 11 (47.82%) patients with diazepam monotherapy, then diazepam and promazine 7 (30.43%) patients, diazepam and haloperidol 3 (13,04%) patients, and diazepam, olanzapine and haloperidol 2 (8.69%). In the therapy of other delirious syndromes, 11 (37.93%) patients were treated with risperidone, haloperidol 8 (27.58%), promazine 3 (10.34%), quetiapine 4 (13.79%), and olanzapine, clozapine and aripiprazole 1 patient each (3.44%). It is important to point out that there was no fatal outcome in the processed sample of patients.

The most common etiological cause of delirious syndrome is the consequence of alcohol withdrawal. Delirium superimposed on dementia is the second most common. The priority of treatment is focused on pharmacological treatment. Atypical antipsychotics (risperidone) are most often used. Haloperidol is the second most common. Benzodiazepine (diazepam) was most often used in the treatment of delirium tremens.

None Declared

The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health.

The objective of this study was to compare the psychopathological characteristics between users whith sexualized intravenous substance use (slamsex) versus those who did not slamsex attended by the non-govenrmental organization Apoyo Positivo in the program “Sex, Drugs and You”.

A cross-sectional descriptive analysis of a sample of users attended by the non-govenrmental organization Apoyo Positivo in the program “Sex, Drugs and You” was performed.

230 participants were included. Slam was associated with higher risk of having and anxiety or depressive disorder, suicidal ideation, induced psychosis and suicidal behavior, the differences were statistically significant (p<0.05) in all cases.

Slamsex is usually reported in our sample. Substance use disorders in slam users are usually associated with other mental disorders. This challenge requires adapt the therapeutical interventions of the professionals who work with patients with chemsex practices, specially with those who practice slamsex.

None Declared

Bariatric surgery is a relatively safe surgical procedure with high success rates. The improvement on patient’s self-esteem and overall quality of life are expected benefits that extend beyond physical health. Nonetheless, current literature describes a higher risk of developing alcohol use disorder (AUD) in patients undergoing bariatric surgery that is not better explained by differences in baseline characteristics such as socioeconomic factors. This reinforces the need to optimize mental health professionals’ intervention in these patients.

Report a clinical case and conduct a literature review on the etiology of the increased risk of alcohol use disorder in patients after bariatric surgery.

Description of a clinical case and a non-systematic review of literature on the PubMed database, selecting articles published in the last decade and their included reference lists, combining the following MESH terms: “bariatric surgery” and “abuse, alcohol”.

The clinical case presented is a 45 years old woman, with a college degree, that was diagnosed with AUD in 2020, 6 years after being submitted to bariatric surgery. She didn’t have any alcohol-related problems before the procedure but she describes the death of her mother in 2020 as the trigger for her current heavy drinking habits. Injuries induced by alcohol intoxication have since then caused multiple visits to the emergency room and she has now a reported cognitive impairment that severely compromises her ability for self-care. The association between AUD and bariatric surgery, as presented in the reported clinical case, is well established in current literature. The switch of patient’s coping mechanisms from eating to drinking, surgical-induced alcohol pharmacokinetics changes or adaptations of neuroendocrine mechanisms (such as ghrelin and it’s impact on the mesolimbic dopamine system) that contribute to the augmentation of brain reward signaling are all factors that could play a role in the increased reinforcing value of alcohol in these patients. Psychosocial factors were also identified as variables that could impact alcohol-misuse post-operatively. Furthermore, data suggests differences between surgical procedures: while both Roux-en-Y-Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) dramatically impact alcohol pharmacokinetics, Laparoscopic Adjustable Gastric Banding (LAGB) does not.

There is a strong possibility that the patient’s drinking habits started as a coping mechanism, but her surgery may have also contributed to her AUD. Our review found multiple biopsychosocial factors that could explain the link between bariatric surgery and AUD and some predictors for its development, but future research is needed to fully elucidate its complexities. Nonetheless, health professionals must be well informed for thetimely prevention, diagnosis and treatment of eventual AUD in these patients.

None Declared

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

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

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

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

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

None Declared

Background of behavioral addictions, which include smartphone addiction, is complicated and unclear. Belonging to an Internet community that shows many forms of virtual pathology and generates new, artificial trends also favors the development of mental implications which include lowered mental immunity, emotional lability, increased depressiveness, aggression, inadequate self-esteem, lowered self-value and personality disorders. Implications regarding the social sphere are above all related to the gradual alienation from the closest environment as a result of preoccupation with the subject of dependence. Those consequences include deterioration of social relations, loss of interpersonal skills and former interests, as well as the minimization of contacts with the closest ones which lead to the sense of social isolation and loneliness.

The aim of this study was to estimate the scale of mobile phone addiction among young adults as well as to establish whether the low level of perceived social support is related to the problematic smartphone use, and whether an addictive pattern of smartphone use is related to the prevalence of depressiveness and excessive daytime sleepiness.

The study involved 567 young-adult respondents from West Pomeranian Voivodship in Poland. The study was carried out using the diagnostic poll method via questionnaire technique. Both the author’s own questionnaire and the following standardized research tools were used: the Mobile Phone Problem Use Scale for Adolescents (MPPUSA), the Beck Depression Inventory (BDI), the Epworth Sleepiness Scale (ESS), the Multidimensional Scale of Perceived Social Support (MSPSS).

Perceived social support was significantly lower in the group of respondents who problematically used their smartphones in comparison with the ones who used them in a correct way (p < 0.05). Severity of depressive symptoms and daytime sleepiness (p < 0.05) was significantly greater in respondents addicted to their mobiles in comparison with non-addicted ones.

The scale of the mobile phone addiction phenomenon in respondents was low. Many respondents though expressed a subjective sense of being addicted to their smartphones in comparison with the obtained results. Problematic smartphone use concerns to the same degree members of both sexes, residents of villages and cities, as well as singles and ones in relationships (both formal and informal). The mobile phone addiction is associated with the risk of severe symptoms of depression and excessive daytime sleepiness. Pathologic pattern of smartphone use much more frequently concerned individuals who perceived their social support level as low.

None Declared