The transgression of the law can be a deliberate act by a lucid adult, but it can also be the result of a deficiency in judgment and discernment due to lack of age or insanity. Psychiatric expertises are more and more solicited in the penal field with the objective of identifying the causal link between mental illness and the criminal act.

The objective of this work was to give an overview of the subjects expertised, the offences and the pathologies encountered through the report of a psychiatric expertise activity in criminal law.

It is a retrospective descriptive study carried out on the criminal psychiatric expertises made for a forensic act in the psychiatric department of Mahdia during the period from January 1, 2003 to March 30, 2022.

In total, we collected 101 defendants. The average age of our study population was 35±12.07 years. The majority of our study sample was male (98%), from an urban area (50%). 46.6% had primary education and only 11.2% had higher education.

The defendants were single in 57.8% of the cases, and almost half (45.7%) had no occupation. Two-thirds of the accused (61.2%) had experienced emotional deprivation at a young age. The problematic use of psychoactive substances was found in 10.3%, as well as alcohol consumption in 46.6%. Moreover, 39.7% of the patients had a personal psychiatric history and 19% had been incarcerated at least once. The forensic acts were mostly against people (62.9%) dominated by physical aggression (33.6%) followed by homicide or its attempt in 19% of the cases.

The majority of patients were not related to their victims (62.1%). The nosographic diagnosis found was a personality disorder in 32.75% of cases, followed by schizophrenic disorders in 22.4% of cases.

Psychiatric expertise is a useful, complex and noble clinical act. Determining the predictive factors of a possible acting out allows to specify the objectives of interventions aiming at limiting the acts of violence, hospitalizations and incarcerations of patients suffering from mental disorders.

None Declared

Treatment resistant schizophrenia and other treatment resistant psychotic disorders are believed to be over-represented in forensic patient clusters. The true rates of treatment resistant psychoses in secure forensic hospitals remain unexplored.

This study aimed to ascertain the prevalence of treatment resistant psychoses within a complete national forensic mental health service. In addition, the study sought to examine the relationships between treatment resistance for psychotic symptoms and treatment resistance in other domains, such as offending behaviour.

This is a cross-sectional study of a complete cohort of patients admitted to the National Forensic Mental Health Service in Ireland during the period 01/11/2021 to 31/01/2022. All inpatients at the time of the study were included. Demographic details, data appertaining to diagnosis, medication, measures of risk (HCR-20), recovery (DUNDRUM toolkit), functioning (GAF), and symptoms (PANSS) were collated. Data were gathered as part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST).

The sample consisted of 170 patients. Majority (n=162) 95.3% were male. The majority (n=116), 68.2%, were admitted from prisons, while a smaller number (n=35), 20.6%, were admitted from other psychiatric facilities. The insanity defense (n=94) 55.3% was the most common legal status, followed by unfit to plead (n=16) 9.4%. The commonest diagnosis was schizophrenia (n=97) 57.1%, followed by schizoaffective disorder (n=27) 15.9% and autism spectrum disorder (n=5) 2.9%. The mean age at admission was 35.52 years and the median age was 34.37 ± 9.43 SD.

Of the total sample, 25.9% of patients were on more than 1000 mg per day chlorpromazine equivalent (CPZE) doses. Those whose psychotic symptoms required treatment with CPZE doses over 1000 mg per day scored poorly on DUNDRUM-3 programme completion, DUNDRUM-4 recovery scale, HCR-20 historical, HCR-20 clinical, HCR-20 risk, HCR-20 dynamic, and had poorer overall functioning (all P<0.001) than those who required lower antipsychotic doses. On binary logistic regression, correcting for age and gender, the only variable that remained significant was GAF (adjusted odds ratio = 0.979, 95% CI 0.962-0.996, P=0.014). In forward entry model regression, only the DUNDRUM-4 recovery scale (odds ratio = 1.13, 95% CI 1.07-1.19, P<0.001) and GAF (adjusted odds ratio = 0.979, 95% CI 0.962-0.996, P<0.001) were significant. This model had a robust forward and backward likelihood ratio.

Rates of treatment resistant psychoses in forensic hospital groups are indeed elevated. Overall functioning on GAF and recovery across a wide range of components in the DUNDRUM-4 scale are the best predictors of treatment resistant psychosis.

None Declared

Past research examining the relationship between psychosis and criminality has typically focused on chronic schizophrenia and violence. However, contact with the criminal justice system is not constrained to the most unwell or most violent. The present study is novel as it examines the different clinical stages of psychosis, from the at-risk mental states (ARMS)/Ultra-High Risk (UHR) to the early and chronic psychotic illness phase, across the entire spectrum of criminal offending.

The main study objective is to establish the prevalence of the clinical stages of psychosis among adults entering custody and to examine the sociodemographic and forensic characteristics associated with the different stages of psychosis. A further aim is to examine whether psychosis-spectrum prisoners differ from non-psychotic prison controls across these characteristics.

Participants consist of unselected 291 adult male and female prisoners entering the largest maximum security reception centres in New South Wales (NSW), Australia. They completed a range of semi-structured questionnaires and adapted mental health screening measures. The Comprehensive Assessment of At Risk Mental States (CAARMS; Yung et al., 2005) was used to ascertain whether participants met the Ultra High Risk (UHR), First Episode of Psychosis (FEP) or Established Psychosis (EP) criteria.

Participants were 34.25 years old (SD = 10.69) on average and men were significantly older than women (p = 0.035). Among prisoners with a psychosis-spectrum illness (n = 121), the prevalence of UHR was 24%, First Episode Psychosis (FEP) was 6% and established psychosis was 11%. Compared to controls, psychosis spectrum prisoners were found to have higher levels of social disadvantage, psychiatric comorbidities and multiple incarceration episodes. However, psychosis was not associated with a greater risk of violent offending. Implications on the complex illness burden associated with psychosis and the need for early identification and intervention across forensic mental health services will be further discussed.

This study is novel as it examines the full spectrum of psychotic illness across the entire spectrum of criminal offending. The findings support the notion that risk of criminal justice contact and complex illness burden exist across the different clinical stages of psychosis, from the UHR to the early FEP and chronic psychosis stages, for both violent and non-violent offending. Early intervention services must consider how to more effectively identify and intervene to reduce the risk of criminal justice system contact among mentally ill individuals.

None Declared

In the UK there are 3500 individuals detained in medium secure forensic psychiatry units. Service users in such settings have complex and serious mental illness (SMI), often with co-morbid physical health problems and a life expectancy of at least 10 years shorter than the general population. They often have low levels of physical activity. There is little evidence about physical activity interventions for medium secure service users in the United Kingdom.

Our objective is to co-produce, with medium secure service users, the content and delivery of an intervention to increase physical activity. We shall assess feasibility, acceptability and pilot data collection methods for outcomes relevant for a future randomised controlled trial.

This is a 24-month mixed-methods project that will follow the Medical Research Council (MRC) framework Developing and Evaluating Complex Interventions. The study has 4 phases.

- Phases 1-2 will gather information required to co-develop an evidence based intervention in Phase 3.

- Phase 4 will assess the intervention in a feasibility study, evaluating and testing the intervention for a future pilot study.

Study settings: Two NHS Medium Secure In-Patient Psychiatric Hospitals in the UK.

This paper presents the findings from the Phase 1 questionnaire and focus groups with service users and hospital staff that identified the barriers and facilitators to physical activity in such settings. The results are then discussed in relation to the Phase 2 qualitative results that explored stakeholders’ and service users’ opinions into how to increase physical activity among medium secure service users by identifying potential elements for inclusion in a physical activity intervention, to gain insight into how we can establish engagement of this group with the intervention, maintain commitment, avoid drop-out and develop the intervention design. All findings are presented using the Capability, Opportunity, and Motivation Model of Behaviour (COM-B model), which is widely used to identify what needs to change for a behaviour change intervention to be effective.

The findings of Phases 1-2 are allowing the team to move forward with Phase 3 that is currently developing an intervention to increase physical activity for adult inpatient service users in the medium secure units. This phase will be guided by the MRC framework and the COM-B model to define the target behaviours and select the most suitable intervention components (functions and techniques) and implementation approach.

None Declared

Working in a care setting is characterised by an increased mental and physical load. During their professional life, personnel in this sector can develop essentially degenerative pathologies, which could influence their professional career as well as their psychological balance.

We aimed to evaluate the impact of chronic pathologies on the prevalence of anxiety and depression among this group.

We conducted a cross-sectional study in hospitals in Sfax using a self-administered questionnaire. This questionnaire evaluated socio-demographic, professional, and clinical characteristics as well as an evaluation of the degree of anxiety and depression by the HAD questionnaire.

Our population consisted of 120 participants. The average age was 37 years, with a female predominance (a sex ratio of 0.69). The chronic pathologies found in the participants were mainly diabetes (18%), high blood pressure (4%), and rheumatic disease (6.7%). The average anxiety score was 8.18± 3.5 and that of depression was 9.02± 3.5. Certain depressive and anxious signs were found in 28.4% and 23.6% of participants, respectively. Although the average scores for anxiety and depression were higher in the subgroup of personnel with chronic pathologies (respectively, 9.8 versus 9.04 and 9.3 versus 8.46), these differences were not statistically significant (p > 0.05).

Physical and mental health are both important to ensure a balanced life. Having good control of somatic illness can improve mental health.

None Declared

Rheumatoid arthritis (RA) is a chronic inflammatory degenerative disease whose symptoms are mainly joint with significant functional impact, resulting in a restriction of the activities of the patient and increasing the impact on mental well-being.

This study aimed to screen for mental functioning in RA patients, detect anxiety and depression, evaluate self-esteem and study its relation to clinical parameters, as well as disease activity.

Single-centre cross-sectional study, involving patients with RA using the hospital anxiety and depression scale (HADs). Rosenberg scale was used to evaluate self-esteem. We evaluated the RA severity Disease Activity Severity (DAS 28).

Fifty patients were included. The average age was 54 years [24-72]. The mean duration of the disease was 10 years. Thirty-nine patients had immunopositive RA with a mean Rheumatoid Factor level of 189.1 ± 291.3 U/ml and a mean anti-CCP antibody level of 165 ± 225.3 U/ml. At diagnosis, the mean DAS 28 of the patients was 5.1 ± 1.4. Moderately active and highly active RA were predominant with percentages of 40% and 50% respectively. All patients were treated, and 36% received biological treatment.

Depression was noted in 42% of the patients with a mean score of 10.1 ± 3.7. Anxiety was noted in 50% of the patients with a mean score of 10.3 ± 4.

In this study, we did not find a statistically significant association between disease activity and depression or anxiety scores (p=0.6 and p=0.1 respectively).

The mean Rosenberg scale score was 27± 3. Sixty-eight per cent of patients had low self-esteem, twenty-one per cent had moderate self-esteem and eleven per cent very low self-esteem. Disease activity was associated with low self-esteem.

RA is a chronic inflammatory disease that has a significant impact on the mental health and quality of life of patients. The detection and treatment of psychiatric disorders such as anxiety, depression and low self-esteem; improve the care of patients with RA.

None Declared

The work conditions of electricians have been associated with heavy physical and psychological workloads. It is essential to know the impact of this perceived workload on the mental health of workers.

This study aimed to assess the relationship between perceived workload on the mental health of workers.

The study was conducted among a group of electricians. Data were gathered between January-June 2022 using a self-administered questionnaire including socio-professional characteristics and Kessler Psychological Distress Scale (K6). To assess the perceived workload, we choose the National Aeronautics and Space Administration Task Load Index (NASA-TLX). In this study, we evaluated raw NASA-TLX scores.

Seventy-four workers participated in the study. They were married in 67,6% of cases. The mean age was 39,3 ± 10,5 years. The average job tenure was 15,5 ± 11,2 years. The mean score of K6 was 5,4±4,8. The proportion of respondents with high levels of psychological distress (K6 score of 13 or greater) was 9.5 %. The mean score of mental demand, physical demand, performance, effort, frustration level and temporal demand were respectively 88.8±14, 60.8±23.6, 85.2±13.1, 82.7±15.4, 34.3±29.3 and 61.8±29.2. The frustration level was correlated with high levels of K6 (p = 0.002, r = 0.36).

A high perceived workload was correlated with the altered mental health of workers. Hence, practices and policies should focus on improving working conditions to enhance the mental health of the employees.

None Declared

Low back pain (LBP) is common among healthcare workers (HCWs) caused by providing patient care by bending forward for long durations. Even when symptoms are short-term and not medically serious, LBP can be associated with psychological distress.

This study aimed to assess the impact of low back pain on mental health among HCWs.

The study was conducted in a group of HCWs from Hedi Chaker hospital in Sfax, Tunisia. Data were gathered between March-August 2022 using a self-administered questionnaire including socio-professional characteristics, the Nordic musculoskeletal questionnaire and Kessler Psychological Distress Scale (K6).

Our study included 74 HCWs. The mean age was 39,3 ± 10,5 years. The average job tenure was 15,5 ± 11,2 years. According to the Nordic musculoskeletal questionnaire, 29.7% of participants had low back pain during the last 12 months. Thirty participants (17.6%) had low back pain during the last 7 days. The mean score of K6 was 5,4±4,8 (range = 0–22). The proportion of respondents with high levels of psychological distress (K6 score of 13 or greater) was 9.5 %. The presence of low back pain during the last 12 months and the last 7 days was significantly associated with a high score of K6 (p = 0.008 and p = 0.01 respectively).

Low back pain was associated with psychological distress. Occupational health and safety programs should focus on building ergonomically safe working conditions to enhance the mental health of the HCWs.

None Declared

The pandemic of Covid-19 has overwhelmed healthcare systems including healthcare workers(HCWs) imposing additional physical and mental workloads.

We aimed to evaluate the impact of the pandemic on the professional quality of life of HCWs.

We conducted a cross-sectional study among HCWs working in the Covid-19 unit in Sfax, Tunisia in December 2021. We used a self-administrated questionnaire including sociodemographic and professional information. Professional issues were assessed by The Professional Quality of Life scale.

Our population consisted of 69 participants. The mean age was 31± 6 years. The sex ratio (M/F) was 1.1. Sixty-eight per cent had a university education. On a scale from 0 to 10,76.8% rated their Health Status greater than or equal to 8 and the mean score was 8.89±1. Medical history of Covid-19 infection was found in 37.7% of paricipants and 94,1% were vaccinated against SARS Cov 2.

Most of the workers showed moderate to high levels of compassion (65.2% and 31.9 % respectively). Fifty-five per cent showed moderate burnout levels. Only 2.9% of the population had a high level of secondary traumatic stress.

Secondary traumatic stress was associated with age (p=0.049; R=0.238). The males were more affected with burnout symptoms. Vaccination Status was associated with compassion satisfaction (p=0.042). Health Status Evaluation was not correlated with compassion satisfaction, burnout or secondary traumatic stress.

The current pandemic has affected the HCWs system professional and social lives. A long follow-up should be maintained to support HCWs dealing with the pandemic.

None Declared

The power line workers have a heavy physical workload. It is essential to know the impact of this perceived exertion on their satisfaction with life to improve their mental health.

We aimed to evaluate the associations between perceived exertion at work and satisfaction with life among power line workers.

We conducted a study among a group of power line workers from January to June 2022 using a self-administered questionnaire. We evaluated socio-professional characteristics, physical exertion with the Borg CR-10, and the satisfaction with life scale (SWLS).

Seventy-four male line workers participated in the study. They were married in 67.6% of cases. The mean age was 39.3 ± 10.5 years. The average job tenure was 15.5 ± 11.2 years. The mean of perceived exertion was 6.1±1.9. High to very high exertion was found in 73% of participants. The mean score of satisfaction with life was 26.8 ±6.5. Five (12.6%) participants were dissatisfied to extremely dissatisfied. Fifty-six (75.9%) participants were satisfied to extremely satisfied. High perceived exertion was correlated with higher satisfaction with the lives of line workers (p = 0.03, r = 0.24).

Power line workers with high perceived exertion were more satisfied with their lives. This can be explained by the positive impact of work on the lives of workers. The work environment is paramount to ensuring good mental health.

None Declared

Ganser syndrome is described as a dissociative disorder not otherwise specified in the DSM-IV, and is not currently listed in the DSM-V.

It is a rare condition, with transient Vorbeireden as the central symptom. This means the patient responds to questions with an incorrect answer, but by the nature of the answer reveals an understanding of the question posed.

This disorder was first described by the German psychiatrist Sigbert Ganser in 1898.

Analyze case reports published in the available literature and intelligibly characterize their clinical presentation and dissect the etiopathogenesis of the disease.

Data was obtained through an internet-based literature search, using the databases PubMed, Cochrane Library and NCBI. The World Health Organization was also utilized. Seven articles from the last four years were included.

The core clinical features of this syndrome are approximate answers, clouding of consciousness, somatic conversion symptoms and hallucinations. However, they are all not needed for diagnosis.

The basic underlying etiology of Ganser syndrome is still unknown. Debates over the factitious versus psychiatric versus organic origin of the symptomatology are common in the literature.

No reliable epidemiological data can be established.

The condition is a rare, probably dissociative, with transient Vorbeireden as the central symptom.

Although the research interest in dissociative disorders, the etiopathogenetic models remain hypothetical. Detailed imaging, neuropsychological and neurological data are required.

None Declared

Presently, the concept of preparing youth for the labor market in the 21st century receives much attention because of the rapidly changing nature of work and the soft skills and hard skills required by employers. Therefore, graduates need to be competent at work skills necessary for the 21st century to be able to face challenges of work in the present age and to have new perspectives for facing challenges and changes of work. According to the Federation of Thai Industries, the estimated number of workers needed by 14 groups of manufacturing industries during 2013-2017 included 58 percent of high school graduates.

The current study aims to survey and assess essential skills development in high school students in Southern Thailand for the workforce in the 21st century.

The cross-sectional study was applied to 1,200 subjects consisting of 400 employers and 800 high school students. Data was analysed using means, standard deviation and t-test

The results revealed that communication, digital literacy, creativity, critical thinking, collaboration, and responsibility were the major skills development needs of high school students in the 21st century labor market. The results indicated that high school students’ levels of skills were lower than those required by employers in four skills: communication, digital literacy, critical thinking, and creativity at the statistical significant level of .001, as presented in table 1.Table 1.Means different for skills development need by sample group.

The high school students possess skills needs for work in the 21st century at lower levels than those needed by employers. This is the issue requiring attention from individuals involved in educational management as they must find ways to develop the teaching and learning methods that can upgrade students’ skills that are needed for work and seen by employers as highly important. These skills are communication, digital literacy, critical thinking, and creativity. The teaching and learning styles should be more active rather than passive to stimulate students to think, to be proactive instead of passively to respond to whatever happens, to propose their ideas or to express differing opinions and using the appropriate language or communicating tools. The fact that these skills are at a moderate level could result in limitations for young people’s development or employment as these skills are required for work in this century where analytical thinking and creativity are necessary for invention both in the workplace and in private life.

None Declared

Previous studies suggest that adults with mental disorders (MD) or Autism Spectrum Disorder (ASD) are more likely to be unemployed than those without MD. However, it is unclear whether working adults with MD or ASD perceive the same effort-reward balance as their counterparts without MD or ASD.

To analyze labor conditions and to identify factors associated with effort-reward imbalance among young adults with ASD, MD and those from the general population (GP).

A qualitative and quantitative study design is being conducted to analyze the rates of employment among young adults with ASD, and to identify factors associated with employment rates (Fondecyt ID11201028.). As part of this study, we conducted a quantitative analysis in young adults 16 to 30 years of age in two regions of Chile between August and October, 2022. Young adults with MD and ASD were compared with adults of similar age recruited from the GP. We applied a questionnaire to collect data on participant’s sociodemographic information, autonomy level and employment status. We applied the short Spanish version of the effort–reward imbalance (ERI) and overcommitment (OC) questionnaire, which has been widely used in Latin American countries.

Chi-square test was used and the Kruskal Wallis H Test was applied to compare among groups. The statistical significance was set at P<0.05.

Overall, 422 participants were included in the analysis (mean age 22±3.2, 64.2% women, 65.2% students, and 4.4% unemployed). Of the total respondents, 22% of young adults from GP, 17.8% with MD, and 4.8% with ASD were working at the moment of the survey. Regarding autonomy level, a higher proportion of participants with ASD needed support (36.4%), compared with 9.7% and 0.8% of young adults with MD and GP, respectively. Of the population who reported working (n=125), about 56.0% have a permanent job, and 44% a seasonal or occasional job. The median value for the effort–reward ratio was 0.96 (range 0.4–1.8), with no significant differences between the groups. Of those participants working, 44.3% showed an ERI ratio higher than 1, which was higher in participants with ASD (60%). ERI-esteem was significantly different (P=0.01) among ASD (7.0; range 5-8), MD (6.0; range 2-8) and PG (6.0; range 2-8). In the OC questionnaire, young adults with ASD were more likely to think about work (P=0.01) and having trouble sleeping at night due to work issues (P=0.03) than GP and MD groups.

The ASD group showed higher overcommitment and a considerable proportion of subjects at risk of effort-reward imbalance at work, were more likely to think about work at home, and had trouble sleeping thinking about work. Our preliminary results highlight the importance of considering the working conditions of young adults diagnosed with ASD and the need to provide them with enough support to promote labor inclusion.

None Declared

Burnout syndrome or professional exhaustion is defined as feeling burned out, exhausted, overloaded, exhausted. It is a syndrome characterized by emotional exhaustion, depersonalization and low personal fulfillment. This clinical syndrome was first described in 1974 by Herbert Freudenberger, a psychiatrist, who defined burnout as “the depletion of energy experienced by professionals when they feel overwhelmed by the problems of others.” Mental Health is one of the specialties with the greatest emotional exposure due to all the circumstances that surround these professions, to maintain health in its 3 axes: physical, mental and social well-being as defined by the WHO

The objective of the study is to determine the presence of Burnout Syndrome in Mental Health professionals through the Maslach Burnout Inventory (MBI) questionnaire.

An observational, descriptive and cross-sectional study is carried out. The people included in the study were the health personnel of the Mental Health Clinical Management Unit (psychiatrists, administrative personnel, nursing assistants, nursing personnel, social workers and psychologists, and training personnel) who wanted to participate in the study. Carrying out the MBI questionnaire and sociodemographic data.

In our study we have a sample of 59 people. Regarding the sociodemographic data, we have 45 women and 14 men. Regarding the results after correcting the MBI questionnaire, we found that 4 professionals presented Burnout Syndrome (a psychiatrist and a 4th year psychiatry resident intern of psychiatry), 35 professionals presented tendency to suffer from Burnout since one of the three areas measured by the questionnaire was affected and 15 did not suffer from Burnout. Regarding the domains, we obtain that emotional exhaustion is the area, together with low personal achievement, that is most affected in the professionals of the community mental health unit, 23 and 22 professionals, respectively. Depersonalization is present at 12. Professionals with temporary contracts presented greater emotional exhaustion and low personal accomplishment. Professionals with permanent contracts show greater emotional exhaustion. Among the professionals in training, low personal achievement and depersonalization stand out. The 4 professionals who present burnout syndrome are married women and 3 of them with temporary contracts.

The results obtained show the presence of Burnout Syndrome and a high tendency to develop it among the professionals of the Mental Health Unit. In relation to the data, we must reassess the care systems for professionals and prevent the causes that can lead professionals who are starting their professional career to develop burnout in normal situations that can lead to collapse in extraordinary circumstances such as the COVID-19 pandemic.

None Declared

Stigma is a complex process and a universal phenomenon that is part of all social groups and that is maintained by its functions related to the establishment of one’s own identity and the facilitation of socialization processes. The stigma of the patient is important to evaluate since it is a subjective experience that can have negative correlations in relation to self-esteem, empowerment and recovery orientation of the patient with mental illness. Hospitalization in mental health takes place at times of mental illness decompensation and is an intervention closely related to the stigma towards mental illness.

The objective of the study is to evaluate the stigma perceived by patients with mental illness hospitalized in an acute mental health unit.

Observational study with 53 patients hospitalized in an acute mental health unit.

Variables collected: Sociodemographic variables (age, sex), clinical diagnosis and stigma is evaluated with the Illness Self-stigma Scale (ISMI).

Sample of 53 patients, 55% women and 44% men, the most frequent diagnoses among those admitted are psychosis spectrum 26.42%, depressive disorders 24.53%, personality disorders 22.64% and bipolar disorders 11.33%. The average age is 41.96 years, between 18 and 72 years. The self-stigma according to the scale (ISMI) we obtain as a total score the patient with the highest stigma scores 100 points and the one with the least scores 44 points. Regarding diagnoses, depressive disorders score 33-72 points, while psychotic disorders score 36-85 points. The highest scores in self-stigma in our study are in personality disorders 49-100 and borderline personality disorder stands out (100 points). In the 5 subscales such as alienation, self-stigma, perceived discrimination, social isolation and resistance to stigma. Higher scores in alienation stand out in all patients.

Patients with personality disorders, especially borderline personality disorder, followed by psychotic disorders, present greater perceived self-stigma in our study than the rest of the patients; it is a very important factor that can affect the evolution of the clinical picture. This factor is important to establish the therapeutic plan and the different interventions, it would be recommended to assess the stigma together with the measures to reduce symptoms.

None Declared

Schizophrenia is a severe, chronic, mental disease. Its stability relies upon a multidisciplinary treatment, where pharmacological treatment is a key aspect. Long-acting injectable antipsychotics (LAIs) have proved efficacy in improving adherence, reducing hospitalizations and relapses, compared with oral treatment[1,2]. Paliperidone palmitate is a long-acting antipsychotic, approved by FDA in 2009 for acute and chronic treatment in schizophrenia. To date, long evidence exists regarding treatment efficacy of paliperidone palmitate 1 month (PP1M) and paliperidone palmitate 3 month (PP3M)[3]. In September 2021 a new long-acting medication was approved for schizophrenia treatment, that is, paliperidone palmitate 6 months (PP6M). This is the first LAI with 6 months duration of treatment, which means, only 2 administrations per year.

We here analyzed the factors explaining transitioning from PP1M and PP3M to PP6M treatment in a population previously described somewhere else[4].

To identify the variables explaining the transition from other long-acting formulations (PP1M and PP3M) to the new biannual formulation (PP6M) in our clinical practice.

123 patients, previously diagnosed with psychotic disorders, in follow-up in our clinical center Fundación Jiménez Díaz Hospital, was analyzed. Sociodemographic factors and clinical evolution were compared in order to identify factors predicting transitioning from PP1M and PP3M to PP6M.

In the PP1M group, patients transitioning to PP6M had more than 6 years of evolution of disease ans active consummation of drugs, compared with patients who stayed on PP1M. Other sociodemographic were similar in both groups. Only 1 patient was readmitted in hospital since transition to PP6M and no emergency visits were accounted for people transitioned.

In the PP3M group, the majority of people transitioning to PP6M were under polypharmacy of which, 42% were on clozapine treatment. The percentage of people with schizophrenia diagnosis was significantly less than in the no transitioning group, though it remained the principal diagnosis. No other significant difference was found with regard to sociodemographic variables. Additionally, no emergency visits nor readmissions to hospital were accounted in this group.

Finally, the PP3M transitioned to PP6M significantly more than PP1M group. Although no clear variable explained this situation.

With these results, we conclude that chronicity and drugs consummation were the main variables explaining transitioning from PP1M to PP6M. In the other hand, the main variable explaining transitioning from PP3M to PP6M was polypharmacy.

These results are preliminary and, therefore, should be taken cautiously. We will probably dilucidated future tendency in these treatment use in the upcoming months.

None Declared

Antipsychotics are the standard in the treatment of first psychotic episodes. Although the majority of patients respond to the established treatment, it is currently known that there is a subgroup of patients whose response is not satisfactory. In this group, the subsequent response to a new antipsychotic is generally poor. Clozapine is an antipsychotic with a unique profile, with demonstrated efficacy and approval in the treatment of treatment-resistant schizophrenia. Its role in the first psychotic episodes remains unclear and its use is, to say the least, controversial.

This work aims to analyze and evaluate the use of clozapine in patients with a first psychotic episode, taking into account the experience of a Portuguese Hospital Center.

We carried out a retrospective study, including all patients admitted to the inpatient clinic of adults with a first psychotic episode, in the Department of Psychiatry of Centro Hospitalar Universitário of São João, in Oporto, between 2007 and 2020. Clinical and socio-demographic data were collected.We performed a retrospective analysis of patients who, at discharge, were medicated with clozapine, proceeding to a descriptive analysis.

In this case series, we intended to describe the cases of patients in whom the use of clozapine in the first psychotic episode was initiated. All patients were discharged with the diagnosis of Schizophrenia. Prior to the introduction of clozapine, patients were treated with other antipsychotics, normally two. Patients taking clozapine were younger and had a longer duration of untreated psychosis. They had also longer length of hospital stay. The pattern of prescribing antipsychotics in the first and subsequent episodes has generally been extensively studied. However, the use of clozapine in the first episodes remains unclear.In the literature, and despite clozapine being considered one of the most effective antipsychotics, there is a high prevalence of polypharmacy and a significant delay in its use in the first episodes.Notwithstanding the unfavorable metabolic and hematological profile of clozapine, compared to other antipsychotics, in terms of hospitalization, mortality and discontinuation rates for all causes, it demonstrates a pattern of superiority.

The superiority in effectiveness of clozapine is well established, despite its underutilization and frequent delay in its introduction.The clinicians attitude remains a significant barrier to the commencement of clozapine, although it is important to define and characterize better potential groups of eligible patients. Education resources for clinicians as well as services specifically dedicated to early identification and management of eligible patients would be beneficial.

None Declared

Schizophrenia (SCZ) is a chronic neuropsychiatric disorder possessing a multifactorial nature and dual facets of symptoms with a core underlying genetic mechanism that is still obscure. Lately, genomic studies revealed numerous single nucleotide polymorphisms (SNPs) that are non-coding and influence ribonucleic acid (RNA) expression, particularly its splicing.

Considering that next-generation sequencing (NGS) protocols focus upon long-read sequencing as opposed to conventional RNA sequencing methodologies once with the advent of Oxford Nanopore Technologies’ (ONT) MinION, we primarily aimed to gather and review all evidence into how this approach may deepen and further offer insight into SCZ still undiscovered domain.

The relevant literature searches were performed using distinct combinations of keywords including “schizophrenia” alongside „Nanopore”, “MinION”, and “Oxford Nanopore Technologies” on four databases (PubMed/Medline, ISI Web of Knowledge, Scopus, and ScienceDirect). We implied the entries to strictly “research articles” written in English as inclusion criteria.

By restricting the returned results starting with the year when the platform was officially launched, a total of n = 69 studies were displayed between the pre-established interval (2014 – 2022). If taken per database, n = 2 were identified in PubMed/Medline, n = 7 in ISI Web of Knowledge, n = 4 in Scopus, and n = 56 in ScienceDirect. In chronological order, n = 0 were published in 2014, n = 3 in 2015, n = 7 in 2016, n = 7 in 2017, n = 9 in 2018, n = 3 in 2019, n = 7 in 2020, n = 19 in 2021 and n = 14 in 2022. Finally, per the strategy applied, n = 49 were returned for “schizophrenia” + “Nanopore” from which n = 2 in PubMed/Medline, n = 5 in ISI Web of Knowledge, n = 4 in Scopus, and n = 38 in ScienceDirect. For “schizophrenia” + “MinION, there was a cumulative number of n = 5, from which we had n = 0 in PubMed/Medline, n = 0 in ISI Web of Knowledge, n = 0 in Scopus, and n = 5 in ScienceDirect. Finally, for “schizophrenia” + “Oxford Nanopore Technologies” were displayed n = 15, and the situation was n = 0 in PubMed/Medline, n = 2 in ISI Web of Knowledge, n = 0 in Scopus, and n = 13 in ScienceDirect.

We presently assist to a fulminant ascension in the literature, with applicability in other fields. Perhaps as cornerstone stands a recent publication in which the authors reveal the risk of the Calcium Voltage-Gated Channel Subunit Alpha1 C (CACNA1C) gene involved, being identified thirty-eight novel exons and two hundred and forty-one novel transcripts following RNA purification from six regions (cerebellum, striatum, and dorsolateral prefrontal cortex) among which targeted were cingulate, occipital and parietal cortexes.

None Declared

Zebrafish (Danio rerio) has evolved over the years as a preferred organism due to its vast repertoire in research fields that mimic a targeted phenotype, particularly behavioral typologies and specific attributes comparable to murine models and relatively high homology with humans. Considering this consideration, different pharmacological treatments have been tested and proven that under different concentrations may trigger schizophrenia (SCZ)-like symptoms.

Starting from the actual stage of knowledge according to which agents used as N-methyl-D-aspartate (NMDA) inhibitors (MK-801, ketamine, and phencyclidine) alongside psychedelic (mescaline, lysergic acid diethylamide), psychoactive substances (amphetamine), and non- and essential amino acids (proline and methionine), we aimed to reunite and review all existing evidence. This approach may offer an updated and critical overview regarding the possible future directions surrounding these compounds regarding the pharmaco-dynamics/kinetics.

To ensure the coverage of all relevant literature, we performed searches in four databases (PubMed/Medline, ISI Web of Knowledge, Scopus, and ScienceDirect) per combinations of keywords: “schizophrenia” with “MK-801”, “ketamine”, “phencyclidine”, “mescaline”, “lysergic acid diethylamide”, “amphetamine”, “proline”, “methionine”, and “zebrafish”. Eligible studies had to be “research article(s)” written in English.

A total of n = 246 studies were returned during the established interval (2010 – 2022). Precisely, n = 16 were identified in PubMed/Medline, n = 16 in ISI Web of Knowledge, n = 17 in Scopus, and n = 197 in ScienceDirect per database. If taken per year, n = 13 were published in 2010, n = 12 in 2011, n = 15 in 2012, n = 24 in 2013, n = 21 in 2014, n = 21 in 2015, n = 32 in 2016, n = 8 in 2017, n = 12 in 2018, n = 9 in 2019, n = 17 in 2020, n = 34 in 2021, and n = 28 in 2022. Depending on the combination of keywords, we had the following situation: n = 65 for “schizophrenia+MK-801+zebrafish”, n = 42 for “schizophrenia+ketamine+zebrafish”, n = 21 for “schizophrenia+phencyclidine+zebrafish”, n = 4 for “schizophrenia+mescaline+zebrafish”, n = 5 for “schizophrenia+lysergic acid diethylamide+zebrafish”, n = 36 for “schizophrenia+amphetamine+zebrafish”, n = 37 for “schizophrenia+proline+zebrafish”, n = 36 for “schizophrenia+ methionine+zebrafish”.

There can be seen an uprising trend in the current literature of studies focused on the administration of MK-801, ketamine, amphetamine, proline, methionine, and phencyclidine aiming to trigger SCZ-like symptoms as opposed to mescaline and lysergic acid diethylamide. Most of the data is contradicting, with either a decrease/increase in behavior (locomotion, aggression, sociability, circling behavior, and memory deficits), which is why additional studies are mandatory.

None Declared

Recent studies find a high level of prolactin in naive patients with consequences on their behavior. These results have shed light on new etiopathogenic avenues in schizophrenia and suggested new preventive approaches.

The objective of our work was to investigate the links that may involve prolactin levels to agressive behavior in patients followed for antipsychotic-naïve schizophrenia or in therapeutic discontinuation.

We conducted a one-year descriptive and cross-sectional study of thirty male patients hospitalized for a treatment-naïve psychotic relapse or who had been discontinued for more than two months. These patients were assessed using a questionnaire as well as the Overt Agression Scale (OAS). A blood sample was taken to specify the prolactin level.

Eleven patients were aggressive (37%). Seven patients (23%) had hyperprolactinemia. Hyperprolactinemia was also inversely associated with aggression since inversely significant correlations were objectified for prolactinemia and respectively the OAS score and the verbal aggression subscore (Rho=-0.391 ; p=0.033) and (p=0.016, Rho=-0.438). The score of aggressiveness towards others also evolved inversely to the prolactin level with a p close to significance (p =0.056).

Our results support the hypothesis of a probable action of prolactin as a protective factor against aggression. High prolactin levels may therefore represent a diagnostic lead for a particular profile of a certain patient group with a particular course. However, this subject is still unresolved in the literature and future studies seem necessary.

None Declared