The lack of insight can be present among patients with a diagnosis of schizophrenia, which often results in lack of adherence to pharmacological treatments1 and, subsequently, in treatment discontinuation and relapses2. This vicious pattern leads to further clinical deterioration, impaired functioning, and reduced quality of life 3. There is a plethora of evidence supporting the fact that long-acting injectable and depot antipsychotics can increase adherence to treatment, reduce the risk of discontinuation and hospital admissions4. It is also known that low fluctuations between peaks and lows in plasma drug levels could be related to a better tolerability profiles5. A new paliperidone palmitate prolonged release formulation, which is administered twice annually, has been approved as maintenance treatment for patients with schizophrenia who are already stable on the monthly or quarterly prolonged release paliperidone palmitate6.

We aimed to evaluate the transition of monthly and quarterly paliperidone palmitate to the new six-monthly formulation and patients’ satisfaction with it in a real-world clinical setting.

We collected a basic epidemiologic questionnaire, responses to a query about local pain after administration, and the Drugs Attitude Inventory (DAI).

A total of 21 patients from an outpatient clinic for severe mental disorders with a long evolution of their disease in Salamanca, Spain, were included. All of them had a DSM5-TR diagnosis of Schizophrenia. Sixteen were male and 5 female. The mean age was 42.6 years. 14 were receiving quartlery paliperidone palmitate (10 with high doses (525 mg) and 4 with moderate doses (350 mg)) and 7 were on monthly injections (6 with high doses (150 mg) and 1 with a moderate dose (100 mg)). Those receiving moderate doses of quarterly or monthly paliperidone palmitate were administered 700 mg of six-monthly paliperidone palmitate; 1000 mg were injected to those with higher doses. The mean score on the DAI scale was 8. Only one patient reported an increase in local pain after the injection, and another reported dissatisfaction with the administration in the gluteus instead of the deltoid muscle. The first administration of the new formulation in our site was on June 26th; to date none of these patients have required hospital admission due to relapse.

Six-monthly prolonged release paliperidone palmitate seems to be an effective maintenance treatment for schizophrenia. In addition, this new formulation is well received and tolerated by patients previously on monthly or quarterly formulations of the same drug.

None Declared

One of the subtypes of schizophrenia is the deficit syndrome (DS). Because of different risk factors, course, response to treatment weak prognosis, researches on this group of patients are important. Etiology of schizophrenia is often hypothesized as the inflammation process. Due to the imbalance of certain cytokines (interleukin-10 (IL-10) -antyinflamation cytokine, among others) changes in the function and structure of central nervous system may occur. That process could stand behind the outbreak of psychotic and deficit symptoms of the illness. Subinflammation can have an impact on the white matter structure. Disturbances in this area can cause impairment of cortical communication and hence, produce psychopathology. One of the structures that seem to have the basis of the deficit syndrome isinferior longitudinal fasciculus (ILF). ILF is a bundle of association fibers with interconnects temporal cortex with ocapital cortex.

The aim of our study was to investigate a relationship between the integrity of ILF and interleukin – 10.

39 schizophrenia subjects divided into two groups DS (16) and non-deficyt sydrome (NDS) (23) and 18 healthy controls (HC) participated in the study. A DTI analysis was performed on all study participants. The psychopathology of schizofrenia was assessed using the Positive and Negative Syndrome Scale (PANSS). The ILF analysis was then conducted using fractional anisotropy (FA) and mean diffusivity (MD) parameters. Blood samples were obtained to analyze serum level of IL-10 level.

The differences in FA value in left ILF between DS and HC group were confirmed. The difference in values of IL-10 between groups were not confirmed. A negative correlation was found between FA values in left ILF and IL-10 (p = 0.033) among DS group.

The imparment of the structure of ILF may be involved in ethiopatogenesis of DS. Moreover, changes in IL-10 levels may be related to the microstructure of ILF bundle.

None Declared

Treatment resistance schizophrenia (TRS) develops in ~ 30% of patients in about 5 years from starting treatment with 5-HT2/D2 APs, resulting in increased morbidity, suicidality, and mortality. Findings from neurochemistry, neurometabolism, functional imaging in TRS patients indicate abnormalities in glutamatergic neurotransmission (Moghaddam B et al 2012; 37 4-15) rather than excess of dopamine synthesis (Demjaha A et al 2014; 75 11-3; Mouchlianitis E et al 2016; 42 744-52), suggesting the need to add a drug that attenuates glutamate release. Evenamide, a selective inhibitor of voltage-gated Na+ channels, is devoid of biological activity at >130 CNS targets, normalizes glutamate release without affecting basal levels, and demonstrated benefits in animal models of psychosis as monotherapy and as an add on to APs (including clozapine), reversing deficits produced by amphetamine, scopolamine, phencyclidine, or ketamine

Studies 014/015 were designed to evaluate the safety and preliminary efficacy of evenamide given orally at 3 fixed doses (7.5, 15 and 30 mg bid) in patients with TRS not responding to a therapeutic dose of an AP. Assessment of efficacy was based on changes of PANSS and CGI-S/C, while tolerability was assessed based on all safety measures

Study 014 is a 6-week, randomized, rater-blinded, international study with completers continuing assigned doses for an additional 46 weeks in an extension study (Study 015). Patients were initially randomized to 7.5 or 15 mg bid; the Independent Safety Monitoring Board (ISMB) allowed randomization to 30 mg bid after reviewing safety data from the first 50 patients. At baseline, patients were moderately to severely ill (CGI-S of 4 to 6), with a PANSS total score of 70-90 and predominant positive symptoms (score of 4 or more on at least 2 core symptoms and a PANSS positive total score ≥ 20), along with functional deficits (GAF ≤50). Efficacy ratings were performed by a psychiatrist blinded to the evenamide dose. Data were analyzed as a single group using descriptive statistics to assess changes from baseline to endpoint (Week 30)

Interim, group-blinded, 30-week results for safety and efficacy data (PANSS and CGI) for the first 100 patients (including 6 on 30 mg bid) will be presented. Patients randomized to 7.5, 15, and 30 mg bid had all safety and efficacy data pooled in a single group to maintain the blind in the study. All results will be submitted to the ISMB, relevant health authorities and the FDA

This trial is the first international TRS trial of an NCE AP used as an add-on to a single typical or atypical AP. Results of this study may change the treatment of future TRS patients

None Declared

Numerous authors have proposed “responder” criteria for patients with schizophrenia treated with antipsychotic monotherapy (Leucht, S et al 2009; 438 7-14; Suzuki T et al, 2012; 197 1-6; Kane J et al 1988; 45 789-96). These suggest reductions greater than 30% on the PANSS total score, improvements of 1 category or more on the CGI-S, or CGI-C ratings of very much, much or minimally improved, as well as various permutations and combinations of the above. No study has met the responder definition of Kane et al in the last 30 years in monotherapy studies in TRS patients. However, a widely accepted definition of response in patients with TRS treated with a putative antipsychotic added to their background antipsychotic monotherapy, is not currently available, and more work is needed on this highly relevant topic (Suzuki, T et al 2011; 133 1-3).

Combining PANSS (30-item anchored scale), CGI-C and CGI-S (both 7-point Likert scales), three of the most accepted scales to evaluate patients with schizophrenia worldwide, we propose two different definitions of response in TRS population

Study 014 was designed to evaluate the safety and preliminary evidence of efficacy of evenamide, a NCE added to an antipsychotic monotherapy, given orally at 3 fixed doses (7.5, 15 and 30 mg bid) in patients with TRS not adequately responding to a therapeutic dose of an AP. Assessment of efficacy was based on changes of the PANSS and CGI-S/C. We reviewed the efficacy data of the first 100 patients at various timepoints up to 30 weeks.

We assessed multiple definitions involving all the three measures (PANSS, CGI-S, and CGI-C) to determine one that would define a “responder” by categories that may be clinically meaningful. Review of the data indicated two definitions of responders based on the different combinations of the individual measures. “Full responder” was defined as PANSS total score improvement ≥ 20%; CGI-C at least much improved (i.e. 1,2); CGI-S at least one point improvement and reaching at least mildly ill (i.e. a score of at least 3 or less). “Partial responder” was defined as PANSS total score improvement ≥ 15%; CGI-C rated as any improvement (i.e. 1,2,3); CGI-S at least one point improvement. These two categories are alternatively true and patients not fulfilling the criteria for the above categories are considered as “non-responders”. Further descriptive analysis will be presented.

These definitions may change the selection of compounds used as add-on therapy for TRS patients as well as the study designs to evaluate them.

None Declared

The proxies used to compose cognitive reserve (CR) in first episode of psychosis (FEP) have varied in the literature. The development of FEP is linked to the peripheral pathways of the central nervous system (Leboyer et al. Psychopharmacology 2016; 233(9) 1651-60) Furthermore, schizophrenia has been linked to the metabolic system, indicating that alterations in the levels of biological parameters, in particular high-density lipoproteins (HDL) (Gjerde et al. Eur Arch Psychiatry Clin Neurosci 2020; 270(1) 49-58) cause worse global functioning and cognitive impairment (Adamowicz et al. J Clin Med 2020; 9(2) 537). Despite this knowledge, no research has considered the introduction of biomarkers as proxies for CR.

The present study aimed to create a quantifiable and objective CR index that adjusts for the multifactorial nature of FEP.

We included 668 patients who had FEP and 217 healthy controls who were assessed for sociodemographic information and levels of biological parameters: waist circumference, hypertension and levels of HDL, triglycerides and glucose. The main analyses were multiple regression analysis, principal component analysis (PCA) and exploratory factor analysis (EFA).

Regression analyses showed that HDL was the top performing biological parameter in a model containing years of education and unemployment (F=11.80; p<0.001) while also outperforming other parameters in a correlation analysis with a composite of the same variables (r= 0.21; p<0.001). In EFA analyses combining all possible components, we found that the most optimal proxies for the composition of biological CR were years of education and HDL. The results using PCA indicated that biological CR would have a greater explanatory power for the phenomenon than classical CR, increasing 7.27% of the explanation for FEP patients and 16.08% for healthy controls.

This article proposes an objective and quantifiable method to measure CR, taking into account endogenous and exogenous factors. This index, introducing biomarkers as proxies could provide a more accurate CR score for FEP patients.

None Declared

Several factors related to the risk of requiring psychiatric hospitalization have been described in patients diagnosed with schizophrenia treated with methods other than home treatment. With regard to the symptoms, high global illness severity and positive symptoms of schizophrenia have been most frequently related to the risk of hospitalization in patients with schizophrenia. However, there are no studies describing which clinical factors increase the likelihood of being hospitalized while undergoing home follow-up.

To determine which of the clinical factors assessed in the PANSS predict the risk of hospitalization in patients diagnosed with schizophrenia following a home treatment program.

All patients with schizophrenia who were visited by a home treatment team in Barcelona between January 2017 and December 2021 were included in the study. A comparative, bivariate analysis of each item of the PANSS and of the global results of each category was conducted on those who were hospitalized and those who were not hospitalized. Finally, a logistic regression of each category of the PANSS was done on both groups, controlling for other socio-demographic and clinical factors.

A total of 1045 patients with schizophrenia were evaluated in this study. PANSS positive symptom subscale (PANSS-S), PANSS General Psychopathology, PANSS Excited Component and PANSS Global Score scored higher in patients who were finally hospitalized in a conventional acute treatment unit. Regarding the PANSS negative symptom subscale, no significant differences were found between the two groups.

In patients who required hospitalization, the scores of all the PANSS positive symptom subscale (PANSS-P) items and all items on the PANSS excited component (excitement, tension, hostility, uncooperativeness and poor impulse control) were significantly higher. Some items regarding general psychopathology (Somatic concern, anxiety, guilt feelings, tension, and mannerisms) were also significantly higher in the hospitalization group. Only 3 items—blunted affect, guilt feelings and motor retardation—scored significantly higher in patients who did not require hospitalization. In the logistic regression, only the global score of the PANSS-P reached statistical significance (P = 0.001).

Positive symptoms scored in the PANSS seem to be the most predictive factors of hospitalization regarding clinical symptoms in patients with Schizophrenia following home treatment. Other items regarding exciting symptoms and general psychopathology also showed as relevant regarding the risk of conventional hospitalization in those patients.

None Declared

There is an increasing need to understand the effectiveness of novel medications in real-world context since despite being the gold standard, double-blind trials have their own limitations as well. Clinical Global Impression is a simple tool for clinicians to assess the severity of an illness (CGI-Severity) as well as to rate how much the patient’s disorder has improved or worsened relative to baseline (CGI-Improvement). In this poster, cariprazine, a third-generation antipsychotic medication that was found to be effective in the treatment of negative symptoms in schizophrenia will be evaluated.

To compare the effectiveness of cariprazine in clinical trial vs real-world setting via the CGI-S and CGI-I scales in negative symptom schizophrenia patients.

We compared the results of a clinical trial (Németh et al. Lancet 2017; 389:1103-13) and an observational study (Rancans et al. Int Clin Psychopharmacol. 2021;36(3):154-161). The latter was an open-label, flexible-dose, 16-week, observational study of cariprazine involving 116 outpatients in Latvia. Adult patients who have been diagnosed with schizophrenia, exhibited negative symptoms based on clinical judgement, were at least mildly ill according to the CGI-S scale and have not previously received cariprazine were eligible to take part in the study. Dosing of cariprazine was based on clinical judgement. The clinical trial was a randomized, double-blind, multi-centred, 26-week study with adults aged 18–65 years with long-term (>2 year), stable schizophrenia and predominant negative symptoms (>6 months). Patients were randomly assigned to monotherapy with cariprazine 4.5 mg/day or risperidone 4.0 mg/day.

116 patients on flexible dose cariprazine (observational study) were compared with 227 patients on cariprazine 4.5 mg/day and 229 on risperidone 4.0 mg/day (clinical trial). Baseline severity of illness as measured by the CGI-S was between moderately and markedly ill in all three groups. By the end of the 26-week trial, cariprazine reduced the CGI-S score significantly (LS Mean Change: -0.9, p<0.01). In contrast, the risperidone group achieved only -0.7-point change from baseline. In the observational study, cariprazine also achieved significant change (-0.9, p<0.001) but by week 16. In terms of improvement, patients on cariprazine improved minimally to much in both the clinical trial and real-world setting.

The effectiveness of cariprazine in clinical trial and real-world setting do not seem to differ as measured by the scales in negative symptom patients.

E. Rancans Grant / Research support from: Gedeon Richter, Lundbeck, Consultant of: Abbvie, Gedeon Richter, Grindex, Janssen Cilag, Lundbeck, Servier, Zentiva, Speakers bureau of: Abbvie, Gedeon Richter, Grindex, Janssen Cilag, Lundbeck, Servier, Zentiva, Z. Dombi Employee of: Gedeon Richter Plc., R. Csehi Employee of: Gedeon Richter Plc., G. Németh Employee of: Gedeon Richter Plc.

Negative symptoms has been classically associated with cognition, psychosocial functioning and quality of life in patients with schizophrenia. But negative symptoms are not a unitary construct, encompassing two different factors: diminished expression, and motivation and pleasure. Few works have studied the relationship between these two different negative symptoms factors and cognition (neuro and social cognition), psychosocial functioning and quality of life, jointly, in patients with a first psychotic episode of schizophrenia.

The objective of the present work was to study, in a sample of patients with a first psychotic episode of schizophrenia, the relationship between the negative symptoms (diminished expression and motivation and pleasure) and neurocognition, social cognition, functioning and quality of life.

The study was carried out with 82 outpatients with a first psychotic episode of schizophrenia from two Spanish hospitals (“12 de Octubre” University Hospital, Madrid and “Virgen de la Luz” Hospital, Cuenca). The patients were assessed with the Clinical Assessment Interview for Negative Symptoms (CAINS) for evaluating diminished expression (EXP) and motivation and pleasure (MAP) symptoms, the MATRICS Consensus Cognitive Battery (MCCB) for evaluating neurocognition and social cognition, the Social and Occupational Functioning Assessment Scale (SOFAS), and the Quality of Life Scale (QLS).

A negative correlation was found between neurocognition and the two negative symptoms subscales: CAINS-EXP (r=-0.458, p<0.001) and CAINS-MAP (r=-0.374, p<0.001); but with social cognition only CAINS-EXP was correlated (r=-0.236, p=0.033). Also, it was found a high negative correlation between SOFAS scores and CAINS-MAP (r=-0.717, p<0.001); and a medium negative correlation with CAINS-EXP (r=-0.394, p<0.001). Finally, QLS score was high correlated with both CAINS subscales: CAINS-EXP (r=-0.681, p<0.001) and CAINS-MAP (r=-0.770, p<0.001).

This study found a relationship between negative symptoms and neurocognition, social cognition, functioning and quality of life in a sample of patients with a first psychotic episode of schizophrenia. But the two different negative symptom factors, diminished expression, and motivation and pleasure, are associated differently with psychosocial functioning, but especially with social cognition where the relationship was only found with diminished expression symptoms.

None Declared

Although generally effective in ameliorating the core manifestations of schizophrenia, antipsychotics (APs) may lead to only suboptimal responses or may be associated with a variety of treatment-related adverse events which require additional treatment strategies. Under such clinical circumstances, switching APs represents a rational treatment option.

The present study aimed to identify the variables that predict AP switch and to quantify the frequency of this phenomenon in people with schizophrenia in real-life.

A secondary analysis was conducted on the data collected at baseline and at a 4-year follow-up from a large sample of community-dwelling Italian people with schizophrenia. Demographic and clinical variables as well as information about AP treatment were recorded at two time points. Over the 4-year period, 34.9% of the 571 participants switched the AP; in particular, 8.4% of participants switched from first-generation APs (FGAs) to second-generation APs or vice versa, while 8.2% of them switched to clozapine.

Logistic regression models showed that combination of APs at baseline was negatively associated with AP switch, while treatment with FGAs and the presence of extrapyramidal symptoms at baseline were associated with AP class switch.

Although the aim of the present study was not to assess predictors of clinical relapse in people with schizophrenia, we might speculate that switching APs represents a surrogate indicator of treatment failure in some patients and could lead into relapse, which is a costly aspect of schizophrenia management in both economic and human terms. The sooner such a negative outcome can be predicted and managed, the sooner the treatment can be optimized to avoid it.

None Declared

Parents of individuals with gender dysphoria may experience distress when dealing with their child’s condition, and how they react can have a significant effect on their own as well as their child’s mental health.

In this study, we aimed to explore the personality traits among mothers of individuals with gender dysphoria in comparison to the mothers of individuals with cis-gender identity by utilizing the Temperament and Character Inventory (TCI) tool.

We enrolled 27 mothers of GD individuals who had obtained licenses for gender affirmation surgery and 28 mothers of cisgender controls for this case-control study. Personality traits were measured by a validated Farsi version of the Temperament and Character Inventory (TCI) tool.

The mean±standard deviation age of mothers with GD children and controls was 53.95±9.44 and 53.00±7.28 years, respectively. 20 of the GD children were born with the female sex. Overall, TCI scores were statistically different between the two groups (p=0.03); however, this difference was only observed among Character scores (p=0.01) and was not significant in Temperament scores (p=0.33). We found significantly higher mean Cooperativeness (CO) and Self-Transcendence (ST) scores in the case group (p=0.007 and 0.031, respectively). We also identified significantly more individuals with a high CO score amongst mothers of GD individuals (Odds Ratio: 5.0, 95% Confidence Interval 1.2-21.0, p=0.028).

By showing more mature, understanding, and kind personalities, the mothers of GD cases who have obtained licenses for gender affirmation surgery, have likely provided a positive atmosphere for the gender identity development and transition of their children. Additionally, their personalities were possibly better suited to deal with their child’s condition through having better compensatory adaptive traits.

None Declared

Sexual life is affected by physiological, psychological and social changes during pregnancy. Therefore, pregnancy is considered as a stressor affecting sexual lives of women and as a period when sexual dysfunctions can easly appear.

The aim of our study was to explore the prevalence of sexual dysfunctions among pregnant womens.

we conducted a cross-sectional and descriptive study among Tunisian pregnant women. The questionnaire used was performed with Google Forms and posted on social media. It contained questions concerning personal and sociodemographic aspects and questions concerning obstetrical data such as parity, gestational age and complications during the current pregnancy. We used the Female Sexual Function Index to examine Sexual dysfunction. Total scores of 26.55 or less characterize deficiency of female sexual function.

Fifteen women (44.1%) were primiparous and 19 (55.9%) were multiparous with 29% being in the first trimester, 27% in the second, and 44% in the third. Half had at least one child. Most of participants reported better satisfaction with their sexuality before pregnancy than during pregnancy (76.5% vs. 26.5%). This difference in satisfaction was statistically significant (p=0.004). A sexual dysfunction was found in 70.6% of cases and we did not identify any correlations between the presence of sexual dysfunction and sociodemographic or clinical data of the current pregnancy.

The prevalence of sexual dysfunction among Tunisian pregnant women was high and not related tosocio-demographic characteristics.

None Declared

Sexual relationship is affected by the emotional factors, changes in women’s body, sexual dysfunctionsand also common beliefs about sex in pregnancy. Couples might tend to avoid sexual intercourse in pregnancy due to different beliefs.

Our objective was the evaluation of sexual related and common beliefs among pregnant womens.

We conducted a cross-sectional and descriptive study. We targeted Tunisian pregnant women whatever the term of pregnancy. We collected data using a self-questionnaire performed with Google Forms and posted regularly on social networks over a period of six months. In order to assess the most common beliefs, we used a panel of questions inspired by the literature.

34 pregnant women participated to the study. Mean age was 31,56 years (SD =3,25). All the participants had a secondry or university education (5.9% and 94.1% respectively). Ninteen women (55.9%) were multiparous with 44% in the third trimester.

Among participants, 20.6% believe that sexual intercourse can be harmful to the baby, 41.2% believe that the number of intercourse should be limited during pregnancy and 17.6% thought that sexual intercourse should be stopped in the first three months.

In relation to body image, 11.8% of women approve that pregnancy takes women’s all beauty and 8.8% thought that their bodies weren’t attractives as before for spouses. About a quarter of our population (23.5%) agreed that pregnant women lose sexual desires and 14.7% approved that intercourse satisfies only men. Only one women (2.9%) reported that intercourse during pregnancy is considered a sin.

We have identified through this study different beliefs about sexuality during pregnancy, sometimes aberrant and which can affect the sexuality of couples. Attention of health professionals should be attracted to this issue and sexuality should definitely be integrated into prenatal care and counselling.

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 describe the sociodemographic and medical characteristics, psychoactive substances use of a sample of users with sexualized drug use (chemsex) 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. Most common drugs used during sexual intercourse were: mephedrone, cocaine, poppers, GHB and methamphetamine. The frequencies of substances consumed during sex were: mephedrone (95%), methamphetamine (80%), GHB (92.2%), ketamine (52%), poppers (alkyl nitrites) (95%), cocaine (89 .7%), speed (amphetamine sulfate) (49.6%) and drugs for erectile dysfunction (86%). 61.3% reported having practiced slamsex intravenous substance use at some time in their life, being a habitual practice at the time of collecting information for 50.7%. The most frequent genitally transmitted infections were: syphilis, chlamydia and gonorrhea. Users reported having been diagnosed with the following genitally transmitted infections: hepatitis B virus (7.4%), hepatitis A virus (18.6%), syphilis (69.6%), human papillomavirus (16 %), herpes (9.4%), chlamydia (43%), gonorrhea (60.5%) and candidiasis (9.7%).

Slamsex and STIs are usually reported in our sample. Interventions for chemsex users must include a colaborative model which includes professionals from different areas, including internists and emergency physicians, psychiatrists, psychologists, nurses, social workers and sexologists.

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. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.

The objective of this study was to understand the impact of chemsex on sexual health and sexual response by the participantes of a sexual health program for chemsex users in two Substance Use Disorder Clinics in Madrid.

Qualitative research approach. We analyze an anonymous survey with chemsex users with open answer questions about the impact of chemsex practice on sexual response and sexual health. Data analysis was based on thematic analysis of content.

Several differences were identifed between chemsex and sober sex. In sober sex it can take longer to feel aroused, sexual desire is more context-dependent and more easyly controled. They connect easily with other people needs when they had sober sex. They described difficulties with consent with some sexual practices when they were on drugs. Shame and guilt was associated with chemsex. They describe more arousal, more independent of the erotic context, longer sexual intercourse and delayed ejaculation when they had sex under the influence of drugs.

Chemsex is a phenomenon that needs a multidisciplinary approach and mental and sexual health must be taken into account including sexological perspective. Interventions that provide sexual counselling and sexual therapy for chemsex users must be developped.

None Declared

Changes in the attitude of modern society to the intimate sphere - the increasing emancipation of women, their desire for equality with men, including in sexual life, significantly changes the nature of the sexual behavior of young women, which is becoming less dependent on the presence of common myths and stereotypes

To identify the features of the sexual behavior of senior university students

One hundred seventy two senior students of the Ural State Medical University aged 20 to 24 years (average age 21±3.15) attended an anonymous online survey using the Google Forms platform. The author’s questionnaire developed at the Department of Psychiatry, Psychotherapy and Narcology together with the Department of Obstetrics and Gynecology of USMU and included 51 questions.

To the question “Are you brought up in the belief that there is nothing shameful in sex?” answered in the affirmative by 63.0% (108 people) of female students. Most of them 94.0% (162 people) consider it possible to have sexual relations before marriage – “Yes, this corresponds to the norms of modern society.” The age of onset of sexual activity for this sample was 17.5 years. Extreme deviations from the median norm: 14 years - 4.0% (7 people); 23 years old – 2.0% (3 people). To the question “What is your attitude towards representatives of non-traditional sexual orientation?” the answers were distributed as follows: neutral attitude 72.0%, (92 people); 22.0% (28 people) expressed a positive attitude; negative - only - 6.0% (7 people). The study showed that the sexual behavior of young women - university students is determined mainly by intimate and personal attitudes, due to the specifics of society, cultural context, individual and personal characteristics.

Based on the identified trends, the features of the sexual behavior of young women - senior students of the university become more definite and predictable.

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Globally, children are abused sexually. It physically and mentally strains society. Abusers can develop eating problems and non-suicidal self-harm. Emotion regulation links purging, NSSI, and abusive situations. We examined 80 13-20-year-olds, 62.5% of whom had CSA, and 30 healthy controls. Victims were given the Toronto Alexithymia Scale, an eating disorders clinical interview, the Difficulties in Emotion Regulation Scale to assess emotion dysregulation, the Self-punishment Scale to assess NSSI, the Mini-Kid for children under 18 and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) for those 18 and older. 62.5 percent have CSA. CSA was connected to emotional dysregulation. Alexithymia is connected with problems describing and identifying feelings and outside oriented thinking. CSA patients exhibited severe self-punishment symptoms, greater than controls. Kids and teens often have CSA.

to look into the link between CSA and NSSI, as well as Alexithymia, emotional eating, and emotion dysregulation.

We interviewed 80 mental outpatients from October to February 2019. 30% of healthy controls have CSA. Participants were 10–24-year-olds without PTSD or ASD. Mini-Kid is a 10- to 18-year-old neuropsychiatric interview (Sheehan et al., 1998), Self-injury scale measures non-suicidal self-harm (NSSI), Problems (DERS; Bjureberg et al., 2016) TORONTO ALEXITHYMIA QUESTIONNAIRE (Bagby et al., 1994). The Eating disorders clinical interview (Kutlesic et al., 1998)

Table.Describing the difference between control group and patients’ group regarding self- punishment scale.

CSA survivors had higher rates of self-injury, emotional eating, alexithymia, and emotional dysregulation than healthy controls. CSA victims should be evaluated for non-self-injury, emotional dysregulation, and emotional eating.

None Declared

Chronic sexual health problems often emerge in young adulthood, when adults begin to build the close relationship and develop lifelong sexual health behaviors. The associations between body estimation and sex education, especially in women group, is not well known in Poland.

The aim of the research was to check a relationship between body estimation and (1) taking part in formal sex education classes in the past and (2) subjective rating of one’s knowledge in the field of sexuality among women in early adulthood.

We examined 159 women between 18 and 35 years. We used a survey, consisted of respondents’ particulars and Body Esteem Scale (Franzoi, Shields, 1984) including 35 items related to body. BES consists of three subscales for women (Sexual attractiveness, Weight concern, Physical condition) and three subscales for men (Physical attractiveness, Upper body strength and Physical condition). Respondents had to pick one of the answers on a five-point scale, where 1 meant „strong negative feelings” and 5 meant „strong positive feelings”. The study was conducted online, via MS Forms platform.

There was a statistically significant relationship between taking part in formal sex education classes in the past and perception of physical condition among women. The analysis also proved the relationship between subjective rating of one’s knowledge in the field of sexuality and rating of one’s sexual attractiveness and perception of these parts of body that can be changed through physical exercises or dieting. Additionally, the research showed a statistically significant relationship between rating of one’s knowledge in the field of sexuality and general estimation of one’s body.

By leading reliable sexual education one may affect better attitude to bodies among young adults, who are in a sensitive phase for building stable relationships with other people. Simultaneously one may improve their mental, physical and social well-being.

None Declared

Gender dysphoria (GD) is characterized by a marked incongruence between one’s experienced/expressed gender and gender assigned at birth, associated with clinically significant distress or impairment in important areas of functioning. Persons with GD are a population with specific healthcare needs. In our hospital, psychiatric assessment of these individuals started in 2008.

Characterization of a population of transgender individuals and their perceived negative mental health and life experiences.

Since the beginning of evaluations of transgender individuals in our hospital, from 2008 to 2022, they were asked to freely elaborate their “life story”: a report of the most relevant events in their lives, related to their condition. We retrospectively analyzed the content of the reports that were sent and associated with the clinical files.

We collected the data of 104 individuals. The gender attributed at birth consisted of 74 (71.2%) females and 30 (28.8%) males. As for the gender identity, the sample consisted of 73 (70.2%) males, 28 (26.9%) females, 2 (1.9%) nonbinary and 1 (1%) person didn’t identify with any of the existent denominations. The medium age in October of 2022 was 27.4 (minimum 18, maximum 60, SD 7.3). The age at first evaluation at consult was 23.6 (minimum 15, maximum 56, SD 7.2). 99 (95.2%) individuals mentioned symptoms of gender non-conformity beginning in childhood, and of those who mentioned their adolescence (n=43, 41.3%), all expressed feelings of anguish relating to their changing bodies. The medium age of recognition of their condition was 17.2 (minimum 11, maximum 30, SD 4.3). Of those who recall their first contact with health practitioners regarding their symptoms (n=31, 29.8%), 32.3% admitted they didn’t feel they were helped. Of those who mentioned early relationships with family and carers (n=65, 62,5%), 35.4% reveal dysfunctional relationships and 79% mention gender expectations from their families. Similarly, 42 (40.4%) individuals reveal experiences of victimization and bullying because of their gender nonconformity. 53 (60.2%) described symptoms of a likely comorbid psychiatric illness throughout their life, particularly depressive symptoms, anxious symptoms, suicide attempts and non-suicidal self-injury.

GD has gained more attention in the recent years, and the scientific community has now developed a more accurate set of criteria for the recognition of this condition. The findings in our study are in accordance with these criteria. Unfortunately, much of the suffering this condition entails is also associated with distress related to stigma and societal gender expectations, and that was evident in this investigation.

None Declared

More than 50% of women with endometriosis report that they suffer from sexual dysfunctions, the most significant of which is pain, which can subsequently be associated with stress, anxiety, depression. The aim of this study was to evaluate the relationship between sexual function, stress, anxiety and depression together with the values of stress hormones such as cortisol and prolactin in women with endometriosis.

Endometriosis can occur in up to 15% of women. A characteristic feature is the presence of tissue resembling the endometrium outside the uterine cavity. Endometriosis is an estrogen-dependent disease that is associated with fertility disorders (incidence up to 40%) and sexual dysfunction (up to 50% of patients). Endocrine and immune changes may be associated with chronic stress, anxiety and even depression.

A total of 92 patients with endometriosis were included in the study. Clinical examinations were focused on biochemical analysis of cortisol and prolactin. At the same time, sexual function, symptoms of stress, anxiety and depression were psychometrically evaluated in these patients.

In the mutual statistical assessment, positive correlations were found between the results of the Beck scale questionnaire for assessing the severity of depression (BDI-II) and PRL (R = 0.39), then confirmed by Mann-Whitney test (z-score is 5.98019, p value is <0.00001, result is significant at p <0.05). Furthermore, the correlation between BDI-II and HAM-A (R = 0.33), confirmed by the Mann-Whitney test (z-score is -8.55827, p value is <0.00001, the result is significant at p <0.05) (Fig.). Positive correlations were found between TSC-40 and FSDS-R (R = 0.30), confirmed by Mann-Whitney test (z-score is 3.89503, the value of p is 0., 0001, the result is significant at p <0.05). We also found a high correlation between PRL and HAM-A (R = 0.86). Cortisol levels did not show any positive correlation.

Sexual dysfunction usually accompanies up to 50% of patients with endometriosis. This in turn affects the mental health and well-being of not only the patients, but also their sexual partners. The results of this study are consistent with the hypothesis of possible relationships between stress, anxiety, depression and neuroendocrine markers in patients with endometriosis.

Women diagnosed with the symptoms of endometriosis should also be examined for psychosocial and psychiatric disorders at the same time. In this regard, it is important not to underestimate the psychological assessment of those patients who are at risk of developing symptoms of anxiety and depression and to provide them with appropriate psychological support.

None Declared

This review determined the effectiveness of female anorgasmia treatments in premenopausal women using a systematic search strategy. This review considers all physiological, pharmaceutical, psychological and social treatments. Thomas and Thurston (Maturitas 2016; 87 49-60) recommend a biopsychosocial approach, where subjective distress and physical factors can coexist (Brotto et al. JSM 2010; 586-614). Yet, methodological issues are rife e.g., obtaining representative samples and limited assessment methods. Further, reviews are narrative with limited synthesis (Marchand SMR 2021; 9(2) 194-211). Frühauf et al. (Archives of Sexual Behavior 2013; 42(6) 915-933) completed a review, but there is no account for research published after 2007 and limited follow-up assessments.

This is the first systematic review of premenopausal anorgasmia with assessment of bias for all treatments. This review is restricted to anorgasmia to better isolate interventions and exclude comorbid conditions.

10 different databases were searched (2007-2021) including studies from peer-reviewed journal articles and grey literature. Results were synthesised in forest plots according to timepoints of data, alongside different treatments to determine effect size from standardised mean differences (SMD). Outcome measures included the self-reported sexual function, sexual distress and clinician observation. The SMD was used as not all scales are consistent across studies. All results given are in line with a pre-defined analysis plan.

Of 1388 studies screened, 15 studies (2002-2020) were analysed: study designs were mixed with mostly self-report measures. Effective treatments included Tribulus terrestris (M=3.77, p<0.01), plasma injection (M=4.48, p<0.01), and CO2 laser therapy (M=4.06, p<0.05). For psychological studies, assessment of active sexual engagement described how subjects felt more aware of their sexuality which improved outcomes. Limitations of most studies included a very high risk of bias, notably in randomisation of subjects, allocation and outcomes. All interventions had a significant effect in independent t-tests, yet synthesis of SMDs show insignificant effect, implying data is inconclusive.

This review aimed to systematically appraise all treatments for orgasmic satisfaction for premenopausal women. Higher levels of significance were observed for treatments across all modalities. The efficacy of natural supplements has been disputed (IsHak et al. JSM 2010; 7(10) 3254-3268), but this review shows promise. All psychological results provided insight into the role of the therapist-client relationship and reappraisal of traumatic sexual experience. Yet, risk of bias is likely impacted by difficulty establishing standardised scientific protocol. Considerations for future research include clear statements of randomisation and multi-faceted outcome measures.

None Declared