In terms of care, family has a major role to play in the evolution of psychiatric illness.

Our aim in this work is to determine the family experience during the hospitalization of their sibling in the emergency room of the psychiatric university hospital Ar-Razi in Salé.

Our aim in this work is to determine the family experience during the hospitalization of their sibling in the emergency room of the psychiatric university hospital Ar-Razi in Salé.

Our work was carried out with families of patients admitted to the emergency department of the psychiatric university hospital Ar-Razi in Salé.

The data collection was carried out with the help of a questionnaire including several items.

Sixty-five family members were included in this study. Their relatives hospitalized in the psychiatric emergency department were male in 70% of cases with an average age of 32.4 years.

• - In 76% of the cases, the family member interviewed was the one who requested hospitalization;

• - 55% of those interviewed were parents.

The analysis of relatives’ feelings during the hospitalization showed:

• - Feelings of guilt were related to feelings of fear of exclusion and worries.

• - Feelings of fear and exclusion were mostly expressed by mothers of patients hospitalized for the first time

At the end of the hospitalisation, 90% expressed relief, and 85% of family members were satisfied with their relative’s stay in the psychiatric emergency department.

Recognizing families as units of care and understanding their situation and experiences facilitates the post-hospitalization care process. A well-informed family about mental illness and the types of therapeutic treatments available helps optimize the treatment.

None Declared

The COVID-19 pandemic has changed social, family, and interpersonal relationships and behaviors. Several studies have identified the increase in psychiatric disorders in the general population (Fountoulakis et al. Psychiatry Res 2022; 315 114702) and an increase in episodes of disease in people already affected by these diseases (Taquet et al. Lancet Psychiatry 2022; 9 815-827; Zhu et al. Adults Psychiatry Res 2021; 301 113959). These episodes were accentuated by the severe limitations that occurred during the greatest peaks of the pandemic. However, few studies have evaluated the effects of these restriction periods on the levels of hetero or self-directed aggression in patients staying in residential facilities.

To evaluate the effects of the COVID-19 pandemic on aggression and psychomotor agitation crises in patients hospitalized in a psychiatric rehabilitation centre.Evaluate the differences in these behaviors in the different stages of external limitation in patients suffering from psychiatric disorders.

This observational study was conducted in a residential psychiatric rehabilitation facility since the outbreak of the COVID-19 pandemic in Italy (March 2020 through September 2020). 354 patients were enrolled in the study. All guests had psychiatric disorders defined according to DSM-5 diagnostic criteria. Table 1 shows age mean and diagnosis at admission.

The several periods were recorded in the number of cases of psychomotor agitation and heterodirect aggression and an increase in emergency pharmacological interventions.

The following rating scales were administered in all patients: BPRS-18, BPRS Agitation (item item 6 tension + 10 hostility+ 17 excitement), GAF, and Epitrack.

The collected data were collected and statistically analyzed with the EZAanalyze 3.0 software in the Microsoft Excel Office.

In tables 1 and 2 and in Graphics 1 and 2 the results obtained from our study are shown. We observed a reduction in the number of agitation and aggression episodes in periods 1, 3 and 6 (4, 12 and 5, respectively). In these same periods, the BPRS agit subscore score was also lower than in the other periods (7.92, 8.08, 7.42, respectively).

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Differently to expected data, the number of episodes of psychomotor agitation and heterodirect aggression proved to be reduced in the periods of greater restraint and limitation. Instead, the levels increased in the month following the reduction of such restrictions characterized by visits with family members, planned outings. it is difficult to give a reliable and definitive explanation to these results. However, the feeling of protection, risk reduction and potentially dangerous stimuli could guide the explanation of the results obtained.

None Declared

The fundamental principle of medical ethics is based on the principle of autonomy, of which consent is part, in addition to the right to information and the free choice of caregiver by the patient. In the psychiatric emergency department, the psychiatrist is confronted in his daily practice with the decisions of outpatient or hospital care, sometimes without the consent of the patients, in particular when the disorders hinder their capacities for self-assessment and judgment or when he there is a vital prognosis involved.

It is therefore important to know certain basic legal rules in order to better manage these emergency situations.

Literature review

Patients requiring care in the emergency department present particular challenges to ensuring valid consent. Patients often present in a crisis situation and their abilities may be altered by, for example, psychoactive substances or impaired judgment. These patients are cared for by clinicians who may have to make urgent decisions based on incomplete information. The emergency department can be a disorienting and frightening environment for patients. The following aspects of consent: autonomy and capacity, are particularly relevant to care in emergency departments.

The interplay between emergent need, presumed incompetence, implied consent, and societal interest, as well as the individual details of each case, are all important in making the right ethical and legal decision in an emergency situation. given, because the emergency situation does not allow any delay in the decision-making process.

None Declared

Phenibut is a synthetic γ-aminobutyric acid (GABA) agonist used to treat symptoms of mental disorders like anxiety and insomnia. The substnce is licensed and widely used in Russia. Its recreational use is increasing in many countries as it is easily accessible online. In a recent years, several case reports of phenibut intoxication and withdrawal have been published worldwide.

We present a case report of intoxication with phenibut in a patient with psychoactive substances use disorder on regular methadone substitution therapy.

A 40-year-old male was hospitalized for the first time in the psychiatrc ward due to intoxication with phenibut. Before admission, he was confused, with incoherent speech. Bradypnea and somnolence were observed. A urine screening test was positive for methadone and benzodiazepines, while there was no information on phenibut intake at that time. After receiving naloxone, the patient became, agitated and haloperidol was introduced.

The main symptoms of phenibut intoxication, which have also been described in other cases, are cardiovascular effects, insomnia, anxiety, agitation, hallucinations, and reduced level of consciousness. In our case, a more heterogeneous clinical picture of intoxication was observed, due to the simultaneous use of methadone and other PAS.

The availability of various synthetic substances available online is constantly increasing. Their use is most common in the population with substance use disorders, in patients on substitution therapy and in patients with mental disorders in general. The clinical picture of intoxication can thus be very diverse and atypical, which requires increased attention from clinicians.

None Declared

Workplace violence (WPV)has been a persistent problem that is underestimated and generally disregarded by the public and professional organisations, and it has been noticed that the highest number of these assaults are directed towards healthcare workers.

The aim of the study is to determine the prevalence of workplace violence against nurses in psychiatry hospitals in Oman and to explore the determinants contributing to the workplace violence

This is a cross-sectional study was conducted at two tertiary mental health care hospitals (Al Masarra Hospital and Sultan Qaboos University Hospital) in Muscat, Oman between October, and December of 2021.Participants were asked to complete the Workplace Violence in the Health Sector to assess level of violence, as well as a sociodemographic survey.

This study included 106 participants with 80% response rate. The Majority of participants aged between 30-39 years. Of this study, 52.8% werefemale and most of the participates are Omani (73%) and working in inpatient (80%). The highest type of violence experiences was verbal violence 86.8%followed by physical violence 57.5%. Most physical violence incidents 26.4% took place during weekdays with highest incidences happened during morning shifts (34%) followed by afternoon shift (25.5%).

Current study revealed a relatively high prevalence of WPV among nurses working at psychiatric hospitals in Oman. Future studies needed to explore the predictors of violent among nurse. It is important to invest in the prevention of WPV by constant training of workers in mental hospital in Oman on how to respond to violent psychiatric patients.

None Declared

The suicidal phenomenon constitutes a real public health problem not only by the human losses it causes, but also by the psychological and social problems to which it testifies.

The objective was to describe suicide attempts in patients hospitalized in the emergency room.

A descriptive cross-sectional study was carried out with patients admitted to vital emergencies for attempted suicide over a period of 6 months.

We excluded Patients with major cognitive impairment, which prevents understanding of the questionnaire

A data collection sheet was used for the evaluation of the suicide attempts.

Our sample consisted of 101 suicide attempts. Using non-physical methods (drugs, caustics, pesticides, gases) was reported in 91.9% of cases and while physical methods (hanging, phlebotomy, drowning) in 8.9% of cases. Self-poisoning by medications was the most frequent (51%) method used in suicide attempt. The majority of suicide attempts were reactive (77.2%). Family or marital conflicts were the precipitating factor most mentioned (74%). The suicidal act was unpremeditated in 66% of cases. Communication of suicidal intent either verbally or in writing was reported in 34.7% of cases. The passage to the suicidal act was preceded by taking alcohol in 7% of cases and cannabis in 3% of cases. In 44.6% of cases, regret was the attitude most adopted by suicide attempters towards the act. The somatic state on admission was unstable on the cardiac level in 23% of the cases, on the respiratory level in 27% of the cases and on the neurological level in 38% of the cases

The data from our study suggest that suicidal attempts were mostly unpremeditated. Clinicians should not minimize the significance of impulsive attempts, as they are associated with a similar level of lethality as premeditated attempts

None Declared

Mental health in the workplace is a rapidly developing field of research, which involves the well-being of the individual on a psychological and social level. However, this balance can be suddenly disrupted and can have such a repercussion that the individual finds himself unable to do his job. In this case, he can benefit from a work stoppage called long term sick leave, governed for the public sector, by the decree number 59-239 of August 24, 1959.

To study the socio-demographic and clinical profile of public sector employees who have been on long-term sick leave and examined as part of the assessment of their ability to work.

It is a retrospective study that focused on all public sector employees on long-term sick leave, examined as part of the evaluation of their ability to work in the psychiatric service CHU MAHDIA during the period from January 2013 to April 2014.

We collected 73 patients. The mean age at the time of the examination was 51.1 years. There was a clear female predominance 67% and the sex ratio was 0.48. The vast majority were married (71%), of average socioeconomic status (52%) and high school level (43%). Most of the patients (67%) were from the Ministry of Public Health, followed by the Ministry of Education with 26% of the study population. The average length of service was 20.4 years with extremes between 3 and 36 years. The average length of leave was 13 months. The most frequent diagnosis of the prescribing physician was adaptation disorder (41%), major depressive disorder (27%). Somatic comorbidity was found in 38% of cases, dominated by hypertension, diabetes and cervicarthritis in 50%, 28% and 18% respectively. At the end of the leave, 82% of the patients were able to return to work. For the other patients, a professional reclassification was necessary.

Long-term sick leave has a heavy economic burden for society and serious socio-economic and psychological repercussions on the patient. Hence the interest in identifying vulnerable subjects and jobs at risk in order to prevent the occurrence of psychopathological disorders.

None Declared

Tobacco use among youth is a real public health concern in most developing countries. To provide recent epidemiological data regarding tobacco use among this specific population, a national survey was conducted in Tunisia in 2021. We aimed to determine cigarette smoking prevalence in Tunisian adolescents and assess associated factors.

We aimed to determine cigarette smoking prevalence in Tunisian adolescents and assess associated factors.

Data from the Mediterranean school survey on alcohol and other drugs (MedSPAD 2021) were used. Based on three-stage stratification sampling method, first and second grade high school students were enrolled. A self-administered standardized questionnaire was used and weighted prevalence estimates for cigarette smoking “at least once in a lifetime” were studied. Binary logistic regression model was used to assess associated factors and Adjusted Odds Ratios (AORs) were presented. The independent factors included were: sex, area of residence, private or public sector, alcohol and cannabis use, and being exposed to tobacco smoking in family and peer’s environment. Epidata and STATA software were used for data entry and statistical analysis, respectively.

Among 6.201 participants with a mean age of 16.8 years, 60.4% were girls; the prevalence of cigarette smoking was 24,75% 95% CI [23.24,26.32], significantly higher among boys (41.1% versus 14.2%, p<10-3). Univariate analysis revealed a significant difference in cigarette smoking by region (p-value< 10-4). The highest prevalence of cigarette smoking was observed in the capital city. Cigarettes were perceived as easily accessible by less than a third of the students (38.46% and 20.94% of boys and girls respectively, p=10-4). In multivariable analysis, the only independently associated factor to this behaviour was male sex (AOR=1.5[0.15 – 2.9], p-value=0.03).

Our study revealed a high prevalence of smoking among students with male sex as an associated factor. Developing a healthy school environment and implementing school-based intervention programs are therefore, highly required.

None Declared

Despite its well-known acute and long-term harmful effects on a person’s mental health and well-being, alcohol remains the most commonly used psychoactive substance among adolescents after tobacco products in many countries.

We aimed at studying the prevalence of alcohol use, and identify associated factors in Tunisian high school adolescents.

We used national data from the 2021-Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD). Based on a clustered two-stage stratification sampling method, a representative sample of teenagers aged 16 to 18 years, was selected. Data collection was performed using a self-administered standardized questionnaire, assessing socio-demographic characteristics and risky behaviours, and including questions about alcoholic beverages patterns of use. Binary logistic regression model was used to assess associated factors and adjusted Odds Ratios (AORs) were presented with 95% confidence intervals (CI). Cspro software was used for data entry and all statistical analysis were performed with STATA software.

A total of 6201 adolescents with a mean age of 16.8 years and a sex ratio female/male of 1.5 were enrolled.

Lifetime prevalence of alcoholic beverages consumption was 8.0%, 95% CI [7.0, 9,1] (n=6196). The prevalence of alcohol consumption during the previous year and month were 5.1 % and 1.7% respectively. Cocktails and beer were the most frequently consumed beverages.

Prevalence of alcohol use was significantly associated with tobacco, cannabis and e-cigarettes use (AOR 9.5, 6.0 and 1.9 respectively; p≤10-3), a higher frequency of nights spent away from home, school absenteeism for non-medical reasons and enrolment in the private sector.

Alcohol intoxication was reported by 2.9% of respondents during their lifetime.

Early onset was reported by 17.2% of respondents for alcohol use and 10.1% for alcohol intoxication.

Although the prevalence of alcohol use was relatively low among Tunisian adolescents compared to European adolescents, early onset- indicating an increased risk of developing an alcohol use disorder- warrant the implementation of primary prevention interventions through mental health promotion and life skill trainings to halt these trends and avert the raising burden of morbidity and mortality attributable to alcohol use.

None Declared

Self-stigma refers to the process in which a person internalizes negative stereotypes, beliefs, and prejudices about their mental illness, adopting a stigmatized view of themselves. Severe mental illness is one of the most socially exclusive stigmata and is associated with poor clinical and functional outcomes and social withdrawal.

In Portugal, investigation regarding self-stigma is scarce. In this study, we aim to evaluate the impact of self-stigma among people with diagnosis of severe mental illness (SMI). For this goal we assess the prevalence of self-stigma of psychiatric patients with diagnosis SMI; and investigate the correlates of elevated self-stigma levels.

Fifty-one outpatients with SMI, were recruited from a community psychiatry unit from Porto, Portugal. After informed consent, evaluations included sociodemographic data, illness characteristics, and self-reported standardized scales. Self-stigma (ISMI), self-esteem (RSES) and quality of life (WHO-QoL) were assessed. Data analyses were performed using the SPSS version 28.0 (IBM Corp., Armonk, NY). p-values<0.05 were considered significant.

From the study sample, 66.7% were male, with mean age of 44.8±11.0 and 56.9% were single. 33.3% reported living with their parents while 31.4% were living with a partner/spouse. The majority of participants had a diagnosis of schizophrenia (60.8%). Concerning the level of education, 58.8% completed basic education, but most patients were retired due to illness (62.7%). In this study, moderate to high self-stigma levels was found in 31.4% participants. Proportion of elevated self-stigma was significantly higher in unemployed/retired patients vs. those who were active (39.0% vs. 0%; P=0.021). No significant correlations were found with age, level of education, age at diagnosis, duration of illness, and number of hospitalizations. In the correlations analysis, a negative correlation between self-stigma and self-esteem (rho=-0.745; P<0.001), as well as self-stigma and quality of life (rho=-0.585; P<0.001) was found. A positive relationship between self-esteem and quality of life (rho=0.551; P<0.001) was found.

This study investigates, for the first time, the prevalence of self-stigma among outpatients with SMI in a community psychiatric unit from Porto. Our findings suggest a high prevalence of elevated levels of self-stigma among these patients. A significant association with being unemployed/retired was also found. Our results support previous evidence that internalized stigma is strongly associated with diminished self-esteem and impaired quality of life, in particular those aspects related to physical and psychological complaints. Targeting internalized stigma and self-esteem among patient with SMI will likely improve their quality of life, besides improving their clinical and functional outcomes.

None Declared

Multiple sclerosis is considered one of the leading causes of neurological non-traumatic disability among young people. Given the chronic progressive nature of the disease, psychiatric disorders are more prevalent among those patients as reported in the literature; however, the data in Saudi Arabia is lacking.

The study aimed to estimate the prevalence of psychiatric disorders among MS patient in Saudi Arabia.

This was a cross-sectional multi-centered study, including patients with multiple sclerosis. Participants were interviewed and asked to fill a validated survey that consisted of demographics, Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Descriptive statistics were performed, and the analysis were made using Chi-square, Fisher’s exact, and ANOVA tests as appropriate.

A total of 192 participants were included in the study. Based on a cutoff score of > 10 in the GAD-7 and PHQ-9 scales, the prevalence of anxiety was 26.1% (n-50), with majority of the participants having minimal anxiety (40%); meanwhile, the prevalence of depression was 42.7% (n=82), and most of them had mild depression (30%). [table 1, image 1 and 2] Females participants significantly scored higher in GAD-7 and PHQ-9 compared to males (p-value= 0.0376 and 0.1134, respectively). [table 2 and 3] In addition, no significant association was detected between functional disability (EDSS score) and the prevalence of anxiety and depression.table 1

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This study reported high level of anxiety and depression among MS patients, with females being more affected. Since these co-morbid disorders could affect the disease course negatively, screening is of paramount significance.

None Declared

Growing attention has been drawn to workplace violence in healthcare settings and toward healthcare workers. Emergency departments have always been vulnerable to workplace violence since its is usually associated to working with people in extreme distress. Healthcare workers facing numbers of situation with either verbal or physical abuse may face an impact on their mental health.

Describe the psychological impact of workplace violence towards nurses in the emergency department

This is a questionnaire-based cross-sectional study including nurses working in the emergency department of different hospitals of Tunis. The respondents’ data were collected from March 2022 to September 2022.

We included 164 nurses. They were mainly women (Sex ratio of 0.6) with a median of age was 30.7±7.6 years. Nineteen nurses had history of one or more mental disorders such as anxiety disorder (12 cases) and depressive disorder (11 cases). All nurses were victim of workplace violence, while most (104 nurses) were witness to at least one act of violence. Study population had different degrees of concern about safety in workplace, 29.8% had little to no concern while 29,9% were mildly concerned and 40.2% were severely concerned for which they felt their security compromised (14.6% often and 12.2% always). Violence in workplace had consequences on the quality of their service for 26.8% of nurses. Many (49.4%) felt prejudice on their mental health contrasting with little resort (14%) to mental health providers. Number of nurses presented nightmares (44 cases), avoidance (56 cases) or flashbacks (48 cases) about workplace violence. Psychosomatic symptoms were described by most of the study population (58.5%) such as throbbing (46 cases), nervousness (56 cases), aches (23 cases), fatigue (29 cases) or non-specific digestive signs (17 cases).

Workplace violence in emergency departments, first interface of the care chain, is a real problem with serious consequences. Healthcare workers are forced to provide care in situations that compromise their health and safety. Implementing a national action plan is essential in order to address this dangerous phenomenon.

None Declared

Paramedical staffs in oncology are among the most exposed to stress factors in the workplace, predisposing them to develop certain psychiatric pathologies, in particular anxiety disorders, depressive syndromes and burnout.

The objective of this study was to study these psychosocial risk factors and to detect the psychological repercussions on this professional category.

Our cross-sectional, mono-centric, descriptive and analytical study was conducted between November 1st and 8th, 2022 at the Salah Azaiez Institute in Tunis. The screening of anxiety and depression was performed with the Hospital Anxiety and Depression Scale (HADS), the assessment of Burnout was performed with the Maslach Burnout Inventory (MBI).

Fifty-four workers were included (mean age 39.72 years and sex ratio 0.22). According to the HADS scale, 68.5% had definite or doubtful anxiety symptoms, 51.8% had definite or doubtful depression symptoms. According to the Maslach scale, 59.3% had a high burnout score, 37% had a high depersonalization score and 38.9% had a low personal accomplishment score. A combination of all three was present in 7.4% of the staff. Anxiety was associated with workplace violence and lack of career prospects, depression was associated with lack of leisure activities, and burnout was associated with age, emergency management for the emotional exhaustion score, and the number of children, workload and workplace violence.

Working in an oncology environment seems to be associated with a number of factors that could significantly increase the risk of psychiatric pathology. Some of these factors are perfectly modifiable, which opens up prospects for targeted preventive actions.

None Declared

Child abuse, sometimes referred to as child abuse and neglect, includes all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child’s health, development or dignity. Child abuse with all its forms is under reported globally in developed and developing countries. The extent of the problem is difficult to ascertain since most of the victims remain silent thus, assessing its prevalence and effects on children is crucial.

To assess the association between child abuse with poor school performance considering related variables including family instability, home environment, and school environment.

This study included 504 participants: 168 cases and 336 controls. Controls were matched for age and gender. Both groups were tested for marital or family instability, home environment, school environment, peer and teacher maltreatment using bi-variate analysis. Test of significance of the result was estimated by confidence interval. Quantification of each factor effect and the interrelationships between all factors that affect academic performance was calculated using multivariate analysis by multiple logistic regressions.

After controlling for confounding factors using a multivariate analysis model, the following was found: a significant increase in the risk of poor academic performance in children who were subjected to maternal physical neglect compared with children who were not (OR= 3.106: CI 95%=1.875-5.147), and in children subjected to maternal emotional neglect compared with children who were not (OR= 1.968: CI 95% = 1.200- 3.226). No association was found between maternal emotional/verbal or physical abuse and poor academic performance.

There is a significant increase in the risk of poor academic performance in children subjected to paternal emotional verbal abuse compared with children who were not (OR= 4.534: CI 95% = 1.833 - 11.214), but the result illustrated no association between paternal physical abuse and poor academic performance.

The risk of poor academic performance is significantly higher in children exposed to frequent parental conflicts or physical abuse from teachers compared with children who were not. There is a significant increase in the risk of poor academic performance in children who experienced maternal physical and emotional neglect and paternal emotional/ verbal abuse. Higher levels of parental education, feeling safe at home, and feeling happy may be protective factors.

None Declared

In 1830, Charles-Albert Perret-Porta, director of a Swiss mental asylum, said « it is especially at birth that alienation is curable ». This assertion dating back more than two centuries ago proves to be close to today’s clinical practice, as biological, social and psychological damage can be irreversible in the case of a delay in adequate psychiatric treatment. The emergence of the « Duration of Untreated Psychosis » concept is worth mentioning, as it is confirmed to be one of the determining factors in the psychotic disorders’ clinical outcome and prognosis.

Despite the risks incurred, many patients that suffer from psychiatric disorders still benefit from late adequate care, for various reasons.

The objective of this study is to identify the different causes of delay in psychiatric consultation in the Moroccan framework, in order to promote early intervention strategies by taking into account and acting on these different factors.

This is a retrospective descriptive and analytic study carried out at the Arrazi University Psychiatric Hospital in Salé, having collected information from 101 patients (69,3% being inpatients).

The analytic part of the study was performed by JAMOVI.

The descriptive analysis showed that the mean age was 36 years ± 11,2. 73,3% were men. 68,3% of the patients were single, 18,8% were married, 11,9% were divorced and only 1 patient was a widow. 87,1% were living in the urban area. 23,8% attended higher education. 61,4% of the patients were unemployed. Patients were diagnosed with the following disorders, according to the DSM-5-R: Schizophrenia (73,3%), major depressive disorder (8,9%), schizoaffective disorder (6,9%), anxiety disorders (5,9%), bipolar disorder (4%), brief psychotic disorder (1%). The median of the first consultation period was 240 days [60,730]. The main causes of first consultation delay were: Lack of awareness about mental illness (34,7%), religious beliefs (33,3%), mental illness denial (10,7%).

There were no associations between the first consultation period and age (p=0.701), sex (p=0,929), diagnosis (Schizophrenia: p=0,420; anxiety disorders: p=0,569; Major depressive disorder: p=0,570; schizoaffective disorder: p=0,855; Bipolar disorder: p=0,624), human settlement (p=0,174).

Mental health and psychiatry are still facing stigma in the Moroccan framework and many others developing countries, which hampers medical care for patients suffering mental illness, leading to both poorer prognosis and clinical outcomes.

Prevention campaigns promoting early intervention strategies should be a subject of concern among public health workers to overcome stigma in the perspective of improving medical care of mental illness.

None Declared

Therapeutic non-adherence is a problem frequently encountered in patients suffering from psychotic disorders. It has consequences on the quality of life and on the prognosis of the evolution of the disease. It is essential to understand the causes in order to best support the patient towards adherence to care.

The objective of the study is to evaluate the therapeutic observance of patients hospitalized in the women’s department of the psychiatric hospital and to collect the reasons for therapeutic non-observance, as well as to identify the desired themes for the implementation group therapeutic education workshops.

It is a monocentric and prospective study, carried out in the women’s department through individual interviews on day 7 +/- 2 of the admission of patients to the psychiatric hospital of Tangier. The inclusion criteria are:

• - the patient’s consent,

• - the autonomous taking of a treatment before admission,

• - sufficient communication skills

The psychometric tool used during this study is the MARS scale (Medication Adherence Report Scale) which allows the patient to assess his compliance, by answering 10 questions, assigning himself a score between 0 and 10 with a good compliance from 8/10. The discussion following the questionnaire makes it possible to identify the reason(s) for non-compliance and the themes to be addressed to improve compliance.

Our first initial results were calculated from 60 patients admitted to hospital. Among them, 35 met the criteria for inclusion in the study. The interview takes place within an average of 8.0 ± 2.3 days. The average age is 40 ± 15 years. Patients present with schizophrenia in 80% of cases, bipolarity (8%) or borderline personality disorder (3%). Nine percent of patients have no diagnosis. Patients take an average of 2.5 drugs [1; 5] before hospitalization. The average MARS score is 5.6 ± 2.6. The reasons for non-adherence identified by patients are:

• - The presence of side effects,

• - Lack of means

• - Feeling of healing

• - The weariness of a long treatment

• - Inefficiency,

• - fear of interactions in case of toxic consumption

• - five patients declared observing and did not identify any reason for non-compliance

Our study has made it possible to better understand the difficulties and support needs of patients to improve their adherence to care. As a follow-up to this work, a multidisciplinary discussion will allow the setting up of group therapeutic education workshops around the identified themes.

None Declared

Coercion in psychiatric wards may improve the safety of patients and surroundings, on the other hand, its use affects compliance and satisfaction with treatment. In Poland the coercive measures are strictly regulated by The Mental Health Act (1994). Most of published studies refers to the coercion only during hospitalisation.

Assessment of the extent of coercive measures in psychiatric emergency room and evaluation of the relationships between the use of direct coercion and selected demographic-clinical factors.

This study was conducted at the Bielanski Hospital in Warsaw on all the patients admitted to the psychiatric ward over one year. The extent of coercion in the psychiatric emergency room, demographic and clinical data were collected. Patients were assessed in Brief Psychiatric Rating Scale (BPRS) prior to admission. Patients’ sociodemographic and clinical factors were tested in a multivariate logistic regression model.

In the study 318 patients were included. Coercion of some form in the psychiatric emergency room was used in 29% of cases: admission without consent in 22% of cases and direct coercion (holding, forced medication, mechanical restraint) in 7%. Use of direct coercion in the psychiatric emergency room was associated with BPRS scoring: positively with severity of disorientation symptoms and negatively with severity of depression symptoms. Suicide attempts in the past were discovered to reduce the risk of being a subject of coercive measures. We found no demographic data associated in any way with coercion use.

Coercion in psychiatric emergency room was related to patients’ mental state and their past medical history. There is no evidence of coercive measures misuse towards any demographic group.

None Declared

Delusions and hallucinations are common in schizophrenia and related psychotic disorders and they are frequently reported at the first admission to psychiatry departments.

The study aims to examine the themes and frequency of delusions and hallucinations in first admitted patients.

Information was collected retrospectively from selected medical files of patients who were admitted for the first time to the department of psychiatry "A" of the university hospital Hedi Chaker, in Sfax, during the years 2020 and 2021.

Ninety patients were included in our study. Their mean age was 34.79 ± 11.4 years, with a sex ratio (M/F) = 1.3. They reached high school in 51.1% of the cases. Half of the patients were smokers, 30% used alcohol and 16.7% used cannabis.

The average age of onset of the disorders was 30.36 years, and the duration of evolution of the illness before hospitalization was 56.54 days. The most common reason for hospitalization was environmental violence (62.5%). The diagnosis of schizophrenia was retained in 32.2% of the cases, and that of bipolar disorder in 23.3% of the cases.

At initial presentation to the ward, 72.2% of patients were found to have delusional beliefs. The most commonly held delusions were delusions of persecution (62.2%), reference (28.9%) bewitchment (27.8%) and grandiosity (26.7%) with changes of behavior in 34.4 % of the patients in response to their delusional beliefs.

Hallucinations reported by 43.3% of the patients were mainly auditory (30%), visual (20%) and 15.6% reported hearing internal voices. Olfactory hallucinations were only reported by 3.3% of the patients.

Delusions of persecution and reference appear to be the main delusional themes in this patient group. Auditory hallucinations were also commonly reported.

A better awareness of clinical presentations of the first admitted patients may aid early identification of the illness and engagement of the patients in the treatment process.

None Declared

Mental illnesses affect one in eight people in the world according to the WHO in 2019. They are a leading cause of morbidity and a major public health problem. Stigma harms the quality of life of people with mental illness.

Our study aimed to evaluate the association of mental illness stigma with socio-demographic characteristics in Tunisian students.

This is a cross-sectional study conducted on Tunisian students who anonymously completed a form circulated online through the groups and social network pages related to each academic institution. The form was containing an Arabic validated version of the “Mental Health Knowledge Schedule” (MAKS) and the “Reported and Intended Behaviour Scale” (RIBS) along with a sociodemographic questionnaire.

We have included 2501 Tunisian students with a sex-ratio Male/Female of 0.37. The mean age was 21.57 (±2.55) ranging from 17 to 42 years. Participants’ fields of study were: Science and Technology (58.7%), Literature (17,4%), Economics and management (15.8%), and Arts (4.8%). Among them, 17.1% had a history of family psychiatric disorders and 17.6% had a psychiatric disorder. Besides, 20.9% of the students were using tobacco and 75.6% of them were religious. We also found that 26.7% of participants had previously attended an awareness session. Several determinants had a statistically significant association with the stigma of mental illness in our study population. We noted that females had higher mental health knowledge scores (p=0.001), while males had higher behavior scores (p=0.002). Moreover, students in the scientific and literary fields had higher scores on both MAKS (p<10-3) and RIBS (p<10-3). In addition, we found greater knowledge of mental illness and less discrimination among participants with a psychiatric history (p=0.013 and p<10-3 respectively) and among those who had previously attended a stigma awareness session (p=0.020 and p=0.002 respectively). We also noted higher behaviour scores among people with substance use (p<10-3) and lower scores among people with religious beliefs (p=0.009).

Our results show a multiplicity of factors related to mental illness stigma that we can target in anti-stigma strategies. Addressing stigma is a long-term effort; small and large-scale interventions should be considered and evaluated on an ongoing basis to strive for a better future.

None Declared

The University Clinic of Skopje – Skopje was part of two Horizon 2020 projects – IMPULSE and RECOVER-e that finished in December 2021. The advances in the field of community mental health in the capital of Skopje, the idea to combine the best aspects of the aforementioned projects and the need of continual implementation and research on an evidence-based community-based service delivery model for recovery-oriented care led to this study which aims to improve functioning, quality of life, and mental health outcomes for people with severe and enduring mental ill health, such as schizophrenia, bipolar disorder, severe depression.

The objectives of the study are: - to design, implement and evaluate recovery-oriented care for people with severe mental illness in community settings using a psychosocial digital intervention - DIALOG+;- to recognize the value of experiential knowledge through inclusion of peer experts as members of community mental health teams;- to develop scale-up plans for national decision-makers, as informed by the intervention’s implementation and impact, for sustained implementation and scale up after the research study’s timeline.- to improve the conditions of people suffering from psychotic disorders and to overcome financial barriers encountered in the treatment of psychotic disorders in N. Macedonia.

DIALOG+ represents an affordable and effective intervention which has already demonstrated positive outcomes in previous research. This study involves the use of the DIALOG+ intervention during home visits, so that patients themselves can decide which aspects of their life that they would like to discuss and work on improving. DIALOG+ lets them rate 12 domains that are related to quality of life, such as physical health, relationships and employment. Patient decide which of these they would like to discuss in detail during the meeting. There is then a 4-step approach to help improve this aspect of their life, using the principles of solution-focused therapy. Researchers will collect information about demographic characteristics, quality of life, and symptoms in patients taking part in the study through the administration of questionnaires and clinical scales.

The study is still in phase of completion. The results will be shown at the EPA Congress 2023.

Having the previous positive outcomes from IMPULSE and RECOVER-e, with this combined approach we expect even more improvement in functioning and better quality of life in patients suffering from severe and enduring mental ill health.

None Declared