Chronic mental illnesses have long periods, are recurring, and require continuous care and, becoming chronic, they double the problems of patients and their family. The study’s purpose is, thus, the development of guidelines for family-centered collaborative care of patients with chronic mental illnesses referring to the medical centers (1).

This mixed methods study is based on the stages of the guideline adaptation provided by the Guidelines International Network (2).

After reviewing and gathering evidence from a qualitative study on key participants and reviewing the literature, which includes a search for articles related to participatory family-centered care of patients with chronic mental disorders and a review of available books, a clinical guide Related and upstream documents of the country were 531 recommendations were extracted and sent to a panel of experts for evaluation.

Providing a family-centered collaborative care guideline will improve the quality of life of these individuals and their families, improve the quality of care, and reduce fragmented health care(3,4).

Development of a clinical guideline for family-centered collaborative care in patients with chronic mental disordersMethods: This mixed methods study is based on the stages of the guideline adaptation provided by the Guidelines International Network .

After reviewing and gathering evidence from a qualitative study on key participants and reviewing the literature, which includes a search for articles related to participatory family-centered care of patients with chronic mental disorders and a review of available books, a clinical guide Related and upstream documents of the country were 531 recommendations were extracted and sent to a panel of experts for evaluation.

Providing a family-centered collaborative care guideline will improve the quality of life of these individuals and their families, improve the quality of care, and reduce fragmented health care

1) Vigo D, Thornicroft G, Atun R. 2016,Estimating the true global burden of mental illness. The Lancet Psychiatry.3(2):171-8.

2) GIN. 2010,guideline Adaptation a source toolkit guideline international network; 95

3) Molu NG, Ozkan B, Icel S. 2016,Quality of life for chronic psychiatric illnesses and home care. Pakistan journal of medical sciences.32(2):511-5

4) WHO. 2014,Integrating the response to mental disorders and other chronic diseases in health care systems. Geneva, Switzerland: World Health Organization; 50 p

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People with severe mental illness have an increased vulnerability to cardiovascular disease due to multilple biopsychosocial factors and a potential adverse effects of longer term treatment with anti-psychotic medications. Treatment of severe and enduring mental illness with antipsychotic medications is likely to cause metabolic changes leading to weight gain and dyslipidaemia, thus increasing risk of cardiovascular disease. Cardiometabolic risk screening can be done using Lester Tool which also provides recommendations for interventions.

To identify the compliance to Lester Tool in the monitoring of cardiometabolic risk factors and intervention provided on acute psychiatry inpatients.

We carried out a retrospective audit of 30 patients on regular antipsychotic medication on an adult inpatient ward in Macclesfield, United Kingdom. Electronic records were reviewed to establish whether the smoking status, lifestyle, BMI, blood pressure, blood glucose and blood lipid were documented with evidence of interventions being provided.

Of all 30 patients, none had shown compliance to all the parameters within the Lester Tool. 100% of the smoking status was documented, amongst which 78% were provided with interventions. 7% has lifestyle and diet status documented, of which 50% were given dietary advice. 80% had BMI documented, amongst which none were provided with any intervention. 90% had blood pressure documented, of which 50% were given any intervention. 40% had blood glucose documented, of which all were provided with intervention. 57% had blood lipid documented, of which none were provided with any intervention.

Our results have shown the need of further awareness on the usefulness of the Lester Tool in an acute inpatient ward. Our recommendation would be to regularly train and educate inpatient staff to ensure that all the necessary parameters be monitored and provided with interventions.

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We present the case of a 41-year-old male patient with multiple psychiatric diagnoses, he was diagnosed with agenesis of the corpus callosum, which explains his clinical presentation.

The objective is to carry out a brief review of the symptoms associated with the agenesis of the corpus callosum.

The patient has been diagnosed with ADHD, cyclothymia, depressive anxiety disorder and social phobia. He has been treated with a multitude of drugs such as antidepressants, anxiolytics, stimulants and even low-dose antipsychotics. Despite the pharmacological treatments received, as well as the therapies, the patient’s functionality has progressively worsened, to the point of restricting going out of the home or maintaining a stable job.

Biographical data were collected, including psychomotor retardation and inappropriate laughter. He showed mannerisms such as fluttering and low frustration tolerance. He was slow to respond to his name and showed little affective resonance with his sister and parents. Restrictive interests, especially with English culture, for which he later studied English philology. On the other hand, his mother explains that he had no symbolic play and that, from early childhood, he had difficulties in relationships with peers.

Due to the aforementioned clinical manifestations, the functional worsening and the examination carried out in the consultation room, it was decided to extend the study with a brain MRI, where an agenesis of the corpus callosum was observed.

Agenesis of the corpus callosum is a malformation of the central nervous system, which affects one in every 4000 births. It can be partial or complete, and occurs between the 7th-20th week of gestation.

Agenesis of the corpus callosum presents with a triad of symptoms:

• - Reduced interhemispheric communication of sensory-motor information.

• - Increased information processing time

• - Difficulty in abstract thinking.

This triad causes difficulties not only cognitively, but also socially. There is difficulty in integrating and learning new verbal and visual information. Tendency to literalism, with difficulty in understanding double meanings. They also have difficulty understanding non-verbal language and reading emotions, which makes interaction with peers difficult. All these symptoms can sometimes be confused with symptoms compatible with Autism Spectrum Disorder.

After the diagnosis and after focusing the patient’s treatment on the most limiting symptoms of his daily life, an integrated approach was initiated, not only at a pharmacological level, with the use of antidepressants and anxiolytics, but also from a psychotherapeutic point of view, working on those areas in which the patient is most dysfunctional. He was accompanied in the disability application process, as well as helped in the search for associations for adults with ASD, finding there the answer to his symptoms and difficulties.

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Caring for individuals with intellectual disabilities is a passionate, but challenging profession. Whether working in residential homes or in occupational facilities, its staff deals with the ordinary issues of teamwork, but also with these clients behavioral comorbidities. It often includes self-harming and aggression towards others – namely towards the staff itself. This is particularly relevant since a high turnover of staff implies the loss of people who are familiar with the needs and specificities of those clients. The quality of care provided may also be affected.

To investigate whether, or not, formal caregivers are at greater risk of occupational health issues, and what their main determinants are.

Research in Medline for intellectual disability caregivers. Only the relevant articles, published in English, were considered.

Among formal caregivers of people with intellectual disabilities, job dissatisfaction and job strain were found to be especially relevant and were associated to the following variables:

• Younger workers or those with less professional experience

• Personality and individual maladaptive coping strategies

• Poor organizational support

• Conflicting, ambiguous, or overloaded professional roles

• Unclear work tasks

The incidence of Burnout Syndrome was also described as relevant among these workers and was associated not only to aggression towards the worker, but also to the fear of aggression.

Caring for people with intellectual disabilities, in a residential or in an occupational context, implies heavy emotional and physical demands and a high prevalence of job dissatisfaction, Job Strain and Burnout Syndrome. In addition to the high risks to the quality of life and health of caregivers, there are consequences for the quality of the care that is provided. For this reason, guaranteeing proper work conditions should be considered part of the Social Institutions main goals. Yet, we lack specific, controlled studies that properly evaluate what measures could indeed help institutions to prevent occupational (and mental) health distress among their staff.

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Autism Spectrum Disorder (ASD) includes a group of developmental disabilities characterized by patterns of delay and deviance in the development of social, communicative, cognitive skills and the presence of repetitive and stereotyped behaviors as well as restricted interests (APA, 2013 DSM 5th ed.).

A 22-years old male outpatient affected by Autism Spectrum Disorder (Level 3) and severe ID presented serious challenging behaviors. The patient did not suffer from other psychiatric or neurologic pathologies. The patient did not have constipation or diarrhea or painful symptoms. The patients assumed carbamazepine (modified release) 800 mg/day (blood dosage 6,8 microgram/ml), clonazepam 2,5 mg/ml 15 drops/day, lorazepam 7,5 mg/die.

Due to the onset of challenging behaviors risperidone was introduced. At the dosage of 2 mg/day, the patient reached a discrete control of challenging behaviors. After stopping risperidone because of oculogyric crisis, the patient started to assume valproic acid (chronic formulation) up to 1000 mg/day. After three weeks the patient presented an increase in the blood dosage of ammonium. After the drug stop, the patient began to re-present challenging behaviors. The authors decided to add topiramate at a dosage of 25 mg per day. After three days, the patient began to present nocturnal urinary incontinence. Topiramate was stopped and Gabapentin was introduced in the treatment up to the dosage of 900 mg/day. Lorazepam was gradually tapered off until the intake was terminated, and clonazepam was reduced to 5 drops/day taken at bedtime. The dosage of carbamazepine remained stable.

Table 1.Behavior Problems Inventory subscales scores

According to the GABAergic hypothesis of ASD, inhibitory signaling of GABA within and between cortical minicolumns appears to be altered. This alteration would result in information processing with high discrimination between correlated stimuli rather than a generalization of them (Casanova et al. Neuroscientist 2003; 9: 496-507). Gabapentin is a ligand of the auxiliary alpha-2-delta subunit site of voltage-dependent calcium channels and acts as an inhibitor of the channel (Sills Curr Opin Pharmacol 2006; 6 (1):108-13). The altered expression of alpha-2-delta 1 or alpha-2-delta 3 can cause a chronic imbalance between arousal and inhibition that is quite characteristic of ASD (Nelson et al. Neuron 2015;87:684-698). The authors want to speculate on a hypothetical function of gabapentin in remodeling the expression of alpha-2-delta subunits in people with autism and the processing of neural information.

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Medical school can be highly stressful and demanding, and negatively impact the well being of the students. Identifying sources of stress and a better understanding of the ways medical students cope can be helpful towards finding ways to increase the quality of life and efficiency of future physicians.

We sought to assess what the main sources of stress and coping strategies are for medical students, as well as how year and socio demographic factors like gender influenced the coping strategies used.

We have performed a cross-sectional study on 489 medical students from Romania that have been asked to complete a survey which included the most common sources of stress, as well as the COPE inventory to assess what are the strategies that students use for coping with stress. Descriptive and comparative analysis of the data was performed using R software.

Most students have reported stress related to learning and the academic setting. The high volume of material to be learned is by far the greatest source of stress for medical students, followed by weekly schedule and methods of examination. First year students are more preoccupied with accommodation and lack of recreational activities, while, comparatively, sixth year students tend to perceive the academic process itself as more stressful. The coping methods used most by medical students are active coping, planning, and positive reinterpretation of stressful events. Fortunately, the least used way of coping with stress is alcohol / drug use, as well as denial and behavioral disengagement, the latter two being associated with poorer academic performance. Compared to their older colleagues, first year students tend to turn more to religion and denial to cope with stress, while sixth year students show more acceptance and active coping mechanisms. Women are more focused on emotions, and tend to use venting more, as well as using emotional support more often than men, while men turn more to humor and psychoactive substances than women do.

The profile of stress sources and coping strategies of medical students differs by year of medical school and is influenced by socio demographic factors. Certain maladaptive coping strategies may affect an individuals’ academic success, yet most students are using active, problem-focused strategies to deal with stress.

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Due to technological advancements, a growing number of tasks can now be accomplished with the help of a screen. However, there may be repercussions to leading a lifestyle dominated by digital screens. Our study determines an association between problematic social media use and an increase in the incidence of negative mental health outcomes.

This paper is a presentation of the mental health issue of young adults related to the use of social media.

Analysis of user behavior.

The frequency of using these networks, the length of time spent in front of the screens, the way these platforms influence the daily activities of the users, the emotional states felt by them and the possible connection between the use of the Internet and face-to-face communication remain real challenges for mental health specialists.

Preventing the occurrence of mental health disorders among young adults in the context of the development of technology remains a topical issue.

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Stigmatization of mental illness by health care professionals is notuncommon, and it represents a source of suffering for patients inaddition to the primary illness.

To research factors influencing family medicine residents perceptions of psychiatric pathologies.

This is an analytical cross-sectional study among family medicineresidents enrolled at the Faculty of Medicine in Monastir (Tunisia),conducted over a period of 3 months (July 2022 to October 2022). TheCAMI (Community Attitudes towards the Mentally Ill) scale was usedto assess the attitude towards mental illness. Sociodemographic datawere collected through a pre-established questionnaire. The data wereanalyzed using SPSS software 26 th version. Percentage comparisonson independent series were performed using the Pearson chi-squaretest.

Our population was made up of 95 family medicine residents, dividedinto 28 males and 67 females. Sex ratio was 2.39. The average of agewas 28 years with extremes 25 and 35 years. 47.4% of residents(n=45) had a positive attitude towards mental illness. The associationbetween this positive attitude and a previous management of apatient with a mental illness was significant (pless than0.05). On the otherhand, there was no significant association neither with the existenceof a personal or family psychiatric history nor with the passagethrough a psychiatric internship of the residents towards mentalillness.

The management of patients with mental illness canreduce the stigmatization of mental illness by health professionals.Measures to raise awareness and create empathetic attitudestowards the mentally ill during physician training are needed toimprove the quality of front-line care.

None Declared

The stigma of mental illness is a complex socialphenomenon that is widespread throughout the world, even amonghealth care professionals.

Assessing attitudes towards mental illness among familymedicine residents in Tunisia

This is a descriptive cross-sectional study among of familymedicine residents enrolled at the Faculty of Medicine in Monastir(Tunisia), conducted over a period of 3 months (July 2022 to October2022). The CAMI (Community Attitudes towards the Mentally Ill)scale was used to assess the attitude towards mental illness. Sociodemographic data were collected through a pre-established questionnaire. The data were analyzed using SPSS software 26 thversion.

Our population was made up of 95 family medicineresidents, divided into 28 males and 67 females. Sex ratio was 2.39. The average of age was 28 years with extremes 25 and 35 years.46.3% (n=44) of the residents were enrolled in the first year, 22.1%(n=21) enrolled in the second year and 31.6% (n=30) enrolled in thethird year. 88.4% (n=84) of the residents did a psychiatric rotationduring their training.We found that 47.4% of residents (n=45) had a positive attitudetowards mental illness.

Improving the attitudes of primary care physicianstowards people with mental illness is necessary to provide goodquality care to these patients

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Asthma is a common worldwide, chronic respiratory disease. It has been shown to impair a person’s health-related quality of life (HR-QoL), but the core influencing factors are not fully understood.

We aimed in this study to evaluate QoL of asthmatic patients and its main determinants.

A prospective single center study was held with asthmatics consulting in the Pulmonology Department a public hospital in Tunisia. A complete structured questionnaire concerning socio-demographic and clinical characteristics were determined. The assessment of asthma control during the last 4 weeks was based on the GINA 2022 report criteria. The quality of life was assessed by the Asthma Quality of Life Questionnaire (AQLQ) scale in its validated Arabic version.

A total of 109 asthmatic patients was included. Most of them were female (N= 73, 67%). Twelve (11%) were current or ex-smokers. The majority of patients (N=101, 92.6%) were active. Thirty-nine patients (35.7%) had comordidities. Asthma were controlled in 40.4% of cases.

The average of AQLQ was4.9±1.2. The most affected domains were environmental stimuli and symptoms with a mean value of 4.6 ± 1.3 and 5.0± 1.3 respectively.

Allergic and uncontrolled asthma and severe disease were significantly associated with the average of AQLQ in the study population with p respectively 0.001, <0.000 and <0.000.

Multivariate analysis demonstrated that factors independently associated with the HR-QoL were : the severity of asthma (OR-0.39, IC95% [-0.62,-0.15], p=0.001) and uncontrolled disease (OR=0.59, IC95%,[-0.87,-0.31], p=0.000).

These results suggest that uncontrolled and severe asthma significantly affect health asthma-related quality of life.

None Declared

Patients who receive primary medical care at the Health Center “La Barca” and its corresponding services receive mental health assistance at the Jerez Community Mental Health Unit (CMHU), which belongs to the Clinical Area of Jerez within the structure of the Andalusia Health Service. A psychiatrist from Jerez CMHU is in charge of the consulting and coordination program with Health Center “La Barca”. Any case that may require mental health assistance is brought for discussion at weekly meetings between primary care physicians and the psychiatrist at the health center, with one of the following case resolutions:

• - Maintain mental health assistance with primary care physician.

• - Refer to the Jerez CMHU for specialized care.

• - Single-appointment evaluation and assistance by the psychiatrist within primary care.

The aim of this descriptive study was to analyze socio-demographic and clinical characteristics of the population assisted through the consulting and coordination program.

Socio-demographic and clinical data belonging to the cases brought to the program was collected between 01/06/2018 and 28/02/2020. An ad-hoc data collection survey was used for this purpose.

Female/Male 53/23. Mean age: 47.13. Only 20% of the cases discussed were referred for specialized care to Jerez CMHU. 65% of the patients attended the appointments given with the psychiatrist within primary care. The most frequent diagnosis were anxiety disorders, adjustment disorders, and dysthymia.

A significant fraction of the cases discussed at the coordination program are resolved within this framework or through a single appointment with the psychiatrist, implying that the program achieves an important optimization of resources, all the while maintaining high quality healthcare. The data suggests that the consulting and coordination program is an improvement in terms of referral protocols within mental health care. A more detailed study would be necessary to confirm and enhance current data.

None Declared

In the last 70 years there has been a massive change in rural versus urban distribution of the population (in the 1950’s only 30 % of the population had been living in urban areas, whereas in 2021 more than 55% were living in urban areas). This mass migration of the rural population, high density cities, traffic noise, severe pollution, high competition have made their mark on mental health, increasing the risk for various illnesses (schizophrenia). On the other hand, rural areas experience high rates of suicide, depression and a lack of access to the mental health workforce.

The goal of this research is to identify the effects of the rapid urbanization on the mental health in rural versus urban areas, as well as the impact of modernization in rural areas.

For this we performed a literature search that synthesizes the newest research on the rural and urban mental health. Review type articles were excluded.

Results show a high frequency of schizophrenia, mood disorders or addictive disorders in urban areas and depression or alcohol dependence in rural areas. However, the improvement of the living conditions (such as Council of the Europe Development Bank), infrastructure, roads, water supply, bridges, sewerage networks have made their mark , modernizing rural economy. On the other hand existing barriers to mental health (desire to receive care, shortage of professionals in mental healthcare, lack of anonymity in treatment seeking, affordability or transportation to care, or even resources to learn) still remain to be addressed.

The modernization of rural areas hasn’t changed the stigma for mental health. There is a need for increasing awareness on the impact of urbanization on mental health.

None Declared

In a broad literature review on the subject we did not find structured interviews in the context of mental health in organizations. However, interviews are in common use in the business field. In Family Science assessment methods of families have fallen into two main categories. The first one is comprised of methods based on the evaluation of family members’ individual answers, while the second is based on the evaluation of group answers. The Structured Family Business Interview (SBFI) presented is based in important systemic studies and psychological practices with families and it belongs to the second method

The purposes of this study is present a structured interview called the Structured Family Business Interview (SBFI) that is a theoretical and practical contribution to access and to promote mental health in organizations.

The Structured Family Business Interview (SFBI) is a structured interview comprised of six tasks which are assigned to the family as a group some of them are hypothetical or role-play type, and they are addressed to a particular family group in the family business.

The relational processes is observed first-hand by the interviewer and by a trained observer who audio-records and documents the non-verbal signals.

This technique was developed and tested in family firm context. In this section we will present illustrative answers to various dimensions studied in a large research project in mental health with family businesses. Results show good indicators of the SFBI capacity to assess dynamic and systemics dimensions of the teams in family firm. Those dimensions are: communication, rules, roles, conflicts, integration and aggressiveness analyzed to promote health resources and human and organizational development. The research with several work teams indicate that it allows for a precise evaluation of the variables.

The Structured Family Business Interview specifically designed for family business takes into account intangible variables described in the organizational management literature like the systemic constructs that has a strong impact on the health of organizations. In addition to the specific contribution to management tools, it is expected that this interview may help to develop new studies and practices about organizational health in work and in family businesses.

None Declared

Military personnel can face unique risks and challenges to their mental health. High-stress situations, prolonged absences, and difficulty adjusting to civilian life can affect their mental health and hence develop psychiatric disorders , particularly major depressive disorder (MDD) and post-traumatic stress disorder( PTSD). That’s why searching for involved factors that could have an impact on these mental disorders or help predict them is crucial in the military population.

Our objectives were to describe the epidemiological profile of military patients followed in the psychiatric department of the military hospital of Tunis (MHT) and to identify the risk factors associated to psychiatric disorders in this population.

This was a retrospective study conducted over a period of 4 weeks , in the psychiatry department of the MHT. We included in our study patients drawn at random at the outpatient clinics, all psychiatric disorders included. We analyzed the epidemiological characteristics of the patients as well as the risk factors with the SPSS software 26.0.

One hundred military patients were included in our study. The mean age of the patients was 38.74(±9.73) years, 93% of them were male, 86% had a high school education, 71% belonged to middle socioeconomic category, and 59% lived in the military barracks. The mean duration of service was 17.68(±9.22) years. Active military members were assigned to weapons jobs (45%), administrative (15%), technical (24%), transportation (8%), and health (6%) specialities.We found that MDD was the main psychiatric disorder found in 64% of the patients with a mean severity of 76.9%. Besides , administrative specialities were the most frequent source of MDD (73.3%), while transportation posts were the most common cause of the PTSD (12.5%). And finally weapons specialties were the most likely to cause adjustment disorders (13.3%). In addition, we found that a long military service duration was associated with a chronic evolution of all the mental disorders (p :0.002).

The army is mostly affected by major depressive disorder . The position occupied by the patient seems to play a role in the type of the disorder . The seniority in the military service would be a risk factor for chronicity of the mental disorder.

None Declared

Lockdowns and social distancing resulting from the COVID-19 pandemic have worsened population mental health and made it more difficult for individuals to receive care. Electronic cognitive behavioural therapy (e-CBT) is a cost-effective and evidence-based treatment that can be accessed remotely. The objective of the study was to investigate the efficacy of online psychotherapy during the pandemic.

The purpose of the present study was to develop and administer an e-psychotherapy program for patients with depression and anxiety d), affected by the COVID-19 pandemic . The program aimed to significantly reduce stress and psychological distress in patients, from pre- to post-intervention.

Participants (n = 59) diagnosed with MDD and/or GAD, whose mental health symptoms initiated or worsened during the COVID-19 pandemic. The online psychotherapy program focused on teaching coping, mindfulness, and problem-solving skills. Symptoms of anxiety and depression, resilience, and quality of life were assessed.

From the participants assessed for eligibility, n = 14 did not meet the inclusion and exclusion criteria and n = 7 declined to participate. As a result, n = 59 participants commenced the study. In total, 21 participants dropped out of the study (n = 11 from Weeks 1-3, n = 7 from Weeks 4-6, and n = 3 at Week 7), and 38 participants completed the study. The large majority of the total sample identified as women (n = 41, 69%). Two participants identified as Other and both dropped out of the treatment at Weeks 4 and 6, respectively. The average age of the sample was 32.26 (SD = 12.67). No significant differences were observed at baseline for any demographic variables or scores of treatment completers and dropouts . A significant difference was observed between the number of sessions completed by those who dropped out and those who finished the program (p < 0.001). On average, treatment dropouts completed approximately 41% of the treatment before dropping out.

Participants demonstrated significant improvements in symptoms of anxiety (p = 0.023) and depression (p = 0.029) after the intervention. Similar trends were observed in intent-to-treat analysis. No significant differences were observed in resilience and quality of life measures.

The evidence strongly suggests that online psychotherapy can supplement the current care model. Although no changes in quality of life or resilience were reported, these findings may be due to the persistent environmental challenges that are outside the normative levels observed pre-pandemic. While the efficacy of e-CBT has been observed across various populations, it is warranted for future studies to investigate the role of gender in treatment availability and help-seeking.

E. Moghimi: None Declared, M. Omrani Shareolder of: OPTT inc, A. Shirazi: None Declared, J. Jagayat: None Declared, C. Stephenson: None Declared, N. Alavi Shareolder of: OPTT inc

Only a few studies analyse the clinical and psychopathological characteristics of first-admitted inpatients regardless of diagnosis.

Describing the psychopathological, demographic, and clinical characteristics of inpatients with acute symptomatology identifying groups with common features using factors extracted from the Brief Psychiatric Rating Scale (BPRS).

We selected 103 (48 F) inpatients from the psychiatric ward of the Sant’Andrea Hospital in Rome from January 2019 to December 2021. We assessed psychopathological characteristics and suicide risk with BPRS, Global Assessment of Functioning, and Columbia-Suicide Severity Rating Scale and gathered the anamnestic and demographic data. We conducted descriptive analyses and factor analysis on BPRS items. Then we used the BPRS factors as variables to perform a cluster analysis.

Major Depressive Disorder (MDD) was the most frequent diagnosis. We obtained five factors: “Psychotic dimensions” (FI); “Anxiety” (FII); “Hostility and lack of cooperation” (FIII); “Depression” (FIV); “Flattening of affectivity” (FV). We identified two clusters (cluster 1 n=31; cluster 2 n=72). Patients in cluster 1 reported higher average scores in FI and FIII while the average scores of cluster 2 patients in FII and FIV were higher than patients in cluster 1. We called cluster 1 “psychotic and hostile patients compulsory admitted with a low risk of suicide”. Cluster 2 patients are “affective patients with a high risk of suicide”. The two clusters share an average age of 38-39 yo and an average GAF score indicating severe impairment and inability to function in almost all areas. They differ in the psychiatric diagnosis represented: respectively, Schizophrenia Spectrum Disorder and Bipolar Disorder with low suicidal risk, MDD, and Personality Disorders with a high suicidal risk. 39% of patients in cluster 1 were involuntarily admitted.

The results of our study show that patients admitted for the first time usually are admitted for psychotic symptoms and a high risk of suicide. Psychotic patients more often show hostility and lack of cooperativeness which can explain the higher rate of involuntary admissions. Patients with predominant affective symptoms show a higher risk of suicide. Our analyses do not consider categorical diagnosis highlighting that exist transdiagnostic groups of patients with specific needs.

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Reducing maternal and newborn mortality is apriority on the health agenda. Priority, integral, integrated and barrier-free care a attention to the population frames the spirit of the route. The Comprehensive Care Route in Perinatal Maternal Health (CRPMH) proposes “to promote health and the improvement of maternal and perinatal health outcomes, through comprehensive health care, including coordinated action FROM the state, THE society and the family on the social and environmental determinants of health inequities” (Minsalud).

To evaluate the implementation of the CRPMH in a group of maternal students from 0-12 months.

Qualitative, through semi-structured interview techniques and focused groups (FG) referenced from the CRPMH (table 1) in 11 undergraduate students in psychology over 18 years from 2 Colombian universities.

Qualitative analysis evaluates convergences/divergences by percentages of questionnaire responses and axial text analysis (FG). In preconception attention 100% of mothers do not report signs of health risk, however, caesarean section was performed in 83.3% of cases, this safer method is perceived for the mother and fetus, and is justified taking into account that the pain of childbirth is very strong (FG).

In gestational health they indicate prenatal control, medical appointments, formation in the condition of the fetus, guidelines on care, respectful upbringing and breastfeeding in 100%. In contrast, the focus group reports low empathy of doctors toward levels their fears, reduced time to address concerns, negative information about labor and satisfaction with medical procedures, considering caesarean section a humanized strategy.

Access to CRPMH is known by 50% of mothers, they do not know the preconceptional consultation. In the GF they conclude that the information on preparation for maternity and paternity is ineffective.

Psychological support is absent during childbirth and postpartum. There is a greater knowledge about breastfeeding 83.3%

The successful implementation of the route could reduce the risks of physical and psychological impact on perinatal maternal health by facilitating decisions about motherhood and its practice in the university educational environment. There was recognition of the clinical factors of the CRPMH and ignorance of the responsibility of the educational environment in its implementation.

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The CCRPMH regulation is insufficient to guarantee its implementation. Risk factors include the quality of service provided by health-care providers and the lack of knowledge of regulations in university management.

None Declared

Scientific disciplines recognize that pregnancy not only refers to the biological dimension. It also constitutes a social category, since sociocultural matrices have implications on what is conceived as the state of gestation (Noguera & Rodríguez, 2008). In this sense, cultures develop protocols to guide the actions of pregnant women and their loved ones regarding self-care during pregnancy in order to contribute to the well-being of mother and child (Carmona, Hurtado and Marín 2007). In this context, the belief category becomes relevant as a form of understanding the ways in which we appropriate reality and intervene it (Peirce, 1903).

To analyze the beliefs that a group of pregnant women belonging to a population group from Montería (Córdoba, Colombia) have about taking care of themselves.

Approach: qualitative. The sample was defined by saturation, for a total of 15 pregnant women affiliated to the Mocarí Hospital in the city of Montería, Córdoba. Instrument: semi-structured open interview; content analysis technique through AtlasTi. Emerging categories: a) care during pregnancy; b) relationships with others.

Main belief: Pregnant women need to take care of themselves physically and psychologically, for which it is necessary to have parents, siblings and partner’s support. Care is based on healthy nutrition, physical activity and mental health prevention. It is assumed that self-care is important for the well-being of mother and child. The importance of the family support networks’ participation is also recognized.

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According to the approaches stated/developed by Peirce (1903), beliefs have implications on the way we behave and intervene in reality. Mental habits function as a link between belief and concrete action. For this research, the beliefs that arise from the sociocultural matrices of the pregnant women are evidenced in their concrete actions.

None Declared

Appropriate and adequate treatment of psychiatric conditions in the community or at first presentation to the hospital may prevent rehospitalization. Information about hospital readmission factors may help to reduce readmission rates.

The scoping review sought to examine the readmission of patients to acute psychiatric hospitals to determine predictors and interventions to reduce psychiatric readmission rates.

A scoping review was conducted in eleven bibliographic databases to identify the relevant peer‐reviewed studies. Two reviewers independently assessed full‐text articles, and a screening process was undertaken to identify studies for inclusion in the review. PRISMA checklist was adopted, and with the Covidence software, 75 articles were eligible for review. Data extraction was conducted, collated, summarized, and findings were reported.

The outcome of the review shows that learning disabilities, developmental delays, and alcohol, drug, and substance abuse, were crucial factors that increased the risk of readmission. It was also established through the review that greater access to mental health services in residential treatment and improved crisis intervention in congregate care settings were indicated as factors that reduce the risk of readmission.

High rates of readmission may adversely impact healthcare spending. This study suggests a need for focused health policies to address readmission factors and improve community‐based care.

None Declared

As one of main aim of broad mental health (MH) reform in Bosnia and Herzegovina (BH), quality of services and continuous improvement are priorities. In last decade network of community services-community mental health centers (CMHC) covered all the parts of the country and is connected with secondary and tertiary medical institutions as well as with broad network of centers for social welfare and growing number of user organizations.

As a novel practice that will be involved in standards of quality for all MH services is joint planning of hospital discharge people with mental illnesses, supported by legislative and connected with other positive results of mental health reform in BH

Review of implementation of results of MH reform in BH with focus on joint planning hospital discharge.

In BH in last decade has been established broad spectrum of services that improved quality of care through multidisciplinary collaboration between sectors. Important role has given to users’ organization. Quality standards are defined trough certification and accreditation. New services were developed or renewed and implemented (such as case management, occupational therapy). Entities’ policies and strategies involved new services and improved MH legislative following the course of more involvement of patients as well as their families, representatives or persons of their trust in decision making and planning of multidisciplinary treatments in the CMHCs. Joint Planning of discharge from the hospital fund as important step in further improvement of quality of care for people with MH disorders, especially for those with severe mental illnesses.

Last decade in BH gave important results in the better quality of MH care. Further plans will be focused on implementation of new MH user-oriented services.

None Declared