As all first line options in treating First Episode Psychosis (FEP) are similarly effective there is a consensus among prescribing guidelines that clinicians and patients should consider side-effect profile as the ‘driver’ of initial choice of antipsychotic. Anecdotally it has been observed that different care teams prescribe particular medications preferentially.

To evaluate the patterns of antipsychotic prescribing in patients with FEP at the time of initial treatment and over the first year with the Early Intervention Service (EIS).

Medical records of all patients who had completed 1 year of follow-up with EIS in Sussex Partnership Foundation Trust (n=274) were reviewed. The first antipsychotic prescribed and antipsychotic prescribed at 12-months was recorded alongside initiating care team (EIS, non-EIS community services, inpatient services).

99% (n=272) of patients were prescribed an antipsychotic. 46% were initiated by inpatient serves, 40% non-EIS community services and 14% EIS. Aripiprazole, olanzapine, quetiapine and risperidone accounted for 95% of initial prescriptions. Different care teams prescribed antipsychotics preferentially (p=<0.005) (Fig.1). Rates at which initial medication was continued at 12-months varied according to initial prescription (P=<0.05) (Fig.2).

The frequency that specialist EIS services prescribed aripiprazole as initial treatment contrasts the preference for olanzapine in other services. Olanzapine has a significant metabolic side effect profile, is sedating and was least likely to be continued at 12 months. This raises questions about why non-FEP specialist services prefer olanzapine and whether EIS services can support these services around initial medication choices more likely to be continued throughout the key first year of treatment.

No significant relationships.

Paliperidone Palmitate 3-month formulation (PP3M) has shown a significantly longer time to relapse compared to placebo, with similar efficacy and safety to Paliperidone Palmitate 1-month (PP1M). However, studies of longer duration are required.

The main objective of this study is to determine the effectiveness of PP3M in the prevention of hospitalizations in patients with non-acute schizophrenia in a naturalistic outpatient psychiatric setting.

Sample: 30 patients diagnosed with schizophrenia (DSM 5) that started treatment with PP3M after being stabilized with PP1M (the treatment dose was not changed in the four months before study inclusion) The mean dose of PP3M was 401. 55 mg Quarterly basis, the following evaluations were performed during a follow-up period of 60 months: The Clinical Global Impression-Schizophrenia scale (CGI-SCH) Treatment adherence, concomitant medication, and the number of hospitalizations. Efficacy values: Percentage of patients who remained free of admissions at the end of 60 months of follow-up. Other evaluation criteria: Average change from baseline visit to the final evaluation as assessed by score obtained on the following scale: GSI-SCH; percentage of patients on antipsychotic monotherapy, and treatment adherence rate.

The percentage of patients who remained free of admissions at the end of the 60 months was 83.25%. Mean variations from baseline scores at 60 months were: (-0.36 ±0-37) on the GCI-SCH. The rate of adherence to treatment with PP3M after 60 months was 86.58%.

In our study, we found that paliperidone palmitate 3-month formulation effectively prevents admissions under daily clinical practice conditions.

No significant relationships.

Clozapine is an atypical antipsychotic, which has been shown to have superior efficacy in the remission of positive and negative symptoms in patients with treatment-resistant schizophrenia, compared to other antipsychotics. However, its benefits have been limited by the lethal adverse effects that this drug can cause, the most common, agranulocytosis. Other less serious and more common adverse effects are sedation, hypersalivation, hypo and hypertension, weight gain and urinary incontinence. It is estimated that approximately 1% of patients treated with Clozapine suffer from urinary incontinence. Data that varies from 0.3% to 42% in the articles reviewed, being undervalued in some of these for many reasons; it is stigmatizing and the patient is ashamed to express it.

The objective of this study is to assess the percentage of urinary incontinence in patients in treatment with clozapine, taking into account the presence or absence of this side effect as the main variable, and the diagnosis, gender and dose of clozapine as secondary variables.

A retrospective observational study was carried out in which 40 patients belonging to the Adult Mental Health area of the Nuestra Señora del Prado Hospital, were collected, all of them diagnosed with some type of psychotic disorder and undergoing treatment with Clozapine.

Of the total of patients studied, 25% presented urinary incontinence as an adverse effect, and of these, 60% were with doses equal to or greater than 400 mg of Clozapine.

We must be careful and bear this side effect in mind in all patients taking Clozapine.

No significant relationships.

Negative symptoms (NS) are a core feature of schizophrenia. NS show heterogeneity proven by factor analysis, which revealed two distinct negative symptoms subdomains: diminished expression (DE) and avolition/apathy (AA) (Marder et al. 2017, Fleischhacker et al. 2019). Some studies showed the different effects of these subdomains on clinical features of schizophrenia that suggest different pathophysiological mechanisms for their development (Stanculete 2021). It has been also shown that the levels of peripheral interleukins (IL) specifically correlate with NS (Enache et al. 2021), in particular, increased IL levels were determined in patients with deficit syndrome compared to non-deficit schizophrenia (Goldsmith et al. 2018).

To search for the association of genes for IL-4, IL-6, IL-10 and C-reactive protein (CRP) with NS subdomains.

The total sample included 551 patients (women 51,4%, aged 18-72 years) with ICD-10 diagnosis of schizophrenia. NS were assessed by PANSS. PANSS-derived factors include AA (items N2, N4, G16) and DE (N1, N3, N6, G5, G7, G13). Genotyping was performed for the following polymorphisms: C-589T IL-4, C-174G IL-6, C-592A IL-10, G-1082A IL-10, CRP (rs2794521).

There are effects of C-592A IL-10 (p=0.017) and G-1082A IL-10 (p=0.012) on AA subdomain. Post-hoc Bonferroni corrected comparisons show that carriers of the haplotype AA (C-592A)- AA (G-1082A) have the highest AA score. A significant effect of CRP (rs2794521) on AA is identified (p=0.007). There is a trend towards the association of C-589T IL-4 and C-174G IL-6 with AA. No association of these polymorphisms with DE was found.

AA and DE may have different genetic background.

No significant relationships.

According to recent research violations of the oxidative-antioxidant balance may play an important role in the pathogenesis of schizophrenia, by changing generate, conduct and reproduce a nerve impulse. Antibodies with oxidoreductase activity may be involved in protection against oxidative stress in schizophrenia.

The study was to compare the superoxide dismutase (SOD) activity of IgG in patients with acute schizophrenia and during remission.

The study included 20 patients with acute schizophrenia (mean PANSS total score 94,3±14), 18 people with schizophrenia during remission (mean PANSS total score 54,7±9), and 10 healthy individuals. All participants signed informed consent for the research. Isolation of IgG from blood serum was performed using affinity chromatography on Protein-G-Sepharose columns. The homogeneity of the substances is confirmed by the SDS PAGE method. SOD activity of IgG was carried out spectrophotometrically. Statistical processing was conducted with Statistica v.10.

IgG of schizophrenia patients and healthy individuals have a SOD activity and studied activity is proved to be antibodies intrinsic property. The activity of antibodies in acute schizophrenia was 1.7 times higher than in healthy individuals (p<0.05). In patients with schizophrenia during remission SOD activity of IgG was 2.4 times higher than in healthy individuals (p<0.05).

We can assume that in the conditions of oppression antioxidant activity in schizophrenia patients, antibodies partially take over the function of protecting the body from patients with generalized oxidative stress. This work is supported by the Russian Scientific Foundation, grant # 18-15-00053P.

No significant relationships.

Schizophrenia is a severe and chronic disorder causing significant disability and functional decline. Schizophrenia is a polygenic disease, with about 100 monogenic sites and 11 sites of chromosomal deletions / duplications involved in its pathogenesis identified. It is a pleiotropic disease, with causative genetic changes leading to multiple symptoms, including bipolar disorder, autism spectrum disorders, ADHD, mental retardation and epilepsy. The chromosomal microarray (CMA) technology detects submicroscopic chromosomal changes, which are involved in neurodevelopmental disorders, and are subject to prenatal diagnosis. Pathological findings in CMA are detected in 10-20% of patients with neurodevelopmental disorders and can contribute significantly to medical follow-up, prognosis assessment, influence treatment choice, and allow prenatal diagnosis. Preliminary studies in schizophrenia identified pathological CMA findings in 10–30% of patients.

CMA testing of schizophrenia patients to detect genetic changes causing the disease.

Recruitment of schizophrenia patients from the Haifa and Western Galilee districts of Clalit, genetic counseling in Carmel Hospital, CMA testing of the consenting patients.

Schizophrenia patients with and without neurodevelopmental disorders underwent CMA analysis, with the findings of significant chromosomal submicroscopic disorders (such as 22q11 microdeletion, among others) in 30% of the patients, providing the explanation for the patients’ symptoms and enabling specific medical follow-up and adjusted pharmacological treatment.

CMA can be used in diagnosing schizophrenia, assessing prognosis, adjusting pharmacological treatment and follow-up and providing genetic counseling including prenatal diagnosis, as in cases neurodevelopmental disorders. The findings support the application of CMA as part of a routine procedures in schizophrenia.

No significant relationships.

Alcohol dependence and depression are often combined, patients with comorbid pathology have a more severe course of the disease, a high risk of suicide and therapeutic resistance. Enzyme dopamine-beta-hydroxylase (DBH) is a key player in a link between dopamine and norepinephrine neuromediations and may be involved in alcohol dependence and depression comorbidity and genetic markers in DBH gene may be associated with the risk of comorbid state.

To test an association of DBH gene polymorphisms rs161111580 and rs1108580 with depression risk in alcohol-dependent patients.

Our sample consisted of 104 inpatients diagnosed by ICD-10 criteria: 40 with alcohol dependence (AD group) (age 45.6 (SD 10.853), 5% females), 64 with depression and alcoholism comorbidity (AD+D group) (age 41.2 (SD 9.903), 22% females) and 112 healthy controls (age 35.5 (SD 8.286), 15% females). rs1108580 and rs1611115 were detected by RT-PCR.

For rs161111580, frequencies of minor T allele (p=0.031) and ТТ genotype (p=0.017) was higher, СС genotype (p=0.042) was lower in AD group vs. controls. rs161111580 T allele and TT genotype increases the risk of AD (OR=3.715, 95%CI [1.728-7.986], P=0.001 and OR=4.009, 95%CI [1.502-10.699], P=0.006). For rs161111580, frequency of ТТ genotype (p=0.009) was higher in AD+D group vs. controls. For rs1108580, frequency of major А allele (p=0.059, trend) was higher in AD+D, then in AD group. Major А allele rs1108580 increases the risk of depression in alcohol-dependent patients (OR=2.74, 95%CI [1.283-5.855], P=0.001).

It was shown that the DBH rs1108580 increases the risk of depression in patients with alcohol dependence.

No significant relationships.

People with diabetes are vulnerable to diabetes-related distress and are more likely to experience depressive and anxiety symptoms than the general population. Diabetes distress, depressive, and anxiety symptoms also tend to commonly co-occur.

This study aimed to apply network analysis to explore the associations between diabetes distress, depressive, and anxiety symptoms in a cohort of adults with type 2 diabetes.

Data were from the baseline (2011) assessment of the Evaluation of Diabetes Insulin Treatment (EDIT) study (N = 1,796; 49% female; mean age = 60, SD = 8) from Quebec, Canada. A first network using the 17 items of the diabetes distress scale (DDS-17) was estimated. A second network was estimated using the 17 items of the DDS-17, the 9 depressive items of the PHQ-9, and the 7 anxiety items of the GAD-7. Symptom centrality, network stability, and bridge symptoms were examined.

Regimen-related and physician-related distress symptoms were amongst the most central (highly connected) in the diabetes distress network. Worrying too much (anxiety), Not feeling motivated to keep up diabetes self-management (diabetes distress), and Feeling like a failure (depression) were the most central symptoms in the combined network. Feeling like a failure (depression) was highly connected to diabetes distress symptoms, representing a potential bridge between diabetes distress and depression.

Identifying central and bridge symptoms may provide new insights into diabetes distress, depressive, and anxiety symptom maintenance and comorbidity in people with type 2 diabetes.

No significant relationships.

Attention-deficit/hyperactivity disorder (ADHD) is a psychiatric condition in which children suffer from inattentiveness, hyperactivity, and or impulsivity. ADHD patients frequently present comorbid psychiatric disorders: in adults, the most common are depression, substance-related disorders, anxiety, and eating disorders. Children and adolescents present conduct disorders, learning disorders, anxiety and depression. Since ADHD and its psychiatric comorbidities share similarities, a partial overlap of their pathophysiological mechanisms has been suggested. ADHD, can be treated with lisdexamfetamine (LDX), a prodrug indicated by the FDA as treatment for binge eating disorder (BED) and ADHD.

To evaluate, through a systems biology-based in silico method, the efficacy of LDX as first-line ADHD treatment to improve ADHD psychiatric comorbidities. Furthermore, we explored the molecular mechanisms behind LDX’s action.

We used the systems biology- and artificial intelligence-based Therapeutic Performance Mapping System (TPMS) technology to characterise and model ADHD comorbidities. Artificial neural networks (ANNs) algorithms were used to identify specific relationships between protein sets. Finally, we modelled the mechanisms of LDX for the most relevant comorbidities by using sampling methods and comorbidity-specific virtual patients in each case.

This study predicts a strong relationship between LDX’s targets and proteins involved in BED and depression (Fig 1). Our results could be explained not only by LDX role in neurotransmitter regulation, but also by modulation of neuroplasticity (BDNF/NTRK2, GSK3), neuroinflammation (interleukins, inflammasome), oxidative stress (NOS2, SOD), and the hypothalamic-pituitary-adrenal (HPA) axis (CRH, CRHR1).

These findings could be used in pre-clinical and clinical future investigations to assess optimal treatment for ADHD patients with psychiatric comorbidities.

JRGC: speaker for Takeda and Shire, research funding from Shire and Lumbeck, collaborations with Laboratoires Servier JQ: speaker or scientific advisor for Takeda, Janssen, Rubio. Investigation funding: Instituto de Salud Carlos III. PR, CM, TPR: full-ti

We proposed to consider the brain and eye as a target of ionizing radiation exposure. Prevention of potential radiation-associated cerebroophtalmic effects are crucial for successful long-term space missions; interventional radiology; medical, occupational and accidental irradiation

Determination of radiation-associated cerebroophtalmic effects in the long term after irradiation in adulthood and in utero.

Neuropsychiatric, ophtalmological, neurophysiological and neuropsychological assessment of irradiated in adulthood (57 Chernobyl accident clean-up workers, liquidators), 52 persons exposed in utero as a result of the Chernobyl accident, comparison group (51 combatants of the Antiterrorist operation in Donbass), and 53 healthy people.

Radiation-associated cerebroophthalmic pathology is characterized by high neuropsychiatric and ophthalmic comorbidity, which increases in proportion to the radiation dose, and is mainly represented by chronic vascular and degenerative diseases of the brain and retina, mild cognitive impairment (after irradiation in adulthood), as well as disorders of the autonomic nervous system; non-psychotic organic mental disorders; neurotic, stress-related and somatoform disorders; vascular and dystrophic processes in the retina (after in utero exposure). Characteristic of both radiological scenarios remains intellectual disharmony due to a decrease in the verbal IQ. The delay and attenuation of cerebral visual afferentation processing were observed in prenatally exposed.

Radiation-associated cerebroophtalmic effects in the long term after irradiation in adulthood and in utero could be mainly classified as a “small vessel disease of the brain and eye” of vascular-degenerative nature and possible latent demyelination after irradiation in utero.

No significant relationships.

The mental health of subjects with chronic medical illnesses, such as Inflammatory Bowel Disease (IBD- Crohn’s Disease and Ulcerative Colitis), is typically compromised and the current COVID-19 pandemic might have additionally increased this burden.

The aim of the present study was to investigate, during the COVID-19 pandemic, if the presence of a comorbid psychiatric disorder has played a role as an aggravating factor on mental health in patients with IBD.

Twenty Five patients with psychiatric comorbidities (PC+) and twenty five without (PC-) comparable for age and gender, were recruited at the Gastroenterology department at Sacco University Hospital in Milan. Participants were assessed a psychiatric evaluation, collecting socio-demographic variables and measures of anxiety and depression [on the Hospital Anxiety Depression Scale (HADS)], sleep patterns [on the Insomnia Severity Index (ISI)] and general health status [on the Short Form Health Survey 36 (SF-36)].

Comparative statistical analyses were performed with t test with Bonferroni correction.

PC+ (n=25) showed more severe anxiety and depressive symptoms compared with PC- (n=25) (p <.001) and worse sleep pattern (p<.05). With respect to general health status, PC+ showed reduced physical activities (p<.05), social activities (p<.05), mental health (p<.01) and role limitations due to physical health (p<.05).

The present findings showed a worse mental health in subjects with IBD and psychiatric comorbidities during Covid-19 pandemic, highlighting the importance of screening and treatment of psychiatric symptoms disorders in these patients.

No significant relationships.

Serious mental illness tends to course with a higher prevalence of comorbidities and schizophrenia is a disabling disease that affects approximately 1% of the world population. Worldwide, cerebrovascular accidents are an important cause of mortality and disability and in Portugal they are one of the leading causes of death in the general population. There is growing evidence that the prevalence of strokes is higher in people with schizophrenia, with pronounced age and gender variations.

To describe the sociodemographic and clinical differences among patients hospitalized with a primary diagnosis of cerebrovascular disease with and without a secondary diagnosis of schizophrenia in Portugal.

We performed a retrospective observational study using a natiowide hopitalization database containing all hosptalizations registered in Portuguese hosptals from 2008 to 2015. Based on the International Classification of diseases version 9, clinical modification, hospitalizations with a primary diagnosis of stroke were selected (431;433;434), and from those, the ones with a secundary diagnosis of schizophrenia (295.xx) were isolated for a sociodemographic and clinical comparative study. Comorbidities were analysed using the Chalson index score.

Episodes associated with a secondary diagnosis of schizophrenia were younger (mean: 66 vs 73.7 years; p<0.001) and had longer median LoS (10.0 vs 8.0 days; p<0.001). In-hospital mortality was lower in patients with schizophrenia (11.7% vs 13.2%).

The understanding of the association of cerebrovascular accidents with schizophrenia is complex. Although some studies show conflicting evidence, more attention should be given to the investigation of the incidence, prevalence and impact of cerebrovascular diseases within this particular population.

No significant relationships.

Patients with severe mental illness (SMI) have a higher risk of weight gain, dyslipidemia and insulin-resistance. It was observed that insulin resistance has a pathoplastic effect: in Schizophrenia it was associated with a greater severity of negative symptoms, whereas in Bipolar Disorder it was associated with more chronicity and rapid cycling. Moreover a correlation was observed between obesity and a worse outcome in Bipolar Disorder type I.

We aimed at assessing the influence of dysmetabolisms on clinical characteristics in patients with SMI.

We recruited 78 patients with SMI consecutively hospitalized in the Psychiatry Clinic of the Ospedali Riuniti of Ancona, Italy. We administered a checklist for socio-demographic and clinical features (diagnosis, age of onset, illness duration, number of episodes, number of episodes per year, suicidal attempts and comorbidities), and evaluated the following metabolic parameters: weight, height, BMI, abdominal circumference, blood pressure, total cholesterol, HDL, triglycerides, glycemia and insulinemia. We determined insulin-resistance according to the HOMA-IR model. We performed bivariate Pearson correlations to compare metabolic and socio-demographic/clinical parameters.

The analyses showed positive correlations between BMI and disease duration (P = 0.003), and BMI and the number of episodes (P = 0.022). Furthermore, a positive correlation was found between HOMA-IR and the number of episodes per year (P = 0.008). The associations remained statistically significant after controlling for age through partial correlations.

Weight gain and insulin-resistance in severe mental illness are associated with a more severe SMI, as suggested by the greater number of acute episodes.

No significant relationships.

Approximately one-third of stroke survivors develop poststroke depression. Post-stroke mania is relatively rare, with a prevalence of less than 2%. One review of case reports of late-onset mania in 2015 demonstrated that 51% of the patients had established vascular risk factors. In 28% of cases, the treatment of underlying organic cause contributed to successful remission of the manic episode.

For this review, we aimed to compile published case reports from the past 20 years to review late-onset mania as one of the neuropsychiatric outcomes of stroke and its management.

literature search on Pubmed, PsychInfo, and Embase utilizing keywords combinations: Bipolar, Manic, Mania, Secondary, Stroke, Poststroke, Post-stroke, Elderly, Old, Late onset, Late-onset, Lateonset, Hemisphere, Brain, Vascular, Infarction.

Among the 17 case reports, the age of onset of manic episode ranged from 47 to 86 with a mean of 67 years. Of the 17 cases, the right hemisphere was the most frequently affected (14/17, 82%), with cerebrovascular lesion involving the left hemisphere in 3 cases (17.6%).

Clinicians should consider mania secondary to an organic cause in patients presenting with focal or soft neurological signs or symptoms, manic episode with atypical symptoms such as visual or olfactory hallucinations, altered mental status, disorientation, impairment in memory or cognition, unusual age of onset for bipolar disorder, or unusual illness course such as single episode of mania or poor response to psychopharmacologic treatment. Some reviews suggest combination of mood stabilizers and second-generation antipsychotics. Benzodiazepines recommended as an adjunctive drug for acute management such as agitation, aggressive behavior or disinhibition.

No significant relationships.

Pseudobulbar affect (PBA) is an emotional disorder characterized by uncontrollable outbursts of laughing and/or crying. It is caused by lesions that damage pathways in the frontal lobe and descending to the brain stem, basis pontis and cerebellum. The main causes are neurodegenerative diseases.

To present a case of PBA secondary to cerebral toxoplasmosis.

The present study is a case report of a patient admitted for HIV-related toxoplasmosis to our hospital. We also researched previous case reports of PBA secondary to CNS infection using a pubmed query.

Mr. JA is a 38-year-old male, with no prior psychiatric or medical history. He reported having had same-sex sexual encounters previously. He was admitted for ataxia and dysarthria in a medical unit, and diagnosed of HIV infection, with a CD4 count of 19 cells/μL. The MRI showed a lesion of 22x19x18mm with ring enhancement predominantly in basis pontis, compatible with toxoplasmosis(Image1). Treatment with sulfadiazine, pyrimethamine and dexamethasone was initiated. After five days of hospitalization he was referred to Consultation-Liaison Psychiatry for involuntary and uncontrollable outbursts of laughing and crying, insomnia, but no other psychopathological symptoms. Therefore, citalopram 20mg per day was started, with reduction on the frequency of outbursts.

The clinical presentation suggested the diagnosis of PBA due to cerebral toxoplasmosis. Although we found no previous reports of PBA related to HIV infection or toxoplasmosis, the location of the toxoplasmosis lesion is congruent with the typical damaged pathways in PBA. To our knowledge, this is the first report about PBA secondary to HIV-related toxoplasmosis.

No significant relationships.

Agonist opiate treatments with diacethylmorphin (DAM) for heroin addiction have proven their effectiveness for a long time. But few studies focused on psychiatric troubles among the treated patients. As a new DAM program will open in Freiburg in Switzerland, in order to assess the eligibility to this program, we consider the psychiatric dimension using the Addition Severity Index French translation (IGT).

Assessing the patient eligibility for the DAM programm and describing psychopathological characteristics

Assessing eligibility for a Dam program in Switzerland is based on some criteria defined by OFSP: Be adult, failure of at least two previous addiction treatments, intravenous consumption. In addition, the included patients (N=10) passed an interview with a trained examiner, to fill the addiction severity index scale (multidimensional psychometric scale). The result of the psychiatric dimension of IGT was compared with the psychiatric diagnosis in the medical file to assess the internal reliability of the descriptive method. Statistical method for little sample, mean, median, descriptive datas and Fisher test were applied.

All kind of affective disorders, were the most representative psychiatric trouble in the studied population (47%) followed by personality disorders (32%) and severe anxiety troubles (21%). The psychiatric dimensional evaluation of IGT was consistent with the description file psychiatric diagnosis. In a surprising way, we found no psychosis spectrum troubles who could explained the previous treatment failure.

Affective disorders are overrepresented in our sample of addicted patient included in the DAM program. These troubles stay often underestimated. The have to be properly treated

No significant relationships.

Since fall 2020, electronic mental health services (eMHSs) like apps can be prescribed by physicians and psychotherapists in Germany. However, future healthcare providers such as medical and psychology students remain reluctant to adopt eMHSs, even though they represent a vulnerable group with respect to developing mental health problems themselves. Reasons include scepticism and lacking awareness, which can be addressed by tailored multi-component information material. However, to date little is known about the most important information attributes to educate prospect healthcare providers on eMHSs.

The objective of this study is to explore information preferences on eMHSs among medical and psychology students.

A total of 21 semi-structured interviews were conducted (n=16 medical and n=5 psychology students) across Germany based on a topic guide. Interviews were recorded, transcribed and content-analyzed using MAXQDA.

Most students reported having little knowledge about eMHSs and that the issue of digital health has never been raised in their study, even though it is perceived as important. Concerning information design preferences, students favored light, neutral colors and a combination of short, compressible texts with matching images. Regarding the content, information about data protection, the underlying evidence base and the match with personal needs were perceived as important for utilization intentions, while there was little interest in tailored information focusing exclusively on psychology or medical students.

This study provides first insights into eMHS information preferences among prospect healthcare providers. In a next step, a discrete-choice conjoint experiment will be conducted to test the relevant information features on eMHSs.

No significant relationships.

Disturbances to sleep-wake patterns are associated with bipolar disorder (BD) and borderline personality disorder (BPD). Objective assessment typically involves actigraphy monitoring, although it may be possible to derive sleep-wake metrics from other digital data, such as smartphone battery degradation.

To assess whether common actigraphy-derived phase markers of the sleep-wake pattern (L5 and M10 onset) are in agreement with measures derived from smartphone battery data and explore if battery metrics differ between people with BD, BPD , and a healthy control group (HC).

High frequency smartphone battery data was collected from 30 BD, 19 BPD and 33 HC participants enrolled in the Automated Monitoring of Symptom Severity (AMoSS) study, over 28 days. Participants also wore an actigraph during this period. L5 and M10 values were calculated separately based on the rate of smartphone battery degradation and conventional actigraphy methods. Bland-Altman analyses were performed to assess agreement between battery-derived and actigraphy-derived values, and Kruskal-Wallis tests used to compare diagnostic groups.

For L5, battery-derived and actigraphy-derived values had a bias of 0.46 [-0.10, 1.02], upper limit of agreement (LOA): 5.45 [4.49, 6.41], and lower LOA: -4.53 [-3.56, -5.49]. For M10, the bias was 0 [-0.92, 0.92], upper LOA: 8.19 [6.61, 9.76], and lower LOA: -8.19 [-6.61, -9.76]. Between diagnostic groups, there was no difference for battery-derived M10 (p=0.652), or L5 (p=0.122).

Our results suggest battery-derived and actigraphy-derived M10 and L5 show good overall equivalence. However, battery-derived methods exhibit large variability, which limits the clinical utility of smartphone battery data to infer sleep-wake metrics.

No significant relationships.

The challenge for primary care physicians (PCPs) is keeping up to date in managing major depressive disorder (MDD) and psychiatric emergencies.

We evaluated whether an online educational video lecture directed at PCPs, could improve knowledge and confidence regarding management of psychiatric emergencies associated with MDD.

Educational effect was assessed using a 3-question repeated pairs, pre/post assessment survey. A paired-samples t-test was conducted to assess overall number correct and confidence change. A McNemar’s test was conducted to assess question-level significance. P values < 0.05 are statistically significant. Cohen’s d test was used to estimate the magnitude of effect of education. The activity launched on 8 April 2021, and preliminary data analysed as of 24 June 2021.

511 PCPs participated in the programme, of which 86 PCPs completed the pre- and post-assessment test. An average overall correct response rate of 28% pre- increased to 64% post- (129% relative increase, P<0.001; Cohen’s d = 1.13). Knowledge on the burden of suicide and MDD improved from 23% pre- to 87% post- (278% relative increase,P<0.001). Knowledge regarding clinical data for novel therapies for use in psychiatric emergencies improved from 29% pre- to 50% post- (72% relative increase, P<0.01). Knowledge regarding signs of suicidal intent in patients with MDD improved from 31% pre- to 53% (71% relative increase, P<0.001) following education.

This study demonstrates the positive effect of online medical education on PCPs’ knowledge and confidence in contemporary management of psychiatric emergencies associated with MDD in Europe.

The results of this study were derived from an educational programme which was developed through independent educational funding from Janssen Neuroscience

Digital mental health interventions, such as chatbots that promote mental health and wellbeing are a promising way to deliver low-threshold support 24/7 for those in need. According to current knowledge about the topic, health care professionals should participate in the design and development processes for digital interventions.

The aim of this presentation is to describe the interdisciplinary content development process of the ChatPal chatbot.

The content development process started in co-operation with mental health professionals and potential users to identify requirements. Content was created, evaluated and tested in international, multi-disciplinary group workshops, and online tools were used to allow the collaboration. Initial conversational scripts were drafted in English, and translated into Finnish, Swedish and Scottish Gaelic.

A multilingual chatbot was developed and the conversation scripts were structured and stored using a spreadsheet. The conversation scripts will be made freely available online in due course using this structured approach to formatting chatbot dialogue content. It will allow repurposing the content as well as facilitating studies that wish to assess the design of conversation scripts for mental health chatbots. Conversation design process also highlighted some challenges in turning empathetic and supportive conversations to short utterances suitable for a chatbot.

The ChatPal chatbot is now available in four languages. As literature about the topic is still scarce, it is important to describe and document the content development processes of mental health chatbots. Future work will develop a conversational UX toolkit that would allow health professionals to design chatbot scripts using design guidelines.

No significant relationships.