Major Depressive Disorder (MDD) is a prevalent mental health condition that significantly impairs daily life and increases suicide risk. Selective serotonin reuptake inhibitors (SSRIs), such as paroxetine, are widely prescribed due to their efficacy and favorable safety profile. However, SSRIs can impact glucose metabolism, leading to both hyperglycemia and hypoglycemia, particularly in diabetic patients.

In rare instances, SSRIs have induced hypoglycemia in non-diabetic individuals. Paroxetine, known for its strong inhibition of serotonin reuptake, has been implicated in cases of hypoglycemia, though the precise mechanisms remain unclear.

With the present report, we examined wheter the hypotesis that paroxetine induces hypoglycemia is valid.

This case report discusses an episode of paroxetine-induced hypoglycemia in a 60-year-old female, non-diabetic patient with a history of MDD.

The patient was admitted to our in-patient psychiatric unit due to worsening depressive symptoms and recurrent episodes of sweating, dizziness, tremors, and loss of consciousness, suggestive of hypoglycemic crises. Over the previous three years the patient had been on paroxetine 40 mg/day, thus the drug was suspected as a potential cause of these hypoglycemic episodes and it was discontinued whereas fluoxetine and trazodone were administered. By discharge, her depressive symptoms and insomnia had improved significantly

This case highlights the potential for SSRIs, particularly paroxetine, to induce hypoglycemia even in non-diabetic patients. Although hypoglycemia is typically linked to diabetic treatments, this case demonstrates that antidepressants can also play a role in disrupting glucose regulation. In this case, the symptoms subsided after the discontinuation of paroxetine, strongly suggesting its role in the hypoglycemic episodes, as supported by a "probable" causality score on Naranjo’s scale. Given the nonspecific nature of hypoglycemic symptoms and the risk of misdiagnosis as psychiatric or somatic conditions, it is crucial for healthcare providers to consider medication-related causes. This report underscores the importance of monitoring glycemic levels in patients on SSRIs, particularly when presenting with atypical symptoms. Increased awareness can help prevent misdiagnosis and facilitate timely intervention to avoid severe complications.

None Declared

The 3-dimensional (3D) marker-less motion capturing (MoCap) systems are an emerging technique in movement analysis. Recent studies have shown that such MoCap assessment have great potential for accurate and objective assessment of motor alterations in psychiatric patients. Gait as a fundamental gross motor function is the final motor outputs of a complex network integrating sensorimotor systems, cognitive and affective stimuli. Understanding gait alterations in catatonia patients can provide insights into their sensorimotor dysfunction and help in diagnosis and treatment in future.

The primary objective of this study is identifying gait alterations using a 3D optical marker-less MoCap system in catatonia patients (CAT) compared to non-catatonia controls (Non-CAT). We hypothesize that there will be significant reduction in the spatiotemporal parameters of gait, such as speed, stride width, stride length, step length, and cadence as well as increased gait instability in CAT group. Moreover, these alterations will be correlated with general psychomotor slowing.

In this cross-sectional study, we examined a total of 61 patients with and without catatonia diagnosis (CAT; n=22, Non-CAT; n=39) according to ICD-11. Participants were assessed with the Positive and Negative Syndrome Scale (PANSS), Northoff Catatonia Rating Scale (NCRS), the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF). We conducted clinical psychomotor examination with the Heidelberger Neurological Soft Sign Scale (NSS), Salpêtrière Retardation Rating Scale (SRRS) and Unified Parkinson Disease Rating Scale (UPDRS). Gait analysis were performed using a marker-less MoCap system with 8 cameras (Qualisys, Goeteborg, Sweden). Participants walked on a marked path (18 m) with a self-selected tempo during the experiment. The spatiotemporal parameters (STP) of gait were obtained automatically through Theia Software.

The two groups did not differ in age, sex, or BMI. The CAT group showed higher scores in PANNS, BPRS, NCRS and GAF (p< 0,05). We found a statistically significant difference in clinical psychomotor parameters in NSS, SAS and UPDRS between the two groups (p <0,05) and more specifically in gait subdomain of each scale. No differences were found in any of STP of gait or gait instability measurements after controlling for covariates (age, sex, BMI and medication).

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This study exhibit a significant difference between the results of clinical psychomotor assessments and objective gait analysis through marker-less MoCap. This discrepancy suggests a potential overestimation of gait alterations in clinical evaluations. The findings underscore the importance of integrating advanced 3D MoCap technologies into the psychiatric assessment to enhance our understanding of gait alterations in mental disorders.

None Declared

Adolescence is a critical period for the development of substance use disorders (SUD), with psychoactive substance (PAS) use posing significant mental and physical health risks. In Slovenia, the absence of specific residential treatment options for adolescents has historically limited care mostly to outpatient settings, often inadequate for severe cases. In December 2023, the University Psychiatric Clinic Ljubljana opened Slovenia’s first inpatient ward for adolescents with SUD, offering a comprehensive, structured program addressing both the psychological and physiological aspects of addiction.

The primary objectives of this study are to present the inpatient ward for adolescents with SUD program in Slovenia and to conduct an analysis of data from the first six months of the program.

The program utilized a multidisciplinary approach, incorporating individual therapy, group therapy, psychoeducation, pharmacotherapy, family involvement and a range of structured therapeutic activities such as music therapy, film therapy and educational groups. A retrospective analysis of patient data from December 2023 to June 2024 was conducted. Key outcome measures included length of stay, abstinence rates, readmission rates and factors influencing premature discharge. Motivation and adherence to the therapeutic agreement were also assessed.

During the six-month period, 20 adolescents were admitted to the ward, resulting in a total of 32 hospitalizations, reflecting a significant rate of readmissions. The average age of the patients was 17.16 years. The length of stay varied considerably, with an average duration of 45 days. Readmissions accounted for 37.5% of total hospitalizations, often due to relapse or behavioral challenges. Motivation for treatment and adherence to the therapeutic agreement were critical factors affecting the length of hospitalization and the risk of early discharge.

The introduction of Slovenia’s first residential treatment program for adolescents with SUD marks a significant development in the country’s healthcare system. The program offers a structured environment conducive to improving abstinence rates and addressing the complexities of adolescent substance use. However, the high rate of readmissions and the ongoing challenge of maintaining abstinence post-discharge highlight the need for refined treatment strategies, particularly regarding patient motivation and long-term relapse prevention. Future efforts should focus on optimizing the length of stay and enhancing post-discharge support to improve long-term outcomes.

None Declared

Technological advancements have identified numerous genetic variations linked to mental disorders, providing potential explanations and, in some cases, enabling targeted treatments. However, clinical genetic testing remains underutilised in psychiatric care, potentially due to inconsistent clinical guidelines across Europe.

This scoping review aims to compile, summarise and evaluate European clinical practice guidelines (CPGs) on genetic testing in mental disorders, identifying gaps and variations in recommendations to inform current practice and future guideline development.

A scoping review was conducted across scientific databases (PubMed/MEDLINE and Ovid) and grey literature sources (Image 1. Flow diagram). Inclusion criteria centred on European CPGs published in English from 2010 onward with specific recommendations on genetic testing in mental disorders. Quality assessment was performed using the International Centre for Allied Health Evidence (iCAHE) checklist. Data extraction focused on guideline characteristics, target populations, and genetic test recommendations.

Sixteen CPGs met the inclusion criteria, displaying considerable heterogeneity in quality and content, and covering a limited range of mental disorders. Six guidelines addressed neurodevelopmental disorders. Most recommended genetic testing in Autism Spectrum Disorder (ASD) when indicators such as intellectual disability (ID) or dysmorphic features were present; however, one guideline recommended routine testing. Only one guideline included recommendations for genetic testing in ID; routine access to Fragile X testing, chromosomal microarray, and whole genome sequencing was recommended as standard care.

Eleven guidelines provided recommendations on genetic testing in neurodegenerative disorders. In dementia, consensus on routine testing was generally limited to young-onset cases or those with distinct genetic profiles. APOE genotyping was generally discouraged. Guidelines for diagnostic testing for Huntington’s Disease (HD) were consistent. Access to predictive testing with appropriate genetic counselling for at-risk adults was also recommended.

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Based on our findings and the wider literature, we recommend considering genetic testing for: 1) all patients with ID, 2) patients with ASD exhibiting features suggestive of a genetic cause, such as ID and dysmorphic traits, and 3) patients with dementia with a young age of onset or a family history indicative of a Mendelian disorder. For HD, testing should be informed by phenotypic features and family history. Establishing harmonised, evidence-based guidelines is essential to integrate testing effectively. Key considerations include clinical utility, patient autonomy, and access to genetic counselling to ensure informed and supportive care.

None Declared

Orthorexia Nervosa (ON) is characterized by an obsessive focus on healthy eating, leading to extreme restrictions and negative impacts on mental and social health. ON shares traits with eating disorders (EDs) and obsessive-compulsive disorder (OCD), but its diagnostic status remains unclear. Recent studies suggest ON may be linked to personality traits like perfectionism, common in both EDs and OCD (3,5). The COVID-19 pandemic has exacerbated these issues, stressing the need for better understanding of ON and its overlaps with other disorders (6).

This study reviews literature from the past seven years to explore the connections between ON, EDs, and OCD. It examines ON as a possible distinct diagnosis, focusing on the role of personality traits like perfectionism and evaluates the clinical implications and treatment needs, considering cultural and contextual factors.

A systematic review was conducted using PubMed, PsycINFO, and Scopus, covering studies from 2017 to 2023. The studies included clinical and non-clinical samples, focusing on psychopathological features and personality traits linked to ON, EDs, and OCD (1-2). The review analyzed diagnostic criteria, prevalence, personality trait correlations, and the impact of contextual factors like the COVID-19 pandemic.

ON has a complex relationship with EDs and OCD. In ED patients, especially those with anorexia nervosa (AN) and bulimia nervosa (BN), orthorexic behaviors were more prevalent, suggesting ON might be a subtype of EDs rather than a separate condition. ON scores in ED patients decreased after targeted treatment, supporting this connection (1). Personality studies showed that orthorexic individuals often display perfectionism, particularly concerns about mistakes and unrealistic standards. These traits are transdiagnostic, affecting ON, EDs, and OCD (2-3). ON was also linked to specific personality profiles, such as paranoid and narcissistic traits, which worsen symptoms and complicate treatment (2). ON symptoms were strongly correlated with anxiety, depression, and ED and OCD symptoms, indicating shared psychopathological mechanisms (5). The ego-syntonic nature of ON, where behaviors are seen as normal, may lead to underdiagnosis and reduced treatment-seeking (5). The COVID-19 pandemic further exacerbated orthorexic behaviors, highlighting the need for tailored clinical interventions for at-risk individuals (6).

ON should be viewed within the ED spectrum, with significant overlaps with OCD and influence from traits like perfectionism. Cultural and definitional differences complicate its classification as a distinct disorder. The COVID-19 pandemic has highlighted the clinical importance of ON and the need for effective prevention and treatment strategies. Future research should aim to develop standardized diagnostic criteria and explore personality traits to improve ON diagnosis and treatment.

None Declared

Frontotemporal dementia (FTD) is the second most common cause of early-onset dementia and is clinically characterised by progressive behavioural changes, executive dysfunction and language difficulties. FTD is often confused with Alzheimer’s disease and other psychiatric disorders. Clinical features of FTD include personality changes, agitation, loss of inhibition, apathy, social withdrawal and impulsivity. In some cases, the disease is accompanied by mood or psychotic symptoms, resulting in the diagnosis of an additional psychiatric disorder. (Gliebus G.(2014). SAGE open medical case reports,2, 2050313X13519977.). This article presents the case of a middle-aged woman who was diagnosed with an anxiety spectrum disorder before developing and being diagnosed with FTD.

A 57-years-old right handed female with previous history of anxiety disorder admitted to psychiatry clinic with restlessness, decreased sleep, and complain of constant non-purpose walking. Physical examination revealed bradymimia and grabellar reflex. Additionally in her psychiatric evaluation she had short-term memory impairment, disinhibition and verbal perseverations. She had been given multiple combinations of medications by outpatient providers and her restlessness only increased. At the time of admission she was taking mirtazapine,olanzapine and clonazepam. The initial impression was that she had akathisia, and her medications were tapered. She was then started on propanolol and lorazepam. After several days her symptoms had not changed.

In routine biochemical and hematological tests, electroencephalogram (EEG) were within normal limits. 18F-FDG PET/MRI revealed hypometabolism in the bilateral temporal-frontoparietal region, more pronounced in the frontal region which is consistent with FTD.

Trazodone was started to control behavioural symptoms and the dose was gradually increased to 150 mg/day. The dose of propranolol was increased to 80 mg/day, and lorazepam was tapered and discontinued. During the follow up with this treatment, there was an improvement in her restlessness and anxiety symptoms, but her memory problems were persistent.

Frontotemporal dementia may overlap and be confused with other psychiatric disorders. Therefore, a comprehensive history, physical and neurological examination are required to differentiate each clinical entity (Khan I, De Jesus O. (2023).Frontotemporal Lobe Dementia. In: StatPearls ). Additionally, the use of functional neuroimaging, such as 18F-FDG PET/MRI, enables the different distribution of pathology in dementing disorders to be highlighted, as can be seen in our case. This case report highlights the importance of re-evaluating patients with psychiatric diseases, especially when symptoms are resistant to treatment.

None Declared

Occupational stress has been identified as a significant predictor of job satisfaction among university staff.

This paper aims to find out the relationship between occupational stress and job satisfaction among university workers in Sfax, Tunisia.

We conducted a cross-sectional study, during the period from September 2022 to October 2023. We used a self-administered questionnaire distributed to university staff. The questionnaire included socio-professional characteristics and assessment of occupational stress using the Work Stress Screener (WoSS-13). Job satisfaction was rated on a 5-point Likert scale from 1 (extremely dissatisfied) to 5 (extremely satisfied).

The average age of the workers was 49.31±8. years. There is a slight female predominance (78 (53.1%)). Among the respondents, 57 (38.3%) were very to extremely satisfied. The medians of WoSS-13 subscales were 11 for WOSS-A1, 6 for WOSS-A2 and 3 for WOSS-B. Job satisfaction was positively associated with WOSS-A1 and WOSS-A2 (positive stress) but negatively associated with WOSS-B (negative stress). In bivariate analysis, being extremely satisfied was positively associated to WOSS-A1 and WOSS-A2 (p=0.000 for each respectively). However, it was negatively associated to WOSS-B (p=0.000).

Occupational stress has a significant impact on job satisfaction among university workers. Addressing job stress through targeted interventions can improve job satisfaction, productivity, and overall well-being among university staff.

None Declared

Patients with bipolar disorder (BD) and major depressive disorder (MDD) face an elevated risk of early mortality from various physical illnesses, particularly cardiovascular disease (CVD). However, it remains uncertain whether depressive or manic symptoms contribute more significantly to CVD outcomes.

This study aimed to assess the association between manic and depressive symptoms and long-term CVD risk factors.

A retrospective study was conducted on patients hospitalized in the female unit of psychiatric department “B” in Sfax, Tunisia, between January and June 2023. Sociodemographic, clinical, and CVD risk factor data were collected from medical records to calculate Framingham Scores. The relationships between mood symptoms (depressive and manic) and Framingham scores, as well as individual CVD risk factors (lipids, blood pressure, BMI, smoking, and fasting glucose), were analyzed.

The study included 50 female patients with a mean age of 45 years (SD = 9.9). Of the patients, 18% were diagnosed with MDD, while 82% were diagnosed with BD; 64% were admitted for manic symptoms, and 36% for depressive symptoms. Clinical obesity was observed in 64% of patients, with 60% diagnosed with hyperlipidemia, 34% with hypertension, and 26% with type 2 diabetes. Notably, 12% of patients had a Framingham score of ≥ 10%, indicating a moderate to high 10-year risk of CVD. Bivariate analysis revealed that patients with manic symptoms had a significantly higher CVD risk than those with depressive symptoms (p=0.034). Manic symptoms were also significantly associated with elevated BMI (p=0.034), fasting glucose (p=0.039), and blood pressure (p<0.001).

This study demonstrates a strong association between manic symptoms and long-term CVD risk in patients with mood disorders, particularly with elevated blood pressure, glucose levels, and BMI. These findings underscore the importance of specific monitoring and intervention programs for CVD risk factors in patients with mood disorders, especially those with BD.

None Declared

Sudan is currently experiencing the largest child displacement crisis worldwide. Since the conflict erupted in 2023, over 4.6 million children have been internally displaced within Sudan, and nearly one million are seeking refugee in neighboring countries (UNICEF, 2023). The mental health of these children has been overlooked, and there is a noticeable lack of data on their psychological wellbeing.

To assess the prevalence of PTSD, anxiety and factors associated with them among internally displaced Sudanese children during war in IDP camps in Al Jabalain district, White Nile state, Sudan, 2024

A cross-sectional study was conducted among internally displaced Sudanese children in 11 camps in Al Jabablain district. Children were interviewed using a standerdised questionnaire consisting of the PTSD Civilian Checklist Version 5 abracic version and the Hamilton Scale arabic version to assess the prevalence of PTSD and anxiety. Data analysis was conducted using IBM® SPSS, version 26.0.

The sample included 223 children; age median was 12 years (IQR: 9-15). 127 (57%) of them were females, with majority 128 (57.4%) in primary school. Participants who met the criteria for probable PTSD were 23 (14.3%), (median: 32, IQR: 17-28). 150 (67.3%) participants had mild anxiety, with a median score of 11 (IQR: 9-14). Older children had higher levels of PTSD and anxiety. Also, both scales were significantly associated with gender, displacement frequency and separation from close ones (p value <0.05). Females were more likely suffer from anxiety 116/127(91%) in comparison to males 76/96(79%). Yet, 19(59.4%) of children with probable PTSD were males. Children displaced more than four times were more prone to PTSD symptoms and moderate to severe anxiety. Interestingly, recently displaced children were more likely to have higher PTSD scores and lower anxiety scores. Educational level was significantly associated with PTSD, with about one-third of high school students experienced PTSD symptoms. Anxiety scale was significantly associated with direct exposure to violence, as 13.6% of those exposed to violence experienced mild to moderate anxiety.

This study identified significant levels of PTSD and anxiety among internally displaced children in the Al Jableen camps, highlighting the urgent need for mental health interventions, which promotes resilience and coping skills. Factors such as age, gender, frequency of displacement, direct exposure to violence, and educational level significantly impact the development of these mental health conditions.

None Declared

Obsessive-compulsive disorder (OCD) is a chronic mental health condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions), which significantly impair daily functioning and quality of life. While common obsessions often revolve around contamination, symmetry, or safety, rarer forms of OCD can involve highly specific and unusual fears.

The aim of this case analysis is to comprehensively examine the possible causes and treatment approaches of obsessive-compulsive disorder, focusing on the investigation of various obsessive conditions that are rarely observed in the literature.

The patient’s history was thoroughly examined, and interviews conducted with the patient’s family were also included in the evaluation. Possible causes of the disorder (from a biopsychosocial perspective) and treatment approaches such as psychotherapy and pharmacotherapy were analyzed through a literature review. Additionally, the patient was assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS), Brown Beliefs Scale, Beck Anxiety Inventory, and Beck Depression Inventory.

The patient, N.C., is a 64-year-old woman whose general appearance is somewhat older than her age, with partially diminished self-care, having insight, divorced, and living with three of her six children. The patient experiences intense anger when any product containing sweets enters her home, including fruits. She feels discomfort even when using or hearing the word “sweet.” The patient insists that no family member brings any sweet-containing products into their home, leading to frequent arguments on the subject. She reports high levels of anxiety, difficulties in social relationships, and significant limitations in daily life activities. Her relatives have also observed and reported these challenges. The patient mentions feeling a sticky sensation on her hands when she sees sweets and experiences a compulsion to wash her hands when this sensation occurs. Her symptoms are consistent with the classical symptoms of obsessive-compulsive disorder, including obsessions (persistent thoughts about sweets and associated anger) and compulsions (the need to wash her hands). The diagnosis was made by Dr. Ece Ilgın.She has been started on fluvoxamine 50 mg/day, which will be titrated. She will return for a follow-up appointment at the clinic in one month.

The symptoms of obsessive-compulsive disorder in patient N.C. include obsessions related to sweets, fruits, a sense of ‘stickiness’ that cannot be clearly identified, and avoidance obsessions linked to these. These symptoms significantly impact the patient’s quality of life and family relationships. It is believed that a combination of psychotherapy and pharmacotherapy will be effective in alleviating the patient’s symptoms and improving their quality of life.

None Declared

While gambling problems are increasingly recognized as a public health concern, knowledge of the prevalence and impact within psychosocially vulnerable populations is scarce. Never before has the prevalence of gambling problems been studied in a forensic psychiatric patient population. Given the risk for gambling problems to exacerbate existing mental health conditions, cause financial strain, and contribute to criminal behavior, understanding its prevalence and associated factors within this population is critical.

The study aims to estimate the prevalence of gambling behavior and gambling problems among forensic psychiatric patients in Denmark and compare the results to the general Danish population. Additionally, the study seeks to identify associations between psychosocial and demographic variables and the occurrence and severity of gambling problems. Lastly, the study will explore gambling motives and their relation to gambling problems in this patient population.

This observational, cross-sectional study will include inpatients and outpatients in Central Denmark Region forensic psychiatric care and inpatients in Capital Denmark Region forensic psychiatric wards from June 1 to December 31, 2024. Participants must be 18, and speak Danish, English, or Greenlandic. Data will be collected via self-report questionnaires and electronic patient records. Key measures include gambling behavior (past year gambling, frequency, and expenditure), gambling problems (the Problem Gambling Severity Index), and gambling motives (the Gambling Motives Questionnaire-Financial).

Data collection ends by December 31, 2024; preliminary findings will be presented at the conference.

Results will provide valuable insights into the prevalence and characteristics of gambling problems in this population, informing clinical care and potentially guiding the development of targeted interventions. By highlighting the need for attention to gambling issues in forensic psychiatric settings, the study may enhance rehabilitation and recovery efforts and successful discharge by addressing potential risk factors for recidivism.

None Declared

Eating disorders (EDs) are complex conditions with significant impacts on physical and mental health. This study investigates hospital admissions and resource utilization for EDs among pediatric patients in Spain over a seven-year period, emphasizing the effects of the COVID-19 pandemic.

To analyze the epidemiological trends, prevalence, and hospital resource use for pediatric ED admissions in Spain from 2016 to 2022.

A retrospective analysis was conducted using data from Spain’s Minimum Basic Data Set of acute hospitals (CMBD-H) for patients aged 10–19 years with an ED diagnosis (ICD-10-CM code F50) between January 1, 2016, and December 31, 2022. Trends in hospitalization rates, types of EDs, comorbidities, and resource utilization were assessed.

The study identified 8,275 pediatric ED admissions, comprising 17% of all mental disorder admissions. Table 1 summarizes the characteristics of hospital admissions by age group (10-14 years and 15-19 years). Hospitalization rates increased from 19.4 per 100,000 in 2016 to 32.7 in 2022, with a notable rise in the 10–14-year age group post-pandemic. Anorexia Nervosa (AN) was the predominant diagnosis (71.6%). Psychiatric comorbidities were present in 35.6% of cases. The average length of stay was 24 days, with annual direct medical costs totaling €3 million and a median cost per admission of €11,580. AN patients had longer hospital stays (median 28 days) compared to other disorders, while Bulimia Nervosa (BN) patients had shorter stays (median 14 days) but higher average costs (€12,300). Table 2 details the average hospital length of stay and average cost of hospital admissions for EDs among adolescents in Spain.

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There was a 70% increase in pediatric ED admissions in Spain from 2016 to 2022, with a significant post-pandemic rise in younger patients. This underscores the need for improved early detection and intervention strategies, as well as enhanced screening for comorbid mental health conditions to manage the growing hospital demand effectively.

None Declared

Self-report instruments assessing self-injurious thoughts and behaviors (STBs) are widely used, but their effectiveness and predictive validity vary.

This study aimed to synthesize findings from previous reviews and identify self-report instruments assessing suicidal thoughts and behaviors (STBs) in adults, followed by a network analysis to explore psychometric properties and inter-item relationships.

Systematic searches were conducted in MEDLINE/PubMed, EMBASE, and the Cochrane Database of Systematic Reviews, covering inception to July 2023, using terms like “suicide risk,” “self-report instruments,” and “psychometrics.” From 318 publications, 22 manuscripts were selected, including reviews, guidelines, and book chapters on STB instruments. Data were extracted under PRISMA guidelines, focusing on scale characteristics, predictive validity, item composition, and psychometric performance. Seven frequently cited scales (SPS, SSI, RFL, ASQ, SBQ-R, ACSS, and C-SSRS) were analyzed using Harmony, which uses NLP via Sentence-BERT to evaluate semantic similarity among items. A correlation matrix based on cosine similarity measured inter-item relationships, forming an undirected weighted graph analyzed with the Louvain community detection algorithm. Centrality measures (strength, betweenness, closeness) and questionnaire-based aggregation enabled scale comparisons. Additionally, Exploratory Graph Analysis (EGA) with the GLASSO model and Walktrap algorithm, assessed by the Total Entropy Fit Index (TEFI), explored network dimensionality and community structures.

Thirty-four scales were identified, with 35% having 1-10 items and 29% having 11-20 items. ASIQ and ASQ displayed high predictive validity (sensitivity: 96% and 96.9%, respectively). The Beck Scale for Suicide Ideation (SSI) had the highest strength centrality (68.1) and eigenvector centrality (0.871), while the CSSRS had the highest betweenness centrality (488.0). Four clusters were identified (Image 1) with a modularity score of 0.0838, indicating moderate cluster separation. The EGA (Image 2) confirmed a multidimensional structure, with an edge density of 0.667 and the Walktrap algorithm identified two main communities focused on cognitive and behavioral/protective aspects. The TEFI score of -3.778 indicated a multidimensional network structure.

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The findings underscore the need for multidimensional approaches to STB assessment. Key tools like the SSI and CSSRS are central, with future research recommended to enhance predictive validity and enable cross-cultural adaptation. To advance psychometric evaluation, future work will include a systematic review and meta-analysis following the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) protocol to assess these scales’ psychometric properties in depth.

None Declared

Relapse refers to the recurrence of psychotic symptoms following a phase of improvement or stability. It often leads to the disruptive re-hospitalization of patients. Notably, a history of relapse is a strong indicator of future relapses and poorer outcomes. According to the literature, relapse rates might be higher in men compared to women due to better response to medication in women. Cariprazine (CAR), a D3-D2 partial agonist, has shown effectiveness in preventing relapse compared to a placebo in stabilized schizophrenia patients

We aimed to investigate whether there is a difference in the efficacy of CAR in preventing relapse by sex.

A post-hoc analysis was conducted on data from a multicentre, randomized, double-blind, placebo-controlled, parallel-group study lasting approximately 96 weeks in adults with schizophrenia. The study included two phases: a 20-week open-label treatment phase and a double-blind treatment phase lasting up to 72 weeks. During the open-label phase, patients were stabilized on CAR at doses of 3.0-9.0 mg/day. Subsequently, they were randomized to either continue CAR (at fixed doses of 3.0, 6.0, or 9.0 mg/day) or switch to a placebo (PBO). Relapse was defined by a worsening of symptom scores on the Positive and Negative Syndrome Scale (PANSS), psychiatric hospital admission, aggressive behaviour, or suicide risk. In this analysis, patients were separately analysed based on their sex. Baseline characteristics, hazard ratios by sex during the double-blind phase were calculated.

Of 200 patients, 132 (66%) were male (M) and 68 (34%) were female (F). In the female group, 57% were receiving CAR treatment, while in the male group 47% were on CAR. The mean age of the patients was between 36-41 years. The open-label baseline PANSS scores were comparable. The adherence of patients during the double-label phase was similar in all four groups (98-99%).

More relapses were documented in the placebo groups (M: 47%, F: 48%) than in the CAR groups (M: 27%, F: 21%). In females, those who received CAR during the double-blind phase had 66% less risk for relapse (HR=0.34, 95%CI= 0.14-0.82) than those who were on placebo. Similarly, male patients on cariprazine had 49% less risk for relapse (HR=0.51, 95%CI= 0.28-0.91) than those receiving placebo. The Cox regression analysis between groups showed that sex of patients did not affect the risk of relapse significantly.

In summary, sex does not seem to significantly influence risk of relapse. CAR decreases the risk of relapse compared to placebo in both males and females.

C. Correll: None Declared, Z. Dombi Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., P. Herman Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., Á. Barabássy Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine.

Early detection of neurodevelopmental disorders (NDD) allows for timely intervention and tailored support to address behavioral and learning issues and reduce the impact of severe disabilities. Certain populations of newborns, particularly premature infants, are at higher risk for developing such disorders; identifying them enables the establishment of preventive monitoring and screening.

to evaluate the frequency of neurodevelopmental disorders (NDD) in preterm children seen at the outpatient Neonatology department

Our study was a descriptive cross-sectional study conducted on 193 premature infants hospitalized in the Neonatology service. All children underwent at least two psychiatric assessments evaluating child development, early interactions, and behavioral problems. These assessments were conducted at the Neonatology outpatient department by a child psychiatrist in the presence of at least one parent, from 2016 to June 2024. Sociodemographic and clinical data were collected from their medical records.

In our sample, the average age of infants was 2 years, with a range from 10 months to 3 years. The sex ratio was 1:1. According to the psychiatric interview and clinical examination, we found that 74.1% of children exhibited psychomotor developmental delays, 15% of them have global developmental delays, 11.4% of children have language delays, and 6.7% of them have been diagnosed with autism spectrum disorder, according to DSM-5 criteria. Among the assessed children, 6.7% showed behavioral issues, and 2.5% presented with reactive attachment disorders. Among the examined children, 24.4% were referred for regular follow-up at the outpatient child psychiatry clinic.

Our study indicates that preterm infants are at a high risk of developing neurodevelopmental disorders due to the immaturity and vulnerability of their brains during critical developmental periods. These findings underscore the importance of Child Psychiatry examination for this population.

None Declared

Hemodialysis, although crucial for maintaining the survival of patients suffering from end-stage renal disease, can have severe repercussions on patients’ overall quality of life and sexuality.

To determine the prevalence and factors associated with sexual dysfunction in hemodialysis patients.

This is a multicenter, descriptive, cross-sectional study with analytical aims, conducted at 3 hemodialysis units (the Mahmoud El Matri Hospital in Ariana, the El Manzah private hemodialysis center and the El Omrane polyclinic) over a 5-month period (August-December 2023). Patients’ sexual dysfunction was assessed using the IIEF5 scale.

Our study population comprised 73 patients. Patient ages ranged from 25 to 86 years, with a median age of 56.87 years. Twenty-eight subjects (38.4%) were between 56 and 70 years of age. Sixty patients (82.2%) were married, with 68 living with relatives. Regarding anamnestic data, organic comorbidity was found in all patients with diabetes in 67.1% and arterial hypertension in 50.7% of cases. The median duration of hemodialysis was 48 months. The frequency of hemodialysis sessions was 3 per week in 69 patients (94.5%).

Erectile dysfunction was diagnosed in 64 patients, corresponding to a prevalence of 87.7%. The dysfunction was mild in 24.7% of cases, moderate in 45.2% and severe in 17.8%.

Erectile dysfunction was significantly correlated with age over 55 with an adjusted OR = 2.43 and the presence of diabetes with an adjusted OR = 1.5.

The prevalence of erectile dysfunction is high in hemodialysis patients. A systematic sexological approach is needed to ensure early and appropriate management.

None Declared

Hypericum perforatum, commonly known as St. John’s Wort, is a widely used herbal remedy for mild to moderate depression. It significantly affects drug metabolism by inducing the Cytochrome P450 enzyme system, particularly the CYP3A4 enzyme. This interaction can alter the metabolism of various medications, including oral contraceptives, cancer drugs, HIV antiretrovirals, and antidepressants. St. John’s Wort increases levels of serotonin, dopamine, and norepinephrine via reuptake inhibition, similar to the action of selective serotonin reuptake inhibitors (SSRIs). However, combining St. John’s Wort with SSRIs can dangerously elevate serotonin levels, potentially leading to serotonin syndrome, a serious and potentially life-threatening condition. This review explores the interactions between St. John’s Wort and SSRIs, focusing on metabolic effects and the risk of serotonin syndrome.

To determine the impact St. John’s Wort has on the metabolism of anti-depressants and to discover the differences in severity of serotonin syndrome between various SSRI’s.

A comprehensive literature review was conducted using PubMed, Google Scholar, and Medline. The review focused on documented drug-drug interactions between St. John’s Wort and SSRIs, particularly their effects on the CYP enzyme system and the incidence of serotonin syndrome in patients taking both therapies.

The review identified that St. John’s Wort affects the metabolism of several antidepressants, primarily through the CYP3A4, CYP2C9, and CYP2C19 enzymes. SSRIs such as citalopram, escitalopram, and sertraline, metabolized by CYP2C19, are more likely to interact with St. John’s Wort than those metabolized by CYP2D6, such as paroxetine, fluoxetine, and fluvoxamine. The most significant adverse effect observed was serotonin syndrome, with case studies highlighting sertraline and paroxetine as the most commonly involved SSRIs. Dosages of SSRIs ranged from 20 mg to 75 mg, with St. John’s Wort dosages typically between 600 mg to 900 mg per day. All reported cases of serotonin syndrome involved both sertraline and paroxetine, suggesting that these SSRIs may have a higher risk when combined with St. John’s Wort, though a larger sample size is needed for statistical validation.

The literature underscores the critical need to screen for patient’s who may have added St.John’s Wort into their treatment regimen, especially when taking SSRIs. St. John’s Wort can significantly alter the metabolism of SSRIs and increase the risk of serotonin syndrome. While interactions with sertraline and paroxetine are well-documented, further research is necessary to determine the risk profile of other SSRIs in combination with St. John’s Wort.

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Aripiprazole monthly (Ar1M) has been the first long-acting injectable (LAI) partial agonist antipsychotic. The benefits of long-acting injectables in terms of relapse reduction are well known.

The aim of this study is to assess the level of acceptance and the doubts presented by patients before switching to 2-monthly Aripiprazole (Ar2M).

25 patients diagnosed with schizophrenia and related disorders in symptomatic remission were asked consecutively whether they would switch to the new bimonthly formulation of aripiprazole and the doubts expressed were collected.

The sample is composed of 25 patients (12 women and 13 men). The mean age is 52.64 years. All are being treated with Ar1M with a mean dose of 408 mg/monthly. Most of the patients present a diagnosis of affective psychosis (N=12 (42%)), 36% a non-affective psychosis (N=9) and 16% a delusional disorder (N=4). Presenting an average of 3.8 previous admissions.

Acceptance was mostly positive, with an initial acceptance rate of 76 % (N=19). Twelve percent (N=3) did not initially want the treatment. Another 12% had doubts and preferred to postpone the decision. 20% of the patients had doubts, related to possible appearance of side effects. 75% of the patients who do not want the treatment have doubts, as do the patients who prefer to wait. Of the patients who initially accepted the treatment, only 1 expressed doubts about it.

The level of acceptance of Ar2M is very high, exceeding 75%. Of the doubts expressed about the possible change, the appearance of side effects is a matter of concern. Given the high level of acceptance, the treatment proposal is important given the wide-ranging benefits it can bring to patients. The clarification of doubts and the successive proposals of the treatment can contribute to a greater acceptance.

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Women who experience childhood trauma may be at a greater risk of developing postpartum depression (PPD), which can result in significant harm to both mothers and their children. Few studies have longitudinally evaluated the effect of childhood trauma on PPD.

This study aimed to evaluate the impact of childhood trauma on PPD among Brazilian postpartum women.

This prospective longitudinal study was conducted with 153 women evaluated at two time points: T1 (immediate postpartum) and T2 (three months postpartum). PPD symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). To verify the differences in PPD scores in the periods assessed and in relation to childhood trauma, generalized estimating equations (GEE) were used. EPDS scores were categorized with values ≥10 defined as the presence of PPD. Multinomial logistic regression analyses were performed to evaluate the influence of trauma on PPD risk subgroups as follows: early PPD (risk of depression at T1), late PPD (risk of depression at T2), and chronic PPD (risk of depression at T1 and T2).

The results demonstrated that women who suffered trauma in childhood had significantly higher EPDS scores at both time points evaluated when compared to women who did not suffer from trauma. However, there was no significant difference in EPDS scores over time or in the interaction between time and childhood trauma, indicating that PPD scores and the impact of childhood trauma on PPD remained constant over time. All types of childhood trauma were significantly associated with late or chronic PPD. Emotional abuse, physical abuse, and emotional neglect are significantly associated with early PPD.

The present study demonstrated that women who experienced childhood trauma had significantly greater symptoms of PPD. However, PPD symptoms did not vary between the two assessments and remained stable. Mental health screening and interventions must be adopted during pregnancy monitoring and in the postpartum period.

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Climate change is one of the main global challenges of the 21st century due to its consequences for the environment, the economy and health. Given that human behaviour exists at the forefront of many of the environmental issues we face, it is crucial to effectively measure pro-environmental behaviours (PEB). Stanley et al. (2021) proposed the PEB Scale (PEBS), a bifactorial measure including eight items asking about personal behaviours and eight collective actions that revealed good psychometric properties. To the best of our knowledge, there is no instrument that validly assesses these parameters in the general Portuguese population.

To analyze the psychometric properties of the Portuguese version of PEBS and to explore its relationship with individual factors.

A community sample of 599 Portuguese adults (64.6% women; mean age=34.40±16.18) answered to the Portuguese preliminary version of PEBS and to the validated instruments: Climate Change Distress and Impairment Scale/CC-DIS, Big3 Perfectionism Scale–Short version/BTPS-SF, HEXACO-60 and Toronto and Coimbra Prosocial Behaviour Questionnaire/ProBeQ. SPSS 29 and AMOS-29 were used for Exploratory Factor Analysis (EFA; with a subsample of n=291) and Confirmatory Factor Analysis (CFA; n=308), respectively.

EFA revealed a 3-factor solution with an explained variance of 60.52% confirmed by parallel analysis. With CFA, fit indices were found to be acceptable for first and second-order models (X²/df=4,0741; CFI =.8638; TLI=.8382; GFI=.8515; RMSEA= .0887, p<.001). Cronbach’s alphas were of .871 for the total scale (16 items), .857 for F1 (Collective actions/CA; 5 items), .832 for F2 (Personal behaviours/PB; 8 items) and .736 for F3 (Political actions/PA; 3 items). PEBS correlated with CC-DIS (r=.48 with total PEBS, r=.42 with CA and PB and r=.21 with PA, p<.01), ProBeQ (r=.24 with total PEBS, r=.12 with CA, r=.37 with PB and r=-.14 with PA, p<.01), Narcissistic Perfectionism (r=.08, p<.05 with CA and r=.20, p<.01 with PA), Honesty-Humility (r=-.15, p<.01 with PA), Emotionality (r=-.12, p<.01 with PB and r=.09, p<.05 with PA), Extraversion (r=.09, p<.05 with CA and r=.12, p<.01 with PA), Agreeableness (r=.11 with total PEBS, r=.12 with CA and r=.14 with PA, p<.01) and Conscientiousness (r=.09, p<.05 with total PEBS). When the correlated variables were inserted as predictors in linear multiple regression models where CA, PB and PA were dependent variables, they explained 19.8% (R2=.198), 24.6% (R2=.246) and 14.9% (R2=.149) of their variance, respectively (all p<.001).

PEBS shows adequate psychometric properties, therefore, it can be used to measure PEB in the Portuguese population, namely, to analyze the efficacy of pro-climate interventions and campaigns. These initiatives should take into consideration the role of individual factors (such as personality traits) in PEB.

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