Anxiety and depression are common psychiatric comorbidities in chronic medical illnesses, such as cardiovascular, endocrine, and neurological diseases. These conditions are associated with greater disease severity, poorer functional outcomes, and reduced quality of life for patients and their families. Despite their significant global burden, they are often underdiagnosed due to overlapping symptoms with primary medical conditions. Symptoms in medically ill patients may differ from classic psychiatric presentations, often involving heterogeneous (psycho)somatic phenomena like fatigue, autonomic irregularities, gastrointestinal symptoms, sleep disturbances, and cognitive impairments. Anxiety typically manifests as hypervigilance, excessive worry, and irritability, while depression presents with persistent sadness, psychomotor slowing, and loss of motivation, pleasure, and interest. Subsyndromal symptoms, though often untreated, can exacerbate functional decline and disease progression. Effective management requires a multimodal approach, with modern psychopharmacotherapy as a cornerstone. Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are recommended first-line treatments due to their safety and efficacy. In case of insufficient response, add-on strategies may include second-generation antipsychotics, lithium, esketamine, or pregabalin for predominant anxiety. Emerging evidence supports the use of phytotherapeutics as Silexan and Rhodiola rosea for subsyndromal symptoms. Non-pharmacological interventions also play an important role. Cognitive Behavioral Therapy remains the first-line psychotherapeutic option, complemented by mindfulness techniques, psychoeducation, biofeedback, and relaxation strategies, particularly for anxiety. Chronobiological treatments like bright-light therapy and sleep deprivation have proven effective for depression, especially in seasonal patterns. Brain stimulation methods, including transcranial magnetic stimulation and electroconvulsive therapy, may also be considered based on individual needs. Importantly, successful physician-patient interactions, directly and promptly addressing emotional and psychological concerns during consultations and daily rounds, are crucial in fostering treatment adherence and improving outcomes. In conclusion, anxiety and depression in medically ill patients present unique diagnostic and therapeutic challenges. Early recognition and individualized, multimodal treatment strategies can enhance adherence and outcomes. Integrating pharmacological and non-pharmacological approaches within collaborative care models and recommended treatment algorithms is essential for effectively addressing individual clinical presentations.

None Declared

The prevalence of prolonged symptoms following a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection represents a significant health challenge with potentially severe individual and societal costs. Our study investigates the long-term cognitive and mental health consequences associated with post-coronavirus disease 2019 (COVID-19) condition (PCC) following a mild SARS-CoV-2 infection.

We conducted longitudinal assessments of cognitive performance and mental health in 50 post-COVID-19 patients and 48 matched healthy controls across 10 months, starting on average 2 years after infection. Cognitive function was evaluated using a comprehensive neuropsychological battery of standardized tests, while mental health was assessed via self-reported questionnaires. Data were analyzed with linear mixed models.

Initial group differences in cognitive performance were observed for memory, executive functioning, and perceptual speed, with worse performance in patients. Improvement across the follow-up period occurred for most tasks, with PCC patients displaying greater improvement compared to healthy controls for some memory and executive function tasks, reaching performance levels of the control group. Fatigue and mental health measures remained elevated in the patient group, with worsening in general fatigue and a small improvement in fatigue after cognitive testing. Factors such as male sex, absence of burnout history, and lower depression scores at baseline predicted cognitive recovery in the patient group.

Our study underscores the importance of addressing cognitive and psychological effects following mild SARS-CoV-2 infection, as persistent fatigue, low mental health, and cognitive impairments significantly impact individuals’ ability to return to their pre-COVID professional and personal lives.

People with severe mental disorders (SMDs) have about 15 years shorter life expectancy than the general population. Cardiovascular disease (CVD) is among the leading causes of premature mortality and shares genetic underpinnings with SMDs. We investigated the link between clinical traits in SMDs and time to the first CVD diagnosis.

The study included 1,627 well-characterized participants with schizophrenia spectrum (SCZ, N = 998) and bipolar spectrum disorders (BDs, N = 629), and a reference group of 1,201 healthy controls. CVD diagnoses were obtained from two Norwegian national registries (covering both primary and specialist health care) for the period of 2006–2020. Applying Cox proportional hazard models, we investigated associations between SMD clinical traits and time to first CVD diagnosis in SMD participants, adjusting for age, sex, diagnosis, and tobacco use.

Among individuals with SMD, recurring self-harming behavior (SHB) was associated with a shorter time to first CVD diagnosis (p = .029) relative to those without SHB. In the subgroup with SHB and a history of attempted suicide(s), more suicide attempts were associated with shorter time to first CVD diagnosis (p = .041). Significant associations of time to first CVD diagnosis with age at SMD onset and comorbid substance use disorder were not demonstrated.

SHB and a history of suicide attempts in individuals with SMD seem to be associated with earlier CVD onset, and may improve the prediction of CVD, in addition to standard cardiovascular risk factors.

Anxiety and depression are prevalent mental health conditions in patients with diabetes, significantly impacting their quality of life and complicating glycaemic control. The interplay between psychopharmacological agents and diabetes medications presents unique challenges in managing both mental health and metabolic conditions. This presentation reviews of psychotropic drugs commonly used to treat anxiety and depression in diabetic patients, with a focus on their efficacy, safety, and potential adverse effects. Special attention will be given to drug interactions between antidepressants, anxiolytics, and antidiabetic medications, which can influence treatment outcomes. Key considerations include the effects of psychotropic agents on insulin sensitivity, glucose metabolism, and the risk of hypoglycaemia. The presentation will also discuss personalized treatment strategies, adjusting for individual patient profiles and comorbidities. By integrating both psychiatric and endocrinological perspectives, we aim to improve clinical outcomes through optimized pharmacological management and minimize the risk of adverse drug interactions in this vulnerable patient population.

None Declared

Since the very beginning of the COVID-19 pandemic, consultation-liaison psychiatry (CLP) services were in first line to face the effects of the novel virus.

Aim of this study was to assess the activity of CLP services during the pandemic, and to identify specific work features associated with the need for psychological/psychiatric support by the CL psychiatrist during the pandemic.

This study was carried out in six European countries. A questionnaire was developed to collect information concerning psychiatric referrals for patients affected and not affected by COVID-19. Multivariate binary logistic regressions were used to study work-related factors associated with the need for psychological and/or psychiatric support by the CL psychiatrist during the pandemic.

The sample included 108 psychiatrists working in CLP services in six countries. The majority reported that the pandemic had not impacted on their work with non-COVID-19 patients. Among patients affected by COVID-19, the most common psychiatric diagnoses were anxious-depressive disorders related to COVID-19, delirium due to COVID-19, anxious-depressive disorders unrelated to COVID-19, suicidal ideation related to COVID-19. The 25% of psychiatrists reported having needed psychological or psychiatric support during the pandemic due to assisting COVID-19-positive patient. The need for support was associated with increased age, few years of medical experience and experience of anxiety while consulting COVID-19-positive patients. The risk was reduced using personal protective equipment and teleconsulting.

Findings prompt to the need of addressing health issues of health care professionals, namely psychiatrists working in the field of CLP and psychosomatics.

Mental disorders affect nearly 970 million people worldwide, impacting individuals and healthcare systems. Large population databases offer insights often unattainable in smaller studies, but their findings may not always generalize across diverse regions. To address this, we introduce a European cohort from Catalonia, Spain, allowing for comparisons between individuals with mental disorders and the general population.

Data were obtained from the “Programa d’analítica de dades per a la recerca i la innovació en salut” (PADRIS). The cohort included all individuals who accessed public specialized mental health services between 2015 and 2019, with retrospective follow-up extending to 2010. These individuals, referred to as cases, were matched by age, sex, and health region with controls, individuals who had no interactions with mental health services during the same period. Sociodemographic and clinical characteristics, including psychiatric diagnoses, comorbidities, smoking status, healthcare utilization, and prescribed treatments, were analyzed.

The study included 1,421,510 individuals (mean age: 41.6±22.1; 53.6% female), with 473,812 cases and 947,698 controls. Cases were more likely to be exempt from income reporting, be ever-smokers, and have musculoskeletal comorbidities. A total of 1,547,374 psychiatric diagnoses were recorded, with anxiety (31.38%) and mood disorders (18.83%) being the most frequent. Over the follow-up, 76.2 million primary care visits and 67.1 million prescriptions were recorded.

This cohort enhances our understanding of mental health service use, diagnostic trends, and treatment patterns in Catalonia. The insights derived from this cohort have the potential to inform mental health policies, improving outcomes within and beyond the region.

Psychopharmacological treatment of anxiety and depression in patients with liver and/or kidney disease is complex, primarily due to the differences in pharmacokinetics compared to healthy individuals. Most medications are excreted via the kidney and/or liver, so dose adjustments are often necessary in these patients. Drug-drug interactions are also a significant clinical concern in liver and/or kidney disease, making regular monitoring essential. These factors may contribute to treatment relapse and severe adverse drug reactions associated with psychotropic medications and comedications.

Medication selection is, therefore, based on these considerations. Clinicians must regularly monitor kidney and liver function, although there are no clear global recommendations. A summary of product characteristics is the primary guideline for dose adjustments related to kidney and liver function, though it has limitations and is updated slowly. The most important monitoring parameters for these patients are liver enzymes and serum creatinine levels.

Patients with liver and/or kidney disease are often excluded from randomized controlled trials, meta-analyses, and clinical guidelines, resulting in a lack of data specific to this population. This issue is even more relevant in elderly patients treated with polypharmacy, as many somatic medications can worsen liver and/or kidney function in patients with anxiety and depression. In this context, some medications, such as vortioxetine, trazodone, agomelatine, quetiapine, and sertraline, are less affected by kidney disease in terms of pharmacokinetics.

Several tools are available for prudent medication selection and monitoring in these patients, including medication lists (e.g., Beers, Priscus), therapeutic drug monitoring (TDM), and collaboration with clinical pharmacists and/or pharmacologists. In this presentation, the presenter will discuss this topic from both pharmacological and clinical perspectives. Participants will learn the fundamental pharmacokinetic aspects necessary for medication selection in these patients, which are valuable for daily practice.

None Declared

Anxiety and depression are prevalent mental health conditions in patients with diabetes, significantly impacting their quality of life and complicating glycaemic control. The interplay between psychopharmacological agents and diabetes medications presents unique challenges in managing both mental health and metabolic conditions. This presentation reviews of psychotropic drugs commonly used to treat anxiety and depression in diabetic patients, with a focus on their efficacy, safety, and potential adverse effects. Special attention will be given to drug interactions between antidepressants, anxiolytics, and antidiabetic medications, which can influence treatment outcomes. Key considerations include the effects of psychotropic agents on insulin sensitivity, glucose metabolism, and the risk of hypoglycaemia. The presentation will also discuss personalized treatment strategies, adjusting for individual patient profiles and comorbidities. By integrating both psychiatric and endocrinological perspectives, we aim to improve clinical outcomes through optimized pharmacological management and minimize the risk of adverse drug interactions in this vulnerable patient population.

None Declared

Youth exposed to poverty and adversities like violence are at higher risk of mental health problems (MHP), but whether antipoverty interventions can reduce this risk remains unclear. We examined the association between participation in the Brazilian Cash Transfer Program (BFP) and mental health of children/adolescents exposed to different levels of adversity.

Observational study using nearest-neighbor propensity score matching to compare BFP participants and non-participants from the Itaboraí study, a community-based cohort of 1,189 children/adolescents (6–15 years) assessed at two waves (meaninterval: 12.9 months).Measures included the Child Behaviour Checklist (CBCL) externalizing, internalizing, and total problems scales; an adversity score derived from a confirmatory factor analysis on violence victimization at home (WorldSAFE), school (threat/maltreatment/being chased by peers) and community (Survey of Exposure to Community Violence), and stressful life events (UCLA Posttraumatic Stress Disorder Reaction Index); and BFP exposure for at least 12 months (yes/no). Latent change score models tested whether BFP participation predicted changes in CBCL T-scores, moderated by adversity levels.

A total of 330 BFP participants were matched with 330 non-participants with similar sociodemographic characteristics. Decreases in total (b=−0.124, SE=0.034, p<0.001), externalizing (b=−0.122, SE=0.036, p=0.001), and internalizing problems (b=−0.141, SE=0.033, p<0.001) between baseline and follow-up were observed among BFP participants exposed to higher levels of adversity compared with non-participants.

BFP participation was associated with reduced MHP only among children/adolescents facing high adversity, suggesting the program may help break the cycle between poverty and mental health problems—but benefits are concentrated among the most vulnerable.

The subtle, subjective nature of basic symptoms (BS) has often led to doubt regarding their clinical significance.

We therefore examined the prevalence, clinical significance and course of BS over three years in a large sample (N = 2684) of 16- to 40-year-old residents of the Swiss canton of Bern (response rate: 64%). At follow-up, persons with a lifetime risk symptom at baseline were compared with control subjects (N = 834; response rate 66%). Fourteen criteria-relevant BSs were assessed by trained clinical psychologists over the telephone, along with information on symptomatic ultra-high-risk symptoms, mental disorders and functioning.

At baseline, 18% of the participants reported any lifetime BS, 10% had still experienced one in the three months prior to the interview. In general, BS were rare, and only 2% of the participants met any BS criteria, which was significantly associated with non-psychotic mental disorders (OR = 5) and especially with functional deficits (OR = 16). At follow-up, five individuals had developed psychosis, one with BS criteria and three more with BS at baseline. In addition, 95% of the participants no longer met the BS criteria, while 3% reported new BS criteria.

Although BS are not rare phenomena in the community, they rarely persist and rarely occur frequently enough to meet the requirements of the risk criteria. Furthermore, they do not appear to occur randomly, but are restricted to a subpopulation of vulnerable individuals – possibly occurring in times of stress and/or low mood and functional difficulties in these individuals.

None Declared

The main contributions of Spanish and Hispano-American authors to the study of basic symptoms, either published in Spanish and English, will be briefly presented. Former publications mainly included translation and validation of different versions of the Frankfurt Complaint Questionnaire, transversal and longitudinal studies, and their role for psychosocial rehabilitation, also in a Penitentiary Psychiatric Hospital. More recent research includes the network analysis of basic, attenuated, and frank psychotic symptoms on 460 subjects attending a German early detection service, where disorganized communication, delusions and hallucinations were the most central symptoms. Interestingly, cognitive and perceptual disturbances, included in basic symptom criteria, appeared to develop across attenuated symptoms to frank positive psychotic symptoms. Concerning the finding of three clusters of symptoms, “subjective disturbances”, “positive symptoms and behaviors”, and “negative and anxious-depressive symptoms”, the predominately attenuated hallucinations of both SIPS and PANSS joined the basic symptoms in “subjective disturbances”, therefore underlining the importance of insight in separating true psychotic hallucinations from other hallucinatory experiences and not justifying antipsychotic medication.

None Declared

Dysphoria is a complex phenomenon, which must be defined in the framework of different forms of affections. It belongs to the broader field of emotions, which are characterized by some essential features: i.e. movement, passiveness, transitoriness, and reference to the others. All these four essential features of emotion are specifically altered in depression. In discussing dysphoria, a first distinction is made between particular and global affections. The first type encompasses emotions and feelings, while the second one includes humor, mood and temper. Dysphoria belongs to one of these global affective states: the humor, which has to do with the spatial dimension of existence. In dysphoria, the patient experiences the world as oppressive and invasive of his/her intimacy; the others are lived as persons demanding answers or actions he/she is not able to fulfill. Finally, the phenomenology of dysphoria is analyzed through the four essential features described above and examples are given. Irritability – as Kraepelin taught us more than 100 years ago- is the most frequent psychic condition of these patients. The humor is very instable and depending, above all, on the interpersonal relationships. It is a typical humor of premenstrual disorder, but also of the borderline personalities, as Stanghellini and Rosfort (2013) have so clearly showed. We have also observed dysphoria in two other conditions, depression and mania, though with different nuances in the form of presentation. Finally, we would like to show how the different features characterizing emotion in general, which are derived from the etymology of the word, are present in dysphoria. First, the movement appears in dysphoria as a corporal restlessness always accompanying irritability. The dysphoric state is the opposite of being in peace with oneself and with the world. It is being under pressure, urgency, loss of control, impulsivity. Second, passivity: the subject cannot decide to be in one state or the other: dysphoria happens without notice and invades the subject, who is unable to defend himself against it. Borderline patients are unable to take distance from their emotional states and particularly from dysphoria, blaming others for the consequent discomfort. The third element is transitoriness. This feature is particularly observed in premenstrual disorder. Menstruation begins and the state disappears. Something similar occurs with pre-depressive dysphoria. In manias, by contrast, dysphoria only diminishes with the treatment. The last element we infer from the etymology of emotion is commotion, that is, its permanent reference to the other. The active participation of the other in the dynamic of dysphoria is particularly evident in borderline personalities, but also in depressive and manic dysphoria, but not in premenstrual syndrome.

None Declared

Aggressive emotions—such as anger, rage, envy, and resentment—play a complex role in human experience, spanning personal, social, and psychopathological dimensions. While anger can serve as a protective, communicative, or motivational force, it can also escalate into destructive emotions such as revenge, hatred, or resentment. This talk explores the phenomenology, psychology, and psychopathology of aggressive emotions, drawing from philosophical, psychoanalytic, and neuroscientific perspectives. These have a bodily-affective nature, shaping perception, behavior, and interpersonal dynamics (Schmitz, 2019; Landweer, 2020). While anger is often a reaction to a perceived transgression, it also functions as a regulatory mechanism for social norms and personal boundaries (Berkowitz, 1962; Bandura, 1973). I examine the ontological independence of emotions, showing how their spatial and embodied qualities influence their regulation and transformation (Fuchs, 2005). A key focus will be the transformation of anger into resentment and revenge, using Nietzsche and Scheler’s theories of ressentiment to explore how powerlessness fuels hostility (Nietzsche, 1887; Scheler, 1912). We discuss how pathological resentment differs from normative anger, leading to chronic hostility, ideological fixation, and moral superiority complexes. Finally, I analyze the role of aggressive emotions in psychopathology, considering their manifestations in personality disorders, trauma-related disorders, and psychotic states (Novaco, 1979; Cameron, 1943). From paranoia’s persecutory anger to the dysregulated aggression of borderline and antisocial personalities, the keynote explores how anger-related emotions are structured, experienced, and acted upon across clinical categories.

None Declared

Gender dysphoria (GD) is defined by the presence of clinically significant suffering associated to the marked incongruence between the experienced gender and the one which was assigned at birth. The inherent duplicity to the human condition forces us to reflect on the fact that, in some cases, the body may be the most intimate piece of the Self, whilst also being the most foreign one. The experience of feelings of shame and hatred for oneself and the importance of the Other’s gaze are pressing in GD, which presents as deeply impactful in the individual’s functioning.

This review aims to identify and explore the phenomenology of the suffering so often mentioned by GD patients, but which has been ignored and remains mainly unidentified in the psychopathology realm.

Through the exploration of both the PubMed database and publications by philosophers who have been, throughout the years, approaching the gender theme and distinguishing its evolution along the years, I aim to review the qualitative literature available of the dissection of the different domains of GD.

GD is an ever growing psychiatric diagnostic, frequently presenting with psychiatric comorbidities. Its treatment poses as highly effective, while its consequences may be pervasive and affecting different domains of the individual’s functioning. The exploration of gender identity may be a never ending journey, which makes the acknowledgement of the associated psychopathology fundamental in the design of a truly empathic relationship with these patients.

None Declared

Dysphoria and impulsivity are embodied experiences that pervade numerous psychiatric conditions and evade easy categorization within traditional diagnostic boundaries. Phenomenological approaches are needed in order to clarify underlying experiential structures. Psychopharmacology has traditionally been perceived as a “biological intervention”, where success is measured by its impact on symptom clusters outlined in the ICD and DSM frameworks, ignoring the specific impact of medication on lived bodies and existential states. An embodied approach to psychopharmacology integrates phenomenology, neuroscience, and physiology, moving beyond traditional reductive perspectives. By examining how medications influence not only symptoms but also the lived experience and embodied sense of self, we can develop a more nuanced understanding of their effects, and possibly strive towards development of distinct phenomenological profiles of medication, which would enhance our understanding of dysphoria and impulsivity.

None Declared

People living with schizophrenia (PLWS) face one of the most significant health equality gaps in Europe. Their life expectancy is 15–20 years shorter than that of the general population, mainly because they are affected at an earlier age by preventable physical illnesses, but encounter barriers in accessing adequate care. PLWS did not benefit from prevention campaigns for cardiovascular, oncologic, or metabolic risk. Antipsychotics might add to the cardiometabolic risk and represent a further reason for monitoring and treating emergent conditions. Notwithstanding international guidance papers or national guidelines, PLWS do not receive adequate screening and treatment.

This presentation will summarize national and international efforts to reduce this health equality gap, illustrating the minimum screening procedures and several interventions that can be integrated into schizophrenia treatment to improve health outcomes of PLWS.

A. Mucci Consultant of: Angelini, Gedeon. Richter Bulgaria, Janssen Pharmaceuticals, Lundbeck, Otsuka Pharmaceutical, Pfizer, Pierre Fabre, Rovi. Pharma and Boehringer Ingelheim

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked genetic enzymopathy that impacts 4.9% of the population, with greater prevalence among Mediterranean, East Asian, and African populations. G6PD deficiency results in levels of nicotinamide-adenine dinucleotide phosphate (NADPH) and glutathione (GSH) that are insufficient for maintaining the balance of oxidation-reduction in the body. This results in elevated production of reactive oxygen species (ROS), oxidative stress on proteins and lipids, damage to DNA, and potential activation of chemokine and cytokine pathways by astrocytes and microglia. We propose that these direct and indirect effects of G6PD deficiency are associated with development of ADHD.

This study investigated the association between G6PD deficiency and Attention Deficit/Hyperactivity Disorder (ADHD).

The study involved 7,473 G6PD-deficient patients and 29,892 matched case-controls (selected at a 1:4 ratio) from a cohort of 1,031,354 within the Leumit Health Services database. Clinical characteristics were analyzed using Fisher’s Exact Tests for categorical variables and Mann-Whitney U tests for continuous variables.

The average age of patients was 29.2 ± 22.3 years, with 68.7% being male. The mean follow-up duration was 14.3 ± 6.2 years. Individuals with G6PD deficiency showed a significant 16% higher risk of being diagnosed with ADHD (Odds Ratio (OR) = 1.16 [95% CI, 1.08-1.25], p < 0.001) on follow up. Furthermore, G6PD deficiency was associated with a 30% greater likelihood of seeking care from adult neurologists (OR = 1.30 [95% CI, 1.22-1.38], p < 0.001) and a 12% higher probability of consulting adult psychiatrists (OR = 1.12 [95% CI, 1.01-1.24], p = 0.048). The use of stimulant medications among G6PD deficient individuals was 17% higher for methylphenidate class drugs (OR = 1.17 [95% CI, 1.08, 1.27], p < 0.001), and use of amphetamines elevated by 16% (OR = 1.16 [95% CI, 1.03, 1.37], p = 0.047).

This study establishes a significant association between G6PD deficiency and an increased risk of ADHD diagnoses. These findings suggest potential opportunities for the development of culturally sensitive interventions.

None Declared

Jonathan will present the impacts of smoking on physical and mental health, the impact of smoking cessation on mental health and the need to reduce doses of some psychotropic medications after cessation in order to prevent toxicity. He will set out the low population coverage of evidence-based interventions for smoking cessation and prevention uptake particularly for people with mental health conditions, and the reasons for this. He will then outline implementable opportunities to scale up coordinated coverage of interventions by different sectors

None Declared

Jonathan will begin by outlining the impact of mental disorder and wellbeing. He will summarise effective public mental health interventions to treat mental disorder, prevent associated impacts, prevent mental disorder, and promote mental wellbeing and resilience. He will outline the scale of implementation failure of such interventions and the reasons for this. He will then set out required actions and real-world solutions to support scale implementation of public mental health interventions leading to sustainable reduction of the impact of mental disorder and the promotion of mental wellbeing.

None Declared

Emerging research reveals a striking overlap between ADHD, hypermobility syndromes, immune dysfunction, and autonomic dysregulation. Studies suggest that approximately half of individuals with ADHD are hypermobile, while ADHD is significantly over-represented in those with hypermobility syndromes, such as Hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorder (HSD). Unlike benign joint hypermobility, these syndromes involve multisystem pathology, often accompanied by dysautonomia (e.g., postural orthostatic tachycardia syndrome, POTS), mast cell activation disease (MCAD), and autoimmune conditions.

This ‘somatic super-syndrome’ encompasses many of ADHD’s under-recognised somatic comorbidities, including hypermobility, allergy and autoimmunity, POTS, fatigue and pain syndromes (Chronic Fatigue Syndrome and Fibromyalgia Syndrome), and sensory processing issues, amongst others. A small but growing body of evidence suggests that mast cells - ‘first responder’ immune cells involved in allergic and inflammatory responses - play a critical role in neurocognitive function and that their excessive activation has been associated with a range of neurological and psychiatric/neurodevelopmental conditions. Could a similar issue with aberrant mast cell activation be contributing to the pathophysiology of ADHD.

Dr. James Kustow, consultant psychiatrist and adult ADHD specialist, will present the latest insights into this complex interplay between connective tissue dysfunction, chronic low-level inflammation, and autonomic dysregulation. He will explore how these factors may, in some, drive an ADHD-like syndrome and discuss emerging research on neuroimmune mechanisms linking ADHD with inflammatory disorders such as infections, asthma, rhinitis, and food allergies.

By illuminating these connections and reviewing the available evidence, this presentation will encourage a broader, integrative approach to understanding and managing ADHD. It will also consider how future research might inform novel therapeutic strategies targeting immune dysregulation and autonomic dysfunction in ADHD.

J. Kustow Consultant of: I have done some consultancy work for a couple of pharmaceutical companies but not for over 3 years, Speakers bureau of: I have previously spoken at and chaired events organised by pharmaceutical companies (but I dont speak on the subject of ADHD medication).