Artificial intelligence (AI) is reshaping mental health care by improving diagnosis, treatment, and patient support. AI-driven tools streamline administrative tasks, enhance clinical documentation, contribute to medical education, and enable continuous symptom monitoring. Additionally, AI augments text-based support programs, offering accessible psychological interventions. However, while AI applications have been assessed for perceived empathy, their impact on clinical outcomes remains uncertain, highlighting the need for evidence-based implementation.

AI can immediately enhance efficiency in routine clinical tasks. Automation optimizes billing processes and reduces clerical burdens, allowing clinicians to focus more on patient care. In clinical documentation, AI-powered transcription and natural language processing (NLP) help generate structured medical records. AI also supports medical education by offering adaptive learning, personalized training, and real-time feedback through large-scale data analysis.

Beyond administrative support, AI plays a role in patient monitoring and early intervention. AI algorithms analyze speech, facial expressions, and behavioral data from smartphones and wearables, detecting mood fluctuations and early psychiatric symptoms. This real-time analysis can facilitate timely interventions and improve overall mental health care. Additionally, AI-powered chatbots and virtual therapists are increasingly used in digital mental health services, providing immediate, text-based psychological support. However, rigorous studies are needed to assess their effectiveness in improving clinical outcomes. A well-established framework for technology evaluation in mental health highlights five key areas for development: equity, privacy, evidence, clinical engagement, and interoperability. Addressing these factors is crucial to ensuring AI-driven solutions are accessible, secure, scientifically validated, clinically integrated, and capable of working across diverse health systems. By prioritizing these advancements, AI can move from theoretical promise to practical application, meaningfully improving mental health care delivery.

None Declared

There is a potential for new technologies in mental health and psychiatry. Artificial intelligence enables the design models that categorize different groups and predict different prognosis trajectories.

Natural language processing enables to use classical text data from electronic health records, for instance, to detect suicide trends and their risk factors (Bey et al., 2024). This opens new perspectives in the analysis of large Electronic Health Records databases.

Artificial intelligence can extract and combine new features, like posture, physiological signal of stress and facial expression. This could be particularly important to bypass insight development in children of adolescents (Bourvis et al., 2021) while taking the opportunity of early management. This could help to optimize exposure therapy (Mahmoudi-Nejad et al., 2024), detect tantrums in non-verbal children (Cano et al., 2024) or even improve motivation for physical activity (Nuss et al., 2020).

In motion assessment, we could detect motor assessment difficulties in children with autism from typical counterparts (Gargot et al., 2022). We can also automatically detect writing difficulties (Agarwal et al, 2023).

However, AI struggles with an interpretability problem (black box). Their model are complex, the features extracted are not always obvious (Minh et al, 2021 ; Linardatos et al, 2020) .

Fine motor skills classic signal processing allows to tailor specific exercises to reeducate children with writing difficulties (Gargot et al., 2021).

Digital psychiatry however is impeded by poor user experience (Witteman et al., 2011), complex market models (Gollier-Briant et al., 2024).

None Declared

Artificial intelligence (AI) is transforming psychiatric training and education by enhancing diagnostic accuracy, improving therapeutic decision-making, and personalizing learning experiences for trainees. AI-driven simulations, virtual patients, and natural language processing (NLP)-based assessments allow for more effective skill development in psychiatric diagnosis and psychotherapy. Machine learning models provide evidence-based guidance, reinforcing clinical reasoning and treatment strategies. Ethical considerations, including patient confidentiality and bias mitigation, remain central to AI implementation in training. This session explores the latest advancements in AI-driven psychiatric education, discussing practical applications, challenges, and future directions for integrating AI into clinical training programs.

AI, psychiatry, education, machine learning, clinical training

1. Ahmed, M., & Rush, A. J. (2023). Artificial intelligence in psychiatry: Current applications and future directions. Journal of Psychiatric Research, 157, 106-121.

2. Ryu, S., & Kim, H. (2022). AI-based learning tools for medical education: A systematic review. Medical Teacher, 44(5), 512-520.

3. Luxton, D. D. (2021). Ethical implications of AI in mental health care. Journal of Ethics in Mental Health, 12, 1-14.

None Declared

In this paper several issues about cultural competence will be addressed, such as assumptions, Mason’s five progressive steps and learning needs of professionals. The notion of cultural competence combines an understanding of different belief systems, good communication skills (including highly specialist skills such as the communication of internal emotional states, and the cultural adaptation of treatment models and therapies. Professionals can measure theircompetence on a continuum developed by James Mason. His five progressive steps are: cultural destructiveness, incapacity, blindness, pre-competence, and competence. Next, the mental health needs of refugees will be discussed, especially for those who are at risk to become violent offenders. For example, some types of environmental and psychosocial stressors that refugees may experience day-to-day. Some of the cultural and attitudinal factors should be taken into account when working with refugees and wider communities. Finally, educational needs for trainees in (forensic) psychiatry and (forensic) psychiatrists will be highlighted. Knowledge about culture, ethnicity, race, religion, and identity is hereby crucial. Reflections will be made on the presented case.

None Declared

For women navigating both ADHD and the (peri)menopausal transition, sleep problems are a common and significant hurdle. This presentation explores effective ways to improve sleep for (peri)menopausal women with ADHD, drawing on research into hormonal, non-hormonal, and behavioural approaches. ADHD can make sleep difficult, contributing to issues like delayed sleep phase, insomnia, and restless legs syndrome/periodic limb movement disorder (RLS/PLMD), with roughly 60% of adults with ADHD screening positive for a sleep disorder. Research indicates that adults with ADHD often take longer to fall asleep and experience more sleep-related challenges than those without ADHD. Similarly, (peri)menopausal women often struggle with sleep disturbances, including poor sleep quality and increased restless legs symptoms. Considering that (peri)menopausal symptoms can also impact cognitive function, addressing these symptoms may lead to better sleep. Menopausal Replacement Therapy (MRT) may be beneficial, especially for women with vasomotor symptoms, as it can improve sleep quality and reduce nighttime awakenings. In addition, multiple studies suggest that bioidentical progesterone can improve sleep quality in perimenopausal women. We will also discuss non-hormonal options and behavioural strategies like cognitive behavioural therapy, exercise, and mindfulness techniques. With a significant percentage of women with ADHD diagnosed with a sleep disorder and prescribed sleep medication, and a similar percentage of perimenopausal women experiencing sleep disturbances, a personalised, integrated approach is key. This includes fine-tuning ADHD medication, managing any co-existing mood issues, and customising treatments to fit individual needs.

None Declared

Artifical Intelligecne is sold as a magic solution, and yet its inscrutability poses a major problem. Who is the source of the knowledge? Who is accountable? Who is responsible? Who can edit or train it? Has it been trained on copyrighted material? If so, have the owners been compensated? If not, is it culturally relevant? Has the ‘black box’ aspect been addressed? Whether a provider of knowledge, a clinical decison aid or a decsion maker, troubling issues arise that as yet have not been solved by legisaltion or the market. We shall explore potential benefits, solutions, and actual problems with real world cases that shed light on where AI may take us, and where we may need constarints that lie beyond medical ethics.

None Declared

Attention-Deficit/Hyperactivity Disorder (ADHD) In my talk, I will present the latest evidence, mainly based on previous meta-analyses, network meta-analyses, dose-response meta-analyses, and umbrella reviews, that can inform clinical decision-making in the field of pharmacological treatment for ADHD, including the choice of initial medication, titration, treatment of stimulant-refractory cases, management of cases with comorbid conditions, and management of adverse event.

None Declared

Early onset psychosis and, especially, early-onset schizophrenia (EOS), defined as the onset of psychotic symptoms before the age of 18, represent severe and frequently disabling conditions with adverse long-term functional consequences. Effective pharmacological treatment is critical to mitigating symptom progression, reducing relapse, and improving long-term outcomes. This presentation provides an update on current evidence-based pharmacological strategies for EOS, with a focus on efficacy, safety, and emerging treatments.

Second-generation antipsychotics (SGAs), such as aripiprazole, quetiapine, paliperidone, and risperidone, remain the mainstay of treatment, with lurasidone and brexpiprazole showing positive results in more recent studies. While olanzapine is clearly an effective SGA, its more pronounced cardiometabolic side effects have relegated olanzapine more to a second-line antipsychotic when other SGAs are ineffective. Thus, comparative efficacy, side effect profiles, and long-term metabolic risks are relevant when choosing among individual agents. The role of clozapine for treatment-resistant EOS and considerations regarding polypharmacy are relevant, given that EOS is one of the most reliable risk factors for treatment-resistant schizophrenia .

Long-acting injectable antipsychotics (LAIs) have not been explored in randomized trials so far, but are an important treatment tool, given the widespread non-adherence risk, which is even higher earlier in the illness. Novel mechanisms, including cholinergic muscarinic agonist treatments, recently approved for the first time for adults with schizophrenia, which address presynaptic hyperdopaminergia and in a highly selective fashion, need to be explored in EOS in the future. Additionally, the importance of early intervention strategies and adjunctive nonpharmacological and pharmacological treatments, e.g., mood stabilizers, antidepressants for specific domains of schizophrenia and for comorbid conditions, as well as best practices for transition into the adult psychiatry sector require further study.

In summary, treatment selection for youth with EOS should balance short-term as well as long-term efficacy considerations and safety concerns. While pharmacological advancements in EOS generally lag behind advances in adults, innovations are hoped to also reach EOS. More individualized and measurement-based approaches needed to be explored in both research settings and clinical care aiming at optimizing the pharmacological management for individuals living with EOS.

C. Correll Grant / Research support from: Boehringer-Ingelheim, Janssen and Takeda, Consultant of: AbbVie, Alkermes, Allergan, Angelini, Aristo, Autobahn, Boehringer-Ingelheim, Bristol-Meyers Squibb, Cardio Diagnostics, Cerevel, CNX Therapeutics, Compass Pathways, Darnitsa, Delpor, Denovo, Draig, Eli Lilly, Eumentis Therapeutics, Gedeon Richter, GH, Hikma, Holmusk, IntraCellular Therapies, Jamjoom Pharma, Janssen/J&J, Karuna, LB Pharma, Lundbeck, MedInCell, MedLink, Merck, Mindpax, Mitsubishi Tanabe Pharma, Maplight, Mylan, Neumora Therapeutics, Neuraxpharm, Neurocrine, Neurelis, Newron, Noven, Novo Nordisk, Otsuka, PPD Biotech, Recordati, Relmada, Response Pharmaeutical, Reviva, Rovi, Saladax, Sanofi, Seqirus, Servier, Sumitomo Pharma America, Sunovion, Sun Pharma, Supernus, Tabuk, Takeda, Teva, Terran, Tolmar, Vertex, Viatris and Xenon.

A bill on euthanasia and assisted suicide is currently under discussion in France. It proposes that only competent adults suffering from a serious and incurable condition that threatens their life in the medium term, or who are in an advanced or terminal phase, and experiencing unbearable physical or psychological suffering—either refractory to treatment or considered unbearable in the absence of treatment—may request medical assistance in dying (MAiD). However, French psychiatrists have expressed concerns about the bill, as it does not mandate a psychiatric evaluation, despite the high prevalence of mental disorders, including depression, in the general population. These disorders are even more frequent in end-of-life conditions and can significantly impact decision-making capacity and the wish to die. Depression, a common comorbidity in cancer—the leading cause of MAiD requests—affects approximately 15% of cancer patients but is often underdiagnosed and undertreated. The bill also raises concerns regarding its implications for suicide prevention. Some MAiD requests may stem from treatable psychiatric conditions rather than a well-considered end-of-life choice. Furthermore, a proposed obstruction offense could potentially criminalize suicide prevention efforts, complicating the role of mental health professionals. Uniquely, the French bill allows a third party chosen by the patient to administer the lethal substance, a provision not found in any other country. This raises significant ethical and psychological concerns regarding the emotional burden on the designated individual, who may experience distress, guilt, or long-term psychological repercussions from actively participating in assisted dying. Finally, the possibility of future expansion to include psychiatric-only indications, as seen in other countries, remains a critical issue requiring careful ethical and medical scrutiny.

None Declared

The Flemish Association of Psychiatry developed due care guidelines for medical assisted dying in cases of severe and unbearable psychiatric suffering, which were adopted by the Order of Physicians. In principle, there are therefore more than enough well-known recommendations on how to handle a request for termination of life from a patient with psychiatric issues.

Nevertheless, occasionally something goes wrong due to misinterpretation of the legal criteria or due to careless actions by the consulting or performing physician.

In 2010, a female patient died by euthanasia because of unbearable mental suffering, which was unacceptable for her family. The family decided to initiate a court case to have the inaccuracies in the decision-making process and the execution of the euthanasia evaluated by a judge. In 2020, three involved doctors, including a psychiatrist, were prosecuted for this euthanasia. An analysis of the court case and the media coverage of this case will be discussed.

None Declared

Medical assistance in dying is an increasingly available option for people suffering (solely) from psychiatric disorders. Initially promoted to alleviate the suffering of terminally ill people, a growing number of jurisdictions are adopting it for any cause of intractable and severe suffering, including mental disorders. Today, the BENELUX countries, along with Spain and Switzerland, explicitly authorise it or allow it de facto. Other countries, such as Canada, are considering implementing it. Although in jurisdictions where it is permitted it is argued that it is discriminatory not to consider mental suffering as sufficient cause, there are reasons for concern. The procedure is likely to be used as an alternative to care, that is, as a gentler form of suicide, more commonly used by women. The long-term impact of this practice must be considered, as it sends the message that mental illnesses may not be curable, and that it is not worth the effort to treat them, or to demand the necessary care. Furthermore, all of these factors must be considered in the context of highly stigmatized disorders to which clearly scarce resources are allocated.

None Declared

In 2002, the euthanasia law was voted in Belgian parliament, depenalising physician-assisted dying under certain conditions for irremediable physical or mental suffering caused by an incurable condition for which all therapeutic options have been exhausted. The euthanasia request needs to be repeated, well-considered and voluntary and the patient should be competent. If the patient is not in a terminal condition, there should be at least one month between the written request and the euthanasia and three independent physicians have to be involved in the evaluation.

Psychiatric suffering was not excluded in the law, but there is discussion whether the possibility of psychiatric euthanasia was intended by the legislator. In the first years after the euthanasia law, psychiatric euthanasia was limited to a few cases, but then rose to a mean of 25 cases per year. There was a peak in 2013 of 54 cases, but after 2013 there was no more increasing trend.

In 2017, the Flemish Association for Psychiatry issued an advice regarding due diligence in psychiatric euthanasia. Controversy regarding psychiatric euthanasia kept stirring the public debate, especially after one court case in which a psychiatrist and general physician were accused and acquitted after a psychiatric euthanasia.

Another prominent topic in the public debate in Belgium is broadening the euthanasia law for advanced dementia based on an advance directive. Now euthanasia is only possible in the earlier stages of neurodegenerative disease, when competence is still sufficiently intact.

None Declared

The presence of large numbers of Ukrainians looking for refuge in Poland is a new experience for Poles. The ongoing war and the uncertainty of the situation of those displaced may cause anxiety and lead to stressful reactions, exacerbated by endlessly circulating information on hostilities. Therefore, the sense of security may be threatened not only among Ukrainians who have fled to Poland, but also among people who support Ukrainians, who offer them help and shelter. Prolonged support, if not accompanied by proper selfcare can increase the risk of burnout as well as lead to distressful emotional states, such as a feeling of helplessness, reluctance to provide further help, or even demonstrate hostility. The Polish government and polish NGO’s have pledged to help refugees from Ukraine, including the provision of mental health care. Raising awareness of the whole society and training employees from sectors other than medical may help in the proper protection of mental health of refugees and the people supporting them. Dividing the organization of mental health care into the four levels (Intervention Pyramid (Inter Agency Standing Committee, 2007)and offering support depending on the needs, ranging from building a basic sense of security, acceptance, and support for meeting the needs of refugees, to the level of highly specialized psychological and psychiatric assistance, enables the use of the resources of the entire society and specialists in an appropriate manner. By activating refugees themselves and training employees and volunteers of various sectors and fields of support, the goal of mental health promotion is spread across many environments, which mental health professionals themselves cannot cope with in these new, difficult conditions.

None Declared

Sweden has a long history as a host country for refugees. In recent years there has been a shift from being one of the most generous host countries in Europe to one of the most restrictive. In Sweden, refugees with a residence permit have a full right to care, but asylum seekers and undocumented migrants only have a right to care that cannot be deferred. Despite relatively good formal access to mental health care, and so far, the availability of free language interpreters, refugees face barriers to and within mental health care.

To give a brief overview of the current challenges for mental health care in Sweden and the work on solutions for people on the move.

Ongoing research and clinical development are summarised in parallel with the identification of challenges.

A complex picture of the development and challenges of mental health care for people on the move in a situation of increasing social pressure on refugees is described.

There is a need for equal treatment of people on the move without discrimination and exclusion.

None Declared

Germany is one of the countries that has taken in a large number of refugees. Around 2.25 million now have recognised protection status in Germany. In addition, Germany has taken in over 1,215,048 refugees from Ukraine. All of these people are very vulnerable refugees who are exposed to many risk and stress factors before, during and after their migration. As a result, they have a high prevalence of mental disorders such as post-traumatic stress disorder (PTSD), depression, anxiety, substance use and persistent grief disorder. At the same time, refugees face numerous barriers to accessing medical care, such as language and cultural barriers, administrative barriers, structural, institutional and interpersonal discrimination and racism. There is also unequal treatment in Germany between refugees from Ukraine and other regions of the world. In addition, healthcare provision has recently been tightened due to changes in the Asylum Seekers’ Benefits Act. This presentation will focus on the sitaution in Germany and discuss üossible solutions.

None Declared

Comorbidities in addiction: It is a rule rather than an exception. The story starts in childhood; even before, in infancy, and may be in prenatal life. The dimensional traits have already been there, existing obviously far before any DSM-5 diagnosis. Among these traits, the developmental features named as stress sensitivity, impulsivity and emotion dysregulation are the leading ones. Comorbidity research addressed childhood abuse, neglect or other childhood adverse experiences as a definite risk factor for adolescence and adult mental disorders, particularly substance use disorders. Developmental and environmental adversities in a mutually amplifying pattern make a vicious cycle in which the individual finally finds an illusionary exit, a pathway to addiction.

This presentation aims to discuss the complexities and challenges for the diagnosis and treatment of cases presenting with ASUD (alcohol and substance use disorders) and comorbid neurodevelopmental and affective or psychotic disorders . The history as well as the life and the management charts of the patients are reviewed in the light of information collected during the follow-up years revealing significant alterations with regard to diagnoses and therapeutic approaches. A specific focus of the case studies will be the missed or mis-diagnoses, and the impact of them on the treatment courses and the outcomes. One of the case studies with an eight year follow-up period, shows ADHD traits, alcohol use disorder, affective disorder and a later emerging severe stimulant use disorder. The second case with a similar ADHD history, presents with a stimulant use disorder, co-occuring with a severe psychotic disorder, that has been mis-diagnosed as schizophrenia. The life and management charts of the studied cases convey the drawbacks of the diagnostic difficulties, the treatment failures and the implication of efficient therapeutic strategies.

The challenges faced by clinicians due to co-occuring disorders that have become a common practice for addiction professionals. should be managed by transdiagnostic and integrative modalities. While big data or empirical large datasets can have their own limitations to help the practitioner for overcoming such complexities of real world situations, as stated in Stein’s article (2022, Psychiatric diagnosis and treatment in the 21st century: paradigm

shifts versus incremental integration) “the age-old single-case studies, may sometimes provide clinical insights that outweigh those from big data analyses.”

None Declared

Attention Deficit Hyperactivity Disorder (ADHD) and Substance Use Disorders (SUD) frequently co-occur. Patients with this comorbidity report poorer qualtiy of life, and have worse treatment outcomes for both disorders, including high relapse rates of the SUD. In this case based discussion, clinical dilemma’s in the diagnosis and treatment of patients with this comorbidity will be discussed. Recent findings of the International Collaboration on ADHD and Substance Abuse (ICASA) will be used as background, including findings from ICASA’s most recent work: the longitudinal International Naturalistic Cohort Study of ADHD and SUD (INCAS), where nearly 600 patients with both ADHD and SUD in treatment were followed for nine months. In addition, ICASA’s consensus statements on diagnosis and treatment of co-occurring ADHD and SUD in youths and adults will be shortly discussed.

None Declared

During the workshop about this complex case, I will discuss aspects of the case and the challenges the individual has faced from a neurodevelopmental and transdiagnostic perspective. It is the norm that those presenting for treatment or support with problematic drug/alcohol use will also have co-occurring neurodevelopmental, mental and physical health traits or disorders. Their relationships are often complex and ingrained. It is generally unhelpful to consider such complexity in terms of ‘primary’ vs ‘secondary’ as this may lead to exclusion from some services. For instance, someone with depression and problematic alcohol use may not be seen by psychiatric services or psychologists due to their drinking and an ‘addiction’ service may not have sufficient mental health expertise for managing their depression. Such ‘silos’ are common and need to be addressed through better understanding of the relationships between problematic drug/alcohol use and co-occurring neurodevelopmental, mental and physical health traits or disorders, through better training of health and social care staff and reducing stigma.

A. Lingford-Hughes Grant / Research support from: Research supported by Lundbeck, GSK, Indivior; unrestricted funds support from Alcarelle for a PhD, Consultant of: Silence, NET Device Corps, Sanofi-Aventis, Astra Zeneca and also consulted by but received no monies from Britannia Pharmaceuticals, GLG, Opiant, Lightlake and Dobrin, Paid Instructor of: Received Honoraria paid into her Institutional funds for speaking and Chairing engagements from Lundbeck, Lundbeck Institute UK, Janssen-Cilag, Pfizer, Servier; receives Honoraria for teaching for British Association for Psychopharmacology.

There are clear unmet medical needs in the treatment of Cocaine Use Disorder (CUD), since there are no pharmacological treatments approved. The neurobiological circuitry of addiction has been described in recent years, and it provides a solid rationale to target specific brain regions to treat addictive behaviors, including CUD. The stimulation of the left Dorsolateral Prefrontal Cortex (DLPFC) with repetitive transcranial magnetic stimulation (rTMS) has proved to reduce craving for various drugs, including cocaine.

We present the results of a retrospective study performed in a private setting with 93 patients with CUD, who were treated with rTMS following the protocol from Terraneo et al. In 12 weeks patients received 32 sessions of 2400 pulses (100% MT; 10 Hz; 60 pulses per train, 15 seconds interval; 40 trains per session), for a total of 76800 pulses.

The main outcome was total abstinence of cocaine (self-reported plus urinalysis). Abstinence rates at days 30, 60 and 90 were 55,9%; 40,8%; and 34,4% respectively.

Psychiatric comorbidities (insomnia, depression and anxiety) were also assessed with validated questionnaires. Drop-out was directly related to recent cocaine use, but initial levels of psychological distress did not predict drop-out.

No relevant side effects were reported. Mild and transient headache was reported by a few patients after the first session.

In conclusion rTMS was well tolerated, drop out rates were high and 34% of the patients remained abstinent after the 90 days treatment period.

None Declared

Transcranial Direct Current Stimulation (tDCS) has already been proven to be an effective modality in substance use disorder (SUD), often targeting the dorsolateral prefrontal cortex bilaterally. However, addiction is a very broad concept, comprising many different neurocognitive defects.

To better guide and investigate the potential benefits of tDCS for people who suffer from SUD, we shall take a transdiagnostic approach to SUD to see which other targets for tDCS might lead to additional clinical use, paving the way for personalised neurostimulation.

None Declared