While an increase in mental disorders has been suggested, the role of societal changes, such as sociodemographic, vulnerability, or health-lifestyle factors, on this increase is scarce. This information is however crucial for health care policy and planning.

We examined trends in the 12-month prevalence of anxiety and mood disorders, their clinical profiles, and how sociodemographic, vulnerability, and health-lifestyle risk factors may have contributed to these trends.

We used data from 11,615 respondents (mean age= 43.5, 53.5% female) of the Netherlands Mental Health Survey and Incidence Study, examining the general population in 2007-2009 (NEMESIS-2, n= 6,646) and 2019-2021 (NEMESIS-3, n= 4,969). The Composite International Diagnostic Interview 3.0 was used to determine DSM-IV diagnoses. Logistic regression and interaction analyses were then conducted to assess the association between risk factors and the prevalence of anxiety and mood disorders, while also evaluating changes over time between the two cohorts.

The 12-month prevalence of all types of anxiety and mood disorders significantly increased from 2007–2009 to 2019–2022, with increases ranging from 56% to 125%. Clinical profiles of those with disorders were not milder in 2019-2022; there was greater mental health care use, a higher number of disorders, and an earlier age of onset. There was no consistent evidence that sociodemographic, vulnerability, or health-lifestyle risk factors became more prevalent over time or had a greater relative impact over time.

Our study showed a consistent increase in 12-month prevalence across all anxiety and mood disorders over the past decade. This rise in prevalence could not be explained by an increase in the absolute or relative impact of specific risk factors, nor were there significant differences in clinical profiles over time.

None Declared

Generalized anxiety disorder (GAD) is a common psychiatric condition characterized by excessive worry, concentration issues, and insomnia. Despite numerous studies, its neurometabolic mechanisms remain unclear.

This study aims to compare the levels of kynurenine pathway metabolites between GAD patients and healthy control groups, and to investigate the relationship between kynurenine metabolism products, executive functions, and disease severity in GAD patients.

The study included 41 GAD patients and 41 healthy controls. Participants were enrolled after ruling out major depressive disorder using the Beck Depression Inventory. They then completed the Sociodemographic and Clinical Data Form, the Wisconsin Card Sorting Test (WCST), the Trail Making Test (TMT) A and B, the Digit Span Test (DST), the Verbal Fluency Test (VFT), the Stroop Test, and the State-Trait Anxiety Inventory. Venous blood samples were collected for serum metabolite measurements. Levels of kynurenic acid (KYNA), quinolinic acid (QUIN), tryptophan (TRP), 3-hydroxykynurenine (3-HK), kynurenine (KYN), and 3-hydroxyanthranilic acid (3-HAA) were measured using liquid chromatography-mass spectrometry (LC-MS).

We found that GAD patients performed significantly worse in terms of the number of categories completed on the WCST (p=0.014), TMT-A (p<0.001), TMT-B (p=0.015) and Stroop Test sub-scores (p<0.001) compared to the healthy control group. GAD patients had significantly higher QUIN levels and a lower KYNA/QUIN ratio (p<0.001) than the healthy control group, while the control group had a higher 3-HK/KYN ratio (p=0.008). A negative correlation was found between DST scores and 3-HAA (r = -0.311, p = 0.048), as well as between the KYNA/KYN ratio and the stroop test subscore (r = 0.368, p = 0.019). In the GAD group, we found a positive correlation between kynurenine levels and state anxiety scores (r=0.34; p=0.032). In regression analysis, the KYNA/QUIN ratio significantly reduced GAD risk (p=0.001; OR: 0.531), independent of test performance.

Our study suggests that neurotoxic metabolites in the kynurenine-tryptophan metabolism may explain the executive function impairments observed in GAD. A key finding is that higher KYNA/QUIN ratios significantly reduce GAD risk, which is etiologically important and provides valuable guidance for future research.

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Though glutamate modulators have been increasingly used with some success in cases of OCD resistant to SRIs, there is limited data on the use of ketamine in OCD. There is one study on the use of multiple ketamine infusions in SRI-resistant OCD, but no studies have yet compared the effectiveness of multiple infusions of ketamine with multiple infusions of an active comparator agent. Benzodiazepines are commonly prescribed for OCD despite the lack of recommendations. The current study was a hospital-based prospective, single-blind, randomised controlled trial conducted over a period of one and a half years to compare the effectiveness of multiple infusions of ketamine with those of midazolam.

To look into the immediate effects of ketamine infusion in terms of reduction in illness severity in OCD treatment non-responders in comparison to midazolam infusion.

To determine the time-point associated with the largest change in symptom severity in patients receiving repeated ketamine infusions in comparison to midazolam infusions.

To determine the overall proportion of response of OCD treatment non-responders to ketamine infusions in comparison to midazolam infusions.

In a hospital setting, we compared the effectiveness of 6 sessions of ketamine infusions (0.5 mg/kg body weight) with that of 6 sessions of midazolam infusions (0.045 mg/kg body weight), given on alternate days on a Monday-Wednesday-Friday schedule, in 30 patients with treatment non-responding OCD. Assessments were made using rating scales: DY-BOCS, MADRS, HAM-A, CADSS and SAFTEE.

At 1 hour and 4 hours after the 1st ketamine infusion, 26% of patients achieved treatment response, while none in the midazolam group did so at these time points (Figures 1 and 2). Maximum symptom reduction occurred after the 1st infusion. By the 6th infusion, 40% of ketamine patients achieved treatment response, compared to 20% in the midazolam group. At 4 weeks after the last infusion, only 1 patient (6%) in the ketamine group maintained treatment response, with none in the midazolam group. Overall, the result indicates that the ketamine group showed significant improvement compared to the midazolam group (F=1.541, p=0.048) with a medium effect size (η2=0.056) (Fugure 3). There were no statistically significant differences between the two groups in terms of overall reductions in MADRS.

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Ketamine, though modest in action, is superior to midazolam. Our findings lie between those of 2 prior studies—that by Bloch et al. (2012), who showed it to be largely ineffective, and that of Rodriguez et al. (2013), who found that half of their participants continued to show response even 1 week after the infusion. The differential overall improvement in DY-BOCS in the ketamine group over the midazolam group was independent of the reductions in depressive symptoms.

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Deep brain stimulation (DBS) is a neurosurgical procedure in which thin electrodes connected to a neuro-pacemaker are implanted into deep brain structures to modulate pathological neuronal activity with electrical current. DBS is used for symptom relief in Parkinson´s disease (Groiss et al. TAN Disord 2009; 2 79–91) and is under investigation for several psychiatric conditions (Naesström et al. NJP 2016; 70 483–91). Severe and treatment-resistant obsessive-compulsive disorder (OCD) may be treated with DBS to achieve reduced OCD symptoms, ultimately aiming for an improved quality of life.

Our objective is to present preliminary data on OCD patients’ self-reported quality of life related to the development of OCD symptoms, before DBS surgery, and up to two years after surgery.

Patients with severe OCD (n=12) were enrolled in an open-label clinical trial on DBS delivered into the brain area of the bed nucleus of stria terminalis (BNST), as previously described (Naesström et al. W Neurosurg 2021; 149 e794-e802). The patients completed the EuroQOL five dimensions questionnaire (EQ-5D-3L) and were assessed with the Yale-Brown Obsessive Compulsive Scale (YBOCS) before DBS surgery and after six, 12, and 24 months. The paired t-test was used to analyze for group differences.

The mean age at DBS surgery was 39.2 years (standard deviation [SD] 15.5) and the baseline YBOCS score corresponded to severe to extreme OCD (mean 33, SD 3.0). The mean EQ-5D index score was 0.62 (SD 0.11) at baseline and had improved to 0.74 (SD 0.13) at the two-year follow-up and the difference was statistically significant (t = 2.8, df = 7, p-value = 0.025). The EQ-5D VAS scores measured pre-surgery were low (mean 35.9, SD 22.2) and had increased two years post-surgery (mean 54.4, SD 21.0), but with no statistically significant difference (t = 1.9, df = 8, p-value = 0.093).

Quality of life in OCD patients two years after DBS surgery measured with the EQ-5D-3L showed an improvement two years following surgery for the EQ-5D index but not for the VAS scale. These preliminary data show that self-assessment with the EQ-5D-3L scale may be used to follow up on patients’ quality of life after DBS and longer follow-up periods are warranted.

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Psychologically, traumatic incidents often involve physical injuries that threaten a person’s survival and sense of security. After a sudden health problem or other kind issues, hospital admission can be an experience that negatively affects psychological health and recovery, often including symptoms of post-traumatic stress disorder, anxiety, and depression. Nurses who spend a longer time with patients can determine the initial changes in individuals and play a crucial role in the decision-making process.

This systematic review aimed to investigate the effect of nurse-led interventions in reducing post-traumatic stress disorder symptoms in inpatients.

In this review, we investigated studies from Pubmed, Cochrane Library, Medline (OVID), Scopus, Web of Science, CINAHL, Dergipark and TR Dizin (a directory) databases that met the inclusion criteria. The methodological quality of the studies was assessed using the Cochrane Risk of Bias 1 tool. This study was performed based on the Guidelines of Systematic Reporting of Examination presented in the PRISMA checklist. The search protocol has been registered at the PROSPERO International Prospective Register of Systematic Reviews.

This systematic review included seven studies with a total sample size of 736 inpatients (intervention group: 350 participants; control group: 345 participants). The meta-analysis revealed that nurse-led interventions showed no statistically significant impact on post-traumatic stress disorder symptoms (SMD: -4,08, Z = .79, p = .43), anxiety (SMD: .28, Z = .18, p = .86) and depression (SMD: -.60, Z = .87, p = .38) in inpatients.

Out of seven studies, five of them indicated that these interventions were not effective in reducing PTSD symptoms while in two studies, the interventions were found to be effective in alleviating PTSD symptoms. To effectively reduce or prevent post-traumatic stress symptoms in inpatients, it is recommended to integrate a comprehensive range of therapeutic, evidence-based practices into clinical settings, facilitated by a multidisciplinary team approach within a educative and collaborative working environment.

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Adolescence is a crucial stage, during which sleep undergoes significant maturation. Among the sleep changes that characterise adolescence, sleep debt is particularly relevant. Although existing evidence indicates that sleep debt is very prevalent in adolescents, little is known about its impact on adolescents’ mental health.

To explore the cross-sectional and longitudinal associations between sleep debt in adolescence and depression in adolescence and young adulthood.

This study is based on the Avon Longitudinal Study of Parents and Children. Here, we used data from 4,993 participants with information on sleep and depression at 15-16 years, and 3,962 on depression at 24 years. Self-reported information on amount of sleep hours per night during weekdays and weekends (i.e., actual sleep) and amount of sleep hours per night they felt they needed (i.e., sleep need) was collected at 15-16 years. Sleep debt at 15-16 years was calculated as the difference between sleep need minus actual sleep, with higher scores indicating higher sleep debt. Depression symptoms at 15-16 years were self-reported using the Short Mood and Feelings Questionnaires and the cut-off of total scores ≥ 8 was used as a criterion for depression. Moderate depressive disorder at 24 years old was measured using the self-administered computerised version of the Clinical Interview Schedule revised. To test the cross-sectional and longitudinal associations between exposures and outcomes, a series of logistic regression analyses (unadjusted and adjusted) were conducted.

The results from the cross-sectional logistic regression analyses showed that the three measures of sleep debt (weekday, weekend and average) were significantly associated with the outcome, indicating that adolescents with higher sleep debt were at higher risk of concurrent depression at 15-16 years (weekday: OR=1.15, CI 95%=1.11-1.19, p<0.001; weekend: OR=1.04, CI 95%=1.01-1.07, p=0.010; average: OR=1.11, CI 95%=1.07-1.15, p<0.001). Regarding the longitudinal associations, only adolescents with higher sleep debt during weekdays were at higher risk of moderate depression at 24 years (OR=1.12, CI 95%=1.05-1.20, p<0.001), despite sleep debt on average being close to significant (OR=1.07, CI 95%=0.99-1.16, p=0.052).

Higher sleep debt is associated with higher risk of depression in adolescents and constitutes a risk factor for depression in young adulthood, particularly when the sleep debt occurs during weekdays. Our results contribute to the debate on early school times in adolescents and how these can impact their sleep patterns and consequently negatively affect their mental health. Further efforts to understand sleep debt in adolescence are needed, to prevent the development of future mental health problems.

None Declared

Prevalence of posttraumatic stress disorder (PTSD) has been documented in war-affected populations. A third of Ukrainians met diagnostic requirements for PTSD according to the UN, but the information on the mental health of medical staff is still insufficient. Well-known increased risk of mental disorder is the result of traumatic experiences in healthcare workers as part of their professional duties.

Based on this we aimed to analyze the potential sources of traumatic experience at work and the severity of PTSD and depression symptoms among medical staff in war condition.

The online and paper-pencil survey was conducted in November 2023 - January 2024. The study included a sample of 96 health care workers (doctors, nurses and paramedics). We used the structured interview on work characteristics of physical and psychosocial factors and standardized questionnaires on PTSD (Posttraumatic Stress Disorder Checklist; PCL-5) and depression (Patient Health Questionnaire; PHQ-9) symptoms. Additionally the needed source of support to cope with stress at work has been investigated.

The correlation and regression analysis allowed revealing patterns between potential sources of traumatic experience at work and the severity of PTSD and depression symptoms among Ukrainian medical staff. The results of the correlation analysis of physical and psychosocial stressors, depression and PTSD symptoms indicated that psychosocial stressors define PTSD development. There were detected job-related specific psychosocial stressors among medical staff in Ukraine leaded to PTSD and depression development: “Conflict in organization/community”, “Being threatened/abused”, “Lack of appreciation by the organization/community in which you work”.

The analysis identified the most important factors (psychosocial stressors) determining levels of PTSD in medical personnel at war. These data contribute to a significant debate on the negative role of job conditions at war for health care workers.

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Parent-focused interventions are an important part of the treatment plan for children with Attention-deficit/hyperactivity disorder (ADHD). Minority families tend to be less involved in psychosocial treatments and are more likely to discontinue the intervention. The Haredi community in Israel is a cultural-religious minority of 1.2 million people

We aimed to assess the feasibility and potential efficacy of culturally adapted psychosocial programs for attention-deficit/hyperactivity disorder (ADHD) within the Haredi community in Israel.

This was an open-label non-randomized study conducted within the Haredi community in Israel between 2018 and 2021. The participants (N=265) were parents of children aged 8-12 years who had been diagnosed with ADHD or exhibited ADHD symptoms. Three culturally adapted programs were compared: 1. A program involving only the parents (N=46), 2. A program involving both children and parents (N=155) and 3. Only recorded video lectures with no interaction (N=38). Parents completed questionnaires to assess their self-efficacy using the Parenting Self-Efficacy tool (TOPSE) and their child’s ADHD symptom severity, using the Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS) both before and after the intervention.

The programs demonstrated high feasibility. Of 335 referrals, 265 parents were recruited. Participation rates differed significantly between the video lectures program (60%) and the two interactive programs (80%, p<0.001). A significant interaction was found between time and program type for both parental efficacy (F(2,213)=5.65, p=0.004) and for ADHD symptomatology (F(2, 213)=5.65, p=0.004). Post hoc analysis revealed that the video lectures program showed no benefit, whereas both interactive programs (parents-only and parent-child) exhibited improvement in parental self-efficacy and reduction in reported ADHD symptom severity.

Despite certain limitations, this study suggests that culturally adapted psychosocial programs for ADHD in the Haredi community are feasible and that including an interactive component is crucial for effectiveness.

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Mental health stigma remains a significant challenge in Moldova despite ongoing progress in mental health services. The negative perception and stereotypes about mental disorders have been socially ingrained, resulting in negative attitudes, fear, or even humor directed towards affected individuals. Addressing this stigma is essential to improve mental health outcomes and integrate services effectively.

The study aimed to evaluate public perceptions and attitudes towards mental health stigma in Moldova, identify common stereotypes, and suggest actions to reduce stigma.

The research employed a comparative study design using a structured questionnaire across two different time points: 2018 and 2022. Data were collected through face-to-face interviews utilizing the Computer-Assisted Personal Interviewing (CAPI) method, ensuring data accuracy and consistency. The study covered eight districts, with a total sample of 2973 participants stratified by geographic region and demographic characteristics.

The findings highlighted that the level of acceptance towards individuals with mental health issues was moderate, with participants showing more acceptance at a distance, indicating persistent stigma. Notable differences between urban and rural areas were observed, with urban areas showing a higher level of openness. Furthermore, stigma was significantly influenced by the level of education and age of the respondents.

Mental health services are currently available across all districts of Moldova, but there remains a need for ongoing improvements to ensure equal access to high-quality care and to minimize both geographical and stigma-related barriers. Ongoing training programs for healthcare professionals are vital for effectively reducing stigma and improving the quality of care for those facing mental health challenges, with a specific focus on non-discriminatory practices and empathetic approaches. To achieve successful mental health care, a collaborative approach that involves healthcare professionals, policymakers, and community stakeholders is essential. This multidisciplinary coordination is key to establishing a supportive and comprehensive care environment. Additionally, public awareness campaigns and educational initiatives targeting both the general population and healthcare providers are critical in reducing stigma and changing attitudes towards mental health, thereby encouraging more people to seek care. Finally, integrating mental health services into primary healthcare should be prioritized to enhance accessibility and continuity of care. This integration will also facilitate early diagnosis and timely intervention, leading to improved outcomes for patients.

None Declared

Migrant people may constitute a vulnerable population with an increased risk of suicide-related behaviour due to the accumulation of multiple risk factors, such as migration-related stress, the history of traumatic experiences and socioeconomic situation in the country of immigration.

To study the prevalence of suicide attempts from migrant population in hospital emergency departments. Moreover, it aimed to study suicide-related outcomes, according to migration status.

Data from 754 patients (73.1% female; m= 40.23, sd= 15.72) with a recent suicide attempt from 10 Spanish hospitals were included. Assessment protocols were delivered within the 15 days after the index attempt. Suicide-related outcomes, clinical and sociodemographic factors were assessed by administering a wide range of clinical tools (C-SSRS, MINI, BIS-21, BSI, ACSS-FAD, CTQ).

One in four patients was foreign-born, mostly being from Latin American countries (74% of foreign-born patients). Foreign-born patients were younger, higher psychopathology symptom severity, child trauma scores (Figure 1), than their counterparts (p < .01). Higher proportion of employed people and lower amount of people receiving pension benefits, were found in the foreign-born group. No between-group differences were observed regarding suicide-related outcomes. Finally index attempt in foreign-born group was featured by using more lethal methods (p < .05) (Figure 2).

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Significant proportion of attempts attended in clinical settings may come from migrant people, mainly featured by child trauma history. Attempts from migrant populations may be featured by more lethal methods. Health care provision adjustment becomes mandatory to meet migrant people needs in current times.

None Declared

Correctional workers face uniquely stressful conditions that can impact their personal and professional wellbeing. Resilience, defined as the ability to adapt and thrive in adverse conditions, may be a key mitigator of occupational stress. Despite its potential benefits, few reviews examine the wellbeing of correctional workers (Miller, O., Bruenig, D., & Shakespeare-Finch, J. 2022; 49(11), 1559-1579) but have not comprehensively addressed resilience.

1. Describe resilience and summarize measures used to assess resilience in correctional settings. 2. Investigate the role of resilience on psychosocial wellbeing, burn-out, work performance, work leaves, attitudes, response to adverse incidents and turn-over among correctional workers. 3. Describe risk factors associated with resilience among correctional workers. 4. Describe study-defined strategies to build resiliency and relevant recommendations for future research and clinical practice.

The present review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Major databases (PubMed/MEDLINE, Embase, PsycINFO, Scopus, and CINAHL) were searched for eligible reports. At least two independent reviewers were responsible for screening and data collection. Conflicts were resolved via discussion, with input from senior authors when necessary. Quality appraisal was conducted for all included reports.

As shown in Figure 1, a total of 679 articles were identified through major database searches. Title and abstract screening yielded 51 articles eligible for full-text review. The majority of articles were set in North American correctional facilities. Key factors for resilience included support systems, purpose, and optimism, while workplace adversity was a risk factor. Resilience was found to reduce symptoms of burnout and depression, and be crucial for managing psychosocial wellbeing. The presentation will discuss strategies to build resilience and highlight relevant recommendations.

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Overall, resilience was found to play a mediating role in the wellbeing of correctional workers. Further studies involving a standardized measure of resilience and broader populations and correctional settings are required to improve the validity and generalizability of findings.

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The use of restrictive practices such as restraint, seclusion and long-term segregation on people with mental health problems remains common in European psychiatric care to manage patients’ violent and other challenging behaviour. These practices violate human rights and thus there is a growing international policy move to reduce or even ultimately stop using them. To achieve this, clinicians, researchers, teachers, trainers, policy-makers and user representatives need to collaborate to transform psychiatric services towards non-coercive services. An international network provides one way towards this vision.

Here we present an international network focusing on developing knowledge and practices aiming at reducing violence and coercion in mental health settings. We will illustrate how networking in an interdisciplinary group can be beneficial to both European psychiatrists as well as other professionals in mental health services.

The EViPRG is a non-governmental research-focused network founded in 1997. Our vision is to work together to improve competency and quality of practice with the aim to reduce coercion and violence in mental health services, and address ongoing human rights issues. Clinicians in the psychiatric field as well as researchers can join the network through an electronic application (https://www.eviprg.eu/). Participation of early career researchers is encouraged.

The EViPRG offers a unique network to connect with like-minded colleagues, collaborate on research projects, learn from various national initiatives to reduce coercion, exchange best practice models and take part in discussions via our various platforms. The network meets 3-4 times per year both in-person and online. Meetings provide an arena to present the latest research findings, generate new research projects and get feedback from colleagues. The EViPRG also organises the bi-annual “European Conference on Violence in Clinical Psychiatry” and members get a reduced fee to attend.

The network has more than 130 members in Europe and beyond. Numerous multi-country studies have been initiated through the network. As an example, in the years 2021-2024, a European Commission-funded project COST Action FOSTREN widened the network to new countries. As a result, we expect a rise in our membership, especially from Eastern Europe. If you want to find like-minded research partners and innovators, link in with a strong community aspiring to influence policy and practice in this area, progress your career and international profile, or just meet new colleagues, membership in the EViPRG can be your choice.

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While climate change affects millions of people in South and Southeast Asia, women and girls are disproportionately impacted, largely due to pre-existing vulnerabilities given their traditional gender roles and intensified adaptive capacity and sensitivity to climate change. They have often less representation and decision-making power in governance processes and structures involved in the development and implementation of climate change adaptation and mitigation policies. Moreover, they face mental health and psychosocial problems due to various climate-related stressors.

The study aimed at exploring the perceptions of people living in contexts affected by climate change in order to better understand the impact on the psychosocial conditions of women and girls.

In 2023, online and in situ interviews were conducted with 30 individuals (15 women, 15 men) from the government, international and national organisations as well as academic and research institutions in Afghanistan, Bangladesh, Myanmar, Nepal, and Pakistan. Moreover, eight focus group discussions were conducted in Bangladesh (Kurigram and Sathkira districts) and Nepal (Rasuwa and Udayapur districts) with 71 community members, including 40 women and girls (aged 14 to 54 years old) and 31 men and boys (aged 15 to 70 years old).

In Bangladesh, both districts face extreme weather like drought and floods, which leads to the migration of men. An increased involvement of women in farming, alongside their household responsibilities. This has transformed the family dynamic and women, as household head, have become the primary decision-makers. In Nepal, there has been a lack of awareness among women and men on the impact of climate change on their living conditions. The significant shift in the traditional gender divisions of labour has not brought an equitable transfer of assets and resources that could help women to cope after a climate-related event. Ultimately, women suffer from mental health issues.

This study shows some causal links between climate change and the psychosocial conditions of women and girls which confirm the necessity to develop gender-responsive climate change strategies, to improve access to mental health services and to prevent long-term changes within communities.

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With increasing urbanization, more people are exposed to mental health risk factors stemming from the urban, social or physical environment. However, research on the connection between urban living and mental health remains unclear.

This study aims to explore environmental and social risk factors for mental health issues using network analysis.

The study was conducted among a nationally representative sample of 2,701 habitants of Poland (51% of women). The measurements used were PHQ-9, UCLA, Neighbourhood Cohesion (Neighbourhood Belonging and Social Cohesion), REAT 2.0 (Quality of architecture conditions in neighbourhood area), distance and frequency use of blue, green, and urban public areas, Self-Rated Health, Physical Activity, urbanicity, size of place of residence per person and sociodemographic survey (age, education, income). We used a sparse Gaussian graphical model (GGM) with a graphical lasso with an EBICglasso estimator.

We showed that urbanicity and physical environment were linked to mental health issues via neighbourhood cohesion and loneliness in the estimated network. Depression and anxiety were the nodes with the highest centrality strength and expected influence. Blue and green areas usage also had high centrality strength. Urbanicity played an important role as a bridge between the network nodes and had a high strength score. Physical health with blue and green areas frequency use had the highest closeness centrality score.

We revealed the connections among mental health, loneliness, social cohesion, and various environmental factors, particularly urbaicity. This will enhance our understanding of mental health risks and protective factors.

This study is a part of the “Urbanization and Health”( NdS-II/SN/0391/2024/012) project financed by state budget funds granted by the Minister of Education and Science within the framework of the Science for Society II Program in Poland.

None Declared

Suicide remains a major cause of death in prison (Status report on prison health in the WHO European Region 2022). In comparison with adults from general population, incarcerated people are at increased risk of presenting suicide-related behaviours (Fazel S, et al. Lancet Psychiatry 2017; 4 946–52). Although certain studies have identified effective programs to reduce suicide in prison context (Carter A, et al. EClinicalMedicine 2022; 44 101-266), there is little evidence examining the relationship between moderators of effectiveness at individual and contextual levels.

This study aims to review empirical research on moderators of effectiveness of interventions in prison to reduce suicide, summarizing effect sizes across studies.

For this systematic review and meta-analysis, we searched EBSCOhost, ScienceDirect, PubMed and ProQuest for articles published from 1990 to 2024. Elegible studies included those evaluating the effect of psychological interventions, delivered to adults during incarceration, on suicidal prevention. The impact of moderators covering bibliometric features (i.e. year of publication, country), methodological features of the study (i.e. sample size, mean age of participants, sex ratio, study design, assessment type and tools), suicide-related features (main outcome, previous suicide history), and other relevant variables (prison type and location, type and length of sentence) as well as psychological traits (alcohol or drugs misuse or other treatments) were also included. This review was conducted in accordance with PRISMA guidelines. Meta-analyses using random-effect models were used to pool effect sizes for moderators’ outcomes. The protocol was pre-registered with PROSPERO, CRD42024538967.

Of 7728 articles retrieved, 18 studies (1695 participants, 330 [19.5%] females, 756 males [44.6%], and 609 [35.9%] unknown) met the inclusion criteria. Mean ages were 32·0 years, and ethnicity data was not sufficiently reported to be aggregated. Type of prison was mostly public sector and located in rural areas. Studies were frequently conducted in UK (n=8; 44%) and used varying study designs; most frequently pre-post with no control group (n=9; 50%). On average, prevention programs in prison context were effective in decreasing suicide deaths, suicidal ideation and self-harm (n=14; 78%).

Findings suggest that explanations for efficiency of psychological interventions to prevent suicide behaviour and self-harm in prison context, are moderated by physical environment, individual and psychosocial factors. Future research identifying what factors moderate treatment outcomes in suicide and self-harm prevention within prison environments could help elucidate associated factors of efficiency, helping develop potential therapeutic actions.

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The differential diagnosis between Major Depressive Disorder (MDD) and Bipolar Disorder (BD) heavily relies on clinical observation. However, the two disorders often show similar symptomatologic profiles, leading to high misdiagnosis rates. Reliable biomarkers are therefore crucial to accurately discriminate between MDD and BD and provide better treatments. In this regard, Machine Learning (ML) could represent a turning point in the field precision psychiatry, given its capability of making single-subject level predictions.

In the present work, we aimed at providing a biomarker-based differential diagnosis between MDD and BD. To that end, we implemented: i) a structural MRI-based ML model; ii) a combined ML model, trained on MRI data and Polygenic Risk Scores (PRS) for different psychiatric disorders.

168 depressed patients (73 MDD, 95 BD) were recruited at the IRCCS San Raffaele Scientific Institute. All patients underwent T1-weighted and Diffusion Tensor Imaging scans. Voxel-Based Morphometry (VBM) measures were extracted with Computational Anatomy Toolbox 12 (CAT12). Fractional Anisotropy (FA), Axial Diffusivity (AD), Mean Diffusivity (MD), and Radial Diffusivity (RD) were extracted with Tract-Based Spatial Statistics (TBSS). PRS for MDD, BD, Schizophrenia, Attention Deficit/Hyperactivity Disorder, Anorexia Nervosa and Autism were computed for a subsample of 155 patients (67 MDD; 88 BD) through Infinium PsychArray 24 BeadChip. We trained a Multiple Kernel Learning (MKL) algorithm with voxel-wise VBM and DTI features, subsequently combining them with the extracted PRS.

The neuroimaging model achieved a Balanced Accuracy (BA) of 71.65% and an Area Under the Curve (AUC) of 0.77 (85.44% sensitivity, 57.86% specificity). All the features contributed to the prediction, with AD (63%) and MD (26%) as the most predictive. Adding PRS to neuroimaging resulted in an improved performance, reaching 74.18% BA and 0.77 AUC (90.97% sensitivity, 57.38% specificity). The most predictive features of the neuroimaging-PRS model were MD (56%) and AD (27%).

Structural MRI discriminated between MDD and BD, and adding PRS to neuroimaging features improved the performance of the ML model. These results highlight the predictive power of structural neuroimaging for the differential diagnosis between MDD and BD, as well as prompting multimodal classifiers as a promising tool in the context of precision psychiatry.

None Declared

Preclinical Alzheimer’s disease (AD) is characterized by subtle cognitive changes that precede the onset of clinical symptoms. Neuropsychiatric symptoms such as anxiety have been increasingly recognized for their potential role in accelerating disease progression. Although various theories have been proposed, anxiety may exacerbate cognitive decline through mechanisms involving stress-induced neurochemical dysregulation, affecting brain regions vulnerable to AD pathology.

This study examines the neural correlates of preclinical AD in individuals with low anxiety scores, employing MRI to explore potential early biomarkers and elucidate the complex role of anxiety in the progression of AD.

A total of 172 participants from the German Center for Neurodegenerative Diseases Longitudinal Cognitive Impairment and Dementia Study (DELCODE) were categorized into three groups: Healthy Controls (HC, n=59), Subjective Cognitive Decline (SCD, n=77), and Mild Cognitive Impairment (MCI, n=36). Anxiety levels were assessed using the Geriatric Anxiety Inventory-Short Form (GAI-SF), and neural responses to novelty were examined using 3-Tesla MRI. Statistical models were adjusted for relevant covariates, including age, education and study site. The differences of the three groups were analysed by one-way ANOVA contrasts and post-hoc analyses were performed with two sample t-tests.

Significant neural differences were observed across groups, particularly in the precuneus, right angular gyrus, and right cerebellum exterior (p < 0.001, p = 0.001, and p = 0.002 respectively). The SCD group demonstrated greater activation in the right angular gyrus compared to HC (p = 0.008), while the MCI group exhibited more pronounced differences L-R precuneus, right cerebellum exterior, right angular gyrus, and right middle frontal gyrus regions indicating further cognitive decline (p< 0.001, p< 0.001, p= 0.001, p= 0.017 respectively).

This study identifies critical brain regions, with a particular emphasis on the right angular gyrus, associated with the early stages of AD in individuals with low anxiety scores. The activation in these areas likely correlates with an early inhibition deficit at the systems level in individuals with preclinical memory impairment. However, the role of anxiety in preclinical AD is complex and variable among individuals. Anxiety may serve as an early response to subtle cognitive changes in some, while in others, it might emerge as a consequence of these changes. Moreover, the relationship between anxiety and neural alterations in AD could be bidirectional, where anxiety both influences and is influenced by the disease’s progression. These findings highlight the importance of considering anxiety when identifying early biomarkers for AD and suggest that targeted interventions addressing anxiety may help slow cognitive decline.

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Electroencephalography (EEG) has been extensively studied for decades in psychiatric research. However, its integration into clinical practice as a diagnostic or prognostic tool remains unachieved. We hypothesize that a key reason for this is the underlying heterogeneity among patients, which is often overlooked in psychiatric EEG research that relies on a case-control approach.

The main objective of this study is to quantify the electrophysiological heterogeneity of psychiatric disorders.

We combine HD-EEG with normative modeling to quantify this heterogeneity using two well-established and extensively investigated EEG characteristics—spectral power and functional connectivity—across a cohort of 1,674 patients with attention-deficit/hyperactivity disorder, autism spectrum disorder, learning disorder, or anxiety, and 560 matched controls, see figure 1.

Normative models revealed that deviations from population norms among patients were highly heterogeneous and frequency-dependent. The spatial overlap of deviations among patients did not exceed 40% for spectral power and 24% for connectivity. Taking individual deviations into account significantly enhanced comparative analysis and the identification of patient-specific markers, which showed a correlation with clinical assessments.

Image 1:

Our study underscores the necessity of moving EEG research in psychiatry beyond the group-level approach to achieve precision psychiatry.

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Generalized anxiety disorder (GAD) is among the most common psychiatric disorders and has significant impairment on patients’ daily life. Effective and well-tolerated pharmacotherapies are needed. The FDA has noted that the inclusion of psychotherapy within trials complicates assessment of psychedelic drug efficacy, although to date many psychedelic trials have included co-occurring psychotherapy.1 Co-occurring psychotherapy confounds the evaluation of efficacy and may complicate commercial labeling. A phase 2b study of the dose response to single treatment MM120 (lysergide D-tartrate) suggests a safe, rapid, and durable dose-dependent response in participants with moderate-to-severe GAD2 and design elements are examined herein.

To examine the methodological use of Dosing Session Monitors (DSM) within MM120 treatment without co-occurring of psychotherapy.

This phase 2b (NCT05407064) multicenter, randomized, double-blind, placebo-controlled study enrolled adults aged 18 to 74 years diagnosed with moderate to severe GAD.2 Two DSMs, meeting FDA recommended qualifications,1 were assigned to a participant throughout the study duration. Prior to dosing, participants engaged in baseline study education with their DSMs. During dosing, DSMs provided assistance and comfort as needed and monitored the participant for safety. Starting at 8 hours post-dose, a pre-specified checklist to end the session was administered, although all participants were required to stay onsite a minimum of 12 hours. The follow up period for the trial was 12 weeks, and DSMs only followed up with participants at Day 2, Week 1, and Week 2 post-dose. DSM follow up focused on participant safety and did not include focus on producing post-synaptic change.

In total, 198 participants were enrolled in the study. The phase 2b study demonstrated a statistically significant safe, dose-response relationship at the week 4, 8, and 12 primary and secondary endpoints.1 Utilizing the prespecified checklist, 45% of participants receiving MM120 100μg met criteria for end of session at 8 hours post dose, with 87.5% achieving criteria at 10 hours.

The results demonstrate that a single treatment with MM120 produces a safe and durable clinical response without co-occurring psychotherapy. These findings indicate that MM120 treatment sessions may be safely shortened from a minimum of 12 hours to 8 hours for some participants, and psychotherapy does not appear to be essential for its safety and efficacy.

1. FDA—Center for Drug Evaluation and Research. Psychedelic drugs: considerations for clinical investigations (FDA-2023-D-1987).

2. Karlin, D et al. Rapid and Durable Response to a Single Dose of MM120 (Lysergide) in Generalized Anxiety Disorder: A Dose-Optimization Study. Poster P03-026. Presented at: APA Annual Meeting; May 4-8, 2024; New York City, NY. 2024.

S. Karas Employee of: Mind Medicine, Inc., R. Barrow Employee of: Mind Medicine, Inc., C. Conant Employee of: Mind Medicine, Inc., J. Freedman Employee of: Mind Medicine, Inc., P. Jacobsen Employee of: Mind Medicine, Inc., J. Jemison Employee of: Mind Medicine, Inc., D. Karlin Employee of: Mind Medicine, Inc., T. Solomon Employee of: Mind Medicine, Inc.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that begins in childhood and persists into adulthood in 35-50% of cases, resulting in a prevalence of 2-4% in the adult population. The core symptoms are inattention, hyperactivity, and impulsivity, while emotional dysregulation is considered an associated symptom. Several lines of evidence support structural and functional brain imaging alterations in ADHD. Decreased volume of the accumbens and amygdala persist from childhood into adulthood, and several resting-state and task-related functional alterations have also been reported.

To investigate differential brain activation patterns in adults diagnosed with ADHD as compared to healthy controls (HC) during an affective Go/NoGo task, to understand the neural background of selective inhibition in emotionally demanding situations.

Data of 61 subjects were analyzed: 34 adult ADHD patients meeting DSM-IV diagnostic criteria (17 women, 17 men, mean age 37.3 years) and 19 HCs (10 women, 9 men, mean age 30.2 years). HCs were screened using the 90-item Symptom Checklist to exclude current psychiatric comorbidity. Symptom severity was assessed using the Conners’ Adult ADHD Rating Scale (CAARS). During the MRI scan in a Philips Achieva 3.0T scanner, we used a block design delivering positive, negative and neutral stimuli from the IAPS System applying a Go/NoGo paradigm. The fMRI analysis focused on contrasts between task and rest, emotional and neutral, and Go and NoGo conditions (activation or deactivation). Contrast between activation and deactivation in the ADHD and HC groups were tested.

Based on the pooled data from both groups, we found significant contrasts between the task and rest conditions, including an activation of primary and secondary visual cortex, frontal areas, corresponding to the Visual Network (VN), the Dorsal- and Ventral- Attention Networks (DAN, VAN), and the Central Executive Network; and a deactivation of the anterior cingulate, precuneus and parietal areas, corresponding to the Default Mode Network (DMN). During emotional vs neutral conditions, we detected activation of the secondary visual cortex, while contrasts between NoGo vs Go conditions manifested as activation of ACC and insular regions. ADHD subjects showed increased BOLD activation in the DAN and VAN areas. In all conditions, DMN areas showed higher deactivation in the ADHD group.

Here, we report differences in VN, DAN and VAN brain regions and the DMN in adult ADHD patients suggestive of distinctive pattern of activation and deactivation during an emotional Go/NoGo task. The results have clinical implications for understanding ADHD patients under in emotionally demanding situations.

Funding: Hungarian Brain Research Program, grants 2017-1.2.1-NKP-2017-00001 ans #NAP2022-I-4/2022 to JMR and PC.

None Declared