The prevalence of depressive symptoms and cognitive decline increases with age. Understanding the temporal dynamics of these symptoms could provide valuable insights into the early stages of cognitive decline, allowing for more timely and effective treatment and management.

Our objective was to explore how depressive symptoms, apathy, limitations in daily life activities, and cognitive impairment evolve and interact over time in older individuals. Specifically, we aimed to determine whether changes in these symptoms could help identify subsequent cognitive decline. We used Dynamic Time Warping analysis to model and characterize the progression of these symptoms, examining their relationships both at individual and group levels.

Participants from the Prevention of Dementia by Intensive Vascular Care (preDIVA) trial cohort with baseline and ≥3 follow-up measurements were included, with a median of 6.7 years of follow-up. Dynamic Time Warping analysis was used to model temporal dynamics of individual constituents of the Mini Mental State Exam (MMSE), activities of daily living (ADL) using the Amsterdam Linear Disability Scale (ALDS) and depressive symptoms using the 15-item Geriatric Depression Scale (GDS-15).

The 1537 participants had an average age of 74 years at baseline, 56.5% were female, and 19.9% had finished a higher education. The directed analyses revealed a nuanced temporal pattern, wherein certain depressive symptoms preceded cognitive decline indicators, and vice versa. The GDS-15 symptoms with the strongest outstrength, meaning changes in these symptoms preceded subsequent changes in other items, were the apathy symptoms ‘dropped activities/interests’, ‘energetic’ and ‘not doing new things’ (all p’s<.001). The MMSE constituents with the strongest instrength, meaning changes in these symptoms were preceded by changes in other items, were ‘immediate memory’, ‘verbal comprehension’ and ‘naming objects’. Decline in ADL function was a consistent predictor of worsening of depressive symptoms and cognitive decline (p<.001).

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An increase in apathy and a decline in ADL preceded mood-related symptoms and cognitive impairment in older people aged 70-78 years.

None Declared

Mental disorders, such as Bipolar Disorder (BD), Schizophrenia (SZ), and Schizoaffective Disorder (SA), are prevalent and often debilitating conditions that significantly impact individuals’ lives (Scangos et al. Nat Med 2023; 29(2): 317-33). Recent findings have identified blood RNA editing gene modifications that may aid in distinguishing between healthy controls, depressed patients, and those with BD and unipolar depression, improving diagnostic accuracy and treatment strategies (Salvetat et al. Transl Psychiatry 2022; 12(1):182).

This study demonstrates that RNA editing biomarkers can accurately differentiate individuals with SZ, SA, BD, and healthy controls, highlighting the potential of artificial intelligence (AI)-based predictions for diagnosis.

A comparative analysis was performed with 85 healthy controls subjects, 39 BD, 31 SZ, and 14 SA patients. Patient samples were collected from two cohorts. Diagnostic assessments were conducted using SCID-1, HDRS, YMRS, and M.I.N.I., while healthy controls had no history of mental disorders or psychotropic medication use.

Significant biomarkers were combined using a multiclass Random Forest algorithm. The algorithm was trained on 70% of the population. Then, the test was performed on the 30% of the population who never saw the algorithm. The analysis shows clear differentiation between the control group and individuals with BD, SZ, and SA with high sensitivities and specificities for ROC area under the curve (AUC).

This proof-of-concept analysis provides strong evidence for using RNA editing signature in diagnosis, and potentially in prognosis and treatment prediction. Further validation will be performed using a larger cohort.

None Declared

Attention Deficit Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD) are common psychiatric conditions, with comorbidity rates ranging from 18% to 34% in adults. Both disorders share symptoms such as impulsivity, emotional dysregulation, and interpersonal dysfunction, complicating differential diagnosis. Their frequent co-occurrence may suggest overlapping developmental and environmental risk factors as well as common underlying mechanisms. Particularly for BPD patients, recognizing the shared characteristics between ADHD and BPD may help reduce the stigma surrounding this disorder and eventually lead to a broader range of pharmacological treatment options.

This review aims to explore the links between ADHD and BPD, focusing on their symptomatology overlap, comorbid presentation, shared risk factors and treatment insights in adults.

A narrative literature review was conducted using the keywords “ADHD”, “borderline personality disorder”, “comorbidity” and “adults” in PubMed and Google Scholar databases.

Findings reveal that ADHD and BPD share several risk factors, including genetic predispositions and early-life adversities. Early-life adversity, particularly trauma, is a shared risk factor; however, the type and timing of adversity seem to play differential roles in developing ADHD and BPD symptoms. In terms of clinical presentation, ADHD is characterized by more severe impulsivity compared to non-comorbid BPD, whereas BPD features more severe difficulties in emotional regulation compared to non-comorbid ADHD. The comorbid ADHD+BPD presentation is marked by heightened severity in both impulsivity and emotional instability. The traditional view of ADHD as an early-onset disorder and BPD as a late-onset personality disorder is increasingly questioned, prompting calls for a dimensional diagnostic approach. Recent studies highlight the potential of ADHD medication, particularly stimulant compounds, in reducing suicidal behavior among BPD patients exhibiting ADHD symptoms. Such medications have been found to lower the risk of suicidal behavior in these patients, while other treatments (e.g., antidepressants, antipsychotics, mood stabilizers) did not show similar protective effects.

This review highlights the complex interplay between ADHD and BPD, emphasizing that both disorders should be considered within a dimensional framework rather than as separate categorical entities. Shared symptoms and risk factors underscore the need for integrated treatment approaches that address the combined symptomatology of ADHD and BPD. Future research should focus on understanding the developmental trajectories of these disorders, refining diagnostic criteria, and evaluating the effectiveness of combined treatment strategies.

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Borderline Personality Disorder (BPD) remains a challenging and complex disorder but it can be successfully treated.

In 2013, the first portuguese BPD specialized treatment programme was created in the Psychiatry Department at Local Health Unit of São João, becoming a very useful tool in the patients’ management.

We aim to study the influence of clinical characteristics on the duration of intervention and discharge from this BPD treatment programme.

Retrospective observational study of patients admitted to this programme until August 31st 2024. Descriptive analysis of the results was performed using the SPSS software, version 29.

A total of 157 BPD patients were admitted to this programme, 154 (98%) of which are female. These patients had a mean age of 24,6 years old, when they engaged in the programme. During the follow‑up 39% have abandoned the programme, and 27% have been discharged due psychotherapeutic stabilization.

We will also present results related to association between clinical factors (namely previous diagnoses and history of use of substances) and the duration of the intervention/discharge plan, in order to know if our results are consistente with the ones from another centers where comorbidity with eating disorders and cocaine use disorder were clinical variables predictors of shorter duration of the intervention.

Understanding the influence of clinical factors and their impact on intervention is essential to enhance this challenging programme to improve the treatment of BPD patients.

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Seeking treatment for infertility is an emotional process, often provoking symptoms of anxiety and depression in both men and women, especially when treatment fails (Milazzo et al, Plos One; 11). While religion may provide hope and comfort to men with infertility, it may also provoke anguish in those whose religious doctrines restrict certain treatments.

The goal of this study is to assess the role of religion in male patients’ ability to cope with their infertility.

An electronic survey was sent to male patients who presented for an infertility visit at an American urology clinic. Using a 4-point Likert Scale, participants reflected on their religion’s role in seeking treatment for infertility, their selection of treatment, and their ability to cope with their diagnosis. The Likert Scale results were analyzed utilizing T-tests via SPSS Software to assess answer variations across religions. Written responses were analyzed for common themes.

73% of respondents (n=288/395) identified with a religion (58.6% Christian, 29.5% Catholic, 11.8% Other Religion). Across all religions, participants reported that religion served as a significantly greater source of coping than of anxiety in their infertility treatment (2.56 vs. 2.03, t-value = 5.64, p-value = <.00001). In comparison with most other religions, Jewish participants (all non-orthodox) were significantly less likely to report their religion having any effect on their coping at all. Among those written responses that attributed their religion with their ability to cope, the most common key words were “prayer,” “comfort,” and words referring to religious community such as “pastor” (Table 1). Most written responses that indicated their religion had a negative emotional impact stated discomfort with a specific treatment or aspect of the treatment process. Of patients who discussed having disagreed with or gone against their religion’s views (7.9%), the majority were Catholic (n=13/17 (76.5%)).

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Religion appears to be a source of coping more than anxiety for males with infertility. This is perhaps less applicable to non-orthodox Jewish patients. Providers of male-factor infertility treatment should practice sensitivity when presenting infertility treatment options as a minority of patients may experience cognitive dissonance when considering treatment at odds with their religious identity. However, in religious patients struggling with mental health due to their infertility, physicians can encourage spiritual health and connection with religious community.

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Negative symptoms of Schizophrenia (NSS) consists of apathy, avolition, anhedonia, social withdrawal, reduced expression (blunted affect and alogia) and impairments in attention, working memory, or executive function. Unfortunately, treatment effects of conventional approaches with antipsychotics, other pharmacological agents or psychosocial interventions are limited and have not shown much improvement in reducing negative symptoms. Non-Invasive brain stimulation such as repetitive transcranial magnetic stimulation (rTMS) & high-definition transcranial direct current stimulation (HD-tDCS) offers a novel approach in the treatment of negative symptoms but with no agreed upon treatment protocol. Priming is a technique that can enhance the sensitivity of the brain to therapy using techniques that increase or decrease the excitability of the cortex. Preconditioning TDCS have shown profound impact on the conditioning effects induced by subsequent administration of rTMS in a few studies done in patients with depression. There has been no study assessing the effects of HD-tDCS primed iTBS in Negative Symptoms of Schizophrenia.

The aim of this study was to evaluate whether HD-tDCS priming improves the efficacy of intermittent theta burst stimulation (iTBS) in improving the NSS.

A prospective hospital based randomized controlled study with a sample size of 40, where the participants were divided into Active or Sham HD-tDCS primed iTBS stimulation groups for a total of 20 sessions over two weeks. Assessments on clinical parameters at baseline, end of 2 weeks, and end of 4 weeks were done.

Primary outcome of the study was the differences in Positive and Negative Syndrome Scale for Schizophrenia (PANSS) & Scale for Assessment of Negative Symptoms (SANS) scores over 4 weeks of HD-tDCS primed iTBS between the two groups.

There was a statistically significant reduction noted in the mean PANSS & SANS scores across all domains over time up to 4 weeks in both the active and sham groups.

Though there was more reduction in mean scores in total PANSS score as well as across domains, the difference between the two groups was not found to be statistically significant in any of the PANSS score. However, the difference was found to be significant for SANS total score and SANS attention score with score showing more reduction in the active group in comparison to the sham group.

These results suggest that the HD-tDCS primed iTBS had a superior effect specifically on negative symptoms, as reflected in the SANS scores, but not on the broader spectrum of symptoms measured by PANSS, which suggests that priming iTBS with HD-tDCS may prove to be beneficial in reducing the Negative Symptoms of Schizophrenia more effectively than iTBS alone.

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Neuroticism, defined by a tendency to experience negative emotions such as anxiety and irritability, has significant public health implications, affecting both mental and physical health. It is also associated with poor career outcomes, including lower job satisfaction and higher rates of occupational failure, highlighting its importance in understanding labour market disparities. Despite advances in genetics, including insights into genetic background for neuroticism through large genome-wide association studies, the relationship between genetic predisposition to neuroticism and labour market performance remains underexplored.

This study examines the association between polygenic score for neuroticism (Nagel et al. Nat Genet 2018; 50 920-927) and individual labour market performance over 25 years in Finland. We aim to uncover how genetic predisposition to neuroticism relates to socio-economic outcomes, contributing to a broader understanding of its public health and economic implications.

Our analysis draws on pooled data from the Finnish Finrisk (1992-2012) and FinHealth (2017) studies, comprising a representative sample of adults aged 25-64 (N=20,121). We integrated genetic, survey and socio-economic registry data. Using probit and semi-structural regression models, we assessed labour market outcomes, with neuroticism polygenic scores as the primary explanatory variable. Controls for socio-demographic factors and genetic principal components were included.

Individuals with higher polygenic scores for neuroticism were found to have lower income, partly through a direct and partly through a mediated association. Higher polygenic risk for neuroticism was linked to a decreased likelihood of completing higher education. Additionally, our study provides novel insights into how elevated polygenic risk for neuroticism was linked to labour market status.

Our findings demonstrate that genetic predisposition for neuroticism is not only associated with educational setbacks but also translates into labour market disadvantages. While the effect sizes are modest, our results suggest that compensatory measures and support may help mitigate the career disadvantages faced by individuals with a higher genetic risk for neuroticism.

A. Hazak: None Declared, J. Liuhanen: None Declared, K. Kantojärvi: None Declared, S. Sulkava: None Declared, T. Jääskeläinen: None Declared, V. Salomaa: None Declared, S. Koskinen: None Declared, M. Perola: None Declared, T. Paunio Consultant of: Idorsia Pharmaceuticals and Biogen (unrelated to the present work).

Obsessive-compulsive disorder (OCD) has an estimated prevalence of 1-2% and causes a significative reduction in functionality and quality of life with a high socioeconomic impact.

First and second line treatment includes serotonin reuptake inhibitors, clomipramine, antipsychotics augmentation strategy and cognitive behavioural therapy. It is ineffective in 20-60% of patients whose approach may include transcranial magnetic stimulation (TMS).

The aim of this study is to assess the effect of treatment with TMS on obsessive-compulsive, anxious, and depressive symptoms in patients with OCD.

A prospective observational study was conducted including all patients diagnosed with OCD who underwent TMS in our department since March 2023.

Our protocol targets the dorsolateral prefrontal cortex and includes a total of 25 sessions using the Food and Drug Administration approved parameters (20 Hz, 100% of the leg resting motor threshold, 50 trains of 2s duration, inter-train interval 20s, 2000 pulses per session). Before each session, symptom provocation is performed. TMS was performed using the Cool D-B80 coil and a MagPro stimulator.

Symptoms before and after treatment were assessed using the Yale Brown Obsessive-Compulsive Scale (Y-BOCS), the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D).

As of 01/09/2024, 21 individuals with OCD completed TMS treatment, 57% male, with a median age of 37 years (interquartile range (IQR) 17). The median duration of illness was 25 years (IQR 15), with 24% of patients having very severe OCD, 52% severe, and 19% moderate—all refractory to psychotherapeutic and pharmacological treatment.

There was a statistically significant reduction in Y-BOCS scores (pre-TMS median score 29 (IQR 6), post-TMS 21 (IQR 13), p=0.003), with 32% of patients achieving a complete response (Y-BOCS reduction ≥35%) and 5% a partial response (Y-BOCS reduction ≥25%). No correlation was found between the change in Y-BOCS scores and other variables such as age, duration of illness, and pre-TMS scores on Y-BOCS, HAM-A, and HAM-D.

Additionally, a statistically significant reduction was observed in HAM-A scores (pre-TMS median 20 (IQR 18), post-TMS 16 (IQR 11), p=0.026) and HAM-D scores (pre-TMS median 19 (IQR 17), post-TMS 15 (IQR 14), p=0.029).

No severe adverse effects were reported.

This study shows significant reductions in Y-BOCS, HAM-A, and HAM-D scores after TMS treatment, with many patients achieving complete or partial response. These findings align with previous research, suggesting TMS is an effective option for treatment-refractory OCD. The absence of severe adverse effects supports its safety.

In conclusion, this study adds to real-world evidence by demonstrating the efficacy and safety of TMS in a clinical setting. Continued data collection is crucial to identify predictors of response.

None Declared

War and conflict have significant long-term effects on mental health, affecting both civilians and military personnel. Exposure to armed conflict greatly increases the risk of psychiatric disorders such as PTSD, depression, and anxiety. These effects are not limited to the immediate aftermath but can persist for years, even across generations. Vulnerable populations, including children, women, and refugees, are particularly at risk, facing compounded mental health challenges due to prolonged exposure to trauma and limited access to support.

This poster aims to:

1. 1. Explore the psychiatric consequences of war and conflict.

2. 2. Investigate the development of PTSD, depression, and anxiety in conflict-affected populations.

3. 3. Assess the role of transgenerational trauma transmission and its epigenetic effects.

4. 4. Highlight the role of resilience and psychosocial support in mitigating these effects.

Data were drawn from various studies examining populations affected by conflict across different regions. Key metrics included the prevalence of PTSD, depression, and anxiety, and the impact of traumatic experiences. The role of social support and resilience factors in mitigating psychiatric outcomes was also analyzed.

The findings consistently demonstrate high rates of PTSD and other psychiatric disorders in individuals exposed to conflict. Mental health impacts are often prolonged, with many individuals showing persistent symptoms years after the initial trauma. Additionally, research on epigenetic changes suggests that trauma can be passed down to future generations, potentially affecting their mental health. However, protective factors such as strong social support and community resilience were found to buffer the negative effects of trauma in some cases.

War and conflict have profound and lasting psychiatric consequences. The prevalence of mental health disorders is significant among affected populations, and these effects can be transmitted across generations. Interventions should focus on providing timely mental health care, building resilience, and addressing the broader societal impacts of trauma. Early identification and support are critical to reducing the long-term mental health burden in conflict-affected areas.

None Declared

Neuromodulation technologies became the safe and effective alternative to treat psychiatric and neurological disorders. The current evidence from the up-to-date state in vagus nerve stimulation application in studies of emotional state modulation demonstrates a strong impact of vagus stimulation on the state of patients with a range of disorders. The normalizing effect of vagus nerve stimulation on abnormal sympathetic nerve activity may explain the beneficial effect on burnout, which is thought to be a manifestation of decreased vagus-mediated heart rate variability (HRV) under everyday stress.

Considering all of the above, we aimed to explore the influence of a novel VNS stimulation protocol on emotional state, as well as highlighting specific features of the activation-related neurodynamics and the effects on HRV time, frequency and non-linear metrics.

11 right-handed male volunteers aged 18-22 years participated in the 1st (EEG) study (6 persons-taVNS group and 5-SHAM) and 62 healthy volunteers 18-49 years old were recruited for 2nd (HRV) study (26-VNS group and 22–Sham). We used the combination of pleasant meditative classical music and a slow bi-polar wave of electrical non-invasive transcutaneous stimulation of auricular area (BrainPatch platform for non-invasive stimulation). Vagus nerve stimulation was arranged as a 4-day course. Psychological testing (State Anxiety, STAI; psychological stress level, PSM-25; severity of emotional burnout, MBI; depression, IDS) was carried out.

Non-invasive stimulation was rated by the participants as a positive experience. We detected beneficial changes in the psychoemotional state of the respondents (improvement of mood, reduction of job related stress – emotional burnout). The increase of vagally mediated parameter RMSSD and decrease of LF/HF ratio has reflected the activation of parasympathetic nervous system (PNS) during stimulation. HRV effects of VNS turned out to be short-term, which was manifested in a drop in the value immediately after the stimulation. EEG analysis indicated a long-term effect of VNS. Increased alpha and beta rhythms (generalized growth in the frontal and posterior cortex) and gamma activity (frontal region) after a series of 4 VNS sessions may indicate the improvement of mental processes and creative thinking (attention, information processing and memory storage). Enhanced activation level was mirrored in an increased beta/alpha ratio.

Our data suggests that VNS has a normalizing effect on the psychoemotional state shifting “sympatho-vagal balance” to the functional optimum. EEG data showed the prolonged stimulating effect on the brain processes related to the cognitive functioning while attenuating the stress impacts at the same time.

None Declared

Depression is a leading cause of disability among youth, with stigma significantly hindering mental health service utilization. Untreated depression is associated with greater severity, poorer outcome, and cognitive impairment. In addition to structural barriers to service use, stigma towards mental health is a profound obstacle that impedes individuals from seeking needed services. Reducing stigma toward depression can improve perceptions of treatment and engage young individuals with depressive symptoms in behavioral services.

This study evaluates the feasibility and acceptability of delivering brief video interventions, proven to reduce depression stigma, via Instagram to promote help-seeking among youth. We hypothesized that the intervention would be both feasible and acceptable, generating higher link clicks and lower cost-per-click (CPC) compared to control videos.

A two-week Instagram campaign in February 2024 targeted U.S. adolescents aged 14-22. The campaign featured a 60-second human-narrated personal story video, previously shown to reduce depression-related stigma. The video showcased a young individual sharing their experience with depression, misconceptions about treatment, and the support they received. Engagement metrics assessed included impressions (video displays), reach (distinct viewers), link clicks (engagement with mental health resources), and CPC (cost-effectiveness). These were compared to four control videos: AI-narrated personal story (“Control 1”), human-narrated educational text (“Control 2”), AI-narrated educational text (“Control 3”), and an un-narrated educational text with background music (“Control 4”).

All five videos successfully reached a broad audience, with a combined total of 808,000 impressions, 287,000 viewers, and 4,148 link clicks. The Human-Narrated Personal Story (Intervention) video was highly effective, achieving 874 link clicks and a competitive CPC of $0.92, outperforming three of the four control videos. The AI-Narrated Educational Text (Control 3) had the highest number of link clicks (985) and lowest CPC ($0.82), while the AI-Narrated Personal Story (Control 1) had the fewest link clicks (680) and highest CPC ($1.18).

The intervention video successfully engaged the target audience, supporting its feasibility and acceptability for broader dissemination. Instagram proves to be a viable platform for disseminating evidence-based mental health interventions aimed at reducing depression stigma among youth. The study supports the potential for using social media in public mental health strategies, though further research is needed to evaluate its impact on help-seeking behaviors and across diverse demographic groups.

None Declared

Bullying, deliberate aggression by a peer or group of peers in a power imbalance that favors the aggressor, is a frequent and preventable traumatic event during adolescence (Abregú-Crespo R et al. The Lancet Child & Adolescent Health 2024; 8:122–134). Mitigating its impact could be a viable strategy for psychosis prevention (Fraguas, D. et al. JAMA Pediatrics 2021; 175, 44–55). A better understanding of its influence on brain development during adolescence could be crucial for implementing effective interventions.

To study the relationship between bullying exposure (BE), distressing psychotic-like experiences (DPLEs), and multi-scale functional network connectivity (msFNC) in the developing brains of 12-year-old adolescents.

We used cross-sectional data from 12-year-old adolescents from the Adolescent Brain Cognitive Development Study, which recruited a representative sample of healthy adolescents from across the United States. We fitted a linear mixed model to predict DPLEs (Prodromal Questionnaire-Brief Child Version) with BE (Peer Experience Questionnaire) as a predictor (n=10,388). We analyzed functional magnetic resonance imaging data with reference-informed independent component analysis and a canonical and replicable multi-scale intrinsic connectivity network template to extract whole-brain 5460 msFNC features (Iraji, A. et al. Hum Brain Mapp 2023 44, 5729–5748). We fitted 5460 linear mixed models to predict DPLEs with BE as a predictor and analyzed the mediation effect of each of the 5460 FNC features (n=5,409). All models were fitted with family and site as random effects, adjusted for covariates (age, sex, race, ethnicity, pubertal development, and family income), and corrected for multiple comparisons.

BE was significantly associated with DPLEs (β=0.39, CI[0.37, 0.41], t(10362) = 41.00, p<.001, R2=0.36, p<.000) (Fig.1). DPLEs were associated with msFNC predominantly between cerebellar, paralimbic, somatomotor, insulotemporal, frontal, temporoparietal, and central executive networks (Fig.2). The association between DPLEs and BE was primarily mediated by msFNC between the paralimbic, somatomotor, insulotemporal, frontal, and temporoparietal networks (Fig.3).

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Bullying exposure may represent a modifiable risk factor for the development of DPLEs during adolescence. It may influence DPLEs through its effects on relevant functional brain networks. The implementation of targeted interventions to prevent BE during adolescence could serve as a viable strategy to mitigate potential functional brain alterations and reduce the risk of psychosis.

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Recovery-oriented care requires a paradigm shift from a vulnerability to a protection model. However, protective factors and resources to recovery in urban milieus remain poorly understood. Whether material, emotional or social, the identification of those resources calls for user-led initiatives and a more situated understanding of environments, where those recovery trajectories occur.

The Lausanne-based Urban Remediation program is a multi-stakeholder (service users, psychiatrists, geographers, community actors and public authorities) initiative, which aims to identify key elements of an ‘urban recovery milieu for psychosis’ and create such a milieu in the city of Lausanne (Switzerland). This talk describes the participatory methods used to create a strategy to foster recovery from psychosis in cities to better inform city’s mental health plan and policies.

We implement a living lab approach aimed at real-world experimentation in four phases: (i) exploration, (ii) co-creation, (iii) experimentation, and (iv) implementation. During phase one, we’ve used participatory mapping, go-along interviews and photovoice for an in-situ engagement with 10 young patients to ensure a systematic understanding of obstacles and resources for recovery. For phase 2, qualitative analysis and collective workshops with the various stakeholders were used to co-elaborate relevant urban interventions and identify partners for further implementation.

Introducing a Living Lab methodology to experiment the recovery-oriented strategy in a limited area in a real-world setting provides us with solutions, which can be further scaled up to inform the creation of a more inclusive city. Lessons learnt with early psychosis patients can benefit to the community as a whole, as high sensitivity of psychotic patients can teach us a great deal both regarding urban stressors and resources common to the general population.

Using real-world methodologies in cities allows to mobilize actors and resources beyond individual resilience to support recovery trajectories. Consistent transdisciplinary efforts are needed to involve all stakeholders (urban planners, mental health plan developers and society at large) for effective user-based changes and implementation of sustainable solutions.

None Declared

Digital mental health interventions have gained prominence as accessible and cost-effective solutions in workplace settings. However, our previous meta-analysis revealed a concerning trend: despite advancements in technology, the effectiveness of these interventions has not improved over time. This stagnation may be attributed to the significant and ongoing heterogeneity among interventions which indicates both variation in both sample and the intervention. We do not kow which theraputic approaches, design aspects or intervetnkion features enahnce efficacy.

We use a Bayesian meta-regression of an unpdated systematic review to develop a comprehensive framework to guide the design, development, and evaluation of workplace digital mental health interventions. By addressing the variability in intervention approaches and design and leveraging evidence-based practices, this framework seeks to enhance the quality and effectiveness of digital solutions for employee mental health.

A systematic literature review was conducted to identify randomized controlled trials of employee based digital mental health interventions. Eligible studies were assessed based on specific criteria, including participant characteristics, intervention characteristics, and outcome measures. Data extraction and coding were performed, followed by a Bayesian meta-analysis approach. This method allowed for a more nuanced evaluation of the effectiveness of various intervention features and designs, accounting for uncertainty and prior knowledge in the field.

The review identified 95 interventions involving approximately ˜25,000 participants. The Bayesian meta-analysis confirmed small positive effects in reducing mental ill-health symptoms. Both sample and intervention characteristics contributed to heterogeneity across studies. Stress management and mindfulness interventions, particularly those designed with input from mental health experts, demonstrated more effiacy than CBT based approaches. Several intervention features, such as videos, feedback scores, and reminder texts, were associated with positive mental health outcomes.

This review provides valuable insights into the optimal design and development of workplace digital mental health interventions. The identified framework and evidence-based practices offer guidance for developers to create effective interventions that address the heterogeneity within studies. Importantly, this framework has the potential to serve as a robust evidence base for app designers, enabling them to create more effective, personalised and engaging mental health applications.

None Declared

Childhood trauma (CT), especially experiences of abuse and/or neglect, is highly prevalent. Although CT significantly impacts mental health, those who experience it often avoid seeking treatment. Stigma –negative beliefs surrounding mental-health and trauma, is a primary obstacle to seeking care. We recently developed and demonstrated the efficacy of a brief video intervention designed to reduce stigma and increase openness to mental health care among CT survivors. This intervention was tested in a controlled environment (crowdsourcing platforms) to ensure that broader dissemination would cause no harm. Given the central role social media plays in the lives of youth, it is crucial to explore how it can be leveraged to deliver evidence-based mental health interventions effectively.

The current study aimed to test the feasibility and acceptability of delivering this evidence-based intervention via social media, specifically Instagram. We hypothesized that the intervention would be both feasible (demonstrating high reach) and acceptable, generating better social media engagement metrics – such as higher link clicks and lower recruitment cost-per-click (CPC) rates, which indicate the intervention’s cost-effectiveness, compared to the control video.

An eight-day Instagram campaign in February 2024 targeted U.S. youth aged 18-24. The campaign featured a 60-second personal story video, previously shown to reduce stigma among CT survivors, and a psycho-educational control video providing generic mental health facts, lacking social-contact elements. We assessed the campaign’s total cost-effectiveness and key social media engagement metrics: Impressions (number of times the video was displayed), reach (number of distinct viewers), link clicks (engagement with treatment resources), and recruitment cost-per-click (CPC).

The campaign generated 628,000 impressions, reached 209,000 Instagram users, and resulted in 4,015 link clicks, indicating its feasibility. The intervention video outperformed the control video in all measures, achieving 2,062 link clicks with a CPC of $0.79, compared to 1,953 link clicks and a CPC of $0.84 for the control group.

The findings suggest that Instagram can effectively disseminate cost-effective interventions, potentially improving attitudes about CT and encouraging youth to seek help.

None Declared

Online workers are individuals who participate in crowdsourced work. They experience a higher rate of internalizing symptoms than the general population, a phenomenon dubbed the “Turker blues.” Three large trials of online single-session interventions (SSIs) failed to find statistical or clinically significant treatment effects in this population. Because these trials tested SSIs, it is unclear if online workers are unresponsive to SSIs in general or online interventions specifically. Moreover, participants in these studies were not selected based on their desire to learn skills online, raising the possibility that intervention effects would be present in treatment-seeking individuals.

We conducted a nationwide, fully remote two-arm randomized (1:1) controlled trial to test the efficacy of a 4-week self-guided online behavioral activation treatment for depression in online workers in the United States (N=804). The intervention was designed as an extension of the Common Element Toolbox (COMET), an SSI previously found ineffective in online workers.

804 online workers were randomized to COMET-BA or a waitlist control (WLC). Self-report measures of depression, anxiety, subjective well-being, behavioral activation, psychosocial function, and emotion regulation were collected weekly for 4 weeks, 1-week post-intervention, then at a 1-month follow-up.

There was a significant time-by-treatment interaction during the intervention phase on the study, suggesting those in the COMET-BA arm improved significantly more than those in the WLC, with a small-medium effect on depression symptoms (SMD=-0.32; 95% CI: -0.47, -0.17). All but two outcomes, suppression and functioning, demonstrated significant improvement. Improvements were maintained during the 1-month follow-up period but did not grow during this period. Attrition was comparable between the treatments and the results were sensitive to missing data imputation.

COMET-BA may be effectively delivered as an unguided online intervention for depression in online workers. Crucially, intervention effects were evident after the second iBA session, suggesting that SSIs may not be effective in adult online workers.

L. Lorenzo-Luaces Consultant of: I have consulted with Syra Health, Inc. who had no involvement in the current research, A. Peipert: None Declared

Mental health disorders are a leading cause of disability in European Union countries. Previous evidence highlighted the role of socioeconomic inequalities on unmet mental health care needs, varying by income or education. Being both reducing inequalities’ gaps and mental health promotion current goals of European Union (EU), it is essential to understand the differences between EU countries and the role of socioeconomic factors on this.

The study aims to assess the socioeconomic inequalities on unmet needs for mental health care in EU countries in 2019.

This was a cross-sectional study using data from the 2019 European Health Interview Survey across 26 EU countries. The main outcome considered was the proportion of self-reported unmet needs for mental health care due to financial reasons. Inequalities for income, education and degree of urbanization were assessed by calculating the rural-city, primary-tertiary education and lowest-highest income quintiles, respectively.

The proportion of self-reported unmet need for mental health care in 2019 ranged between 1.1% (Romania) and 27.8% (Portugal), with a median of 3.6%. Regarding income inequality, all countries except Hungary (ratio=0.88) showed highest share of unmet need among inhabitants with the lowest income quintile. The country with the highest inequality was Greece with a ratio of 23.8. Regarding education inequality, 15 out of 26 countries showed that less educated inhabitants had highest unmet needs of mental health care, with values ranging from 0.5 in the Netherlands and 7.2 in Bulgaria. As for degree of urbanization, rurality showed lowest unmet needs for 21 out of 26 countries, with the highest ratio being 2 in Romania.

The study highlights significant and wide socioeconomic (income, education, and urbanization) inequalities in unmet mental health care needs across EU countries.

While income inequality plays a similar role across EU countries with the poorer quintile showing higher unmet needs due to financial reasons, EU is divided on the role that education plays. On the opposite side, there is also a tendency across the EU for rural areas showing lower unmet needs for mental health care. Policymakers should prioritize strategies to ensure financial access to mental health services, as well as promoting mental health literacy and improve service availability for vulnerable populations.

J. V. Santos Conflict with: This article was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020), V. Pinheiro: None Declared

Gambling disorder is a rising concern among young adults, highlighting the need for effective screening to offer appropriate support and intervention.

This study aims to characterize gambling disorder among young adults (ages 18-25) in Portugal.

A quantitative cross-sectional study was conducted using a self-administered online questionnaire completed by young adults.

This study included a population of 554 participants, 166 of whom were gamblers. Among the gamblers, the prevalence was as follows: 63% did not show signs of pathological gambling, while the remaining participants exhibited gambling addiction at varying levels: 25% mild, 9% moderate, and 3% severe. The typical profile of a gambler was identified as a male university student with an average age of 23.5 years, of a middle economic status and residing in an urban area. The preferred types of gambling were sports betting and online casino games. Most online gamblers had previously engaged in offline gambling at the age of M=19.25. The primary attractions of online gambling for these individuals were accessibility, the variety of games, and the potential for economic gains. The main encouragements to gamble online were friend´s influence and online advertising. No significant differences were observed in depression (PHQ-9) and anxiety scores (GAD-7) between gamblers and non-gamblers (p > 0.05). However, among gamblers, a strong positive correlation was found between higher levels of addiction (assessed by DSM-V gambling disorder criteria) and both depression and anxiety scores (r = 0.732, r = 0.681; p < 0.01). Furthermore, severe gambling cases were associated with a higher prevalence of prior formal diagnoses of psychiatric disorders, such as ADHD, anxiety, and depression, although this association was not statistically significant (p > 0.05). All gamblers showed a higher prevalence of substance abuse (p < 0.01). However, this trend did not extend to alcohol consumption (p > 0.05). The Jacobs Dissociative Experiences Scale was used to assess the presence of dissociative symptoms in relation to the severity of gambling addiction, revealing a strong positive correlation (r = 0.721; p < 0.01). Gamblers reported negative impacts on their family and romantical relationships. In contrast, they did not perceive their gambling behavior as having an adverse effect on their friendships or work performance. The majority (71.4%) of high-severity gamblers did not seek professional help and were not receiving any psychopharmacological therapy.

This study features the critical need for effective screening and intervention strategies for gambling disorder among young adults, given its correlation with mental health disorders and substance abuse. Addressing these challenges is essential for enhancing support and improving outcomes for individuals with gambling disorder.

None Declared

Seasonal patterns in bipolar disorder episodes, particularly manic episodes, have been widely studied, revealing a peak in early spring and a decline in late fall. However, less attention has been given to the seasonal variation of mixed states. Mixed episodes, a subtype of bipolar disorder, are characterized by both manic and depressive symptoms. Recent studies have suggested that mixed episodes may follow a different seasonal pattern compared to pure manic episodes, peaking in late summer. Understanding this seasonality can offer valuable insights into the timing and management of hospital admissions for bipolar disorder. In this study, we conducted a retrospective analysis of hospital admissions for bipolar disorder, evaluating the influence of meteorological factors on the frequency of admissions, particularly for mixed episodes.

This study aims to analyze the prevalence of hospital admissions due to bipolar disorder at the Psychiatry Service of ULS-VDL during 2021 and 2022, with a particular focus on mixed episodes. Additionally, it seeks to explore the relationship between meteorological factors, such as temperature and cloud cover, and the frequency of admissions, identifying any seasonal patterns associated with bipolar episodes. This analysis aims to explore the potential link between environmental changes, such as temperature and cloud cover, and the occurrence of mixed states in bipolar disorder.

A retrospective analysis was conducted of hospital admissions for bipolar disorder between 2021 and 2022 (n=71) at the Psychiatry Service of ULS-VDL. Monthly averages of meteorological data (temperature, precipitation, cloud cover, and solar radiation) were obtained from a local weather station. Poisson regression was used to assess the relationship between monthly admissions and meteorological variables.

Of the 71 total episodes, 16 were mixed episodes of bipolar disorder. The results showed a statistically significant association between decreased temperature (IRR=0.843, 95% CI [1.568-0.118], p=0.023) and increased cloud cover (IRR=0.162, 95% CI [0.023-0.302], p=0.023), compared to the previous month, and an increase in admissions for mixed episodes.

The findings of this study indicate a significant association between decreases in temperature and increases in cloud cover with higher rates of hospital admissions for mixed episodes of bipolar disorder. These results highlight the potential influence of meteorological factors on the seasonality of mixed episodes. Further research is needed to confirm these patterns and to explore their implications for the management and prevention of bipolar disorder hospitalizations.

Note: We intend to increase the number of years included and episodes.

None Declared

Alcohol use disorder (AUD) is associated with increased dopaminergic activity, and evidence suggests that α1b-adrenergic and 5HT2A serotonergic receptors play critical roles in modulating dopamine-mediated behavioral responses. Preclinical studies indicated that simultaneous blockade of these receptors with prazosin (α1b blocker) and cyproheptadine (5HT2A blocker) can reduce alcohol preference. This phase 2 clinical study aimed to evaluate the efficacy and safety of this combination in reducing alcohol consumption among patients with severe AUD.

The primary objective of the study was to assess the efficacy and safety of a combination of prazosin extended-release (ER) and cyproheptadine in reducing total alcohol consumption (TAC) in patients with severe AUD.

This was a phase 2, double-blind, parallel-group, placebo-controlled, randomized clinical trial conducted across 32 addiction treatment centers in France. A total of 154 participants (108 men and 46 women) with severe AUD were randomly assigned to one of three treatment groups for 3 months: 1) low-dose group (LDG) with 8 mg cyproheptadine and 5 mg prazosin ER daily, 2) high-dose group (HDG) with 12 mg cyproheptadine and 10 mg prazosin ER daily, or 3) placebo group (PG). The primary outcome was the change in TAC from baseline to Month 3. Secondary outcomes included changes in heavy drinking days, abstinence days, Obsessive Compulsive Drinking Scale (OCDS), and Beck Depression Inventory (BDI) scores. Safety was assessed through adverse events (AEs), sedation, and orthostatic hypotension (OH).

A significant main treatment effect in TAC change was observed in the intent-to-treat (ITT) population (p=0.039). Compared to the placebo group, the HDG showed a greater reduction in TAC from baseline to Month 3 (-23.6 g/day, p=0.016, Cohen’s d=-0.44), while the LDG also showed a reduction (-18.4 g/day, p=0.048). In the very high-risk drinking level subgroup (>100g/day of pure alcohol for men and >60g/day for women), the HDG showed a reduction of -29.8 g/day compared to the PG (p=0.031, d=-0.51). A significant dose-response relationship (p=0.027) was observed. Both low and high doses were well-tolerated, with AEs predominantly mild or moderate. No serious adverse events were reported in the HDG, and OH incidence was comparable across groups.

The combination of prazosin and cyproheptadine showed efficacy in reducing alcohol consumption in individuals with severe AUD, with a larger effect observed in the high-dose group. Both doses were well-tolerated, with a safety profile comparable to placebo. These findings suggest that the prazosin-cyproheptadine combination may be a promising treatment option for severe AUD and warrant further investigation in phase 3 trials.

J. Guiraud Shareolder of: Vergio, Employee of: Vergio