The association between prenatal acetaminophen exposure and the development of Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) remains a subject of considerable debate. Despite extensive research, the evidence regarding this relationship is conflicting.

To perform a systematic review and meta-analysis of studies comparing the incidence of ADHD and ASD in patients that were either exposed or not exposed to acetaminophen prenatally.

We systematically searched Pubmed, Embase and Cochrane Central for eligible studies up until August 2024. Only studies which included participants with a medical diagnosis of ADHD/ASD and reported acetaminophen exposure as a binary measure were included. Available summary data was extracted from published reports and pooled with a random-effects model using odds ratios (OR) with 95% confidence intervals (CI). Hazard ratios (HR) adjusted for potential confounding factors were used for sensitivity analyses. All statistical analyses were conducted utilizing Review Manager 5.4.1. PROSPERO iD:CRD42024587662.

We included five studies with a total of 2,647,536 patients with ADHD (150,741) / ASD (63,726), of whom 271,126 were exposed to acetaminophen prenatally and 2,376,410 were not exposed. Prenatal acetaminophen exposure was associated with an increased risk of developing ADHD (OR 1.30; 95% CI 1.17 to 1.45; p<0.01; I2 = 73%; Figure 1) and ASD (OR 1.17; 95% CI 1.14 - 1.20; p<0.01; I2 = 0%; Figure 2). Sensitivity analyses revealed that acetaminophen exposure during the third trimester of pregnancy was associated with an increased risk of ADHD (HR 1.26; 95% CI 1.07 to 1.47; p<0.01; I2 = 0%; Figure 3), but not during first (HR 1.10; 95% CI 0.97 to 1.26; p=0.13; I2 = 0%; Figure 3) and second (HR 1.07; 95% CI 0.95 to 1.19; p=0.26; I2 = 0%; Figure 3) trimesters.

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In this systematic review and meta-analysis, prenatal acetaminophen exposure was significantly associated with risk of developing ADHD and ASD, especially if exposure occurs in the third trimester of pregnancy.

None Declared

Body dissatisfaction is becoming more common among adolescents and is a putative risk factor for adverse mental (e.g., eating disorder and depressive symptoms) and physical health outcomes (e.g., excessive weight gain), both of which have also been increasing. Targeting body dissatisfaction through preventative interventions might improve these outcomes, however robust evidence of causal associations is limited.

To investigate the association between body dissatisfaction at age 16 and eating disorder symptoms at age 21, as well as depressive symptoms and BMI at ages 21 and 26 using a co-twin control design.

We used data from the Twins Early Development Study (TEDS) and validated self-report measures. We fitted univariable and multivariable linear mixed effect models adjusting for a comprehensive list of confounding factors (Figure 1) to investigate the association between body dissatisfaction, eating disorder and depressive symptoms, and BMI in the full twin sample. We then repeated these analyses using a co-twin control design, which allows to fully and partially control for genetic confounding in monozygotic (MZ) and dizygotic (DZ) twins, respectively, and for any shared measured and unmeasured environmental factors. We conducted primary analyses in imputed datasets for participants with complete exposure data.

The analytical sample included 2,183 twins (60.2% females, 61.7% DZ twins). In the full twin sample, one unit increase in body dissatisfaction at age 16 was associated with: (i) a 1.80-point increase in eating disorder symptoms at age 21 (95%CI: 1.49 to 2.11), (ii) a 0.59-point increase in depressive symptoms (95%CI: 0.46 to 0.72), and (iii) a 0.20-point BMI increase (95%CI: 0.08 to 0.32) across age 21 and 26 years. In co-twin control analyses, the association between body dissatisfaction and eating disorder symptoms was larger in DZ twins (N=661; 1.72, 95%CI: 1.11 to 2.33) than in MZ twins (N=414, 0.96, 95%CI: 0.15 to 1.77), whereas effect sizes for depressive symptoms were comparable [DZ: (0.56, 95%CI: 0.33 to 0.78); MZ: (0.50, 95%CI: 0.15 to 0.85)]. Associations with BMI were smaller in DZ (0.20, 95%CI: 0.00 to 0.40), and null in MZ twins (0.07, 95%CI: -0.21 to 0.35).

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Our findings suggest that greater body dissatisfaction might be a causal risk factor for eating disorders and depression in young people, as associations seen in the full sample persisted in co-twin control analyses. This indicates that body dissatisfaction could be a modifiable target to reduce the risk of these mental health problems in adolescents and young adults. Evidence of associations between body dissatisfaction and increased BMI was weaker in co-twin control analyses than in the full sample. This might be due to larger proportions of shared genetic risk and thus require larger sample sizes to detect.

None Declared

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder that significantly affects children’s behaviour, attention, and academic performance. While the impact of maternal smoking during pregnancy on ADHD risk is well-established, emerging research suggests that paternal smoking may also contribute to this risk. However, the relationship between paternal tobacco use and ADHD remains underexplored, with existing studies presenting mixed results.

This systematic review and meta-analysis aim to clarify the extent of this association and provide a comprehensive assessment of the evidence available.

All relevant studies in CINAHL, Embase, PsycINFO, PubMed, Scopus, and Web of Science databases were searched from inception until 15 March 2024. Both conventional and cumulative meta-analyses were conducted. Pooled odds ratios with 95% confidence intervals (CIs) were calculated using a random-effects model. The heterogeneity among studies was assessed using the I2 test, and the presence of small study effects was evaluated using funnel plots and Egger’s test. Sensitivity and subgroup analyses were also performed.

Twenty observational studies involving over 294, 236 study participants from 16 different countries were included. We found that paternal smoking was associated with a 22% increased risk of ADHD in children (RR=1.22, 95% CI: 1.12, 1.33). The observed association has remained stable since 2014, with minimal fluctuations in effect sizes and their corresponding 95% CIs. Our subgroup analysis revealed that this association is only evident among studies that did not account for maternal smoking (OR=1.23, 95% CI: 1.10, 1.38, n=8), while no increased risk of ADHD was found in studies that adjusted for maternal smoking (OR=1.14, 95% CI: 0.98, 1.33), suggesting that maternal smoking may confound the observed association.

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Paternal smoking may increase the risk of ADHD in children. Future studies should focus on maternal and paternal comparisons to disentangle the independent and combined effects of parental smoking on ADHD risk in children.

None Declared

Tobacco smoke exposure(TSE) is a significant public health issue, children and adolescents, who are often involuntarily exposed through secondhand or thirdhand smoke.This exposure has been linked to a range of neuropsychiatric conditions and can negatively impact mental and physical well-being. In the U.S., TSE is prevalent among certain sociodemographic groups, including those with lower income and specific racial backgrounds.The goal of this study was to evaluate the prevalence of TSE and its association with neuropsychiatric comorbidities.

Assess TSE prevalence among U.S. children and adolescents

Examine sociodemographic factors influencing TSE

Analyze the link between TSE and neuropsychiatric conditions’ prevalence and severity

This cross-sectional study used data from the 2020-2021 National Survey of Children’s Health (NSCH), a survey conducted by the U.S. Census Bureau.Parent-proxy responses were collected in English and Spanish through mail and web-based surveys.A total of 91,404 children aged 0-17 were included for the analysis of TSE prevalence, while 79,182 children aged 3-17 were analyzed for neuropsychiatric comorbidities.The primary measures were TSE, assessed through household smoking behavior, and the presence of neuropsychiatric conditions. Statistical analyses included t-tests, Chi-Square tests, and multivariate regression models to identify associations between TSE, socio-demographic factors, and neuropsychiatric comorbidities, providing adjusted odds ratios and confidence intervals. Statistical analyses were carried out using Stata version 17.

TSE was identified in 12.9% of the sample population. The likelihood of TSE was higher among males and adolescents aged 11-17 years. Children from lower-income households and American Indian/Alaska Native backgrounds had a greater risk of TSE. Among children exposed to tobacco smoke, 36.4% had at least one neuropsychiatric comorbidity, with anxiety (15.7%), ADHD (15.5%), and conduct problems (13.7%) being the most common. Females had lower odds of anxiety and autism spectrum disorder(ASD)compared to males, and Asian children exhibited lower odds of ADHD and other conditions. TSE was associated with increased severity of neuropsychiatric conditions. Figure 1.

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TSE is a significant concern among U.S. children and adolescents, particularly affecting males and those from lower-income families. Exposure to tobacco smoke notably elevates the risk and severity of neuropsychiatric conditions, with ADHD, behavioral and conduct problems, and learning disabilities being the most common co-occurring issues. These findings highlight the importance of early screening and intervention for youth exposed to tobacco smoke. Addressing sociodemographic disparities in exposure and implementing prevention strategies could play a critical role in reducing these negative health outcomes.

None Declared

ASD is a neurodevelopmental disorder with 1% prevalence among children and adolescents, with high comorbidity with Intellectual Disability. ASD imposes a significant disease burden and is a leading cause of disability among children and adolescents. Its aetiology is multifactorial, including both genetic and environmental factors. Although prior studies have explored the incidence, comorbidities and several prenatal risk factors, research especifically focusing on ASD categorization by ID is limited.

The aim of this study was to report the incidence and cumulative incidence of overall ASD, and HF and LF-ASD categorization, utilizing several national registers.

This study consisted of all singltone born in Finland between 1998 and 2015 (N=1,044,102), who were diagnosed with ASD from age 3 to 20. We devided study sample into four cohorts by birth year: 1998-2002, 2003-2007, 2008-2011 and 2012-2015. We also categorized ASD into LF-ASD and HF-ASD, based on their comorbidity with ID (ICD 10 codes: F70-F79). All cases (n=10,171) were matched with Controls (n=49,391) on the age, gender and place of birth. We limited our study of other psychiatric disorders comorbidities to the oldest birth cohort, born in 1998-2002. The association between sociodemographic risk factors and ASD cases and separately for HF-ASD and LF-ASD was analysed using Conditional logistic regression.

The incidence of ASD increased with age, specifically among girls. Among the birth cohorts, the cumulative incidence of HF-ASD increased from 0.52 (95% CI 0.49-0.54) to 0.89 (95% CI 0.84- 0.94), by age 10, while in the cumulative incidence of LF-ASD remained stable at 0.17 (95% CI 0.16-0.19). Several socio-demographic risk factors were associated with both HF-ASD and LF-ASD, except for parental immigration, which was only associated with LF-ASD. A total of 58.99% cases had at least one comorbid diagnosis, 35.91% of HF-ASD and 31.86% of LF-ASD. The most common comorbid diagnoses among HF-ASD cases were ADHD (33.9%), depressive disorder (25.4%) and anxiety disorder (23.9%). Among LF-ASD cases were ADHD (17.2%), anxiety disorder (10.5%) and Schizophrenia (5.2%).

The incidence of diagnosed ASD increased with age from 1998-2018, especifically HF-ASD. This result could indicate a real increase in incidence or is due to improved access to mental health services and enhanced awareness of ASD among population and professionals. The rise in ASD incidence underscores the need for specialized mental health services and social support. The association between immigration and the risk of ASD highlights the importance of ensuring mental health services are accessible to immigrants.

None Declared

Opioid use disorder (OUD) is a national public health concern. Craving is a diagnostic criterion and is also implicated in the risk of relapse to opioids. Although sleep impairment is believed to relate with OUD, little research to date has examined the relationship between sleep components and craving in individuals with OUD as well as the moderators in the relationship.

This cross-sectional study was designed to address the relationship between sleep disturbance and OUD.

Individuals with current OUD (n=51) were enrolled. Each participant completed validated scales, including the Pittsburgh Sleep Quality Index for sleep, and Barratt Impulsiveness Scale for impulsivity, and the Opioid Craving Scale for cravings. Correlation and moderation analyses were performed using SPSS, v29.

Total scores of the PSQI were significantly associated with cravings (r=0.44, p=0.006). Among sleep components, sleep quality, sleep efficiency, and sleep disturbance were significantly associated with cravings, while four other sleep components were not. Impulsivity moderated the relationship between sleep impairment measured using total score of the PSQI and cravings for participants (b=0.15, p<.05).

Although preliminary, the findings add to literature on craving, impulsivity, and sleep among individuals with OUD. Sleep impairment and impulsivity may be important targets of a comprehensive, long-term treatment plan for some patients with OUD.

None Declared

Pathological anxiety in social anxiety disorder (SAD) is characterized by dysregulated arousal and altered cardiac autonomic responses, with lower heart rate variability (HRV) potentially indicating emotional dysregulation.

This study aimed to explore the relationship between peripheral and central autonomic nervous system activity during emotional processing in patients with SAD.

Thirty-two patients with SAD and 41 healthy controls participated in a passive viewing task that alternated between neutral and angry faces. We analyzed correlations between brain activation during emotional processing and root mean square of successive differences (RMSSD) in HRV during both resting state and task conditions.

Unlike the controls, the SAD group showed a trend toward significant correlations between baseline RMSSD and left anterior insula activity during neutral face processing (R2 = 0.118, β = -0.003, F= 3.886, p = .058) and significant correlations with both left anterior insula and right amygdala activities during angry face processing (R2 = 0.157, β = -0.003, F= 5.415, p = .027 and R2 = 0.135, β = -0.002, F= 4.360, p = .046, respectively). In the control group, task RMSSD was significantly correlated with right amygdala and right dorsomedial prefrontal cortex activities during neutral face processing (R2 = 0.160, β = -0.003, F=6.284, p = .017 and R2 = 0.222, β = -0.009, F=9.443, p = .004, respectively), while in the SAD group, correlations were found with the right parahippocampal gyrus (R2 = 0.148, β = -0.002, F=4.5, p = .044). Additionally, only in the control group, RMSSD during neutral face trials was significantly correlated with neural activation during angry faces processing (R² = 0.132, β = -0.002, F=4.856, p = .035).

This study identifies distinct patterns of autonomic and neural responses to emotional stimuli in SAD patients, highlighting heightened autonomic readiness and reduced flexibility when processing social threats.

None Declared

The Lancet Commission noted severe mental health service disparities in low- and middle-income countries facing crises. Regarding this, the World Health Organization (WHO) developed the early adolescent skills for emotions (EASE), an experimental group-based intervention delivered by non-specialists, to offer evidence-based psychological support for adolescents with mental distress.

This systematic review and meta-analysis assesses EASE’s effectiveness in alleviating post-traumatic stress disorder (PTSD) compared with enhanced treatment as usual (ETAU).

We systematically searched PubMed, Cochrane, and Scopus for randomized controlled trials (RCTs) comparing EASE with ETAU. Our outcomes included the overall improvement in post-traumatic and depressive symptoms, measured by the Children’s Revised Impact of Event Scale (CRIES-13) and the Patient Health Questionnaire-Adolescent version (PHQ-A) scores respectively. We pooled mean differences (MD) with 95% confidence intervals (CI) in RStudio using a random-effects model. Heterogeneity was assessed with I² statistics.

Six RCTs were included with 1,417 patients, of whom 642 (45.3%) received EASE treatment. In 67% of the studies, Syria was the main location of RCT’s. A total of 688(49%) were female. CRIES-13 (MD = -0.18, 95% CI [-1.88, 1.52], p = 0.84, I² = 0%; Figure 1) and PHQ-A (MD = -0.69, 95% CI [-1.47, 0.09], p = 0.08, I² = 15%; Figure 2) scores in the EASE intervention group compared to the ETAU group showed no significant difference. In both outcomes the heterogeneity was low.

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The benefit of EASE in improving mental distress in adolescents is uncertain. Additional trials will provide new evidence for EASE potential therapeutic benefits.

None Declared

Adolescents face significant stress, which can undermine their subjective health, often manifesting as psychosomatic symptoms. Perceived self-efficacy is a critical resource for resilience, potentially buffering the impact of stress on subjective health. While action self-efficacy indicates one’s perceived ability to set goals and take initiative, coping self-efficacy refers to one’s ability to achieve the goals. By investigating both components, researchers and mental-health professionals can better understand how different aspects of self-efficacy influence the stress-symptom relationship, providing a more nuanced view of coping mechanisms.

The aim of this study is to determine how these key components of self-efficacy - action self-efficacy and coping self-efficacy - moderate the relationship between stress and psychosomatic symptoms.

The analyses were based on the Hungarian contribution to the representative international Health Behaviour in School-aged Children (HBSC) survey, collected in 2021/2022. The study population comprised self-report data from high-school students (N = 3,410; mean age = 16.77 years). We examined the main effects of self-efficacy dimensions and perceived stress, and their interactions in explaining psychosomatic complaints, using linear regression analysis with Hayes’ PROCESS macro (Model 1) in SPSS. Age and gender were controlled for as covariates.

Coping self-efficacy: The overall model explained 33% of the variance in psychosomatic symptoms (R² = 0.33, F(5, 3404) = 330.96, p < .001). The results showed that stress (b = 1.93, p < .001), coping self-efficacy (b = 2.18, p = .02), and their interaction (b = -0.33, p = .002) were significant explanatory variables. This suggests that the relationship between stress and psychosomatic symptoms is weaker among adolescents who reported stronger coping self-efficacy. Action self-efficacy: In contrast, the interaction between stress and action self-efficacy was not significant (p = .16), implicating that the ability to set goals did not mitigate the effect of stress on symptoms.

The findings imply that coping self-efficacy significantly reduces the relationship between stress and psychosomatic symptoms. Adolescents with stronger coping skills are better equipped to mitigate the adverse effects of stress. However, action self-efficacy did not show a significant moderating effect, highlighting the distinct roles different self-efficacy components play in stress management. These results emphasize the importance of enhancing coping skills, such as cognitive reappraisal, in primary prevention interventions to reduce stress-induced psychosomatic symptoms.

adolescents, HBSC, psychosomatic symptoms, self-efficacy, stress

This study was supported by the Hungarian National Research, Development, and Innovation Office (K139265 and K143764).

None Declared

Depression is one of the most common mental health disorders in children and adolescents. In India, many parents resist psychotropic medication for children due to potential side effects, highlighting the need for non-pharmacological interventions like yoga.

The current study investigates the impact of additional yoga therapy on depressive symptoms, global functioning, and parental stress among children and adolescents diagnosed with Major Depressive Disorder (MDD) on children seeking treatment at the Department of Psychiatry of a tertiary care medical institute in India.

This study included 80 participants aged 6 to 17 years. After taking written informed consent from the parents and assents from the adolescents, they were randomized into two groups: one receiving yoga Therapy alongside treatment as usual (TAU) and the other a waitlist control group receiving only TAU. Assessments were done on both children and their parents, and the instruments included were Centre for Epidemiological Studies Depression Scale for Children (CES-DC), the Children’s Global Assessment Scale (CGAS), the Clinical Global Impression scale (CGI), and the Depression Anxiety and Stress Scale (DASS) for parents. Follow-up assessments occurred at 6 and 12 weeks.

In the experimental group, CES-DC scores showed significant improvements, with p value < 0.01 at 6 weeks and < 0.01 at 12 weeks. Global functioning scores also improved, recording p values of < 0.01 at 6 weeks and < 0.01 at 12 weeks. The control group also exhibited results, with CES-DC p values of < 0.01 at 6 weeks and < 0.01 at 12 weeks. Global functioning scores revealed p values of < 0.01 at 6 weeks and < 0.01 at 12 weeks. However, there were no significant differences in the improvement in CES-DC score and functioning in the experimental and control group at the end of 6 weeks and 12 weeks. At the baseline, at end of 6 weeks and at the end of 12 weeks, there were no significant differences in parental depression, anxiety, and stress score.

Yoga therapy was beneficial for the children and adolescents with major depressive disorder. However, there were no significant differences in the improvement in depression and functioning in the experimental and control group.

B. Patra Grant / Research support from: The Department of Science & Technology, Govt of India under its scheme “SATYAM”, R. Sagar: None Declared, G. Sharma: None Declared

The role of the brain-derived neurotrophic factor (BDNF) in the pathophysiology of depression is well established, with decreased BDNF levels being associated with the emergence of depressive symptoms. More recent studies have reported that the precursor protein – proBDNF – might also be involved in the pathogenesis of depression since both particles are biologically active and elicit opposing effects: mature BDNF promotes the proliferation of neurons and synaptogenesis, while proBDNF evokes neuronal death. The BDNF/proBDNF ratio has been suggested as a possible biomarker of depression state and treatment response among adults with depression. However, no study has analyzed BDNF/proBDNF serum ratio levels in adolescent depressed patients.

We aimed to verify the changes in serum BDNF/proBDNF ratio levels during the course of treatment in adolescents with depression in relation to healthy control. We also aimed to investigate whether this parameter could predict the antidepressant treatment outcome.

Thirty female inpatients, aged 11-17, diagnosed with a first-lifetime depressive episode were assessed at two time-points: before (t0) and after (t1) the minimum six-week period of the first-line antidepressant treatment and compared with thirty age-matched healthy girls. The assessment at t0 and t1 involved the analysis of BDNF and proBDNF serum levels (ELISA method) and clinical symptoms evaluation using standardized depressive symptoms scales: Children’s Depression Inventory (CDI-2) and Hamilton Depression Rating Scale (HDRS). Patients with at least 50% symptom reduction in CDI-2 and HDRS or HDRS<7 were classified as ‘responders.’ The control group underwent one-time BDNF and proBDNF evaluation. The BDNF/proBDNF ratio has been calculated.

The BDNF/proBDNF serum ratio did not significantly differ between the studied and control groups. We proved no significant differences in BDNF/proBDNF serum ratio before and after the antidepressant treatment, regardless of the treatment outcome. However, responders had a significantly higher pretreatment BDNF/proBDNF ratio when compared with non-responders (Figure 1). The ROC analysis revealed that the BDNF/proBDNF ratio at t0 could predict the remission status at t1 with a sensitivity of 66.67% and a specificity of 81.25% (Figure 2).

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Pretreatment BDNF/proBDNF ratio could be considered a possible biomarker predictive of antidepressant treatment response in adolescent girls.

None Declared

Severe psychiatric disorders, including schizophrenia (SCZ), bipolar disorder (BIP) and anorexia nervosa (AN), are frequently comorbid with lung function decline and asthma. Despite considerable heritability, the genetic relationships between severe psychiatric and respiratory comorbidities are inconclusive.

We aimed to thoroughly investigate the shared genetic architecture between three severe psychiatric disorders (SCZ, BIP and AN) and lung function (forced expiratory volume/forced vital capacity ratio) or doctor-diagnosed asthma based on available genome-wide association studies.

We performed linkage disequilibrium score regression analyses (LDSC) and MiXeR to quantify the genetic overlap. A conditional/conjunctional false discovery rate (cond/conjFDR) approach was employed to detect shared genomic loci. Functional annotations, gene mapping and gene-based enrichment analyses were adopted to explore shared biological mechanisms. Web-based cell-type-specific enrichment analysis (WebCSEA) was employed to identify the cell types enriched for shared genes across tissues. Transcriptome analyses were conducted via S-PrediXcan to prioritize biologically plausible shared genes in relevant tissues.

Despite weak or null genetic correlations identified by LDSC, MiXeR analyses demonstrated extensive moderate polygenic overlap (~400 to 800 shared variants) across all pairs of psychiatric and respiratory phenotypes. The cond/conjFDR approach detected a total of 378 unique loci jointly associated with severe psychiatric disorders and lung function or asthma, harboring a mix of concordant and antagonistic variants. Gene-based enrichment analyses applied to the 4,105 genes mapped to shared loci highlighted cell types including type II pneumocytes and macrophages in lung and monocytes in blood as well as biological processes involving the interferon (IFN) JAK-STAT pathway and natural killer cell activation, suggesting common immune mechanisms. Furthermore, when stratified by respiratory outcome, genes shared with asthma were enriched for immunity-related pathways, whereas genes shared with lung were enriched for non-immune mechanisms, indicating divergent shared etiology. A total of 22 shared genes identified by conjFDR approach were prioritized as biologically plausible in transcriptome analyses.

This study reveals the complicated shared genetic etiology between severe psychiatric disorders and lung function or asthma and implicates overlapping immune and non-immune mechanisms. Our findings suggest that individuals with severe psychiatric disorders should be screened for lung function decline and asthma in clinical settings.

None Declared

There is strong clinical evidence that patients with depression have high probabilities to present a cardiovascular disease and vice versa. Thus, it is important to accurately identify these patients in order to provide the optimal management of the comorbid conditions.

To identify patients who have depression and cardiovascular disease using social and molecular biomarkers which are routinely collected in the clinical practice.

Data from 502,379 participants in the UK Biobank were utilized in this work. A subset of the participants has a mental assessment using questionnaires about the presence of depression. CVD assessment was also available for the majority of the patients. In total, 126,033 participants had clinical assessment of both depression and CVD. From these, 8,925 patients had both comorbid conditions. An automated medical data curation tool described in a previous study was utilized to detect and mitigate data inconsistencies and elevate the input data integrity and usability. Hybrid boosting ensembles, including the XGBoost algorithm with a customized hybrid loss function was trained on the curated data, to reduce training and testing loss and to avoid overfitting effects. Dropout rates from deep learning theory were used in the hybrid loss function to further reduce biases during the decision-making process by controlling for the shape of the loss function. Random downsampling with replacement was also applied to match the control and target populations due to the increased class imbalance (ratio?) and with respect to the pre-defined set of confound factors. Additional classifiers including bagging classifiers were used for comparison purposes. The classification performance was assessed based on stratified 10-fold cross validation, where various metrics like the accuracy, sensitivity, specificity and area under the ROC curve scores were estimated. Advanced feature selection methods from coalition game theory, including the Shapley additive explanation (SHAP) exploratory analysis was utilized to identify predictors with positive or negative impact to have both the comorbid conditions These explanations were based on the classification outcomes from specific training and testing instances.

The XGBoost classifier had the best performance among all tested classifiers. The results were 0.85, 0.88, 0.81 and 0.92 for the accuracy, sensitivity, specificity and AUC, respectively. The figure 1, presents the explainability analysis for the selected biomarkers. As shown, there are simple social questions, but also some blood biomarkers which can be used for the identification of the patients with both the comorbid conditions of depression and CVD.

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We developed an AI-based approach which can diagnose depression and CVD to patients in a cost effective way with accuracy of 85% and AUC equal to 0.92.

None Declared

Patients suffering from severe mental disorders have a reduced life expectancy of approximately 10-25 years compared to the general population. This mortality gap is mainly due to physical comorbidities among which metabolic disorders play a significant role.

In our study we used the Body Mass Index (BMI), an indicator of general health that can be easily calculated in daily clinical practice, to investigate how weight and the different psychopathological and psychosocial dimensions mutually influence each other in patients with mental disorders.

This naturalistic observational multicenter study was carried-out in 7 Italian university centers (Universities of Campania “L. Vanvitelli,” Catania, Magna Graecia of Catanzaro, Cattolica del Sacro Cuore of Rome, Padova, Sapienza University of Rome, and Tor Vergata of Rome). Patients were recruited if they: 1) had diagnosis of bipolar disorder (BD) or major depressive disorder (MDD) according to DSM-5 criteria; 2) had an age between 18 and 65 years; 4) were in a stable phase of the disease (total score < 9 on the Hamilton Rating Scale for Depression and a score of ≤11 on the Young Mania Rating Scale). Affective temperaments were assessed with the Munster Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego, impulsivity with the Barratt Impulsiveness Scale, and suicidal ideation with the Columbia Suicide Severity Rating Scale.

A total of 598 patients were recruited, of which 60.9% affected by DB and 39.1% by MDD. Univariate analyzes revealed an association between higher BMI and male gender (p<0.001), BD diagnosis (p<0.001), high levels of impulsivity (p<0.05), presence of psychotic symptoms during the acute phases of illness (p<0.05), greater number of hospitalizations (p<0.01), cigarette smoking (p<0.05) and depressive temperament (p<0.001). Furthermore, patients treated with lithium (p<0.05), antiepileptics (p<0.05) and first-generation antipsychotics (p<0.001) had a significantly higher BMI compared to those not taking the aforementioned pharmacological treatments.

The results of our study highlight a strong link between BMI and some clinical outcomes in patients with affective disorders. The routinary assessment of these outcomes would be useful for the early identification of potential metabolic comorbidities as well as to identify patients at higher risk to develop a worse outcome.

None Declared

While various fields and work areas have been impacted due to COVID-19, undergraduate students appear to have compounded stress. We sought to investigate the variables that predict meaning in life for Omani college students during the COVID-19 pandemic.

This study investigated the personal and academic factors associated with the presence and search for meaning in life among college students in Oman.

A cross-sectional study was conducted in April 2021. A self-reported survey comprising the Meaning in Life Questionnaire (MLQ) and a sociodemographic questionnaire was completed by 970 students at the National University of Science and Technology in Oman. We used multiple linear regression to explore the independent predictors.

Compared with engineering students, medical students were found to have a higher degree of both the presence of meaning in life as well as the search for meaning in life (p-value 0.001), and with each advancing academic year, the presence of meaning in life was found to be lower (p-value = 0.002). Students with chronic physical disease had a lower degree of presence of meaning in life and a lower degree of search for meaning in life (p = 0.001) compared with those without chronic disease. In addition, mental illness was associated with a lower degree of presence of meaning in life (p-value 0.001) and financial strain was associated with a lower degree of presence of meaning in life (p-value = 0.001).

In conclusion, no prior research demonstrated higher levels of meaning in life among medicine major students compared to those in engineering or pharmacy majors. Moreover, other academic, socio-economic, and health-related factors correlated with individuals’ sense of meaning & search in life. Therefore, psychologists and psychiatrists should consider these diverse factors when designing interventions to support individuals in exploring and enhancing their meaning in life, considering their unique needs and contexts.

None Declared

In humanitarian settings, populations face extreme adversity, and women in the perinatal period are particularly vulnerable, often at heightened risk of depression. This impacts not only their mental health but also their ability to care for themselves and their newborns, presenting a serious challenge for maternal and nfant well-being.

This project aimed to reduce the risk of perinatal depression while strengthening infant care practices and parenting skills, ensuring that mothers, despite living in distressing and hostile environments, can be in the best possible state of mind to care for their babies.

As part of Action contre la Faim’s psychosocial support projects, we adapted the WHO’s “Thinking Healthy” (TH) protocol specifically for low- and middle-income countries (LAMIC), focusing on cultural sensitivity and the unique challenges of the intervention areas. The standard manual was condensed into three sessions, with additional cultural adaptations and the inclusion of two projective sessions (protolanguage approach) to allow women more freedom to express their specific challenges. The protocol was delivered to groups of up to eight women, separated based on whether they were pregnant or breastfeeding to better target their unique needs. Due to logistical and security constraints, the TH protocol required further adaptation to fit each context’s specific limitations.

Over the past three years, the adapted TH protocol has been implemented in three countries across Central Africa, including both humanitarian crisis zones and more stable developmental settings. The programme reached approximately 5,000 preganant women, mothers, and their babies. It was delivered not only in healthcare centres but also directly in communities and internally displaced person (IDP) camps, providing wider access. Results demonstrated significant reductions in psychological distress and depressive symptoms, with improved mother-infant interactions. The programme also helped train healthcare workers, including midwives, enhancing local capacity for long-term support. Quantitative and qualitative results, along with details of cultural adaptations, will be presented.

The adaptation of the Thinking Healthy protocol for low-resource, high-stress environments proved to be an effective and scalable approach for addressing perinatal depression. By tailoring the intervention to fit the cultural and logistical realities of Central Africa, we were able to provide meaningful support to thousands of families. The programme not only reduced depressive symptoms but also fostered stronger maternal-infant bonds and built local healthcare capacity. This model can serve as a reference for implementing mental health interventions in similar contexts globally.

None Declared

In Eastern Cameroon, the psychological needs of both Central African refugees and host communities are significant. Following psychological group interventions over a two-month period, many participants expressed a desire to continue the support process. To meet this need, a self-support protocol was implemented to encourage participants to maintain and strengthen their emotional and social bonds.

The aim of this intervention was to enable participants to continue engaging in psychological support autonomously, enhancing their well-being, resilience, and coping mechanisms. The program sought to provide tools for ongoing emotional regulation and peer support, addressing the psychosocial challenges identified during the initial psychological care.

A flexible, peer-led protocol was developed and implemented after group psychological sessions. Participants were invited to form their own self-support groups, with a recommended size of up to 10 members, meeting weekly for approximately 90 minutes. The structure was intentionally loose to promote autonomy, creativity, and peer leadership. Two initial sessions were facilitated by psychosocial supervisors, while subsequent meetings were primarily observed to assess group evolution. Key dimensions such as emotional well-being, resilience, and social cohesion were measured pre- and post-intervention.

The qualitaive analysis revealed increased cohesion and social connection between group members, especially between refugees and host communities. Participants reported feeling empowered and valued the emotional stability gained through the exercises introduced during the program. However, the evaluation also highlighted challenges, such as maintaining motivation without ongoing supervision and the need for economic opportunities to sustain long-term engagement.

This self-support protocol demonstrated the feasibility and positive impact of peer-led psychological care in contexts with limited resources. The program reinforced emotional resilience, social cohesion, and mutual support, but future iterations should consider integrating economic empowerment initiatives and more structured follow-up to ensure sustained participation.

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Psychiatry has historically underserved Indigenous people. Earlier, cross-cultural psychiatry assumed that psychiatric disorders were universal and varied little across cultures. This approach has not worked well for Indigenous people who may have different views of mind and mental health. For example, Indigenous philosophy tend to explain the world and states of mental health from a storied approach encompassing relations to land, spiritual beings, ancestors, and the community which can result in different conclusions from conventional psychiatry.

We wanted to explore what modifications in their approach practicing psychiatrists have made to be successful in Indigenous communities and to determine what was common among how communities in which they worked conceptualized mind and mental health.

We interviewed psychiatrists working in Indigenous communities regarding what was effective and how they had changed their practice to work in those communities and how those communities had changed them. We used the iterative processing of constructivist grounded theory to find commonalities in their responses. We present from rural and remote Indigenous settings in Canada (Saskatchewan and Northern Ontario), New Zealand, and Maine (USA).

We found a modified approach to psychiatric services that emphasized Indigenous values and that determined positive aspects of the client’s history as well as problem areas and engaged the client in therapy from the beginning of the evaluation. Some key concepts that emerged from qualitative analysis of interviews and case histories using constructivist grounded theory as a method of analysis included (1) reframing the person’s self-story within a threat-power-meaning network, (2) working with stories about the spirit of the suffering, (3) exploring right relationships and meaningful conduct, (4)acknowledging the intergenerational transmission of suffering. Physicians came to understand that the client sets their goals and defines what recovery means for them in discussion with their family and important community members including elders. This led to a different understanding of what privacy meant to clients. Indigenous cultures encountered were different but appeared to share some similarities including a highly relational approach to defining the self, a collectivist mindset in which the needs of the group can supersede the needs of the individual, a reliance upon stories for transmission of knowledge and culture, and a commitment to a biopsychosocial and spiritual approach.

Psychiatry can form effective collaborative relationships with Indigenous communities requring modifications in the usual worldview and orientation to how psychiatry is practiced.

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Burnout is a longstanding issue among educators and has been associated with psychological and physical health problems such as depression, and insomnia.Chronic stress has been associated with burnout, defined by three dimensions of overpowering exhaustion (emotional exhaustion), cynicism (feelings of cynicism and detachment from work), and inefficacy (a sense of ineffectiveness and lack of accomplishment) which conceptualize the individual stressful experience in a social context.

To assess the prevalence and predictors of the three dimensions of burnout (emotional exhaustion, depersonalization and lack of professional accomplishment) among elementary and high school teachers.

This is a quantitative cross-sectional study with data collected via an online survey. The Maslach Burnout Inventory-Educator Survey (MBI-ES), the Brief Resilience Scale (BRS) and the Perceived Stress Scale were used, respectively, to assess burnout, resilience and stress among teachers. Data was collected between September 1st, 2022 and August 30th, 2023. SPSS (version 28, IBM Corp) was used for the data analysis.

Overall, 1912 educators received a link to the online survey via a text message, and 780 completed the burnout survey questions, resulting in a response rate of 41%. The prevalence of emotional exhaustion, depersonalization, and lack of professional accomplishment were 76.9%, 23.2%, and 30.8%, respectively. Participants with high-stress symptoms were 6.88 times more likely to experience emotional exhaustion (OR = 6.88; 95% CI: 3.31–14.29), 2.55 times (OR = 2.55; 95% CI: 1.65–3.93) more likely to experience depersonalization and 2.34 times (OR = 2.34; 95% CI: 1.64–3.35) more likely to experience lack of professional fulfilment. Additionally, respondents with low resilience were 3.26 times more likely to experience emotional exhaustion symptoms (OR = 3.26; 95% CI: 2.00–5.31),) than those with high resilience. Males were about 2.4 times more likely to present with depersonalization compared to female teachers, whilst those who indicated their marital status as partnered or cohabiting and those who selected “other” were 3.5 and 7.3 times respectively more likely to present with depersonalization compared with those who were single. Finally, Physical Education were 3.8 times more likely to present with depersonalization compared with English teachers.

The current study highlights the predictive effects of low resilience and high stress on the three dimensions of burnout among teachers in Canada. Interventions aimed at addressing systemic stress and fostering resilience are needed to reduce burnout among teachers.

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Many people experience at least one traumatic event in their lifetime. Although such traumatic events can precipitate psychiatric disorders, many individuals exhibit high resilience by adapting to such events with little disruption or may recover their baseline level of functioning after a transient symptomatic period.

To investigate the prevalence and correlates of low resilience in patients before discharge from psychiatric acute care facilities.

Respondents for this study were recruited from nine psychiatric in-patient units across Alberta. Demographic and clinical information were collected via a REDCap online survey. The brief resilience scale (BRS) was used to measure low resilience. A chi-square analysis followed by a binary logistic regression model was employed to identify significant predictors of low resilience.

Overall, 1004 participants took part in this study; 360 (35.9%) were less than 25 years old, 269 (34.7%) were above 40 years old, and most participants were females 550 (54.8%) and Caucasians 625 (62.3%). The prevalence of low resilience in this cohort was (555/1004, 55.3%). Respondents who identified as female were one and a half times more likely to show low resilience (OR=1.564; 95% C.I.=1.79-2.10), while individuals with ‘other gender’ identity were three and a half times more likely to evidence low resilience (OR=3.646; 95% C.I.=1.36-9.71) compared to male gender persons. Similarly, Caucasians were two and one-and-a-half times respectively more likely to present with low resilience compared with respondents who identified as Black people (OR=2.21; 95% C.I.=1.45-3.70) and Asians (OR=1.589; 95% C.I.=1.45-2.44). Additionally, persons with a diagnosis of depression were more than two times and four times, respectively, more likely to present with low resilience than those with bipolar disorder (OR=2.567; 95% C.I.=1.72-3.85) and those with schizophrenia (OR=4.081;95% C.I.= 2.63-6.25)

Several demographic and clinical factors were identified as predictors of likely low resilience. The findings may facilitate the identification of vulnerable groups to enable their increased access to support programs that may enhance resilience.

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