Floatation-REST (restricted environmental stimulation therapy) has shown promising potential as a therapeutic intervention in psychiatric conditions such as anxiety and anorexia nervosa. We speculate that the sensory deprivation might act as a kind of interoceptive training. Within our lab, interoceptive trait prediction error has been used to predict states of anxiety in autistic adults. There is also emerging research conceptualising interoceptive mismatches potentially playing a role in fatigue. Our aim was to run a feasibility study assessing the tolerability of Floatation-REST for participants with disabling fatigue. We also aimed to establish the feasibility of gathering data on mechanistic measures, such as heart rate variability (HRV) and interoception, during floatation.

Participants were recruited via online advertisements and were screened to check they scored at least 36 on the Fatigue Severity Scale (FSS). Pertinent medication changes and previous float experience within the last 6 weeks were amongst the exclusion criteria. Baseline measures included: Modified Fatigue Impact Scale (MFIS); Body Perception Questionaire; hypermobility questionnaire and Tellegen Absorption Scale. Participants completed four 90 minute sessions of floatation-REST across a 2–6 week period with 1 week of ecological momentary sampling (EMS) before and after. Immediate pre and post float measures included testing interoceptive sensibility, accuracy and awareness. HRV was measured during floatation. Change in energy was measured by retrospective subjective assessment, changes in validated fatigue scales and EMS.

Baseline MFIS scores (median = 67.5; range = 55–77) indicated a high degree of severity of participant fatigue. 15 participants were recruited to the study. 13 participants started the float intervention and 11 completed all four sessions. No drop out was due to poor tolerability. Most adverse events were mild, expected and related to the pre/post float testing. HRV data was successfully captured throughout all sessions. Participant surveys described improvements in energy levels, sleep and relaxation and 73% “strongly agreed” to an overall positive effect. Furthermore, both statistically and clinically significant reductions were noted in the mean FSS scores (56.9 to 52.6; p = 0.044) and the MFIS scores (67.0 to 56.4; p = 0.003). Detailed energy assessment was obtained by EMS with 37 to 86 data points per participant.

Floatation-REST appears to be a feasible intervention for people with severe fatigue. EMS, HRV data, interoceptive data and other measures were reliably recorded. Reported subjective benefits were supported by an improvement in objective fatigue scores, though the lack of a control group makes these improvements speculative at present.

Depression poses a significant public health concern globally, characterized by prolonged periods of sadness, loss of interest, and impairment in daily functioning. With over 800,000 annual deaths attributed to suicide, it stands as the second leading cause of mortality among 15–29-year-olds worldwide. To address this growing crisis, various digital methods are being increasingly developed for screening depression efficiently in large populations. However, the ethical implications surrounding the use of these tools remain debated. This scoping review aims to explore the landscape of research on digital screening methods for depression in India, elucidating ethical challenges and identifying research gaps.

By synthesizing available evidence, this study seeks to contribute to the discourse surrounding the ethical use of digital tools for depression screening in India, ultimately striving for improved mental health outcomes in the population.

Using a pre-tested search strategy in January 2024, we searched PubMed and Google Scholar for studies regarding digital divide in the use of digital technology for mental health. Relevant studies were selected using a two phased screening process. Studies included in the review were synthesised qualitatively using a thematic synthesis approach.

Out of 379 titles identified in our database search, only four were included in the qualitative synthesis. Two of these were cross-sectional, followed by a qualitative study and a pre-post evaluation. These studies were conducted in remote villages in the state of Andhra Pradesh, urban slums of Delhi, pan-Indian national survey and rural and under resourced urban areas.

The studies examined diverse aspects of the digital divide in India, revealing profound socio-economic disparities and gender inequities. Disparities in ownership of digital devices and usage were stark, with less educated, lower-income, and lower-caste groups facing marginalization due to limited access and skills. There were gender discrepancies in mobile phone ownership and internet access, with females significantly less likely to possess these technologies compared with males. However, there is a strong potential of mobile technology in increasing mental health service utilization in rural areas, fostering community awareness and stigma reduction.

Collectively, these findings illuminate the multifaceted challenges of the digital divide in India, emphasizing the urgent need for targeted interventions to promote equitable access to technology and bridge socio-economic gaps.

Non epileptic attacks (also referred to as psychogenic non-epileptic seizures, functional seizures or dissociative seizures) are similar in appearance to epileptic seizures but are not accompanied by ictal electroencephalographic (EEG) discharges. NEAD is classified as either a conversion or dissociative disorder in DSM-V and ICD11 respectively, and is often associated with significant long-term disability. People with NEAD often access care across many different specialties and healthcare settings. Their experiences of doing so are frequently negative, based both on interactions with clinicians and integration of care.

The aims of this study were to review the existing literature on the attitudes of clinicians towards non-epileptic attack disorder (NEAD), and any differences that exist between professional groups.

The study followed PRISMA 2020 guidelines and was registered on the international prospective register of systematic reviews (PROSPERO). Three electronic databases (MEDLINE, EMBASE and PsycInfo) were searched for studies of clinician attitudes towards NEAD using pre-developed terms. These terms were optimised following familiarisation with the literature. Specific inclusion and exclusion criteria were applied, and studies were selected if they included data regarding the attitudes of healthcare professionals from any group towards NEAD. A data extraction template was used to synthesise study characteristics and outcomes. The Mixed Methods Appraisal Tool was used to appraise methodological quality of the included studies. Two reviewers independently completed the selection process and data extraction.

The search strategy yielded 2885 citations, of which 76 were selected for review of the full publication based on the title and abstract. Inclusion/exclusion criteria were applied to full texts. The literature mainly included clinicians from general practice, neurology, emergency department and psychiatry. There was general negative stereotyping of people with NEAD and a lack of confidence in management. Attitudes differed between professions, particularly with respect to aetiology.

The literature highlighted that many clinicians held a negative attitude towards people with NEAD, and there was evidence of a general lack in confidence towards NEAD across all healthcare professional groups. There was a difference between healthcare professional groups, mostly related to views on aetiology. The review highlights the need for greater education related to NEAD with a focus on understanding aetiology and greater transparency in interdisciplinary working.

Sleep problems are common in opioid users and in patients receiving opioid agonist treatment. The aim of the present study was to study the pattern and prevalence of subjective sleep disturbances in opioid dependent subjects maintained on opioid agonist treatment (buprenorphine and methadone).

Methods: A cross-sectional observational study was conducted in a tertiary health care center in India. 106 adult opioid dependent male patients maintained on buprenorphine and 50 adult opioid dependent male patients maintained on methadone who were initiated on medication at least six months prior, on stable dose of medication for last one month and were adherent on medication for at least 50% occasions in last one month were included in the study.

The mean age of the sample for buprenorphine-maintained group and methadone maintained group was 41.1 (SD: 14.3) years and 27.7 (SD: 7.8) years respectively. Tobacco, alcohol and cannabis were used by majority of the participants in both the groups. Most participants had used heroin by smoking before starting buprenorphine (n = 68, 64.1%) and methadone (n = 46, 88.5 %). The duration of use of illicit opioids was for median duration of 10 (IQR: 5, 22) years for buprenorphine group and 5 (IQR: 3, 7) years for methadone group.

In buprenorphine group, the participants had been on buprenorphine for a median duration of sixty (IQR: 17, 120) months. The mean current dose of buprenorphine was 10.2 (SD 3.8) milligram per day. The mean PSQI score was 6.6 (SD 3.4). About 63.2% (n = 67) of the participants have scores more than five (PSQI > 5) suggesting sleep problems. The mean subjective total sleep time of the sample was 403.5 (SD 94.8) minutes and median sleep latency was 35 (IQR 18.8, 62.5) minutes.

Similarly, in methadone group, the participants had been on methadone for a median duration of seventeen (IQR: 10, 22) months. The median current dose of methadone was 20 (IQR: 14, 36) milligrams per day. The mean PSQI score was 5.2 (SD 2.8). About 44.2% (n = 23) of the participants have scores more than five (PSQI > 5) suggesting sleep problems. The mean subjective total sleep time of the sample was 466.5 (SD 114) minutes and median sleep latency was 30 (IQR 15, 97.5) minutes. Subjective sleep problems were associated with past three months opioid use.

The methadone group had relatively younger population with early onset of substance use. They were on relatively lesser dose of methadone. This group also had lesser sleep problems than the buprenorphine group.

Introduction: Second-generation antipsychotics are widely used in psychiatry but are associated with weight gain. Obesity is more prevalent in mental illness and may contribute to the mortality gap. Non-pharmacological management of antipsychotic-induced weight gain (AIWG) has limited success whilst pharmacological treatment typically involves antidiabetic medications that psychiatrists have less experience with. Recent developments in the field have shown promise with using centrally-acting opioid receptor antagonists (CORAs) at treating AIWG.

Objective: Review and synthesise the available RCT evidence on the efficacy of CORAs at treating AIWG.

Methodology: Four databases (Medline, Embase, PsycINFO, Cochrane) were searched, from database inception to present, for RCTs using CORAs (naloxone, naltrexone, samidorphan) to reduce AIWG. Our primary outcome sought was weight change in kilograms, with secondary outcomes of change in percentage of body weight, waist circumference and 7% or 10% weight change thresholds. We used random-effects meta-analysis due to study heterogeneity.

A total of 450 articles were found (319 post-deduplication), of which seven met criteria (samidorphan = 4, naltrexone = 3, naloxone = 0) including n = 1,416 patients. On meta-analysis, change in body weight (kg) for CORAs as a class was statistically significant (RE = 1.37 kg; 95% CI: 0.51, 2.24). However, change in BMI was not statistically significant (RE = 0.61kg/m2; 95% CI: −0.56, 1.78). Remaining analysis was only available for samidorphan, which showed statistically significant improvement in change in body weight (%) (RE = 1.81%; 95% CI: 1.07, 2.55), absolute risk of weight gain ≥7% (RE = 12.41%; 95% CI: 6.55, 18.27), absolute risk of weight gain ≥10% (RE = 10.83%; 95% CI: 5.46, 16.21), and change in waist circumference (RE = 1.50 cm; 95% CI: 0.32, 2.67).

Evidence is strongest for samidorphan, though CORAs as a class remains poorly researched and the benefits are modest. Additionally, samidorphan is currently only available in the combination medication olanzapine-samidorphan and the literature reflects this. Further research is needed to examine its efficacy in AIWG from other antipsychotics.

Patients with opioid dependence seek treatment for the discomforting withdrawal symptoms. Accurate clinical assessment is essential as medications are optimized based on these withdrawal symptoms. However, subjective reporting can present challenges. Heart rate variability (HRV) can enhance clinical assessment and has taxonomic and therapeutic implications. This study aimed to explore the correlation between HRV and subjective withdrawal in patients with opioid dependence and to compare the HRV parameters in patients undergoing detoxification to those maintained on opioid agonist treatment and healthy controls.

3 groups of adult male participants were included. Group 1 included 40 patients with opioid dependence undergoing inpatient detoxification. Group 2 included 40 patients with opioid dependence receiving stable doses of buprenorphine on outpatient basis. Group 3 included 49 healthy controls. The Subjective Opiate Withdrawal Scale (SOWS) was used for withdrawal symptoms. For Group 1 and Group 2, HRV was assessed twice – before administration of morning dose of buprenorphine, and then 2 hours post administration. For Group 3 HRV was assessed once.

At baseline, resting heart rate differed significantly between the 3 groups (p < 0.001), it was highest for Group 2 (92.4) and lowest for Group 3 (79.4). In time domain parameters of HRV, the beat-to-beat variability was highest for Group 1 with standard deviation of all normal RR intervals (SDNN) = 134.8, root mean square of successive differences between normal heartbeats (RMSSD) = 181.7 and RR tri index = 8.9 (p < 0.005). In frequency domain parameters of HRV, total power was highest for Group 1 (98334.1, p < 0.001) while relative power did not differ significantly among the groups. The SOWS had a weak negative correlation with RMSSD in Group 2 (r = -0.312, p < 0.05) but did not have any correlation with HRV parameters in Group 1. Post administration of morning buprenorphine, the HRV parameters did not show a significant change in either of the groups (except reduction in very low frequency percentage in Group 1 from 12.013 to 7.196, p < 0.05).

A higher degree of subjective withdrawal is associated with lower beat-to-beat variability in patients on stable doses of buprenorphine. However, this exploratory study did not find a robust relationship between HRV and subjective withdrawal symptoms. Higher RMSSD (representative of higher vagal tone) in patients undergoing detoxification may suggest greater physiological adaptation to withdrawal symptoms. This study provides additional insights into HRV in patients with opioid dependence.

The aim of this study is to investigate incident and total benzodiazepine prescribing in the Netherlands during the COVID-19 pandemic, including the impact of lockdown periods.

A national Dutch pharmacological registry was used, investigating extramural psychiatric drug prescriptions, between March 2020 and March 2022. Data included incident and total prescriptions as well as daily defined doses (DDDs) of benzodiazepines. The data covered 96% out of a total Dutch population of 17.5 million people. This was compared with the previous calendar year as a reference expressed as a monthly risk ratio (RR) and was corrected for population growth. Changes over time will be discussed if the RR was above 1.1 or below 0.9.

A total of 13.4 million prescriptions over a period of three years were included of which 5.8% were incident prescriptions. Three lockdown periods were identified during pandemic.

When analysing the total benzodiazepine prescription group, prescriptions and DDDs remained mostly stable throughout the pandemic. A brief relative increase in prescription DDD amounts was found during the second lockdown (RR: 1.11). When viewing the incident benzodiazepine prescriptions, there was a short period between the first and second lockdown when both prescription numbers and DDDs decreased (RR: 0.86 and RR: 0.83 respectively). The DDDs of incident prescriptions increased sharply during the second and third lockdown period and remained elevated between both, with an average RR of 1.13.

Total monthly benzodiazepine prescriptions and DDDs remained mostly stable during the COVID-19 pandemic in the Netherlands. COVID-19 related lockdowns seem to have mainly influenced incident benzodiazepine DDDs dispensed during the second and third lockdown. Increased incident DDDs, but not prescription numbers, imply that new patients on average received larger benzodiazepine prescriptions. The increase in incident prescription DDDs could be indicative of decreased accessibility to (psychiatric) healthcare. It could also have been driven by an increase of the incidence and/or severity of sleep and anxiety symptoms during the second and third lockdown. A better understanding of exact causes and mechanisms behind these changes is relevant in order to limit the psychiatric repercussions of future (inter)national emergencies.

There is evidence that children and young people (CYP) of Black ethnicity are more likely to experience involuntary hospital admission. This is not explained by clinical and sociodemographic factors. One possible explanation are differences in pathways into, and/or use of mental health services (MHS). This study investigates the associations between ethnicity, pathways into MHS, MHS use and involuntary hospitalisation in CYP.

Using data from the Clinical Record Interactive Search (CRIS) system for (South London and the Maudsley) SLaM services we identified 652 CYP under 18 years admitted to inpatient units between 2008 and 2021 living within the SLaM catchment; 458 (70.2%) were admitted informally and 194 (29.7%) were detained. We conducted univariable logistic regression to investigate the association between pathways into MHS (referral source, S.136 presentation), MHS use (time known to services, recent appointment prior to admission, and presence of a care plan), clinical factors (diagnosis, severity, risk) and social factors (gender, age, ethnicity, deprivation) with the outcome i.e. involuntary admission. We then conducted multivariable logistic regression to investigate the association between the clinical and social factors and involuntary admission.

In multivariable analyses we found evidence that adverse pathways into MHS such as S.136 presentation (OR 6.25, 95%CI 2.06-19.01, p = 0.001), and referrals from social services (OR 4.92, 95%CI 1.49-16.19, p = 0.009) and police/legal services (OR 4.22, 95%CI 1.03-17.31, p = 0.045) were associated with involuntary hospitalisation. There was no evidence that the duration of contact with MHS, having had an appointment in the 28 days prior to admission or a care plan in the 12 months prior to admission were associated with involuntary hospitalisation after adjusting for other factors. There was evidence that being of Black ethnicity (OR 2.04, 95%CI 1.19-3.50, p = 0.010), older age (13–15 years: OR 4.46, 95%CI 1.57-12.72, p = 0.005; age 16–17 years: OR 8.67, 95%CI 3.08-24.41, p < 0.001) and having a diagnosis of a psychotic disorder (OR 4.21, 95%CI 2.21-8.02, p < 0.001) were associated with involuntary admission after accounting for pathways into and use of MHS.

In this cohort of child and adolescent inpatients living in South East London, we found that CYP who experience adverse pathways into MHS are more likely to experience involuntary hospitalisation. Prior contact with MHS did not appear to influence involuntary admission. We found that Black CYP remained more than twice as likely to be admitted involuntarily after accounting for MHS use and pathways into MHS as well as social and clinical factors.

Self-stigma is common among patients suffering from depressive disorders and negatively affects their quality of life. Quality of life reflects individuals' general well-being, an important measure of treatment outcomes. However, local research on the relationship between self-stigma and quality of life in patients with depressive disorder is lacking. Information on clinical and personal characteristics associated with self-stigma in depression is also limited.

The primary aim of this cross-sectional study was to examine the relationship between self-stigma and the quality of life of patients suffering from depressive disorder in an outpatient department. The secondary aim was to identify socio-demographic, clinical, or personal characteristics associated with self-stigma in these patients.

One hundred and thirty-one patients with depressive disorders were recruited from the outpatient clinic of a psychiatric centre in Hong Kong. Depressive disorder was diagnosed with the Chinese-bilingual version of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I Disorders. Socio-demographic and clinical information were obtained. Self-stigma was measured with the Self-Stigma Scale-Short Form. The quality of life was evaluated with the World Health Organization Quality of Life-BREF Hong Kong Version. Self-esteem, coping strategies, personality traits, and social functioning were evaluated. Bivariate analyses were performed to explore the association between the above factors with self-stigma or quality of life. Regression analyses were conducted to explore the relationship between self-stigma and quality of life, and to identify the factors independently associated with self-stigma.

Self-stigma was independently associated with the four main quality of life domains after controlling for socio-demographic, clinical, and personal characteristics among patients with depressive disorder. A multiple regression model showed that high levels of neuroticism and low self-esteem were independently associated with higher levels of self-stigma.

This cross-sectional study supported the negative association between self-stigma and quality of life among individuals with depressive disorder. Neuroticism and self-esteem were found to be independently associated with self-stigma in depressive patients. Considering the associations found, identifying and focusing on depressive patients with a higher risk of self-stigma and implementing self-stigma interventions is important. Specific self-stigma reduction strategies should be introduced to mitigate the self-stigma in depressive patients and to improve their quality of life.

The COVID-19 pandemic placed increased pressure on service provision and healthcare worker [HCW] wellness. As the pandemic recedes, staff need an appropriate response to facilitate individual and organisational recovery, to minimise long-term healthcare worker burnout and to be better equipped for future crisis in healthcare. The aim was to explore and reflect on the experiences of staff working during the COVID-19 pandemic in an acute paediatric hospital to determine an appropriate response in the post-crisis work environment.

A Qualitative research design using responses from open ended questions from one hundred and thirty-three clinical and non-clinical staff (89% clinical) from an Irish paediatric teaching hospital. Reponses were thematically analysed.

HCWs experienced frustration, uncertainty, anxiety and stress, during the pandemic crisis. This included communication inconsistencies, inadequate support and staffing and other resource shortages, leaving staff at high risk for long-term burnout as the pandemic recedes. Three themes were developed detailing this; 1) Support, 2) Communication and 3) Trust.

This research supports the long-standing need to increase mental health service investment and to implement an appropriate response to regain and maintain a healthy workforce, post COVID-19. This response should address the biopsychosocial needs of the individual and healthcare organisations should work dynamically, creatively and collaboratively to ensure the psychological safety of its workforce moving forward.

Adults with Down syndrome (DS) face significant health inequalities and are at increased risk of numerous health concerns. Despite the need, there is a lack of high-quality randomised trial evidence and clinical interventions for people with DS are largely based on consensus guidelines or clinician preferences. As life-expectancy of those with DS increases, the research gap continues to widen.

There is a perception that randomised controlled trials (RCTs) involving people with DS may be hard to carry out due to difficulties in recruitment and retention of participants. However, there is no scientific literature exploring this topic. This systematic review aimed to assess planned vs actual recruitment and retention in RCTs involving adults with DS, and to summarise reported facilitators and barriers to participation of adults with DS in relevant trials.

The MEDLINE, PsycINFO, EMBASE databases were searched systematically to retrieve all RCTs involving adults with DS aged 16 years or older published from 01.11.1961 to 15.12.2023. Ongoing RCTs were identified from trial registries and searches were supplemented by review of reference lists. Data extraction is ongoing but seeks to elicit details of trial design; planned and achieved recruitment sample size; planned and achieved retention rate, and any specific recruitment or retention strategies described. Risk of bias analysis was not relevant to the research question and so not performed. The review was prospectively registered on Prospero (CRD42023447126).

The database searches retrieved 1,825 results. Post deduplication, 1,518 articles underwent title and abstract screening, of which 82 full texts were reviewed. 53 papers were included in the final analysis, reflecting 47 RCTs involving 1,772 individuals. Commonly studied interventions included exercise programmes for physical fitness and pharmaceuticals that may augment neuropsychological function. Studies typically reported small sample sizes at the point of randomisation (mean = 38.5, SD = 49.6), with over half reporting a sample size of n < 50. A significant number of studies reported difficulty recruiting and retaining participants (detailed data will be available in the poster). Of the minority of articles that reported power calculations, several reported failure to meet target sample size.

Initial results point to a paucity of high-quality, large-scale RCTs involving adults with DS and challenges related to recruitment of participants. The results may aid development of strategies that allow clinical trial teams to overcome challenges in recruitment and retention in RCTs, and may eventually contribute to the improved health and wellbeing of adults with DS.

Caregivers of autistic children may experience greater stress and reduced mental well-being compared with caregivers of typically developing children or children with other neurodevelopmental conditions. Less is known about earlier child and family predictors of later caregiver stress, as most studies have been cross-sectional. This study aimed to examine how caregiver (coping strategies and appraisal of their child's autism) and child factors (behavioural difficulties and adaptive functioning) were related to mental health and quality of life in caregivers of 2–7-year-old autistic children over 4–6 years.

Methods: At Time 1 (T1), 119 caregivers completed the Coping Health Inventory for Parents (CHIP), Family Impact of Childhood Disability (FICD), Centre for Epidemiology Studies Depression Scale (CES-D), Autism Treatment Evaluation Checklist (ATEC), and Scales of Independent Behavior-Revised (SIB-R). Of those, 50 completed the same measures 4–6 years later (Time 2-T2). Demographic data at T1 and the World Health Organization Quality of Life (WHOQOL) questionnaire at T2 were also collected. The relative contributions of T1 caregiver and child factors in predicting T2 caregiver self-reported depression and quality of life were analysed with multiple regressions.

Caregivers’ depressive symptoms remained generally stable across 4–6 years (30% at T1 and 38% at T2 scoring at or above the CES-D cut-off), and earlier caregiver depression predicted later caregiver depression. At T2, child adaptive functioning significantly improved compared with T1, while mean child behavioural difficulties (e.g., behaviours disruptive to others, damaging to property, socially offensive or inappropriate) remained generally stable. Caregiver appraisal of the impact of child's autism on the family also did not change much over time, but higher T1 negative caregiver appraisals of their child's diagnosis predicted poorer later social quality of life on the WHOQOL. There were mixed findings regarding the helpfulness of coping patterns assessed by the CHIP, with our findings suggesting that family integration and optimism could be helpful in improving caregiver mental well-being.

Modifiable predictors of longer-term caregiver adaptation indicate that in addition to providing early supports for children's adaptive functioning and social communication, caregivers’ appraisals of autism, caregiver and family coping strategies, and earlier caregiver depressive symptoms also need to be targeted.

Functional outcome can be even more important than syndromic outcomes, as the ability to meet role expectations at work, home, or school and the quality of interpersonal relationships are often cited as the most important outcomes for people with bipolar disorder (BD) and their families. We investigated the factors correlated with functioning by using the Functioning Assessment Short Test (FAST).

A total of 197 bipolar disorder out-patients were involved in this study, 166 (84.3%) were bipolar I disorder (BD-I) patients and 31 (15.7%) were bipolar II (BD-II) patients. We used the FAST for functioning of the patients and the severity of depressive and manic/hypomanic symptoms were measured by bipolar depression rating scale (BDRS) and Young Mania Rating Scale (YMRS). We also examined the disturbances in biological rhythm by the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN).

There were significant positive correlations between FAST and numbers of depressive episode, YMRS, BDRS and BRIAN and showed negative correlation between FAST and age at onset of mood disorder. FAST was associated with YMRS (β=0.3768, p < 0.001), BDRS (β=0.293, p < 0.001), BRIAN (β=0.167, p = 0.011), with 47.1% of the variance explained (R2=0.471, Durbin-Watson test = 1.51, p < 0.001) in multiple linear regression. In other words, residual mood symptoms and biological rhythm imbalance have a negative impact on the functioning of BD patients.

Although the other factors must be present to predict the functioning of bipolar disorder patients, manic symptoms, depressive symptoms and biological rhythm imbalance have negative impacts on functioning of BD patients in this study.

At the core of medical diagnosis lies specific blood tests, urine analysis, microscopic and histologic examination of tissues, and as well radiological investigations that are usually confirmatory of the presence of a disease. However, the diagnosis of ADHD currently relies on reports of clinical symptoms which is usually subjective, with variable interpretations by different professionals, thus posing issues of misdiagnosis and reliability. This study set out to explore, appraise and summarize molecular biomarkers in literature over the past 30 years, which can be applied for the diagnosis of ADHD.

Attention-deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric and neurobehavioral disorder that affects children and adolescents, and more recently, gaining recognition in adults. It is characterized by a pervasive pattern of inattention, hyperactivity, and impulsivity or a mixture of the three, that cuts across the individual's multiple domains of life.

One-thousand articles collated across multiple sources and databases were systematically reviewed and analysed for this project. The keywords for the search criteria in the Boolean operators are “biomarkers and ADHD”, “molecular biomarkers and ADHD” and “biomarkers and ADHD and Diagnosis”.

5.6% of the articles from several types of studies were included in the final analysis after the inclusion and exclusion criteria were applied. The results revealed various heterogeneity across age, gender, ethnicity, medication status, comorbidities, and study type, in applying biomarkers to assist in the diagnosis of ADHD. Genetics and epigenetics studies were the most common type of molecular biomarkers studied and identified, accounting for 25% of the results. 80% of the studies analysed blood samples with a few others focusing on saliva, urine, cerebrospinal fluid, hair, and stool samples. All the studies identified focused on diagnostic biomarkers with 25% of them combining either prognostic or response-monitoring subtypes of biomarkers.

This study identified several potential molecular biomarkers in ADHD. However, most of the results showed only associations between the findings and the diagnosis/occurrence of ADHD. It remains a scientific goal to identify a specific and reliable biomarker for ADHD to assist psychiatrists in making accurate diagnosis. Lastly, it would be pragmatic to explore other types of biomarkers such as radiologic and electro-neurologic markers; given that diagnosis is a constellation of signs and symptoms together with appropriate tests. Combining them logically would increase the specificity of diagnosis of ADHD. This study was completed in partial fulfilment of Master of Science (MSc) in Clinical Psychiatry with the University of South Wales.

To assess the knowledge, attitude and practices of psychiatrists and religious leaders in Baguio City, Philippines regarding mental health, religion, and spirituality.

Two sets of questionnaires were adapted from the study of Foskett et al. (2004). Some questions and choices for the corresponding choices for answer were modified according to the objectives of this project. The questionnaires were prepared to collect data on knowledge, attitude and practices of psychiatrists and religious leaders regarding mental health, religion/spirituality (R/S). The questionnaire covered three main areas: (1) the links between mental health, R/S, (2) the state of collaboration between psychiatrists and religious leaders, and (3) the training each had received that was relevant to this area of their work. The platform used in the Data Collection is via Google Forms. In this method, identity of the responders were anonymized. Data like the name, clinic or office address, age, sex, religious affiliation of the responders were not collected. Descriptions and interpretations of the results were done using frequency and percentages and histograms.

Among the psychiatrists in Baguio City, only 58.8% responded to the questionnaire. Percentage of R/S leaders who responded could not be accounted due to insufficient data on the registry of all religions/spiritual groups in Baguio.

Neither disciplines has any doubts that there is a link between mental health, and R/S.

Majority of the psychiatrist respondents recognize the relevance of their own religion and spirituality. Their belief and inner resources were integral for their coping and implicitly affects their work.

Although majority of the psychiatrists think that referring a patient to R/S leaders should always be the case, and referring the terminally ill will be useful.

Majority (80%) of the psychiatrist respondents are not familiar with their institution's chaplain coordinator/unit. Also, majority (80%) never made a referral to the chaplain. It is also noted that 50% of the psychiatrist respondents did not receive referral from R/S leaders.

Majority of psychiatrists responders did not receive training on R/S aspect of mental health prior and during their qualification.

On the other hand, about 35% of the R/S leaders have a training on mental health prior and during their qualification. Religious/spiritual leader respondents equally think that they need further training on mental health.

Psychiatrist and religious/spiritual leaders both recognize the role of R/S in mental health. The relationship of the two professions in collaborating still needs strengthening by collaboration, education, and training.

Several modalities of psychotherapies have an established therapeutic evidence base for many psychiatric disorders. Stakeholders around the world including the Royal College of Psychiatrists, recommend training of psychiatry trainees in psychotherapy as part of Psychiatry training. However, the quality and quantity of training in psychotherapy differ across different regions. Psychiatry training programmes in high-income countries are regularly audited to ensure minimum standards of training in psychotherapies among psychiatry trainees. There is a lack of reporting regarding psychotherapy training in low- and middle-income countries such as Pakistan. This study explores the experiences of Pakistan-based psychiatry residents regarding their psychotherapy training within the fellowship programme of the College of Physicians and Surgeons (FCPS) Pakistan.

This study employs a mixed-method survey approach, targeting psychiatry trainees registered with College of Physicians and Surgeons (CPSP) four-year training programme (FCPS) across different cities of Pakistan. Utilising a convenience sampling strategy supplemented by the snowball sampling method, an electronic survey was disseminated using social media platform over a 4-week period. The survey was anonymous and structured into three sections; essential demographic data of the participants, experiences with psychotherapy training, and open-ended questions allowing participants to freely express their thoughts and insights on improving psychotherapy training in Pakistan.

Out of the 41 responses received, the majority were female respondents, totalling 27 (65%). All participants were FCPS trainees at various stages of their training, hailing from ten different cities across Pakistan. Findings indicated that 61% of respondents reported insufficient time to learn, understand, and apply psychotherapy techniques, while 53% identified a deficiency in supervision.

In terms of therapeutic exposure, a predominant 34 participants (82%) encountered Cognitive Behavioural Therapy during their training. Mindfulness, Dialectical Behaviour Therapy, and Family Therapy each were reported by 12 respondents (30%). Interestingly, 34 of the respondents (82%) noted an increased interest in psychotherapy since starting their psychiatric training. However, only 20 respondents (48%), felt confident in delivering psychotherapy independently.

A recurring theme emerged from the feedback: participants advocated for a more structured psychotherapy training program, emphasising the need for dedicated time specifically allocated for supervision and practical learning opportunities.

This survey highlights that FCPS Psychiatry Residents in Pakistan are keen to learn more about psychotherapy. However, identified shortcomings in delivery, structure, and supervision suggest a need for comprehensive reforms. The findings emphasise on refining the psychotherapy training in low- and middle-income countries.

Ox-CRISP is an innovative trainee-led course using Near-Peer teaching, designed to empower new junior doctors in psychiatry to enhance their diagnostic and communication skills. The course provides patient centered simulation scenarios around interview skills in Psychiatry aiming to improve patient safety, boost confidence of junior doctors and promote effective clinical strategies. The curriculum covers a wide range of topics, including mood disorders, psychotic disorders, anxiety disorders, personality disorder, intellectual disability including CAMHS, old age psychiatry, and substance use disorders.

• • Curriculum Content: Covers 9 prevalent psychiatric scenarios.

• • Teaching Strategy: Evidence-based, co-produced with experts by experience.

• • Teaching Approach: Near-peer teaching for safe, supportive learning.

• • Assessment: Pre- and post-course questionnaires to track learner progress.

• • Implementation: Offered to junior doctors in Psychiatry at Oxford Health NHS Foundation Trust's Medical Education department.

The qualitative data showed that the course, run through multiple sessions, resulted in improved confidence & competence of trainees in clinical practice, positive impact on trainers & trainees, and enhanced well-being of junior doctors. The cope of impact affected patient care across two counties in South-East England.

To our knowledge, this is a unique course of its kind in the UK. The OxCRISP course represents an innovative and effective approach to mental health education that provides learners with the skills and knowledge they need to provide high-quality patient care. The success of the OxCRISP course demonstrates the value of a patient-centred approach to medical education and highlights the importance of ongoing training and mentorship for mental health professionals.

Integrated Learning Activities (ILAs) are a teaching method in Sheffield Medical School for Phase 3a students, where students will be in their third to fourth year of study and building clinical experience and skills. They're a flipped classroom technique, meaning students should arrive prepared to provide most input and clinicians are session facilitators. Each ILA has associated learning outcomes and reading material, and one or more case scenarios are used in sessions from which questions are generated for students to discuss. There are nine ILAs covering core psychiatric presentations, for example psychosis, and self-harm. Following student feedback, it became apparent that key themes around sustainability, diversity and culture were either not evident enough or used improperly. The project aimed to review the ILAs and associated documents to update and diversify the curriculum and integrate the above themes.

Feedback was initially obtained from medical students and representatives from student societies on ILAs, with one scenario receiving strong feedback on its use of cultural themes. Further meetings with students were held, and the one scenario was collaboratively rewritten and rolled out across South Yorkshire.

A feedback survey was sent out regionally to gather facilitator feedback on the format and content of existing ILAs, and thoughts on adding content on sustainability and transcultural issues. Expressions of interest were called for from facilitators across the region, medical students and student societies, and patient experts to create a working group to review all ILAs and associated documents, with a view to diversify the curriculum and incorporate themes on culture, diversity and sustainability.

Two working groups successfully took place with diverse representation from each invited group. All ILAs and scenarios were reviewed, and these themes were able to be added using different techniques such as ensuring scenarios include cases from diverse backgrounds, removing descriptions of race and gender when not relevant, adding learning objectives on transcultural mental health issues and the impact of mental health on culture and vice versa, and adding scenarios and learning objectives on sustainability and sustainable practice.

Further surveys were generated for planned dissemination to students and facilitators for feedback which are planned for initial distribution in January 2024 onwards and results are awaited.

ILAs and associated documents were successfully reviewed allowing the curriculum to be diversified and updated. Due to the time constraints for project completion, it wasn't possible to have specialist input on gender and gender identity and so these themes were not able to be incorporated into the curriculum. Plans have been made for a further review to be conducted in approximately 12 months and these themes to be added at that time.

This review has allowed for positive changes in the undergraduate curriculum and important issues around diversity, culture and sustainability and their impact on mental health and care are now specifically addressed. This aims to be the first of such collaborative curriculum reviews to ensure that the Psychiatry curriculum is up-to-date and fit to address emerging needs in mental health.

The war-ridden northern part of Syria was struck by a powerful earthquake in February 2023 leaving thousands of people dead or injured. The consequences of the earthquake on people's mental health are harder to evaluate but are likely to be severe and long-lasting, especially as people have lived through years of war and devastation.

This poster reports on facilitating reflective practice groups, online, where Syrian mental health professionals in northern Syria explored the psychological impact of the earthquake on them as individual and as professionals.

The author facilitated a series of online reflective practice group meetings. Three distinct groups of mental health workers were formed, each group consisting of 6–12 participants. Each group met twice, each session lasting an hour and a half, resulting in 6 meetings that took place between the 25th of February and the 18th of March 2023. In the first session the group discussed the psychological impact of the earthquake on them as individuals, and in the second the psychological impact on them as professionals.

Thematic analysis was conducted on the discussions in the 6 reflective group meetings, resulting in three main themes: emotional responses, cognitive responses and helpful strategies. These themes are grouped detailed in terms of the impact of the earthquake on the personal and the professional lives of the participants.

Notwithstanding the limitations of this experience, it highlights the importance and value of group reflective spaces, as a way of helping mental health professionals process their emotional experiences in the aftermath of natural disasters.

Training within medical schools often neglects that mental health patients are very culturally diverse, contributing to a lack of cultural competence in future doctors. This deficiency exacerbates access to healthcare barriers for this population. To address these issues early in the course, we initiated a student-led teaching programme on Cultural Humility (CH) for first-year medical students, aiming to enhance cultural awareness (CA) about mental health patients.

CH emphasises the lifelong development of skills, knowledge, and attitudes, fostering a perspective of ‘becoming the student of the patient' to address power imbalances between doctors and patients with mental illness, particularly from minority groups. It promotes culture as expansile incorporating many characteristics from race and religion to sexual orientation, disability and age.

This study assessed the knowledge and perceptions of first-year medical students following the introduction of CH.

After exposure to an author-developed CH learning resource, students participated in a baseline survey to gauge their understanding of CH. Subsequently, an interactive student-led workshop with a reflective exercise encouraged medical students to embrace their cultural diversity and that of others, emphasising the multifactorial nature of mental illness. The workshop incorporated prompts inspired by peer experiences of mental illness. Students then engaged in an early clinical contact programme, interacting with patients with mental illness to implement their understanding of CH into practice. Reflective blogs, written by students as part of the programme, were analysed for data inclusion using an author-selected framework.

Out of 312 participants, 188 provided responses, revealing higher scores for perceived CH importance (4.83/5) compared with understanding (3.86/5) and perceived preparedness for CH implementation (3.98/5). Analysis of free-text survey responses identified learning gaps, particularly in demonstrating cultural sensitivity during patient interviews, and highlighted preferred pedagogies. Thematic analysis of ten collected blogs followed a 5R framework: Respect, Reflection, Regard, Relevance, and Resiliency. Findings indicated a demand for better training in identifying patient-specific sensitive topics and a preference for appreciating patient characteristics such as socioeconomic class without explicit labelling of these qualities as culturally engendered or directly linked to their diagnosis.

CH aims to foster a patient-centred approach, encouraging medical students to look beyond the diagnosis of mental illness. This study explored the multimodal integration of CH as a CA toolkit into the undergraduate curriculum, providing insights into the application of preclinical CA teaching and students’ perceptions of its clinical applicability in their learning about different patient populations experiencing mental illness.