Even though international guidelines suggest that psychoeducation for carers should be provided systematically, it remains insufficiently available in psychiatry (1), including for eating disorders (EDs). The complicated interplay of factors contributing to the maintenance of EDs, including family/carer influences, highlights the importance of carer interventions within ED treatment (2). Carer interventions demonstrate positive outcomes for carers themselves, though are also hypothesised to benefit the patient indirectly. The BREF programme is a short, early and systematic single-family psycho-educational programme. The BREF programme is already proven to be effective for other mental disorders (3)

The aim of this study is to adapt the BREF programme to the specific needs of carers of patients eating disorders (ED).The main objective was to identify the issues in the experience of the disorder that are most important to carers and which should be the focus of the BREF programme for cares of patients with eating disorders.

Twenty-eight topics relating to difficulties commonly encountered by carers of patients with eating disorders were identified by a group including mental health professionals with expertise in these disorders, patients and their relatives. The topics tested are illustrated by 2 decks of cards presented to the participants; the first concerns the problems frequently encountered by users living with ED and the other the problems frequently encountered by their carers. The 2 decks were tested by the participants to the first 15 sessions of the BREF ED programme run from January to July 2023 as part of the pilot conducted in a university-hospital department specialised in eating disorders.

30 participants participanted in the study.

The 10 most frequently selected topics relating to patient problems were, in descending order: relative’s fear and anxiety; relative’s false-self functioning; ambivalence towards care; dysmorphophobia; food restrictions; relative’s hyperactivity; eating disorders; denial of symptoms; perfectionism; malnutrition. The 10 most frequently selected topics concerning the issues of carers were: social withdrawal; difficulty navigating care; fatigue/helplessness; disruption to family life as a result of the illness; guilt; right attitude to have with the ill relative; fear for your loved one’s future; fragility of the relative; not knowing/understanding the care their relative is receiving; cost of care and food expenses.

The priority topics highlighted in this study helped to identify relevant content for the BREF programme adapted to the context of eating disorders. This programme appears to be a promising way of responding to the concerns and information needs of carers of patients with ED. In this regard, it addresses a major shortcoming in the organisation of mental health services.

None Declared

In psychosocial rehabilitation (PSR), rank scales are widely used to assess the severity of functional disorders in patients. The main problem of evaluating the effectiveness of PSR is related to the methods of processing data obtained using psychometric scales used to evaluate the effectiveness of interventions within PSR. The proof of the non-numerical nature of ranks was obtained by J. Pfanzagl (1968). Incorrect processing of rank information obtained in the framework of psychosocial research leads to contradictions in the assessment of the patient’s condition. Consequently, rank processing does not allow classical mathematical operations (summation, average), which makes it impossible to correctly estimate the effectiveness of PSR numerically.

Development of algorithms for numerical evaluation of PSR efficiency based on rank information processing using the analytic hierarchy process (AHP) [1].

Clinical, psychometric, AHP algorithms

The analysis of the problems of assessing the patient’s conditions on the basis of categorical and psychometric (rank) scales and subscales shows that these problems can be presented in the form of appropriate hierarchies, the structure of which must be taken into account when processing the initial information.

According to the results of the analysis of the data of preliminary studies, the main areas of impaired functioning of patients affecting the evaluation of the effectiveness of PSR have been identified. Rank estimates of changes in the relevant areas of the patient’s dysfunction after the PSR program compared to the initial level are the basis for the conclusion about the effectiveness of the PSR components. Algorithms of the AHP normative approach were used to translate rank information into numerical information [2]. The weight of the areas of the patient’s functioning disorders was used in the formation of integral estimates of the effectiveness of PSR.

The fundamental difference between AHP-based assessments and rank assessments is due to the fact that numerical estimates of the weight of the criteria and the corresponding changes in the patient’s condition are obtained, which depend on the qualifications of specialists, the characteristics of the scales used to measure violations in the relevant areas and the procedures of the PSR.

Obtaining the results of processing rank information in a numerical scale allows to obtain the correct integration of the patient’s personal characteristics when considering PSR procedures and to obtain correct prognostic models of the patient’s condition. 1. Saaty T. European Journal of Operational Research.1990; 48(1):9-26. https://doi.org/10.1016/0377-2217(90)90057-I 2. Mitikhin V.G., Solokhina T.A. et al. Psychiatry, 2022; 20(2): 51-59. DOI: 10.30629/2618-6667-2022-20-2-51-59

None Declared

In psychosocial rehabilitation (PSR), rank scales are widely used to assess the severity of functional disorders in patients. The main problem of evaluating the effectiveness of PSR is related to the methods of processing data obtained using psychometric scales used to evaluate the effectiveness of interventions within PSR. J. Pfanzagl (1968) obtained the proof of the non-numerical nature of ranks. Incorrect processing of rank information obtained in the framework of psychosocial research leads to contradictions in the assessment of the patient’s condition. Consequently, rank processing does not allow classical mathematical operations (summation, average), which makes it impossible to correctly estimate the effectiveness of PSR numerically.

Development of algorithms for numerical evaluation of PSR efficiency based on rank information processing using the analytic hierarchy process (AHP) [1].

Clinical, psychometric, AHP algorithms.

The analysis of the problems of assessing the patient’s conditions on the basis of categorical and psychometric (rank) scales and subscales shows that these problems can be presented in the form of appropriate hierarchies [2], the structure of which must be taken into account when processing the initial information.

According to the results of the analysis of the data of preliminary studies, the main areas of impaired functioning of patients affecting the evaluation of the effectiveness of PSR have been identified. Rank estimates of changes in the relevant areas of the patient’s dysfunction after the PSR program compared to the initial level are the basis for the conclusion about the effectiveness of the PSR components. Algorithms of the AHP normative approach were used to translate rank information into numerical information [2]. The weight of the areas of the patient’s functioning disorders was used in the formation of integral estimates of the effectiveness of PSR.

The fundamental difference between AHP-based assessments and rank assessments is due to the fact that numerical estimates of the weight of the criteria and the corresponding changes in the patient’s condition are obtained, which depend on the qualifications of specialists, the characteristics of the scales used to measure violations in the relevant areas and the procedures of the PSR.

Obtaining the results of processing rank information in a numerical scale allows to obtain the correct integration of the patient’s personal characteristics when considering PSR procedures and to obtain correct models of the patient’s state. 1. Saaty T. European Journal of Operational Research.1990; 48(1):9-26. https://doi.org/10.1016/0377-2217(90)90057-I 2. Mitikhin V.G., Solokhina T.A. et al. Psychiatry, 2022; 20(2): 51-59. DOI: 10.30629/2618-6667-2022-20-2-51-59

None Declared

Mental disorders represent complex phenotypes and are the leading causes of global disease burden. Human endogenous retroviruses (HERVs) are ancient retroviral DNA sequences established into germline. Their tight regulation is mainly achieved by epigenetic mechanisms, which can be altered by environmental factors - viral infections, inflammation, leading to HERV activation. The aberrant expression of HERVs associates with neurological diseases and mood disorders. We showed earlier that HERV-E ƛ 4-1 activation is associated with the recurrent depression stage of exacerbation and are accompanied by a pronounced increase in the proinflammatory activity of the peripheral blood mononuclear cells (PBMC).

The purpose of the study was to evaluate the activity of HERV-E ƛ 4-1 on PBMCs of patients with recurrent depression in remission, including under the influence of recombinant human IL-1β.

The study included 30 patients with an established diagnosis of recurrent depression (F 33.0) aged 26–45 years. PBMC were isolated using the Ficoll density gradient method and further cultured in the presence or absence of 1 mkg/ml of recombinant human IL-1β for 24 hours. HERV-E λ 4 – 1 env gene expression was determined by the PCR. Cells proliferative activity was determined by H3-thymidine incorporation. Cytokines content in culture supernatants was assessed by ELISA.

It was shown that in all samples of PBMC cultured without IL-1β the HERV-E λ 4 – 1 env expression was not determined. After the PBMC cocultivation with recombinant human IL-1β, HERV-E λ 4 – 1 env gene expression was determined in 86,7% of cases. The HERV-E ƛ 4-1 activation in PBMC after IL-1β influence was accompanied by increased cells proliferative activity and production of IL-1β, IL-6.

Our data indicate that the HERV-E λ 4 – 1 env expression in PBMC of recurrent depression patients in the stage of remission induced by the influence of proinflammatory cytokines, such as IL-1β. This mechanism may be one of the possible regulators of HERV-E λ 4 – 1 activation in recurrent depression.

None Declared

Unipolar depression is a growing global Public Health challenge. During last years, life factors such as diet, have been identified as a target for the development of adjunctive treatment that could reduce the rates of depression. The Mediterranean Diet (MD) is one of the most studied dietary factors that has been inversely associated with depression (Rahe et al. Eur J Nutr. 2014;53:997–1013). The PREDIDEP study is an ongoing secondary prevention trial aimed at assessing the effect of a MD enriched with extra virgin olive oil (EVOO) on depression recurrence (Sánchez-Villegas et al. BMC Psychiatry. 2019 Feb 11;19(1):63).

This study aims to assess the effectiveness of a remote Mediterranean diet–based nutritional intervention in the context of a trial of depression.

The PREDIDEP study is a 2-year multicenter, randomized, single-blinded trial designed to analyse the effect of the MD enriched with extra virgin olive oil (EVOO) on the prevention of depression recurrence. The inervention group received phone contacts with dietist and had access to web-based information, and the control group had usual care for depressed patients. The 14-item MD Adherence Screener (MEDAS) questionnaire and a semiquantitative food frequency questionnaire (FFQ) were collected by dietitians at baseline and at 1-year and 2-year of follow-up. We used mixed effects linear models to assess changes in nutritional variables according to the group of intervention. The trial was registered at ClinicalTrials.gov NCT03081065.

We observed that participants in the MD group increased their adherence to MD (between-group difference: 2.50; 95% CI 1.88-3.12; p<0.001) after one and two years (between-group difference: 2.57; 95% CI 1.93-3.22; p<0.001) of intervention compared with control group.

We found that this multifaceted remote nutritional intervention is a useful tool kit to maintain the quality of the diet according to the goals of the MD among patients at risk of depression.

None Declared

Adolescence is a period marked by highest vulnerability to the onset of depression, with profound implications for adult health. Neuroimaging studies have revealed considerable atrophy in brain structure in these patients with depression. Of particular importance are regions responsible for cognitive control, reward, and self-referential processing. However, the causal structural networks underpinning brain region atrophies in adolescents with depression remain unclear.

This study aimed to investigate the temporal course and causal relationships of gray matter atrophy within the brains of adolescents with depression.

We analyzed T1-weighted structural images using voxel-based morphometry in first-episode adolescent patients with depression (n=80, 22 males; age = 15.57±1.78) and age, gender matched healthy controls (n=82, 25 males; age = 16.11±2.76) to identify the disease stage-specific gray matter abnormalities. Then, with granger causality analysis, we arranged the patients’ illness duration chronologically to construct the causal structural covariance networks that investigated the causal relationships of those atypical structures.

Compared to controls, smaller volumes in ventral medial prefrontal cortex (vmPFC), dorsal anterior cingulate cortex (dACC), middle cingulate cortex (MCC) and insula areas were identified in patients with less than 1 year illness duration, and further progressed to the subgenual ACC, regions of default, frontoparietal networks in longer duration. Causal network results revealed that dACC, vmPFC, MCC and insula were prominent nodes projecting exerted positive causal effects to regions of the default mode and frontoparietal networks. The dACC, vmPFC and insula also had positive projections to the reward network, which included mainly the thalamus, caudate and putamen, while MCC also exerted a positive causal effect on the insula and thalamus.

These findings revealed the progression of structural atrophy in adolescent patients with depression and demonstrated the causal relationships between regions involving cognitive control, reward and self-referential processes.

None Declared

Eating disorders (ED) negatively affect physical, mental, and social well-being. The exact psychopathology of ED is still unknown, with research suggesting the interplay of a combination of factors.

The aim of our study was to estimate the prevalence of ED in the Tunisian general population, and to identify associated risk factors.

We conducted a cross-sectional, descriptive and analytical study among Facebook group members, using an online questionnaire, over the period from February 17, 2023 to May 26, 2023. All respondents over the age of 18 were included in the study. All participants filled a socio-demographic questionnaire. The Eating Attitudes Test (EAT-26) was used to screen for those at risk of eating disorders.

A total of 528 responses were included in the study.33.3±11.95 years. The subjects were unmarried in 63.4% of cases, of low socio-economic level in 19.5%, with a university education in 75.2% and with a regular occupation in 56.1% of cases.

The mean EAT-26 score was 12.36±10.34. according to this scale, 12.3% of our population were at high risk of developing an ED.

In a multivariate analysis, the female gender (p = 0.006), the low economic status (p = 0.012), a psychiatric comorbidity (p < 0.001), and physical activity (p= 0,037) were strongly associated with ED.

This study highlighted the magnitude of the risk of disordered eating attitudes in the Tunisian population and the need for programs to prevent and control these disorders.

None Declared

In recent decades, there has been extensive research on the association between Autism Spectrum Disorders (ASD) and Eating Disorders (ED), as well as the existence of sensory sensitivity alterations in both diagnostic groups.

The present study aimed to examine the presence of autistic traits in a sample of adult women diagnosed with different ED, and the concurrent role of autistic traits and sensory sensitivity in both their eating disorder symptomatology and their autism-related eating behaviours.

Seventy-five women with different ED completed the Eating Attitude Test (EAT-26), the Autism Quotient (AQ), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), the Sensory Perception Quotient - Short Form 35 item (SPQ-SF35) and the Swedish Eating Assessment for Autism Spectrum Disorders (SWEAA), which investigates specific eating behaviour related to autism.

12% of the sample scored above the cut-off at both the AQ and the RAADS-R, while 68% scored above the cut-off at the RAADS-R only. We found an association between: i) hypersensitivity in the taste domain and ED severity and autistic-like eating behaviours; ii) hypersensitivity in the vision domain and autistic-like eating behaviours; iii) higher autistic traits and ED severity and autistic-like eating behaviours.

This study confirms the presence of autistic traits in patients with ED and underscores the significance of conducting additional systematical investigations on this topic across all diagnostic categories of ED. It is becoming progressively evident that identifying and measuring the levels of autistic traits in patients with ASD is crucial not only for a better understanding of the causes of these disorders, but also because it would help to tailor specific therapeutic interventions, especially considering the cognitive flexibility issues presented by these patients and the socio-emotional challenges they face. Additionally, this study has laid the foundation for further insights into the relationship between sensory sensitivity and dysfunctional eating behaviours typical of ED and ASD.

None Declared

Eating disorders (ED), especially anorexia nervosa, are known to be the most associated with high mortality rates among psychiatric conditions. In many cases, they are resistant to treatment because patients tend to show low compliance, concealing symptoms from doctors. Body image concerns may affect communication and hinder building connections with people, making patients feel alienated.

The study aimed to examine the specific characteristics of attachment styles and evaluate their interrelationships with psychological features in women with eating disorders.

A total of 52 women with a clinical diagnosis of eating disorder (namely, 26 with anorexia nervosa (AN) and 26 with bulimia nervosa (BN)) and 43 healthy controls were included in the study. All participants completed the following psychometric scales: Relationship Questionnaire (RQ), Experience in Close Relationships (ECR), Relationship Profile Test (RPT), and Multidimensional Perfectionism Scale (MPS). The Kolmogorov-Smirnov normality test was applied, confirming a non-normal distribution of the sample; therefore, the non-parametric Mann-Whitney test and Spearman statistics were administered.

The results show a marked difference between the two groups. In the ED patients’ group, only 15% of respondents classified their attachment style as secure, compared to 37% of the participants in the control group. 85% of women in the ED group identified themselves as having one of the insecure attachment styles (anxious, avoidant, or disorganized). The level of relationship anxiety and the rate of relationship avoidance in the respondents of the ED group is 27% and 19% higher, respectively, compared to the control group. Likewise, the level of destructive interpersonal overdependence is 20% higher in the ED patients’ group respondents, whereas healthy dependence is 18% lower compared to the controls. The respondents with ED showed 18% higher self-oriented perfectionism and 39% higher socially prescribed perfectionism. A direct correlation between avoidant attachment style and destructive interpersonal overdependence was found in women with diagnoses belonging to the ED group. When comparing AN and BN patients, no statistically significant differences in the distribution and peculiarities of attachment styles in the anorexia and bulimia groups were found.

The study has proved the hypothesis that insecure attachment is more common among women with eating disorders than those without the diagnosis. We suggest a more profound scientific elaboration of the attachment in ED patients to increase the level of compliance of this group of patients, to improve the effectiveness and reduce the duration of treatment, and develop new therapeutic approaches to cure this disease.

None Declared

Orthorexia nervosa is defined as an unhealthy obsession with eating healthy food. Recent studies currently demonstrated that students in health-oriented academic programs, highly focused on nutrition and physical exercise, are more prone to develop orthorexia nervosa than students in other educational areas.

Determine the prevalence of orthorexia nervosa in medical students and identify associated factors.

We conducted a cross-sectional, descriptive, and analytical study in the faculty of medicine of Sfax in Tunisia, between February and April 2023. We used ORTO-15 for the assessment of orthorexia.

The research has enrolled 220 students. Their mean age was 21.40±1.68 years, with female predominance (70%). The mean Body mass index (BMI) was 22.46±4.15 kg/m2. The prevalence of overweight (BMI≥25 kg/m2) and obesity (BMI≥30 kg/m2) were respectively 19.5% and 3.6%. Over a third of students (34.1%) were using means of weight control, of which the diet represented 62.66% of cases. The participants had consulted a nutritionist in 11.4% of cases. The ORTO-15 mean total score was 36.88±6.76, with a mean score of 12.95±2.69 for cognitive dimension, 13.31±2.70 for clinical dimension, and 10.61±2.52 for emotional dimension. A total of 60% of participants had a score under the threshold.

Orthorexia was significantly associated with female gender (p<10-3), overweight or obesity (p=0.037), the use of weight control methods (p<10-3), following a diet (p<10-3), and consulting a nutritionist (p=0.009).

In our study, orthorexia seems to be quite widespread among medical students, particularly females, who are overweight or obese, and who use weight control methods.

None Declared

This study investigates the effects of transcranial direct current stimulation (tDCS) on food craving improvement and changes in brain function associated with craving in overweight and obese subjects.

Food craving disregards the homeostatic mechanisms related to appetite and nullifies the rewarding effects of food, directly contributing to body weight and eventually leading to obesity. In this study, we aim to explore the effects of transcranial direct current stimulation (tDCS) on food craving improvement and changes in brain function associated with craving by conducting a total of 10 sessions of tDCS over a period of 2 weeks on overweight and obese subjects.

A total of 86 patients who were overweight or obese (BMI ≥ 23 kg/m2) during the study period were included. The tDCS montage involved placing the anode over the left and the cathode over the right DLPFC. Weight, BMI, neuropsychological variables, and food craving-related variables were assessed. We measured absolute and relative EEG power in 19 channels and analyzed QEEG according to the following frequency ranges: delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), beta (12–25 Hz), high beta (25–30 Hz), and gamma (30–80 Hz).

After the application of tDCS, there was no significant reduction observed in weight and BMI. However, all measures related to food and eating showed a decrease in the intensity of cravings, and there was also a significant reduction in depression, anxiety, and perceived stress. In quantitative EEG analysis, an increase in theta waves was observed in the left frontal area (F7 and F3), an increase in alpha waves in the right parietal area (P4), and a decrease in beta waves in the frontal area (FP2) and occipital area (O1).

This study investigated the effects of tDCS on food craving in overweight and obese individuals, and it was found that there were improvements in psychological factors such as depression and anxiety. Additionally, using quantitative EEG, neurophysiological changes were observed, including an increase in theta waves and a decrease in beta waves.

None Declared

The COVID-19 pandemic involved stringent social restrictions, a surge in mortality, and significant economic consequences, affecting age groups differently and leading to increases in loneliness and mental health problems, particularly depression, which was already very common before the pandemic.

Analyse changes and related factors of the relationship between loneliness and depression by age group from (1) before to the COVID-19 outbreak, (2) during the pandemic, and (3) after the last state of emergency. Moreover, we aim to (4) evaluate the effect of social support to alleviate feelings of loneliness and improve the course of depression.

We used data from three different cohorts, all representative of the Spanish adult population. (1) We longitudinally analysed the association between loneliness and depression with a sample interviewed before (N = 1,880) and during (N = 1,103) the pandemic. We used mixed-models to study changes in major depressive disorder (MDD) by age group and regression models to quantify the association between age and potential mediating effects. (2) We analysed data of 2,000 adults during the pandemic. Several regression models were constructed to assess the impact of pre-pandemic mental disorders on the main association by age group. (3) Out of those 2,000 participants, 1,300 were interviewed 9 months later, to determine group-based loneliness trajectories and its associated risk factors. (4) We analysed the relationship between loneliness, social support, and MDD over a 7-year period (N=404 individuals aged 50+ having MDD). We tested cross‐lagged panel models using structural equation modelling.

During the pandemic the probability of having MDD increased significantly among younger individuals, and was partly explained by loneliness, low resilience, and worsened economic situation. Loneliness was associated with more depressive symptoms, and this association was stronger in younger adults without pre-pandemic mental disorders and in older adults with them. At the end of pandemic, three courses of loneliness were detected: invariant low loneliness (42.6%), decreasing medium loneliness (51.5%), and fairly invariant high loneliness (5.9%). Risk factors for worse trajectories were being younger, female, not married, and, notably, having pre-pandemic mental disorders. Among individuals with depression prior to the pandemic, lower social support predicted higher subsequent levels of loneliness, resulting in an increase in MDD recurrence.

Strategies to decrease the impact of loneliness on depressive symptoms should consider individuals mental health background, address social determinants, and adopt an age-driven perspective.

None Declared

Religiosity is believed to be a factor that may reduce the risk of addiction and substance use both in adults and in young people. It is a complex construct that is neither measurable nor objectifiable, thus it must be estimated from proxy characteristics. For this purpose, researchers differentiate between subjective religiosity (i.e., individual religious experience) and extrinsic religiosity, that is, participation to religious services (extrinsic-personal subtype) or to social activities consistent with religion-based principles (extrinsic-social subtype).

This work aimed at exploring the role of different facets of religiosity – intrinsic (subjective), extrinsic-personal (service attendance), and extrinsic-social (church-based social activities) – in terms of deterring cannabis use among adolescents.

Aggregated data of NSDUH (2015-2019) on 68,263 adolescents between 12 and 17 years of age were analysed using a structural equation modelling (SEM) to determine pathways of intrinsic and extrinsic components of religiosity in cannabis use. Several covariates were considered in the analyses, including comorbid depression and civil volunteering activities.

About 15% of participants admitted cannabis use in the previous year. Intrinsic and extrinsic-personal religiosity was reported by 66% and 25% of the sample, respectively. A percentage of fifty-seven of participants were involved in at least one faith-based activity, while 74% reported participation in secular community activities. Both intrinsic and extrinsic-personal religious components were likely to reduce cannabis use at the SEM regression model analysis controlling for putative confounders (cannabis use coeff.: -0.065, p=0.001; coeff.: -0.176, p<0.001, respectively). Considering the joint contribution of relevant covariates (community-based activities, lifetime MDE, sex, and poverty status), the outputs were similar. Cannabis use was not influenced by extrinsic-social component of religiosity, even though the involvement in non-faith based volunteering activities was protectively associated.

From a policy-makers perspective, the reduction of cannabis use among young people may be obtained by supporting secular volunteering programs, which seem to be a cost-effective strategy. Moreover, whilst promoting religiosity is beyond the scope of any preventive programs, religious practices should be considered relevant protective factors.

None Declared

Individuals have difficulty controlling their use of technology, it constantly on their minds when they don’t have access to it, it takes up too much time in their daily lives, and these situations negatively impact daily life are referred to as “problematic technology use”. The widespread use of technology from a young age is leading to an increase in the number of children with problematic technology use. Problematic technology use negatively impacts children’s development, especially their mental development. Important risk factors for problematic technology use include a long stay at home, a previous traumatic event, and low life satisfaction. In addition, it is possible that problematic technology use is more common in children with low social competence and low behavioral levels.

The aim is to determine the level of problematic technology use in 48-72-month-old children receiving preschool education, to examine some variables thought to be related to it, and to assess their level of social competence and behavior.

The study was a cross-sectional research conducted between January and September 2023 among the parents of children studying in Eskişehir and Bolu. The study group consisted of the parents of 883 children. In our study, the Problematic Technology Use Scale for Young Children (PTUS-YC) and the Social Competence And Behavior Evaluation-30 Scale (SCBE-30) were used.

The age of the parents ranged from 20 to 54 years (mean: 35.5±4.8), 740 of them were women. The average age of the children was 63.2±7.3 months and 442 of them were boys. The scores obtained from PTUS-YC ranged from 26-104 and the mean was 55.1±14.9 points. Among the variables associated with problematic use of technology, those related to parents were place of residence, age and marital status, while those related to children were time spent at home with technological devices, parental control over content used, adaptation to school and ownership of a technological device. There is a weak positive correlation between children’s scores on the PTUS-YC and the SCBE-30 (r:0.336; p < 0.05).

It can be said that problematic technology use in our study was at a moderate level. As the level of social competence and behavior increase, problematic technology use decreases. It is recommended to limit the time children spend with technological devices, ensure that parents control the content they use on technological devices, support their adaptation to school, and work on gaining social competence and positive behavior.

None Declared

Much has been made of the decline in population mental health over COVID but most studies show this just exacerabted a loing term trend This has predominnatly been attributed to changes in adolescent mental health over the past decade but there ahs been little evalaution of whether this post Millenium cohort was the first to demonstrate such a decline

This study investigates to what extent mental differs in people born in different decades – i.e., possible birth cohort differences in the mental health of the popualtion over the past two decades To remove the linear dependency and identify any differences in trends between cohorts, we model mental health for each cohort as a nonlinear smooth function of age in an age-cohort model.

This analysis draws on 20 annual waves of the Household Income and Labour Dynamic in Australia (HILDA) survey.,is a nationally representative household panel that commenced in 2001 with 13,969 participants. The birth cohort of each person was defined by the decade of birth year(1940s, 1950s, etc). Mental ill health was assessed with the MHI5 from the SF36, in each wave and K10 from alternate waves. We estimate and compare penalized smooth trends in mental health for each cohort using restricted maximum likelihood (REML) using generalized additive mixed modelling (GAMM). Cohort effects are captured by directly estimating the differences between the smooth age trends of adjacent cohorts.

Later cohorts were more likely to have poorer mental health, higher distress, more likely to be single and unemployed, and less likely to be chronically ill or disabled. Mental health was worse for younger age-groups in each survey year, and this discrepancy is much greater in more recent surveys - consistent with a birth cohort effect. Millennials (those born in the early 1990s) had a lower score at the same age as earlier generations, and the later cohorts do not show the age-related improvement seen in other earlier cohorts as they aged. At age 30 the average MHI-5 score of those born in the 1990s was 67, compared to 72.5 and 74 for people born in the 1980s and 1970s.

The deterioration in mental health over time which has been reported in large cross-sectional surveys, likely reflects cohort-specific effects related to the experiences of young people born in the Millennial generation and, to a lesser extent, those from the immediately prior cohort born in the1980s. We need to understand whether later cohorts are less resilient to similar risk factors experienced by earlier cohorts or whether they experience more and/or a greater severity of risks for mental ill-health. Such evidence is critical if the deteriorating pattern of mental health is to be arrested.

None Declared

Therapeutic leave, the temporary and authorized absence of a patient from a psychiatric inpatient facility, is a practice rooted in the shift of mental illness towards more humane and recovery oriented care. This shift began to gain momentum in the mid-20th century, with the deinstitutionalization movement, which sought to treat psychiatric patients in less restrictive environments and facilitate their integration into the community. Today, therapeutic leave remains relevant in general psychiatry inpatient treatment facilities, and on an international level. It’s additionally used as a way to assess the progress and the stability of the patient outside the controlled environment that is the hospital, and to provide a gradual transition back into independent living and potential stressors of the outside world. But it is administered more on tradition and perceived benefits than on solid scientific grounding, reflecting a practice guided by clinical experience rather than empirical data or guidelines.

Our review aims to evaluate the existing body of research on therapeutic leave in general psychiatry inpatient units. We intend to identify the outcomes that have been studied, and assess the extent and nature of their impact.

This scoping review was conducted through a comprehensive search of academic databases, including Google Scholar, PubMed, Embase, Cochrane Library, and PsycINFO. Search terms were carefully selected to capture relevant publications, and the results were screened for their pertinence to the review’s aims. Studies focused on forensic settings were excluded.

The literature on therapeutic leave is notably limited, and the prevalence of its utilization in clinical practice remains unclear. Scientific publications primarily address readmission rates, with two indicating an increased risk in patients granted leave during their inpatient treatment. However, one report suggested a potential reduction. Length of stay (LOS) was negatively impacted, with prolonged hospitalization in these patients shown in one report. Post-discharge emergency room visits seem unaffected. A rise in readmission rates and LOS typically suggests higher subsequent healthcare costs. However, findings from another study contradict this expectation, with reduction of costs post-initial inpatient treatment. The literature also explores the hazards linked to therapeutic leave, highlighting that a significant portion, between 30 to 80%, of inpatient suicides transpire during such leave. Additional concerns extend to non-fatal self-harm, as well as the possibility of patients causing harm to others or to property.

Our review reveals a significant research gap in therapeutic leave’s effects, with a reduced number of outcomes studied and inconclusive findings. Future studies should aim to clarify these outcomes and eventually define therapeutic leave protocols.

None Declared

The present study examines self-reported factors related to discontinuation of ADHD medication in Danish adults. Based on insights from six patient interviews, a questionnaire was developed with themes such as perception of ADHD, perceived beneficial- and adverse effects of the medication, to examine patients’ reasons for continuation or discontinuation of the prescribed medication.

ADHD medication has proven effective for treating ADHD in adults. Large registry-based studies have generally shown high discontinuation rates over time and focused on different risk factors, such as comorbidity, gender and socioeconomic status. However, in the present study we explore patient reported reasons for continuation or discontinuation of ADHD medication as well as what drives their choice of living with or without medication despite ADHD.

The present research is a questionnaire study consisting of 1,050 Danish adults who redeemed a prescription of ADHD medication for the first time between 2017-2019. Questionnaires were sent out by Statistics Denmark to 4.748 adults, a representative sample from the 17.334 Danish adults who redeemed a prescription within that period. A gap of 12 months between redemptions was defined as discontinuation and questionnaires were sent out to an equal number of patients who continued or discontinued the ADHD-medication. Chi2-tests were performed to examine the differences between adults who continued vs. discontinued ADHD-medication in relation to different main themes.

The patients who continued medical treatment more strongly perceived ADHD as a biological illness whereas patients who discontinued, more strongly perceived ADHD as an illness constructed by society. Furthermore, patients who continued medical treatment reported that the medication has a more positive influence on their lives whereas patients who discontinued the medication reported that the treatment involved more negative feelings and decreased the positive sides of themselves. Finally, patients who continued the prescribed ADHD-drugs reported more strongly that they continued the treatment for themselves, to be able to work and be social than the patients who discontinued the medical treatment.

The present findings suggest that the perception of ADHD as being either a biological or social construct is central to why patients choose to continue or discontinue ADHD-medication. Moreover, patients who continued the medical treatment generally reported more positive effects of the ADHD-drugs whereas patients who discontinued the medical treatment reported different negative effects of the medication. From a clinical perspective, these findings show the importance of understanding the individual patient’s perception of ADHD. These perspectives should be addressed in the clinic alongside with awareness of how ADHD-drugs may have a positive and negative effect on the individual patient.

None Declared

Families and friends of individuals with alcohol and other drug use (AOD) issues are highly stigmatised and vulnerable, which often leads to social isolation, decreased quality of life, psychosocial vulnerability, heightened distress, less access to social support, and development of maladaptive coping strategies and own mental health challenges and/or AOD use issues. While peer support for families is commonplace in Australia, in Darwin, psychosocial support activities delivered by peers are very sparse.

The NT Lived Experience Network (NTLEN), in allyship with a team of researchers from Flinders University, has secured multiple fundings aimed to develop, implement, and evaluate a peer education and recovery program called Circles of Support (CoS) for families and friends of persons with AOD use issues.

The suitable evaluation approach was co-designed with live experience representatives from NTLEN and other local key stakeholders. It applied a mixed-method approach, including pre and post-program surveys (n=26) and individual interviews with program participants and the program delivery team (n=11). We also used a co-design approach to develop survey instruments to ensure they were strengths-based and recovery-oriented.

While most participants showed sound stress management skills and understanding of stressors at the program start, about 30% did not think they could handle distress if it got worse and did not have the tools to live the life they wanted. Also, about 25% did not know when to ask for help. Many participants (40%) expressed that they were not hopeful about possible changes in their own family context, such as fewer experiences of stress. By the end of the program, participants reported lower stress levels and higher total empowerment scores. The qualitative interviews highlighted the complexities and challenges participant faced in their journeys. Among them, stigma was considered the most critical, especially among participants from culturally and linguistically diverse backgrounds. In some cases, perceived stigma prevented participants from joining the program. The program was well-received and successful in empowering families and friends and improving their own mental wellbeing. Their key learning and experiences included identifying the stage of their situation, learning to cope with challenges, reducing stress, developing hope, experiencing growth, creating a better and more supportive relationship with their loved ones, and implementing self-care on a regular basis.

Our findings emphasise the critical role of peer support for families and friends in improving their mental health and wellbeing. They also draw attention to improving help-seeking behaviours, which may be influenced by stigma, shame and prioritising the person’s needs.

None Declared

The prenatal period poses a risk of both onset and relapse of mental health difficulties. Anxiety and depressive symptoms are the most common, with a prevalence of 10-20%. Untreated mental health difficulties can have serious consequences for the child’s development, the quality of the mother-child relationship, and the whole family system. Peer support can be an effective form of care for women at risk.

The aim of the study is to examine the effectivness of remote “Mom Supports Mom” peer support intervention in reducing prenatal anxiety, depression and psychosocial stress levels.

A randomized controlled trial was conducted. The Edinburg Postnatal Depression scale (EPDS) was used to assess the risk of mental health difficulties in pregnant women. Women with EPDS score ≥ 10 were randomized 1:1 to control and intervention groups. The intervention group received the “Mom Supports Mom” peer support intervention. The control group received care as usual. Between group-differences in anxiety, depression and psychosocial stress levels were measured one month after the enrollment/the start of the intervention. The Perinatal Anxiety Screening Scale (PASS), the Edinburg Postnatal Depression Scale (EPDS), and the Prenatal Psychosocial Profile (PPP) were used to assess the mental health difficulties.

The study involved a total of 67 participants in the intervention group, and 77 participants in the control group. Levels of anxiety (U = 2016, P < 0.05) and psychosocial stress (U = 1862, P = 0.001) were significantly decreased in the intervention group, showing a medium effect size of the intervention (Cliff’s delta= -0.218 and -0.317, respectively). There was no significant difference in depression levels (U = 2288.5, P = 0.243; Cliff’s delta = -0.113); see Table 1.Table 1

Between group differences in study outcomes (n=144)

The remote “Mom Supports Mom” peer support intervention can be effective in reducing anxiety and psychosocial stress levels in at-risk pregnant women. Nevertheless, it didn’t show effectivness in reducing depression levels.

None Declared

According to data, choking is one of the principal causes of death in mental health units. Specifically, research reveals that psychiatric patients -compared to the general population- are 43 times more likely to die due to choking. Nevertheless, only a limited number of studies has been focused on the risk factors of choking among this category of patients. Interestingly, dysphagia and choking on food are underdiagnosed and underreported in the UK psychiatry departments while there is an important insufficiency of provided information in national guidance archives as well as in regional clinical settings for adults with mental health diseases.

To explore the risk factors of choking among psychiatric patients and to highlight interventions of preventing choking-related incidents.

A review of 36 articles -from 2010 to 2023- on PubMed and Google Scholar regarding choking-related incidents among inpatients of mental health units.Articles exploring choking suicide-related incidents or choking as cause of neurological illness, were excluded from the research. Keywords: choking, psychiatric patients, death.

Numerous risk factors of choking have been identified, such as:

Antipsychotics,

Anxiolytics,

Bradykinetic dysphagia (extra-pyramidal syndrome),

Intellectual disabilities,

Dementia,

Anxiety,

Coughing while eating,

Fast paced eating and cramming food,

Mealtime-related stressors such as willingness of avoiding peers.

There is an absolute need for a specialized training of nurses, caregivers, mental health clinicians to prevent incidents and injuries of inpatients due to choking. Close supervision, routine screening during the mealtime, and detailed information from relatives about the patient’s eating habits are essential for the safety and the ameliorated quality of hospitalization for the mentally ill.

None Declared