Several studies have demonstrated the unfavorable and neurotoxic effects of untreated psychosis (UP) on the brain. An estimated 10 to 12 cc of brain tissue could be potentially damaged due to neuroinflammation and oxidative stress when a first episode of psychosis goes untreated. Other studies have found a correlation between the duration of untreated psychosis (DUP) and treatment resistance or nonresponse. Evidence-based schizophrenia treatment mainly relies upon the use of first and second-generation antipsychotics, without solid evidence that the former is superior to the latter regarding the treatment of negative symptoms. Both groups, however, can come with a risk of side effects. Cariprazine, a third-generation antipsychotic, represents a safe and effective treatment, targeting both the positive and negative symptoms of schizophrenia.

To report a clinical case of a woman with an extreme DUP with predominantly negative symptoms of schizophrenia and highlight the favorable outcome cariprazine monotherapy had on her global functioning.

We report a clinical case of a 58-year-old woman with a history of a 40-year UP successfully treated with 4,5mg of cariprazine. The woman was brought involuntarily for psychiatric assessment at the emergency department with a clinical image of catatonic stupor and predominantly negative symptoms of psychosis. Her total PANSS score at admission was 129. The negative subscale score was 49. She was initially treated with 3mg cariprazine and 10mg olanzapine and was gradually left on 4,5mg cariprazine monotherapy with an adjunctive 30mg mirtazapine.

The patient was dismissed after 47 days of hospitalization. Cariprazine was effective in targeting both the cognitive and affective symptoms of long-standing UP. In the long-term, cariprazine also improved remnant delusional ideas of somatic and persecutory types, enhancing the patient’s social life, ensuring her support network, and assisting her integration into the community. The patient did not report any side effects, and her blood test results were within the normal range.

Not all cases of schizophrenia are dramatic at presentation - some can have a chronic and insidious course predominated by negative symptoms. UP can lead to disastrous consequences for the patient’s biopsychosocial well-being, leading to future treatment resistance and disability. Although such cases of untreated psychosis seem to be from the past, we should be conscious of their existence and treat them with a patient-personalized and symptom-centered approach. Cariprazine was successful and effective in treating this patient with a remarkable course of UP.

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The increasingly well-established links between psychosis and distant traumas (often established in childhood) oppose purely neurobiological explanations. The influence of psychosocial factors on the development of a later disorder has been studied. In studies, a strong association has been found between psychosis and childhood sexual abuse, especially when sexual intercourse was involved.

A case of a patient with psychotic symptoms is presented followed by a theoretical review on the topic.

A case is presented with a bibliographic review.

A 37-year-old woman was admitted to the Acute Hospitalisation Unit for behavioural alterations in the form of heteroaggressiveness towards family members in the context of psychopathological decompensation.

On arrival at the unit, she presented psychomotor restlessness, ideas of harm in relation to her neighbours and an attitude of referentiality, especially towards her father.

At the pharmacological level, Quetiapine 100 mg was replaced by Aripiprazole 10 mg and sleep was occasionally supported with Lormetazepam 1 mg.

Progressively her rest is normalising, she remains calm, behaviourally adequate, approachable and cooperative. She does not spontaneously allude to delusional ideation and no hallucinatory attitude is observed.

Daily individual psychotherapeutic interviews and family meetings are held with her parents, in which they refer to experiences of abandonment by her parents during her upbringing, persistent irritability and ideation of harm towards the family, which seems to be of long standing. They also report that prior to the first psychiatric admission, the patient reported being sexually abused at the age of 6 and suffered repeated physical aggression by a teacher at the age of 9. Both the patient and her parents relate the origin of the current malaise to all these events.

Upon discharge from the unit, throughout the follow-up carried out in the resource specialised in first psychotic episodes, during psychotherapeutic interviews, the feelings and emotions related to the traumatic experiences mentioned above are worked on. This therapy, associated with the pharmacological regimen previously indicated, has promoted a notable psychopathological improvement.

A review of 46 studies in women, both inpatients and outpatients, many of whom had a diagnosis of psychosis, revealed that 48% reported having suffered sexual abuse, 48% physical abuse in childhood and 69% of them both. Among men, the figures were 28%, 50% and 59%, respectively. Childhood abuse has been shown to play a causal role in many mental health problems.

There is clear evidence that physical and sexual abuse during childhood is related to symptoms of psychosis and schizophrenia, particularly hallucinations and paranoid delusions. Also, studying possible variables, a greater severity has been observed the more intense the abuse has been.

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Delusion of pregnancy (DP) is a false and persistent belief of being pregnant despite realistic evidence to the contrary. Being considered a rare phenomenon, more cases of DP have been reported lately, however the literature about this topic is still scarce.

Clarify the etiology and clinical aspects of this pathology in order to diagnose and to treat it properly.

A search on Pubmed was performed using the MeSH terms “delusion pregnancy” or “pseudocyesis”. The DSM-5 and ICD-10 were also a source of information.

DP can be sometimes confused with other disorders, like pseudocyesis, pseudo-pregnancy and Couvade syndrome, but it is important to differentiate all of them to have a clear view of the pathology and follow a correct approach to the problem.

DP can manifest isolatedly, but it is more commonly associated with other diseases. Etiologically, several factors can intercede: biological, psychosocial and cultural factors, iatrogenic factors and coenaesthesis processes.

Demographically, about 50% of the patients are 20-40 years old and the most common psychiatric diagnoses are schizophrenia, bipolar disorder and depression.

Concerning the treatment, it is essential to exclude non-psychiatric causes and treat those, if present. After doing so, the therapeutical approach can be non-pharmacological, using psychotherapy or electroconvulsive therapy, although the latter has inconclusive results and sometimes it only remits the comorbid depressive symptoms; or pharmacological using 2nd generation antipsychotics.

In general, there is now a good response in 50-64% of the cases (Bera and Sakar, Indian J Psychol Med 2015;37(2)131-137) (Yadov et al, Indian J Psychol Med 2012;34(1) 82-84).

DP can be a psychiatric diagnosis itself or a manifestation of other psychiatric or non-psychiatric disorder so we must be allert to make a precise differential diagnosis. Its genesis is multifactorial and that must be taken into account when thinking about its treatment approach.

In the past, the prognosis of the DP wasn’t good, but in the recent literature it was found a good response in more than half of the patients treated accordingly.

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Difficulties in emotional, cognitive, behavioral, and social functions are considered important factors of global functioning in schizophrenia.

A better understanding of difficulties in the mentioned facets might lead to the development of better-adjusted treatment approaches for individuals with schizophrenia, as well as impacting to reduction and elimination of stigma in Bosnia and Herzegovina’s wider social context in relation to difficulties spanning the daily life of individuals with schizophrenia.

Thirty- one patients with schizophrenia (SCH), and 30 healthy controls (HC) participated in our study. The Adult Self-Report (ASR), Achenbach’s scale for adults (ASEBA- Achenbach System of Empirically Based Assessment), and World Health Organization, Disability Assessment Schedule 2.0 (WHODAS 2.0) tests were administered.

Groups differed in age, education, employment status, marital status, friendships existence, and disability existence. According to the regression equations, thought problems predicted Getting around; withdrawn predicted Getting along with people and Life activities- Household, School/Work in the group of individuals with schizophrenia.

Our study revealed the role of different facets of difficulties in the prediction of global functioning in SCH. These findings might directly point to the importance of eliminating stigmatizing beliefs in a wider social context, developing techniques for improving the social support segment, focusing on healthy family functioning, as well as investigating job presence and perceived quality of life.

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Significant and measurable cognitive symptoms are present at the onset of the disorder and these remain stable in the subsequent period between 2 and 5 years. Their deterioration increases with the course of the disease. Attention, concentration, psychomotor speed and resolution of conceptual tasks are usually affected and are more significant in the presence of positive symptoms.

Sometimes, the typical positive or negative symptoms of the disease do not adequately reflect the severity of cognitive impairment. Measuring this deterioration can be very relevant when evaluating the severity and the prognosis of the disorder.

31-year-old male with a previous diagnosis of schizophrenia of 4 years of evolution. He gets a maintained treatment with amisulpiride 400mg with an apparent good response. A single hospitalization at the onset of the disease. An assassination attempt on his mother is done by suffocation with a pillow and observing a significant cognitive impairment despite an apparent control of the symptoms of schizophrenia.

An exhaustive neuropsychological evaluation is carried out, observing a very important cognitive deterioration that had not been previously detected and allowing a pharmacological adjustment of the underlying disease with global improvement of the patient.

It is very important to evaluate the patient as a whole without forgetting the frequent cognitive damage that these patients can have. An intense neuropsychological study can be very useful to evaluate the prognosis and adequate treatment of the patient in order to reduce serious risks.

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Individuals with schizophrenia are known to be at an increased risk of suicidal behavior (Sher & Kahn, 2019). However, the relationship between chronotype, which refers to an individual’s preference for sleep-wake patterns, and suicidal attempts in schizophrenia patients remains an area of interest and investigation.The relationship between chronotype and suicidal attempts in schizophrenia patients has not been extensively studied. However, research in other populations has shown that individuals with evening chronotypes, also known as “night owls,” may be at a higher risk of mental health issues, including depression and suicidal ideation (Verma et al., 2016). It is plausible to hypothesize that individuals with schizophrenia who have evening chronotypes may also be at an increased risk of suicidal attempts. Further research is needed to explore this relationship and its potential implications for clinical practice. In conclusion, the relationship between chronotype and suicidal attempts in schizophrenia patients is an area that requires further investigation.Early identification and intervention are crucial in preventing further suicidal attempts in this vulnerable population. Future research should focus on exploring the relationship between chronotype and suicidal attempts in schizophrenia patients to provide a comprehensive understanding of the factors contributing to suicide risk in this population.

This study investigates the relationship between chronotype and suicidal attempts in patients with schizophrenia.

The study was conducted cross-sectionally using quantitative research methods and using purposive sampling. The personal information form and scales used for data collection in this study, which was planned with patients hospitalized in the psychiatric ward and patients applying to the outpatient clinic, are based on self-report. The personal information form developed by the researcher by reviewing the literature, the Morningist-Evening Scale (SAM), the Suicide Probability Scale, the Suicidal Behavior Scale, the Positive Symptoms Rating Scale (SAPS) and the Negative Symptoms Rating Scale (SANS) were used as data collection tools. Participants signed an informed consent form before the interview.

Data extraction is still ongoing in detailed style by principal authors. A description of the studies and the key findings will be presented.

Reducing the risk of suicide in patients with schizophrenia is of vital importance. Awareness of the risks related to suicide may help reduce mortality rates in schizophrenia patients as in all patients. It is thought that the study’s results will be an important resource in knowing the risks related to suicide and determining the risk factors so that prevention studies can be initiated.

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Schizophrenia is often considered as pathology of consciousness. Some authors have considered that patients’ self-perception of their cognitive difficulties expressed in the form of subjective complaints could represent a source of stress. These cognitive difficulties may then interfere with the interpretation of symptoms, leading to poor insight.

Insight and cognitive complaints in stabilized outpatients with schizophrenia.

Study the relationship between subjective cognitive complaints and clinical insight in a Tunisian population with schizophrenia.

This is a cross-sectional, descriptive and analytical study carried out on 72 stabilized patients followed at the post-cure psychiatry consultation ‘A’ at the CHU Hédi Chaker in Sfax diagnosed with schizophrenia according to the DSM 5 criteria.

We used the schedule for the Assessment of Insight–Expanded Version(SAI-E) scale to assess Clinical Insight and the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) to determine subjective cognitive complaints

The mean age of the patients was 46.83 ± 11.6 years, with a sex ratio (M/F) of 2. In our study, 48.5% were single and 69.4% were unemployed.

The median total SSTICS score was 25.

Using the SAI-E scale, an average score of 20.1 was objectified in our study.

In our study, the better the insight, the greater the subjective cognitive complaints were in all cognitive domains (p=0.00).

Awareness of illness was statistically associated with working memory (p=0.001), explicit memory (p=0.004), attention (p=0.001), language (p=0.01) and executive functions (p=0.001).

Our study highlights the relationship between awareness of illness and cognitive complaints. The clinician, faced with repetitive cognitive complaints, should assess the insight before incriminating another cause (effects of a drug, cognitive deficit, etc.).

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The internalized stigma associated with mental illness is considered as an additional burden faced by people with mental disease. Among mental illnesses, schizophrenia is considered as the most stigmatizing.

To Assess the level of stigma in a sample of people with schizophrenia

This is a cross-sectional and descriptive study carried out on 72 stabilized patients followed at the post-cure psychiatry consultation ‘A’ at the CHU Hedi Chaker in Sfax diagnosed with schizophrenia according to the DSM 5 criteria. Socio-demographic and clinical data were collected using a pre-established sheet

We used The Internalized Stigma of Mental Illness (ISMI) scale to assess internalized stigma

The mean age of the patients in our study was 46.83 ± 11.6 years, with a sex ratio (M/F) of 2.

They were single in 48.5%, unemployed in 69.4%. Their level of education did not exceed primary school in 44.4% and their socio-economic level was low in 63.9%. 2% of the patients had no somatic history and 36.1% had a history of attempted suicide.

The median for the total ISMI score was 2.45, which corresponded to the absence of strong stigma. The median of the subscales was distributed as follows: 2 for the level of alienation, 2.28 for stereotype endorsement, 2.4 discrimination experience, 2.36 for social withdrawal and 2.60 for stigma resistance.

In our study, 45.8% of patients reported experiencing high levels of self-stigma (total score>2,5).

Our study found levels of self-stigma in individuals with schizophrenia that align with previous research, suggesting that schizophrenia-related stigma is a global phenomenon unaffected by factors such as origin or ethnicity.

None Declared

Schizophrenia is a chronic condition that leads to major socio-professional disintegration and personal suffering. In addition to the classic clinical symptoms, these patients also suffer from poor insight.

To assess insight in a population followed up for schizophrenia

We conducted a cross-sectional and descriptive which concerned the patients followed in the unit of outpatient post-cure consultations of psychiatry ‘A’ at the CHU Hedi Chaker of Sfax. We included 72 stabilized patients diagnosed with schizophrenia according to the DSM criteria 5. For the collection of sociodemographic and clinical data, we used a pre-established sheet. We used the schedule for the Assessment of Insight–Expanded Version(SAI-E) scale to assess clinical insight

The mean age of the patients in our study was 46.83 ± 11.6 years, with a sex ratio (M/F) of 2.

They were single in 48.5%, and unemployed in 69.4%. Their level of education did not exceed primary school at 44.4% and their socio-economic level was low at 63.9%.

In our study, 72.2% of patients had no somatic history and 36.1% had a history of attempted suicide.

Using the SAI-E scale, the mean score was 20.1 with a minimum of 5 and a maximum of 28.

At the end of this evaluation, it is important to emphasize that insight seems to be an important prognostic factor.

None Declared

In addition to the classic clinical symptoms, patients with schizophrenia suffer from cognitive difficulties, self-stigma and poor insight.

This study aims to evaluate the impact of stigma, symptom severity, and insight on subjective cognitive complaints in patients with schizophrenia.

This is a cross-sectional, descriptive and analytical study carried out on 72 stabilized patients followed at the post-cure psychiatry consultation ‘A’ at the CHU Hédi Chaker in Sfax diagnosed with schizophrenia according to the DSM 5 criteria.

We used the schedule for the Assessment of Insight–Expanded Version(SAI-E) to assess clinical insight, The Internalized Stigma of Mental Illness (ISMI) scale for the assessment of internalized stigma, the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) scale to determine subjective cognitive complaints and the Positive and Negtive Syndroms Scale (PANSS) to assess positive and negatives symptoms.

The average age of the patients was 46.83 ± 11.6 years, with a sex ratio (M/F) of 2. In our study, 48.5% of the patients were single, 52.8years,% were smokers and 23 6% consumed alcohol. The level of education did not exceed the primary level for 44.4% of the patients. The average age of disease onset was 24.56 ± 5, 82. Our participants had an average score of 25 on the SSTICS total score and 20.1 on the SAI-E. The median ISMI total score and PANSS total score were 2.45 and 46respectively

The predominant negative symptoms(p=0.003), stigma(p=0.009), and insight (p<10-3)were significant factors associated with increased cognitive complaints.

In schizophrenia, the combination of cognitive difficulties, self-stigma with a low insight makes the management of these patients more difficult.

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Schizophrenia is a common chronic disease in psychiatric long-term care institutions. Taipei City Hospital Songde Branch Psychiatric Nursing Home (TCHSBPNH) is the first public psychiatric nursing home in Taipei City. There’s not only a complete interdisciplinary care system, but also detail initial evaluation at admission of residents, including basic demographic information, cognitive assessments, activities of daily living, and so on. It is known that patients with schizophrenia are generally accompanied by cognitive impairments, which further affects their activities of daily living (ADL) performance, but we still don’t know the correlation between of them.

This study aimed to investigate the relationships between cognitive function and ADL function of psychiatric nursing home residents with schizophrenia. The results would promote clinical intervention in ADL training for institutional patients.

39 participants with chronic schizophrenia (mean age =63.95±6.59 years) were recruited for the study from 2020 to 2021 in TCHSBPNH. We collected every resident’s assessment data, including Mini-Mental State Examination (MMSE), Barthel Index, Lawton - Brody Instrumental Activities Of Daily Living Scale (Lawton IADL scale) and Composite Physical Function (CPF) Scale. The Pearson correlation coefficient was used to examine the correlation between cognitive function and ADL.

Moderate positive correlations were showed between cognitive function and ADL (p<.05). The statistic results as follow, MMSE and Barthel Index (γ=.627, p<.001), Lawton IADL scale (γ=.431, p=.006), and CPF (γ=.341, p=.034) respectively exhibited significant correlations.

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There is a positive correlation between cognitive function and ADL in psychiatric nursing home residents with schizophrenia. The better cognitive function performance becomes, the better independent ADL functions will be. Thus, the psychiatric nursing home residents’ independent ADL training will also vary from person to person.

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Acute dystonia, an adverse effect of neuroleptics, is linked to D2 neuronal receptor hypersensitivity or neurotoxicity due to oxidative stress mechanisms. Pisa syndrome (PS) or Pleurothotonus, a relatively uncommon condition, manifests as dystonia of the trunk and is potentially reversible with early intervention.

To describe PS following haloperidol decanoate injection in a treatment-resistant schizophrenia (TRS) patient, identify associated risk factors, and present therapeutic options.

We provide a comprehensive case description and perform a PubMed database search using the following keywords: “Pisa syndrome,” “dystonia,” “schizophrenia,” and “antipsychotic”.

A 54-year-old man with TRS, previously treated with 100 mg of haloperidol decanoate and 10 mg of olanzapine due to clozapine-induced myocarditis, exhibited hallucinatory delusional syndrome and behavioral disturbances. Neurological examination, lab tests, and brain imaging confirmed a psychotic relapse. Haloperidol decanoate dosage was increased to 150 mg. Four days later, the patient developed a trunk tilt that resolved after receiving anticholinergic treatment.Despite PS being more common in females and associated with brain conditions, this patient presented multiple risk factors, including prolonged typical antipsychotic treatment, advanced age, and an increase in antipsychotic doses. Discontinuing the causative antipsychotic or adding synthetic anticholinergics led to symptom reversibility.

PS is a rare occurrence. Understanding associated risk factors and frequently implicated medications is crucial for elucidating the phenomenon and managing the disorder

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Malondialdehyde (MDA) is a product of polyunsaturated fatty acid peroxidation (Del Rio D, et al. A review of recent studies on MDA as toxic molecule and biological marker of oxidative stress. Nutr Metab Cardiovasc Dis. 2005;15:316-28). It is a biomarker of oxidative stress and is involved in the pathophysiology of schizophrenia (Goh et al. Asian J Psychiatr. 2022;67:102932). Schizofrenia is linked to disrupted oxidative balance and inflammation (Więdłocha et al. Brain Sci. 2023;13:490). Prior research has shown connections between biomarkers and circadian rhythms in schizophrenia (Morera & Abreu. Acta Physiol Scand. 2007;43:313-14) and diabetes type 2 (Kanabrocki EL, et al. Circadian variation in oxidative stress biomarkers in healthy and type II diabetic men. Chronobiol Int. 2002;19:423-39). To determinate if MDA levels have a role in schizophrenia and follow a circadian rhythm may be useful.

The aim of our study is to compare diurnal and nocturnal MDA serum levels in patients in acute and stabilized phases of schizophrenia according to CIE-10 to find out if there are variations related with circadian rhythms

47 patients were included in our study in two clinical phases: acute episode and stabilization. Blood samples were collected at 12:00h and at 00:00h. MDA serum levels were measured twice: when patients were decompensated (admission) and at clinical stabilization (discharge). The relationship between quantitative variables at both times was analysed by T-Student test

There is no significative difference between night and day MDA levels in the acute phase of the schizophrenia (2.22±1.352 vs. 1.93±1.530, p<0.09). There is statistical significance between 12:00 and 00:00 (1.90±1.136 vs. 1.34±0.868, p<0.001) at discharge: it was observed that levels decreased. This result can be interpreted as there is circadian rhythm in stabilized phases.

MDA levels in patients with schizophrenia do not follow a circadian rhythm in the acute episode. When they are clinically stabilized present a circadian change. These patients lose the circadian rhythm in acute episodes. MDA circadian rhythm may help diagnose the clinical phase and its severity. It is necessary to perform more studies to know its utility as an oxidative biomarker

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Ekbom syndrome also known as Morgellons syndrome or delirium of parasitosis is a psychiatric condition where the patient has the absolute conviction of being infested in spite of medical evidence. Patients may even mutilate themselves or apply toxic substances in order to get rid of these hypothetical organisms. Sometimes they bring samples of these hypothetical parasites to the office to prove their existence, which is known as the “matchbox sign”, a pathognomonic finding.

The aim of this clinical case is to make visible the impact that this psychiatric condition can have on the patient’s quality of life

We present the case of a 40-year-old woman from Peru who was admitted to the otorhinolaryngology unit for injuries compatible with necrosis of the right pinna. When the patient was examined, scars were found on the lower limbs and back. The patient justifies the scratching lesions with the presence of pathogenic organisms, with no trace of them by the physician.

The patient was evaluated by psychiatry service during her admission in otorhinolaryngology, being diagnosed with Ekbom’s delirium and starting treatment with 3 mL of Aripiprazole. Subsequently she was referred to the mental health unit where she left the follow-up until today.

Different effective treatments have been described, among them pimozide, atypical antipsychotics and some SSRIs. However, the complexity of treatment arises when dealing with the irreducible idea that the patient has of being infested, refusing in most cases to receive psychiatric treatment. This can degenerate into major organic and psychological problems that turn the patient’s life into a real hell, which often end up losing much of their daily functionality. The fact of empathizing with the patient and trying to elaborate a plan adjusted to the reality and needs of the moment, can help us to establish a good therapeutic bond that facilitates an early start of treatment and greater therapeutic adherence, enabling a significant improvement in their quality of life.

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Mental state changes can affect one’s sexual life, while sexual dysfunction can lead to relationship challenges. Delusional jealousy, also called Othello syndrome, involves a paranoid belief in a partner’s infidelity, leading to controlling and violent behaviors. It can manifest as a paranoid disorder, as a delusional symptom of psychiatric, neurological or other medical conditions, or as side effect of dopaminergic medication. Although its exact prevalence remains uncertain, it has been identified in 0.5-1.4% of psychiatry inpatients.

To describe sexual dysfunctions associated with delusional jealousy and to explore strategies for addressing these dysfunction.

A non-systematic review of the literature available at PubMed was conducted using the keywords “Sexual Dysfunction” AND “Delusional Jealousy OR Othello Syndrome”.

A number of factors, including sexual dysfunction, can trigger or exacerbate delusional jealousy. This is especially true for middle-aged men who have a history of alcohol consumption, neurological or personality disorders. Individuals with sexual dysfunction experience feelings of insecurity, projecting these concerns onto their partners and suspecting extramarital relationships. On the other hand, sexual dysfunctions such as Hypoactive Sexual Desire Disorder, Female Sexual Arousal and Orgasmic Disorders, Erectile Dysfunction and Ejaculation Disturbance may occur as consequence of Othello Syndrome. Multiple factors contribute to these dysfunctions, including increased testosterone and cortisol levels, chronic alcohol use, comorbid psychiatric conditions and antipsychotics. There are reports of increased sexual desire, especially in cases of dementia.

Although the evidence is limited and dated, it points to a bidirectional association between delusional jealousy and sexual dysfunction. Further studies are essential to determine the prevalence and types of sexual dysfunctions in Othello syndrome, and the causal relationship between them. Additionally, investigating gender differences is crucial, given the male-centric focus of existing studies. This research can contribute to clinical care by promoting the screening for sexual issues and their integration into delusional jealousy management.

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Dementia is a clinical syndrome affecting 1-2% of the population under the age of 65, while at older ages the frequency doubles every five years. The clinical manifestations include memory loss, communication deficits, agnosia, apraxia and executive dysfunction.Schizophrenia is a complex, chronic mental disorder affecting approximately 1% of the population, presenting with disturbances in perception, thought and behavior.

To investigate the relationship between schizophrenia and later-onset dementia; more specifically to explore whether schizophrenia increases the dementia risk.

A review of 35 articles -from 2010 to 2023- on PubMed and Google Scholar regarding patients with schizophrenia or other type of psychosis, who later presented dementia.

Patients with a history of schizophrenia, schizotypal disorder, or delusional disorder are more likely to develop dementia.The greatest risk is presented in patients showing the shortest duration of psychotic symptoms (5 years or less), while at 5-10 years the probability of developing dementia decreases.The most common types of dementia occurring in psychotic patients are alzheimer’s disease (50-70%),vascular dementia (30%) and unspecified dementia (15%).Chronic patients (10+ years of symptomatology) are less likely to develop dementia. Psychotic patients over the age of 65 are more likely to develop dementia later in life, while individuals who develop schizophrenia after their 40s are three to four times more likely to present dementia compared to patients carrying a schizophrenia diagnosis before their 40s.Females with Late-Onset Schizophrenia have an increased dementia risk compared to males carrying the same diagnosis and compared to healthy females of the same age. Physical conditions implicated in the onset of dementia in schizophrenic patients include cardiovascular diseases, lung disease, substance and alcohol use, head injuries and diabetes.

According to data, there is a strong correlation between schizophrenia and dementia.However, the related studies are limited in number, while their results require further investigation because of limitations (small sample sizes, co-morbidities, selection of chronic elderly patients).Furthermore, most of these studies were conducted in Western countries, highlighting the necessity of pursuing additional research.

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Atypical antipsychotic (AAP) drugs are the gold-standard treatment for psychotic patients but are nowadays also widely prescribed among people with other mental disorders. Notwithstanding the benefits of AAP in terms of symptom improvement, there are severe adverse effects including the metabolic syndrome. A novel hypothesis is that part of these undesirable effects of antipsychotics could be mediated by their deleterious effects on the microbiome. This may result in dysbiosis, the disruption of bacterial species of the gut microbiota. Recently, dysbiosis has been linked to poor quality of life, depression and anxiety through the gut-brain axis. Mounting evidence proposes that prebiotic consumption may be helpful in the recovery of dysbiosis, although this effect is unclear among long-term antipsychotic users.

The main objective of this study is to assess the potential beneficial effects of the prebiotic Galacto-oligosaccharides (GOS) in combination with 2′-fucosyllactose (2’-FL) on the gut microbiota, by showing a relative increase in Bifidobacteria in fecal samples following intervention. The secondary objective is to assess the effects of GOS on mental wellbeing, sleep, and metabolic parameters. We hypothesize that GOS+2’FL supplementation will improve gut health, mental wellbeing, sleep, and metabolic parameters. Data will be collected 4 weeks prior to the start of the intervention during an observation only phase [t0], at baseline [t1], and after 2 [t2] and 6 [t3] weeks of GOS+2’FL intake. A follow-up will take place at week 10, 4 weeks after the intervention [t4]. Other outcomes that are assessed include the FiberScreen tool, the form of human faeces (Bristol Stool Chart), side effects and the defined daily dosis (DDD) of antipsychotic medication.

The study is a single-arm pilot study (non-randomized and non-blinded). We aim to include 30 psychiatric patients on long-term atypical antipsychotic use, irrespective of their specific psychiatric disorder, with a BMI > 25 kg/m2. Following a run-in period of 4 weeks (no intervention but all other aspects of the study), the participants will consume GOSplus (7.0 g BiotisTMGOS + 0.7 g 2’-FL) daily during the first consumption moment of the day (preferably in the morning) for 42 days. The GOSplus powder has a slightly sweet flavour. The primary endpoint is the change in Bifidobacteria in fecal samples from week 0 to week 6.

The study started recruiting participants in October 2023.

Conclusions are expected by the end of 2024.

None Declared

Despite improvements and innovation in recent years, people living with schizophrenia face variations in access to optimal treatment and care. There is a lot about schizophrenia that is not fully understood, and the high-quality care and support needed by people living with this condition is often unavailable.

Develop an evidence-based, compelling policy narrative on schizophrenia Engage a pan-European, multidisciplinary group of experts Offer concrete tools to patient and professional advocacy groups Disseminate findings Draw from our findings practical solutions on how to implement recommendations

Based on carefully selected existing literature and available resources, literature review includes but is not limited to: Value of Treatment Recommendations, Global Burden of Disease Study, Comprehensive Mental Health Action Plan, Mental Health Atlas. The aim is to establish state of play, identify problems and solutions and take stock of current recommendations.

We established a multi-disciplinary working group to lead the project, and ensured that representation on this group is cross-disciplinary and cross-sector. The expert group includes country-level patient advocates and clinical leads including key opinion leaders (KOLs) to keep the project focused on what is happening at a national level, and to help create ownership at the national level to take recommendations forward within each country.

We conducted qualitative semi-structured interviews with people living with schizophrenia where they provided their insights into how to rethink the way we deal with schizophrenia.

Provide clear, concrete and adaptable solutions Joint ownership by key stakeholder groups of a common policy narrative on schizophrenia Sustained policy engagement on schizophrenia at the EU and national level

There is a clear need to rethink the management of schizophrenia and redesign the care pathways to ensure optimal treatment and care for all people living with schizophrenia in Europe. Based around patient testimonies, the aim of the session is to highlight the need to optimise the way we manage schizophrenia by building a strong, coherent, evidence-based policy narrative which speaks to the current priorities in schizophrenia and draws from the current policy landscape in Europe.

Experts involved in the Rethinking Schizophrenia project, coordinated by the European Brain Council, have explored the ways in which we can and need to change the way we deal with schizophrenia. The Rethinking Schizophrenia project falls under the Rethinking the management of brain disorders series, research-driven projects offering policy recommendations to make tangible changes with the aim to improve the lives of people living with brain disorders, neurological and mental alike, across Europe.

None Declared

Patients with schizophrenia confront with stigmatization in their everyday life. Differences in their perception of stigmatization based on the number of hospitalizations and duration of treatment are unsufficiently researched.

Our aim was to investigate whether patients with first-episode schizophrenia differ in their perception of stigmatization from schizophrenia patients with more than one hospitalization,

A consecutive sample of 120 stable outpatients (70 males, 50 female) diagnosed with schizophrenia were included in the study. Diagnosis of schizophrenia was established with Neuropsychiatric Interview. First episode patients consisted 28.3% of the group.

All patients were at least once hospitalized for mental illness. Patients were dichotomised based on the number of hospitalizations.

The study was approved by Ethic committee of the institutions. Stigma was assessed with Internalized Stigma of Mental Illness (ISMI) scale.

ISMI scale contains 29 Likert items rated on a 4-point scale ranging from “strongly disagree” to “strongly agree”. It contains five subscales: Alienation, Stereotype Endorsement, Discrimination Experience, Social Withdrawal and Stigma Resistance. The overall internal consistency for the global ISMI was 0,89; Alienation-0,76; Stereotype endorsement- 0,63; Discrimination- 0,72; Social withdrawal- 0,57.

All analyses were performed using the SPSS 25.0. The differences between groups on continuous variables were evaluated using t-test with Bonferroni correction. For all analyses, the level of statistical significance was defined as an alpha less than 0.05

There were no differences in first-episode and more episode patietns in ISMI and its subscales. Number of hospitalizations was associated with Stereotype endorsement subscale (r=228;p=0,012) Age was correlated with stigma.

Although stigma did not differ between first-episode patients and patients with two or more hospitalizations, stereotype endorsement was strongy associated with the number of hospitalizations leading to conclusion that stigma is associated with psychiatric treatment and our aim must be to destigmatize the treatment and avoid hospitalizations.

None Declared

In recent decades, there has been increasing interest in neurocognitive function, including non-social and social cognition. Cognitive impairment has a significant impact on functional outcome, especially in schizophrenic disorders, but also in affective and other psychiatric disorders.

It is our aim to present the assessment and measurement of cognitive dysfunction through adequate instruments and to evaluate the effects of combining pharmacotherapy and cognitive remediation.

A review of the modern literature is undertaken and results of own investigations using the Screen for Cognitive Impairment in Psychiatry (SCIP, Sachs G et al. Schizophr Res Cogn. 2021 May 12;25:100197; Sachs G et al. Schizophr Res Cogn. 2022 Jun 6;29:100259) are presented and evaluated.

Our data show that it is possible to capture cognitive dysfunction in clinical practice.

After a differentiated assessment of cognitive dysfunction, a specific combination of pharmacotherapy and cognitive remediation should be applied to patients with schizophrenia and affective disorders.

None Declared