1.Introduction MDD is a heterogeneous disorder, with a wide variety of symptoms and inconsistent treatment response, and is not completely understood. A dysregulated stress system is a consistent finding, however, and exhaustion is a consistent trait in adolescent patients. In order to open up our thinking about MDD we take up the challenge to reframe depression, specifically focusing on the possible role of the Microbiota-Gut-Brain-Axis in the etiology of MDD.

We propose a ‘bidirectional feedback hypothesis’: microbiota can promote or inhibit a pro-inflammatory state, (in)directly altering the hypothalamic pituitary adrenal (HPA) axis response and the microbiome and further increasing or decreasing its pro-inflammatory state. The aim is to show that the pro-inflammatory state is an integral part of a HPA axis stress spiralling mechanism that plays a role in the etiology of MDD.

A systematic review based on publications from PubMed, Embase and PsycInfo

The etiology of MDD can be understood as sliding down a spiral. This stress spiralling mechanism can be promoted or inhibited by: 1.factors such as a poor lifestyle or (pre-existing) illness 2.bettering someone’s lifestyle, coping behavior or providing pro-/prebiotics in combination with personalised therapeutics.

We argue that an interdisciplinary One Health approach is the most promising preventive and therapeutic option for MDD.

No significant relationships.

In major depressive disorder (MDD), reward-based decision-making (DM) is frequently impaired: e.g. patients don’t engage in pleasant activities as much as healthy subjects. Put differently, previous and expected future rewards have less reinforcing effects on DM. This study investigated two experimentally well-observable reward-based DM modes, namely model-based (based on cognitive models of the environment) and model-free (based on previous experience) DM.

We hypothesized that model-based training can improve reward-based DM in patients with MDD. Answers to these questions could enhance the development of cognitive-behavioral therapeutic interventions.

27 patients with MDD were recruited and assessed with psychometry. All patients performed the „two-step Markov decision-task“ (Daw, 2011), which allows the simultaneous investigation of model-based and model-free DM via computational modelling. All subjects performed the task 4 times: at the beginning and at the end of 2 assessment days (session-interval: 4 days). Subjects were randomly allocated to an intervention group, which performed model-based training, and a control group, which performed model-free training. The main outcomes of training effect were the influence of model-based reward expectations on decisions (quantified by computational modelling parameters) and overall monetary reward-success.

In all patients, the influence of model-based reward expectations on decisions increased after training. However, there was no significant effect of group allocation. Furthermore, patients in the intervention group did not achieve significantly higher overall monetary reward.

Results suggest that in MDD, the influence of model-based reward expectations on decisions can be improved regardless of specific training type. Future studies should investigate the effects on everyday functioning.

No significant relationships.

ICD-11 describes Gaming disorder as a behavioral pattern characterized by impaired control over gaming, increased gaming priority, and escalation despite consequences. This description is similar to other addictive behaviors with minor specifics. However, it is unclear if gaming disorder has any specific psychopathological profile.

The study aimed to investigate gaming disorder’s connection to primary psychopathological symptomatology.

515 gamers aged 16-56 (75% male) anonymously completed online questionnaires: SCL-90-R and Video Games Addiction Scale (VGAS) – our new 26-items questionnaire based on ICD-11 criteria for gaming disorder. VGAS showed good reliability (Cronbach`s α=0.858) and external validity (positive correlation with Chen Internet Addiction Scale, r=0.472, p=0.000).

Gaming disorder severity showed positive correlations (p=0.000) with all SCL-90-R scales. Pearson`s r ranged from 0.311 (phobic anxiety) to 0.431 (depression). Thus, gaming disorder showed no specific combination of psychopathological symptoms. Instead, all symptoms had almost equal correlations with the VGAS score.

Gaming disorder is not linked to any particular combination of psychopathological symptoms. On the contrary, as suggested by our study, different symptoms are almost equally related to excessive gaming. Several interpretations are possible. Problematic gaming can be a way for psychologically distressed people to deal with different symptoms. Conversely, gaming disorder can itself lead to psychological maladjustment. Thus, further thorough research is required, specifically when deciding on the primary diagnosis in comorbid cases or choosing the therapeutic aims.

No significant relationships.

No significant relationships.

Among psychosocial interventions, recent studies have highlighted that sport-based interventions can positively impact on the long-term outcomes of patients with severe mental disorders, in terms of improving their quality of life and promoting social inclusion. Although sport-based interventions should be considered an effective strategy for promoting patients’ recovery, few data are available on their dissemination in the clinical routine care in Europe.

to evaluate the availability of sport-based psychosocial interventions in European countries.

In the framework of the EU-Erasmus+, the European Alliance for Sport and Mental Health (EASMH) project has been funded. In order to evaluate the availability of sport-based interventions, an ad-hoc online survey, sent to national mental health centres, has been developed.

103 responses were obtained (49 from Italy, 31 from UK, 17 from Finland and 12 from Romania). The respondents were mainly psychiatrists working in community mental health centers. Sport-based interventions were frequently provided by mental health services, in particular in Italy, UK and Finland. While in UK and Finland sport-based interventions are commonly offered to all patients, in the other countries these are provided only by patient’s request. The most frequent types of sport practised were: running, football, volleyball, tennis and table tennis and basketball. Almost all respondents reported to not use a dedicated monitoring tool for evaluating the efficacy of those interventions.

Sport-based interventions are not frequently provided in the routine clinical settings, although no monitoring tools are routinely adopted. The EASMHaims to fill this gap by disseminating good clinical practice related to sport-based interventions.

No significant relationships.

Among non-communicable diseases, depression is a leading cause of morbidity in elderly people with varying magnitude across countries. No systematic review and meta-analysis has yet examined the pooled prevalence of depression among elderly in Africa.

The current systematic review and meta-analysis aimed to estimate the pooled prevalence of depression among elderly people in Africa.

We have searched CINAHL, PubMed, SCOPUS and Psych-iNFO databases to identify observational studies which reported the prevalence of depression among the elderly. We used a random-effects model due to reported heterogeneity among the studies. The publication bias was examined by using egger’s test, visual inspection of the symmetry in funnel plots and adjusted using Trim and Fill analysis. We used Cochran’s Q and the I2-tests to measure heterogeneity across the studies.

A total of 23 studies conducted in Africa were included in the current systematic review and meta-analysis, representing a total of 14, 350 elderly population. The pooled prevalence of depression among elderly people in Africa was estimated to be 26.3% (95% Ci; 22.2, 30.4%). The estimated pooled prevalence of depression among the elderly in Africa was much higher (43.1%) in studies that used a screening tool to measure depression when compared to studies that used a diagnostic tool (24.2%). Also, the prevalence of depression among female elderly participant (43.10%) was higher than that of male elderly participant (30.90%).

One in five elderly population in Africa were depressed. Timely and targeted screening of depression among the elderly and evidence-based interventions were highly recommended.

No significant relationships.

Psychiatric Inpatient units are important resources of the mental health network. These units have elevated costs, so it is important to get to know some factos that might mediate the lengh of stay in these units.

Psychiatric Inpatient units are important resources of the mental health network. These units have elevated costs, so it is important to get to know some factos that might mediate the lengh of stay in these units.

An observational and descriptive analysis of the sample of patients between 12 and 17 years-old, that were admitted to the inpatient mental health unit since its opening on April 2021.

205 patients were admitted April 2021 until October 2021. The most common reason for admission (RFA) was suicidal ideation/attempt (57.07%), eating disorders (15.1%), mood disorders (11.2%), conduct disorders/challenging behaviors (7.8%) and psychosis (7.3%). Adolescents with eating disorders had the longest length of stay, with an average of 23.8 days. They were followed by those suffering from psychosis (17.8 days) and suicidal ideation/attempts (17.1 days). Mood disorders average length of stay was 15.1 days and conduct disorders/challenging behaviors was the shortest one with a LOS of 12.5 days.

Adolescents with eating disorders seem to need longer lentgh of stay, what differs from Zeshan et al study that concludes that patients with schizophrenia might need longer LOS. Nevertheless, just as Zeshan et al study, we conclude that patients admitted with conduct disorders/challenging behaviors have the shortest LOS.

No significant relationships.

The transition into parenthood is associated with an increased psychopathological vulnerability. Most studies have focused on mothers, although recently, the role of fathers has grown more importance. Paternal perinatal depression (PPD) is an episode of major depressive disorder occurring in new or expectant fathers during the perinatal period. PPD is not widely acknowledged and research are rare.

The authors intend to review the literature about PPD, focusing on its prevalence, risk factors, clinical features, treatment and consequences.

Non-systematic review of the literature through PubMed.

A meta-analysis of PPD estimated a prevalence of 10.4%. Risk factors of PPD are multiple and complex. There are sociodemographic factors, such as marital status, monthly income and social support. Psychological factors, for instance history of depression, maternal prenatal anxiety and maternal depression. Some literature also suggests hormonal changes on men like increase estrogen and lower testosterone levels. PPD can present with symptoms of mood alterations, like irritability and restricted emotions, anxiety, fatigue, insomnia, loss of appetite. Also common are behavioural disturbances such as interpersonal conflicts, impulsivity, violence, avoidance behaviour, and substance abuse. There are no studies to specific treatments to PPD, so the treatment is the same for women, such as antidepressants and psychotherapy. If untreated, PPD can have an adverse influence on the health and wellbeing of the mother and child.

PPD is still underscreened, underdiagnosed and undertreated. It is fundamental identifying risk factors and the development of specific interventions. Further research on PPD is needed.

No significant relationships.

Previous studies suggest that individuals with tattoos and piercings exhibit higher impulsive personality traits compared to peers without body modifications. No studies on body modifications and core-symptoms of ADHD are available.

This study aimed to compare self-reported ADHD symptoms between non-clinical adults with and without body modifications.

A non-clinical adult Swedish population (n=815) completed the Adult ADHD self-report scale (ASRS-v1.1) and answered questions concerning body modification. ADHD diagnosis served as exclusion criterion. Three grouping variables were analysed separately; tattoo status, piercing status and a combination of having both tattoo and piercing. Linear regression compared mean ASRS total- and subscale scores between individuals with and without body modification according to each grouping variable, while adjusting for candidate covariates age and sex.

The prevalence of each body modification variable was; 30% for tattoo, 18% for piercing other than earlobe and 12% for combination of tattoo and piercing. Any combination of body modification was associated with significantly higher ASRS total- and subscale scores compared to no body modification. The most pronounced differences between groups were for the combination of tattoo and piercing, and on the hyperactivity/impulsivity (HI) subscale; revealing adjusted mean differences of 4.3 points (range 0-72) on the ASRS-total score (p <0.001) and 2.6 points (range 0-36) on the ASRS HI subscale (p <0.001).

Body modification was associated with more pronounced ADHD core symptoms amongst non-clinical adults. Although statistically significant, the clinical significance is uncertain. The prevalence rates of body modifications in our cohort indicate that they are becoming cultural normal.

No significant relationships.

Adolescence, when physical body image changes occur, is highly vulnerable to the development of eating disorders. At this age, there is an acute task of accepting oneself as another - an adult who has changed.

To study the features of the image of an adult in young people with eating disorders.

The study involved 58 girls (from 17 to 22 years old). The main group included 31 people with a high risk of eating disorders, the control group - 27 people with an average and low risk. Respondents filled in: Taylor Manifest Anxiety Scale, Eating behavior rating scale, projective drawing of an adult and child, association test about words «adult» and «child»

1. A high level of personal anxiety was revealed in the main group; 2. The visualized image of an adult in the main group has more distortions and fewer signs of gender identification than in the normal group; 3. Semantic ideas about adulthood in the main group are negatively emotionally colored and include categories related to eating behavior; 4. Semantic ideas about childhood in the main group are more negatively emotionally colored, and ideas about the present are more connected with appearance than in the control group. Semantic ideas about the future in this group are often negatively colored.

Figurative and semantic ideas about childhood, adulthood and about oneself in the present and in the future in girls with eating disorders have qualitative characteristics in comparison with the control group.

No significant relationships.

The COVID-19 pandemic and the lockdown brought about a sense of fear and anxiety around the globe. This phenomenon led to both short and long term psychosocial and mental health implications for children and adolescents.

To evaluate the effect of COVID-19 pandemic on hospital admissions for suicidal ideation in a Portuguese adolescent and young adult psychiatry service.

We conducted a single-center, retrospective study including adolescent and young adult patients (15-25 years old) admitted to our service with suicidal ideation within a year before and a year after the declaration date of SARS-CoV-2 disease as a pandemic. Patients were divided in two groups: Group A - patients admitted before the pandemic (March 11, 2019 and March 11, 2020) and Group B – patients admitted after the pandemic declaration (March 12, 2020 and March 12, 2021). The groups characteristics and outcomes were assessed and compared.

A total of 647 admissions were assessed (Group A, n= 372 and Group B, n=275). Demographic characteristics were similar between groups. 75 patients (vs 25 patients) were admitted with suicidal ideation in the year before the pandemic. There was a lower proportion of patients admitted with suicidal ideation during the year after the pandemic year - OR 0.374 (95% CI 0.228-0.614, P<0.001).

Our study showed a decrease in admissions for suicidal ideation in this service in the year after the pandemic. More studies are needed to understand the factors that may justify this decline and evaluate the longer effects of this pandemic in mental health.

No significant relationships.

Reflection on the impact of this law on people with a Mental health disorder is required. It is a complex issue, in which it must be considered that these disorders are very prevalent, can greatly affect the quality of life and are often resistant to treatment.

Explore the first request of this type and review aspects to consider in patients with mental health disorders.

Collection of data from the first patient who requests it and review related aspects.

This is a patient with a personality disorder who presents significant suffering, in a chronic context, but at the same time makes the request in a moment of crisis as an impulsive gesture.

Pending evolution, we consider that it is difficult to assess compliance with the requirements of the law in patients of this type and we recommend caution.

No significant relationships.

The 5-HT2A agonist classic psychedelic, psilocybin (O-phosphoryl-4-hydroxy-N,N-dimethyltryptamine) is a tryptophan, indole-based alkaloid present in up to 2% of certain hallucinogenic “magic” mushroom species; typically Psilocybe azurescens, semilanceata, and cyanescens,. In addition, mushrooms may contain psilocin (4-hydroxy-N,N-dimethyltryptamine). Both are indolylalkylamines (tryptamines); other naturally occurring tryptamine compounds include norbaeocystin, baeocystin, norpsilocin, and aeruginascin. A putative synergistic contribution of these compounds has been referred to as the “entourage” effect. Aeruginascin (N,N,N-trimethyl-4-phosphoryloxytryptamine) is found naturally in Inocybe aeruginascens and Pholiotina cyanopus mushroom species and ingestion reportedly invokes elevation in mood without accompanying hallucinogenic effects:

To review the pharmacology of aeruginascin and putative entourage effect.

The extant literature on aeruginascin was reviewed and discussed.

Methylation of aeruginascin results in an active metabolite, 4-hydroxy-N,N,N-trimethyltryptamine (4-HO-TMT) which has been shown to bind at 5-HT1A, 5-HT2A, and 5-HT2B receptors with Inhibition Constants (Ki) of 4400, 670, and 120 nM respectively; compared with psilocybin’s binding of 567.4, 107.2 and 4.6 nM respectively. Further, 4-HO-TMT does not bind at the 5-HT3 receptor, and as a quaternary trimethylammonium compound it is less likely to be able to cross the blood-brain-barrier (BBB).

There are very limited data with respect to the pharmacology of aeruginascin. Its activity at serotonin receptors is less by several orders of magnitude than psilocybin and it has potentially less brain penetrance. Given that it is found in different mushrooms species the data would suggest that its direct contribution to any entourage effect is limited. Further research in needed into other naturally occurring tryptamine compounds.

PC is a member of the Scientific Advisory Board of Zylorion. AA, EB, JC, CE have no disclosures to report.

No significant relationships.

In current clinical practices, there exist very few methods that allow patients to be truly engaged in violence risk assessment and management. This may hinder an individual’s experience of basic psychological needs; autonomy, competence, and relatedness.

To describe patients’ ideas on how they would develop current violence risk assessment and management practices.

The data collection took place as part of a larger project in one PICU unit specialized in the treatment of patients with psychosis and violent behavior in Finland. Individual interviews were conducted with patients (n=13) and were guided to focus on the development of violence risk assessment and management. The data were analyzed using inductive content analysis.

Patients’ ideas focused on themes related to developing patient engagement and violence risk management methods. Developing patient engagement involved noticing patient’s individuality and collaboration between a patient and staff: for instance, by shared risk assessment and individualized risk management. Developing violence risk management methods included themes about providing alternative risk management methods and developing nursing staff’s work. Suggestions were, for example, related to providing ways how to calm down, having meaningful activities during treatment days, and ensuring the realization of patient’s rights.

Patients having treatment in the PICU unit have clear and concrete ideas on how violence risk assessment and management methods could be developed further. These findings indicate, that patients need to be given a more active role in their care and thus ensure that basic psychological needs are promoted. Funding by Academy of Finland (316206 ) and TYKS foundation.

No significant relationships.

Alcohol and (illicit) substance abuse are among the most common psychiatric disorders within the general population and their impact can not be underestimated. Reputedly for these disorders, there is a large treatment gap and treatment delay, i.e. large numbers of afflicted individuals never receive appropriate treatment and if they do so often many years after the onset of the disorder. The Covid19 pandemic has only aggravated these gaps. In many countries, due to the Covid 19 pandemic and its associated restriction measures telepsychiatric tools have become increasingly implemented (and funded) as regular parts in the possibilities in delivering interventions. With respect to substance abuse treatment, a vast body of research already showed promises both in the field of telepsychiatry as broader the use of digitalization (e.g. the use of virtual reality designed treatment interventions, digital monitoring). In the current presentation, an overview will be presented of both telemental health interventions and digital tools/interventions in the field of substance abuse treatment.

No significant relationships.

The use of social networks is an integral part of our daily life as a means of communication. Scientific dissemination through these kind of platforms has expanded enormously in recent years, for example in networks such as Instagram, a free photo, text messaging and video sharing social media application. Instagram has been used extensively in different fields of medicine. Initially it was limited to visually rich fields but it has been extended to others such as mental health. This tool has enormous potential as a means of more effective communication and prevention.

To analyze the role of Instagram as a tool of psychoeducation and prevention in mental health

An analysis of different mental health profiles was carried based on different items: publications, interactions, likes, commentaries, shares, accounts reached, accounts engaged and hashtags.

Mental health has become one of the sanitary fields generating more traffic on social media reaching a great number of publications per day. Topics that generated more interaction were: depression, anxiety, trauma, sleep and emotion regulation difficulties among others. However most mental health information available in social media had not been provided by proffessinals of the mental health but by many others.

Instagram is presented as a valuable mental health prevention tool and professionals should engage and adapt to new scenarios of communication. In the era where information is easy to get but knowledge is difficult to find, experts of mental health should more involved.

No significant relationships.

TikTok is a free mobile application, that enables users to create short videos. TikTok has an estimated one billion monthly active users, comprised of a mostly younger audience. There has been a noticed rise in content discussing ADHD – hashtag ADHD on TikTok has 6.3 billion views. The discussions continue on Twitter, where users are reporting watching TikTok content explaining ADHD symptomatology, subsequently relating to the condition and requesting referrals to specialist psychiatry services. This study aims to identify key themes in discussions around TikTok and ADHD, and its ramifications.

This study’s objective is to discuss the relationship between viewing ADHD content of TikTok and self-diagnoses of ADHD in young people.

In our study, Twitter posts were identified with the words ‘ADHD’ and ‘TikTok’ and established key themes relating to self-diagnosis of ADHD.

Numerous tweets were found discussing individual’s experiences of self-diagnosis of ADHD after watching TikTok videos and relating with the symptomology. Furthermore, many users discussed their efforts to seek diagnosis from psychiatrists. These posts highlighted positive discussion of mental health, and the improvement in quality of life since diagnosis.

Many young people are self-diagnosing ADHD after viewing TikTok videos. This may improve mental health stigma, however the expertise of the video creators should be scrutinised. Furthermore, the impact on already stretched waiting lists should be considered, with individuals who’s perceived ADHD traits are not impacting on their quality of life.

No significant relationships.

The Covid 19 pandemic has had an enormous psychological impact in which women were mentally more affected than men (Berthelot et al 2020 - Liu et al 2020). More over it exacerbated symptoms and suffering in individuals with psychiatric disorders. The question is how did it affect individuals with autism (ASD). And if so, did it affect women and girls more that men and boys or differently.

To evaluate the impact of the covid 19 pandemic and the subsequent lockdown in patients with ASD

a combination of literature review and assessement of the population of individuals with autism spectrum disorders in a large specialized unit for individuals with ASD

No seperate reports on individuals with ASD were found in the recent literature. Obviously the pandemic and confinement had great impact on individuals with intellectual disabilities amongst whom many individuals with comorbid developmental disorders as ADHD and/or Autism (e.g.Palacio-Ortiz et al 2020 - Guessoum et al 2020) In our population some remarkable outcomes were noted in the sense that a substantial part of the population with autism had positive experiences: e.g. clear social rules / less contact. Males enjoyed more online contact and games / experienced less loneliness - In females we found significantly more depressive symptoms, anxiety and suicidal behaviour.

Covid 19 has had a great psychological impact with marked gender differences. Remarkably in ASD men enjoyed some of the benefits of the confinement. In women with ASD the emotional impact was significantly higher.

No significant relationships.

Clinicians often do not have experience assessing perinatal patients unless they work as part of a perinatal team. Informal feedback points to a lack of confidence in performing perinatal assessments.

The aim of the project was to assess clinicians’ confidence in performing perinatal assessments in outpatient and inpatient settings including the Emergency Department. Additionally, we wanted to assess whether access to a perinatal assessment tool was beneficial. We hypothesise that clinicians lack confidence in performing perinatal assessments and would benefit from using a perinatal assessment tool.

We designed a survey of 10 questions assessing the above. The survey was sent out to psychiatric trainees and nurses at South London & Maudsley NHS Foundation Trust. The participant’s confidence in completing perinatal assessments in various settings was assessed using a 5 point Likert scale.

52 responses were received. 50% of participants felt not so confident in performing perinatal assessments in the outpatient setting. 40.38%(n=21) of participants felt not so confident in exploring the mother and foetal relationship. 71.15% (n=37) of participants felt that they would benefit from additional teaching with 48.1% of participants citing that they would benefit from access to an assessment tool.

As predicted, the results of the survey show that clinicians lack confidence in performing perinatal assessments. Therefore, we have commenced work on modifying the existing Stafford Interview. This is a structured interview that explores the obstetric and psycho-social background and psychiatric complications of pregnancy. The survey is due to be replicated in other project locations to allow transcultural comparison.

No significant relationships.