The 2019 WHO report on suicide warned of a serious public health problem. It was found that suicide is a serious problem for global public health, causing approximately 703 thousand deaths every year. Self-extermination is among the leading causes of death worldwide, with more deaths than from malaria, HIV/AIDS, breast cancer, war and homicide. More than one in every 100 deaths (1.3%) in 2019 were the result of suicide.Suicide is the fourth leading cause of death in older adolescents (15–19 years). Risk factors are multifaceted and include harmful use of alcohol, which includes abuse during childhood, stigma against seeking help, barriers to accessing care and means of suicide.The total number of deaths due to self-extermination registered in the adolescent population in the period from 2016 to 2021 was 6,588. According to the WHO director-general, “attention to suicide prevention is even more important now, after many months of living with the pandemic and many of the risk factors, such as loss of employment, financial stress and social isolation, still very present.” Therefore, suicide prevention work with young adolescents in Rocinha, one of the largest slums in Rio de Janeiro, is extremely important, given the increase in suicide rates and mental health problems in this age group. This approach must be thoughtful, culturally sensitive, and involve a range of strategies to address the complex issues affecting adolescents in the community. The Community of Rocinha was chosen to host this prevention project.

Create a preventive event by surveying participants’ opinions, integrating, welcoming and deconstructing stigmas about suicide.

This study investigated, in a population of 140 young adolescents with cultural differences in a theater class, their level of knowledge regarding relevant information about suicide. A structured questionnaire was presented and answered before and after a lecture, resulting in a class at the end, carried out by the young participants themselves. The scenes were filmed and a film produced. This dynamic process also included the distribution of a shirt alluding to the fact, making the participants multiplier references.

The results of the lecture showed a significant improvement in mental health awareness and willingness to seek help among young people, totaling a 20% increase in knowledge.

Students attended the event in significant numbers, taking into account that the slum had a curfew due to armed conflict. The results of the lecture showed a significant improvement in mental health awareness and willingness to seek help among young people, totaling a 20% increase in knowledge. The young people reported a feeling of support and belonging to the community, highlighting the importance of the debate in a final lecture given by them.

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Autobiographical memory is known to be disturbed in schizophrenia. In addition, a leading theory of auditory hallucinations (AVH) is that they are intrusive – typically negative – autobiographical memories that are misinterpreted as perceptions.

The aim of this study was to examine the brain functional correlates of recall of negatively emotionally valanced autobiographical memories in patients with schizophrenia, with a longer term aim of comparing patients with and without AVH.

11 patients meeting DSM-5 criteria for schizophrenia or schizoaffective disorder and 10 age, sex and estimated premorbid IQ-matched healthy controls have so far taken part.

Participants underwent functional MRI in a 3T scanner while performing a task requiring them to recall autobiographical memories in response to individually tailored pairs of cue words. The cue words were based on autobiographical memories previously elicited in an interview with each patient and were designed to evoke the same memory. The cue words were presented in 10 20-second blocks interspersed with blocks where the subjects viewed cue words that did not evoke autobiographical memories. Brain activations were examined in three contrasts of interest: memory evoking words vs baseline, neutral words vs baseline and memory evoking vs neutral words.

Pre-processing and analysis were carried out with the FEAT module included in the FSL software. Statistical analysis was performed by means of a General Linear Model (GLM) approach.

In the memory evoking vs baseline contrast the patients showed hypoactivation in the medial frontal cortex compared to the healthy controls (Figure 1). There were no differences in activation between the patients and the controls comparing the memory evoking and neutral cues.

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The finding of hypoactivation in the medial frontal cortex compared to low level baseline in patients with schizophrenia suggests dysfunction in the default mode network, which is known to activate during recall of autobiographical memories.

These preliminary results suggest that recall of negative autobiographical memories in patients with schizophrenia is associated with reduced activity in the default mode network. A planned larger sample of patients and controls will be used to examine activations in patients with and without AVH.

None Declared

Children with non-syndromic orofacial clefts are at higher risk for developmental difficulties. Speech and language as commonly affected developmental domains in these children.

The aim of the current study was to explore the effects of early interventions for speech and language on later cognitive outcomes in this patient population.

A combined retrospective/prospective-comparative study was carried out at the Department of Pediatrics of the University of Pécs in Hungary. The participants were children between 6 and 16 years of age. The study consisted of a self-designed demographic questionnaire and an IQ test (WISC-IV).

A total of 41 children with non-syndromic orofacial clefts and 44 age-matched controls participated in the study. Children of the cleft group were examined by pedagogical professional services and required special education plans significantly more often than controls (p<0.001 and p=0.02, respectively). Participants of the cleft group who received early speech and language therapy score higher on the Verbal Comprehension Index (p=.005). Full-Scale IQ score was also higher for cleft participants who received therapy, however not significant but borderline (p=0.08).

Early language and speech interventions for children with non-syndromic orofacial clefts may have a positive effect on verbal skills and overall cognitive development. Future longitudinal studies examining baseline cognitive functioning of infants are needed to provide more conclusive evidence on the effects of interventional programs on speech and language development in cleft patients.

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Subclinical psychotic experiences (PEs) are far more prevalent than psychotic disorders, with an estimated prevalence of 7.2% (Linscott & Van Os. Psychol Med 2013;43(6) 1133-1149). PEs are particularly prevalent in late adolescence and young adulthood, when obtaining academic education is one of the main developmental tasks. University students are at the peak age of onset of mental disorders, and often experience high levels of social and academic stress that may contribute to the onset of psychopathology. Hence, estimating the prevalence and correlates of PEs among university students is particularly important.

To estimate the prevalence of PEs in a sample of Israeli students; assess whether rates of PEs differ by selected sociodemographic characteristics; and examine the association between PEs and non-specific psychological distress.

150 students from universities and colleges in Israel participated in a cross-sectional online survey. All students were over the age of 18 and were not diagnosed with psychotic disorders. Participants completed self-report questionnaires, including the Prodromal Questionnaire - Brief Version (PQ-B), Kessler Psychological Distress Scale (K10) and sociodemographic details. The PQ-B yields a score for the total number of items endorsed (range 0–21), and a total distress score (range 0–105). A cutoff of ≥8 distressing symptoms was used to identify participants at high-risk for psychosis.

21 participants (14.0%) reported 8 or more distressing PEs. PEs were more common in males and among those with a psychiatric illness (Table 1). PEs were not associated with marital status, religiosity, or immigrant status. While a greater number of PEs was positively associated with non-specific psychological distress (r=0.589, p<.001), there was no association between distress caused by PEs and non-specific psychological distress (r=0.145, NS).Table 1.

Sociodemographic characteristics by group

The findings confirm that self-reported PEs are much more prevalent than clinically diagnosed psychotic disorders, particularly among young adults. As PEs were found to be associated with non-specific psychological distress, and as they are known forerunners for severe mental disorders, it is important to address mental health issues in school settings and promote prevention and early intervention programs.

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The United States of America are currently facing a public health crisis characterized by the abuse of synthetic opioids, notably Fentanyl, and the veterinary sedative Xylazine. While each of these substances has been associated with significant risks, their current misuse presents a formidable challenge to healthcare professionals, law enforcement agencies and policymakers. While the opioid epidemic has long held the nation in its grip, the emergence of Xylazine as complementary agent in substance abuse has added a disturbing layer of complexity to an already terrible situation, due to its cost-cutting, an increase in its addictive properties and its ability to extend the duration of the opioid with which it is combined.

The authors intend to review the relevant and current literature in order to extend the knowledge about this condition and find the best conducts for clinical practice.

Non-systematic literature review

Various regions of the United States are facing a troubling surge in the co-abuse of Fentanyl, a potent synthetic opioid many times more potent than morphine, and Xylazine, a veterinary sedative and muscle relaxant, particularly in urban areas. The motivations for this combination appear to vary, ranging from the enhanced euphoria to cost-saving measures, further fueling its prevalence. However, the consequences are devastating. Both substances depress the central nervous system, with a sharp increase in overdose deaths and emergency medical services are strained to their limits in responding to these crises. Law enforcement agencies are facing a daunting task in curtailing the distribution of these substances, often grappling with clandestine networks that exploit the accessibility of these drugs.

The concurrent abuse of Fentanyl and Xylazine represents a critical public health challenge in the United States of America, demanding immediate attention and a multidisciplinary response. Failure to address this issue comprehensively will have profound implications for the well-being of individuals, families and communities across the nation. It is imperative to mobilize resources, foster interdisciplinary collaboration and develop evidence-based policies to combat this dual-threat crisis. Novel intervention strategies, including community education programs, targeted outreach efforts, and supervised consumption facilities, are urgently needed to address this complex issue.

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Forensic psychiatric services address the therapeutic needs of mentally disordered offenders in a secure setting. Clinical, ethical, and legal considerations underpinning treatment emphasize that the Quality of Life (QOL) of patients admitted to forensic hospitals should be optimised.

This study aims to examine changes in the QOL in Ireland’s National Forensic Mental Health Service following its relocation from the historic 1850 site in Dundrum to a new campus in Portrane, Dublin.

This multisite prospective longitudinal study is part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST). Repeated measures were taken for all inpatients in the service at regular six-monthly intervals. The WHOQOL-BREF questionnaire was offered to all inpatients and an anonymised EssenCES questionnaire was simultaneously used to measure atmosphere in the wards. Data were obtained at five time points for each individual patient and ward. WHOQOL-BREF ratings were obtained across five time points with comparisons for four time intervals, including immediately before and after relocation. For 101 subjects across the four time intervals, 215 sets of data were obtained; 140 before and 65 after relocation with 10 community patients who did not move. Using Generalised Estimating Equations (GEE) to correct for multiple comparisons over time, the effect of relocation, with community patients as a control, was analysed by ward cluster and whether patients moved between wards. Observations were categorised according to security level — high dependency, medium secure, rehabilitation, or community — and trichotomised based on positive moves to less secure wards, more secure wards (negative moves), or no moves.

The hospital’s relocation was associated with a significant increase in environmental QOL (Wald X2=15.9, df=1, p<0.001), even when controlling for cluster location, positive and negative moves. When controlling for ward atmosphere, environmental QOL remained significantly increased after relocation (Wald X2=10.0, df=1, p=0.002). EssenCES scores were obtained within the hospital for three time points before relocation and two time points afterward. No significant differences were found in the three subscales before and after the relocation. All three EssenCES subscales progressively improved with decreasing security level (Patient’s Cohesion: Wald X2=958.3, df=1, p<0.001; Experienced Safety: Wald X2=152.9, df=5, p<0.001; Therapeutic Hold: Wald X2=33.6, df=3, p<0.001).

The GEE model showed that the hospital’s relocation improved self-reported environmental QOL. The cluster location made significant differences, as expected for a system of stratified therapeutic security, with a steady improvement in scores on all three atmosphere subscales.

None Declared

Increasing volumes of information are being collected via electronic health records and there is growing multi-site expertise in utlising these for research. This emerging field of healthcare data science is not only concerned with the technical challenges associated with complex data, but also with the need for effective security and governance in the use of sensitive information with robust structures for stakeholder input and guidance. To date, most of the focus has been on supporting observational cohort studies nested within clinical records data - particularly investigating research questions around treatment response and course/prognosis. It is likely that electronic health records will become increasingly integrated with clinical trials, providing opportunities for pre-study feasibility scoping, targeted recruitment, and enhanced and extended follow-up. In addition, there is interest in emulated trials using routine data. For mental health data science, key challenges lie in the quality and quantity of data made accessible, with a particular need for natural language processing to derive structured data from extensive clinical text. Many of the challenges have been addressed for observational research, creating exciting prospects for a transformed trials landscape.

R. Stewart Grant / Research support from: Janssen, GSK, Takeda

Transcendental cinema, distinguished from slow cinema by Paul Schreader, draws on the philosophy of existentialism and depicts the complexity of the human psyche using psychoanalytic tools. We claim that through the use of special procedures, the projection of transcendental cinema essentially becomes a meditation session in the spirit of mindfulness, which has been proven to alleviate and cure more than just neuropsychiatric ailments.

The purpose of this work is to demonstrate the similarity between mindfulness philosophy and transcendental cinema. We believe that the assumptions of both currents are so similar that we can treat the film screening in the category of a meditation session. Thus, we arrive at a situation in which we not only watch the protagonist developing his own consciousness in accordance with the mindfulness philosophy (also following the path of psychoanalysis), but also we, as viewers, develop self-awareness.

We analyze D. Lynch’s Twin Peaks series in accordance with Paul Schrader’s understanding of ‘transcendental cinema’. In addition, we use the scientific achievements of classical psychoanalysts, analyzing the metaphysical world of the characters in accordance with this trend. Using J. Kabat Zinn’s scientific publications, we analyze cinema in terms of a meditation session.

Participation is crucial; in meditation and in the transcendental cinema. Mindfulness means focusing on the emotions and feelings experienced at a given moment, on what comes to us, what we experience. Transcendental cinema using specific formal and narrative tools (e.g. extended scenes, no cuts, etc.) forces us to actively participate. Transcendental cinema fulfills the tenets of mindfulness, and during the screening we undergo a meditation session. What’s more, this style in cinema allows an in-depth exploration of the psyche, it brings us closer to the metaphysical, emotional dimension of humanity what develops in us the ability to understand the psyche of others, as well as our own.

We claim that the similarity between the philosophy of mindfulness and transcendental cinema allows us to treat a film screening as a meditation session. Cinema enriches us not only with knowledge about disorders and the therapeutic process, but is in itself a supportive tool - screening can allow viewers to deepen their awareness and improve their health. What is more, David Lynch’s work brings us closer to exploring the human psyche and the individualization of inner experiences, while also showing us what influence transcendental meditation has on characters and what happens when they undergo a kind of therapy; in the spirit of psychoanalysis or mindfulness philosophy.

None Declared

In the last 30 years, Switzerland has been established as a destination country for psychiatric trainees. The needed competences for the work as a trainee deviate regarding colleagues from foreign countries though, hindering a viable solid development professional without specific on-boarding program. A similar approach to the figure of tutor anchored in the Spanish postgraduate medical training is still missing in the Swiss medical System. Hereby we performed a survey in the new colleagues who are part from the medical team in an observer status before beginning with the responsibilities as a trainee.

Recognizing competences and needs of the onboarding in current trainees that are still allocating because of the work conditions as stated in the following paper, (Bischof et al. Swiss Arch Neurol Psychiatr Psychother. 2021;172:w03198)

Survey with open questions collecting needs and competences expected to fulfil in Switzerland were distributed in 5 different medical colleagues in an observer status between August 2022 and September 2023.

Response rate was 62,5 %. Main reasons for the migration were considering better perspectives in education and professional development in the goal country, coming push factors as the current work situation in the original country to the fore. Support regarding the local language and an overview of the interprofessional communication were outlined as the advantage of the internship prior to the duties as a psychiatric trainee.

An structured on-boarding program is a demand for the newcomers - majority of trainees from foreign countries - to step in better in the Swiss health system. Elements of the Spanish trainee system could be adapted for a suitable allocation and integration process in the goal country.

None Declared

The DiSCoVeR Project: ‘Examining the synergistic effects of a cognitive control videogame and a self-administered non-invasive brain stimulation on alleviating depression’ is a double-blind, sham controlled, randomized controlled trial investigating the feasibility and efficacy of an innovative, self-applied treatment approach for patients diagnosed with major depressive disorder. The trial is conducted at three clinical trial sites (Hadassah, Israel; Riga Stradiņš University, Latvia; Ludwig-Maximilian-University, Germany). The treatment approach combines prefrontal transcranial direct current stimulation with a videogame designed to enhance cognitive and emotional control. This treatment is self-applied at home and remotely monitored. At the beginning of the intervention the patients are randomized in an active group receiving both active stimulation and videogame and the other group receiving sham stimulation and visually similar but not active videogame.

The present interims analysis after half of the patients included examines patients’ intrinsic motivation after completing the first five sessions (of 30) of the treatment. We also examine patients’ interest/enjoyment, perceived competence, effort, felt pressure/tension, and perceived choice following the first week of treatment. Intrinsic motivation has been associated with enhanced learning and performance, so it can be used as one of the predictors for patient compliance.

At the end of the 5th session, the patients filled in the Intrinsic Motivation Inventory (IMI) including the following subscales: interest/enjoyment, perceived choice, perceived competence, effort/importance and felt pressure/tension (scored on a 7-point Likert scale, ranging from 1 “not at all true” to 7 “very true”).

This report includes the first 55 patients randomized (27 patients in the active group and 28 patients in placebo group) for the DiSCoVeR trial. Patients rated their overall interest/enjoyment at 4.50 out of 7 (SD±0.17 95% CI 4.16 to 4.84), their perceived choice at 5.55 (SD±0.16; 95% CI 5.23 to 5.87), their perceived competence at 4.52 (SD±0.15; 95%CI 4.22 to 4.82), their effort/importance at 5.07 (SD±0.16; 95%CI 4.74 to 5.40) and their pressure/tension at 3.00 (SD±0.13; 95% CI 2.73 to 3.26).

We conclude that overall patients were quite interested in the treatment and had inherent pleasure while doing the sessions, felt that it was their choice to do them, felt that they performed the task quite effectively, were invested in doing the sessions and the experienced pressure and tension were low. The perceived choice and competence are positive predictors of intrinsic motivation. This aligns with the previous published data of a smaller patient subset (L. Konosonoka et al Medicina (Kaunas) 2022;58(Supplement 1):72) with the standard deviations being smaller in our larger patient sample.

None Declared

Some studies have shown that late-life depression is related to faster cognitive decline and may increase the risk of dementia.

Identifying risk and protective factors for dementia is essential to develop preventive interventions. Some literature has suggested that mood disorders (namely depression) are potential modifiable risk factors for dementia.

Thus, it is important to know clinical presentation of depression that is associated to dementia, as a manifestation of subclinical dementia or as a risk factor for neurocognitive disorders.

We aim to identify clinical characteristics related to dementia of inpatients admitted for first time due to depressive episode after 55 years old.

Retrospective cohort study of inpatients admitted between January 1st 2010 and March 31st 2022 in a psychiatry inpatient unit of a tertiary hospital. Descriptive analysis of the results was performed using the SPSS software, version 26.0.

Our sample included 57 inpatients, 15,8% (n=9) with the diagnosis of dementia 5,2 (SD 5,6) years after admission. All of these patients presented a depressive episode with psychotic symptoms, namely delusion activity. In those with hallucinatory activity, no one developed dementia.

Interestingly, 33,3% of patients with dementia (n=3) presented with delusion of ruin, 55,6% (n=5) with delusion of prejudice/persecutory delusion and 66,7% (n=6) manifested delusion of ruin and/or prejudice.

We also found that 42,9% (n=3) of patients with dementia manifested Cotard delusion while this type of delusion was observed in 13,6% of patients without dementia (p=0,095).

Our study has several limitations because is based on results of only one hospital, with a small sample size.

However, since depressive symptoms are potentially modifiable risk factors for dementia, future studies are essential to understand the mechanisms that link depression to cognitive decline as well as clinical characteristics that may constitute predictors of dementia.

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Psychotic disorders are strongly linked to a higher risk of mandatory hospitalization, often affecting men more, though some studies report the opposite. Recent investigations also show a higher rate of involuntary admissions in younger individuals. Knowledge in this area is still limited despite extensive research.

Analyze whether there is an association between sex and age with involuntary admissions of individuals with psychotic disorders.

Retrospectively, 254 people with psychotic disorders admitted between 2018-2023 to the adult psychiatric inpatient unit at Hospital Universitari Germans Trias i Pujol were selected, collecting their nature of admission, sex, age, and discharge diagnosis. Comparisons between voluntary and involuntary admissions, with respect to sex and age variables, were conducted using independent sample t-tests, Mann-Whitney U tests, Fisher’s exact test, and chi-square tests. A logistic regression model was used to identify variables significantly associated with mandatory admission.

In both the male and female groups, there were no statistically significant differences in terms of the mean age at admission (p = 0.162) or the nature of admission (p = 0.586) (Table 1). When analyzing the voluntary nature of admission based on age and sex, statistically significant differences were only found in the female group (p = 0.01), resulting in a 9.18 year age difference among those admitted voluntarily (Table 2). The model that best predicted the probability of involuntary admission in individuals with psychotic disorders included the sex variable (OR = 4.88) and the interaction between sex and age (OR = 0.97) (Table 3).Table 1:

Differences between sex regarding voluntariness of patients with psychotic disorders.

Young women with psychotic disorders face a higher risk of involuntary admissions, emphasizing the need for gender-specific strategies to improve care of these patients.

None Declared

The Contrast Avoidance Model (CAM) was developed to explain pathological worry in generalized anxiety disorder (GAD). The CAM posits that those with GAD are sensitive to sharp increases in emotions, and use worry to maintain heightened states of negative arousal to avoid these emotional shifts. Research has widely supported the CAM in the conceptualization of GAD, and has extended these findings to other disorders, including major depressive disorder (MDD) and social anxiety disorder (SAD). Despite the utility of the CAM model in informing the etiology of these conditions, research has yet to expand these findings beyond GAD, MDD, and SAD. Specifically, obsessive-compulsive disorder (OCD), which co-occurs with GAD, MDD, and SAD in adults at a rate of 15.0%, 40.7%, and 14.7%, respectively, and shares many of their etiological features, has yet to examined in the context of the CAM. Thus, examining CA as a relevant mechanism and therapeutic target for OCD is an unstudied conceptual framework that may offer meaningful clinical utility.

The present study used receiver operator curve (ROC) analyses to examine the predictive utility of the CAQ-W and CAQ-GE in detecting probable OCD in a large undergraduate sample. We hypothesized that the CAQ-W and CAQ-GE would be higher in participants with probable OCD and would offer sufficient sensitivity and specificity in predicting probable OCD.

1259 undergraduates were recruited for a mass University screening. Participants were included in the OCD group (N = 291) if they met diagnostic criteria for OCD (DOCS total score > 20). Participants were included in the nondisordered group (n = 249) if they did not meet diagnostic criteria for any of the screened disorders (SAD, MDD, GAD, OCD, panic disorder, post-traumatic stress disorder, OCD, borderline personality disorder), denied suicidality, and denied receiving mental health treatment in the last 12 months. ROC analyses were used to examine the accuracy of the CAQ-W and the CAQ-GE in detecting probable OCD.

Results of ROC analyses are reported in Table 1. AUC values for the CAQ-W and CAQ-GE were significantly different from the null hypothesis (AUC = .50, p < .001), and demonstrated excellent (.89) to outstanding (.91) accuracy in predicting probable OCD (Figure 1), respectively. Optimal sensitivity and specificity to detect probable OCD (Table 2) was achieved at a cut off score of 67.5 for the CAQ-W (Sensitivity = 81.4%; Specificity = 82.3%) and a cutoff score of 43.5 for the CAQ-GE (Sensitivity = 84.9%; Specificity = 85.5%).

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Results suggest that OCD can be accurately characterized by CA. Findings also highlight the utility of examining CA as a relevant maintenance factor for OCD symptoms. Future research should examine the impact of CA on OCD symptoms in-laboratory and ecological settings.

None Declared

Inflammation has emerged as a critical factor in the pathophysiology of both depression and chronic heart failure (HF). Chronic heart failure, a complex clinical syndrome, is often accompanied by a state of heightened inflammation, with elevated levels of proinflammatory markers. Likewise, depression, a prevalent comorbidity in HF patients, has been intricately linked to inflammation, with evidence suggesting a bidirectional relationship.

This study aimed to evaluate the effect of antidepressant treatment on plasma fibronectin levels in patients with comorbid depression and chronic heart failure.

We enrolled a total of 113 patients with HF, all of whom had comorbid depression. The patients were divided into two groups based on the antidepressant treatment they received: Group 1 (n = 78) received vortioxetine, and Group 2 (n = 35) received sertraline. Before initiating treatment and after 6 months, we measured fibronectin levels in the patients’ plasma.

The study revealed a significant difference in the effects of the two antidepressants on fibronectin levels. Patients treated with vortioxetine demonstrated a substantial reduction in fibronectin levels post-treatment, with an approximate threefold decrease compared to the pre-treatment levels (pre-treatment value ± standard deviation) μg/ml to (post-treatment value ± standard deviation) μg/ml, (p<0.05). Conversely, patients treated with sertraline experienced a comparatively lesser reduction in fibronectin levels, with a change from (pre-treatment value ± standard deviation) μg/ml to (post-treatment value ± standard deviation) μg/ml (p<0.05).

This study highlights the considerable impact of vortioxetine on fibronectin levels in patients with comorbid depression and chronic heart failure, resulting in a significant reduction. In contrast, sertraline’s effect on fibronectin levels, while present, is notably less pronounced. The study emphasizes the potential therapeutic benefit of vortioxetine in cardiac remodeling associated with depression in patients with chronic heart failure, underscoring the need for further research and exploration.

None Declared

It is known that the formation of aggressive behavior is accompanied by neurodegenerative and neuroinflammatory changes. Immune cells have a regulatory effect on the central nervous system functions, including regulation of behavior.

We first demonstrated that ex vivo chlorpromazine - modulated immune cells have a positive aggressive behavior editing effect. The aim of the study was to investigate the influence of the indicated cells on some central mechanisms underlying the development of aggressive reactions.

(CBAxC57Bl/6) F1 aggressive male mice, developed in conditions of chronic social stress, were undergoing the transplantation of syngeneic spleen lymphocytes with ex vivo chlorpromazine-modulated functional activity. In recipients the immunohistochemical analysis was performed assessing the expression of the microglial marker Iba1. The levels of brain-derived neurotrophic factor (Bdnf) and cytokines was assessed by ELISA. For histological examination Nissl staining was applied.

Aggressive behavior editing after the chlorpromazine-modulated immune cells transplantation registered against the background of some structural and functional changes in the brain. It was found an increase in the density of pyramidal neurons in CA1 and CA3 hippocampal regions and augmented level of Bdnf. The decreased expression of microglial activation marker Iba1, accompanied with decreased levels of pro-inflammatory cytokines (IL-1β, IL-2, IL-6, INF-γ) and increased  anti-inflammatory (IL-4) cytokine was found. Visualization of functionally active lymphocytes pre-treated with chlorpromazine in the brain parenchyma of aggressive recipients suggests a direct effect of injected lymphocytes on CNS.

The effect of chlorpromazine - modulated immune cells that edits aggressive behavior is realized by stimulating neurogenesis, neuroplasticity and reducing neuroinflammation.

None Declared

Sleep quality depends on several factors such as smoking, physical activity, diet, and certain pathologies, namely obstructive sleep apnoea syndrome. Indeed, following their vaccination against COVID19, several medical trainees complained about a deterioration of their sleep quality.

To evaluate the quality of sleep of medical trainees who work at Charles Nicolle Hospital and who were vaccinated against SARS-COV2.

We conducted a descriptive cross-sectional study among medical trainees at Charles Nicolle Hospital who were vaccinated against COVID-19 during the period from March 2020 to August 2022. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Trainees were contacted during the period August 2022 to September 2022.

Sixty-nine medical trainees, vaccinated against Covid19 joined our study. Forty-nine of them had a significant sleep disturbance: Pittsburgh Sleep Quality Index (PSQI) greater than five. The average age was 29.39±3.04 years with a female majority (73.5%). No psychiatric history was found. The most affected category of trainees were residents (71.4%). Forty-three of them were inoculated with the messenger RNA vaccine and 4 with inactivated vaccine. Twenty-one patients vaccinated with the messenger RNA vaccine received two doses, seventeen received three doses and only one received a single dose. Sleep latency was high in 20,4% of cases. A sleep duration of less than five hours per night was found in 18,4% of the cases. Six participants reported using a sleep aid three to four times a week.

Our study revealed a significant sleep disturbance in medical trainees at Charles Nicolle Hospital. This could be due to the SARS-COV2 vaccination but can also be explained by the night shifts and the stress to which they are exposed, especially during this pandemic period.

None Declared

New data from the MRC funded project “Integrating psychological models with biological pathways in psychosis” will be presented. The overall objective of this project is to use both environmental and genetic data to understand the biological pathways in patients with schizophrenia and bipolar disorders. Specifically, to find out if polygenic risk and childhood adverse events increase the relative risk of mental illness above that of its individual case-control explained variance, and secondly, the effect of both polygenic risk and childhood adverse events on clinical characteristics and ageing processes. Both data from new unpublished systematic reviews and original data will be presented.

None Declared

Low back pain (LBP) is common among electricians caused by work conditions. Even when symptoms are short-term and not medically serious, LBP can be associated with psychological distress.

This study aimed to assess the link between LBP and psychological distress according to the job tenure among electricians.

The study was conducted in a group from a Tunisian Electricity society. Data were gathered between January-June 2022 using a self-administered questionnaire including socio-professional characteristics, the Nordic musculoskeletal questionnaire during the last 12 months and Kessler Psychological Distress Scale (K6). Our population was divided into two groups according to job tenure. The first group (G1) consisted of electricians with less than ten years of job tenure and the second (G2) consisted of electricians with more than ten years of seniority.

G1 consisted of 10 participants with a mean age of 30.6 ± 6.7 years and with average job tenure of 3.3 ± 1.1 years. G2 consisted of 64 participants with a mean age of 40.7 ± 10.3 years and average job tenure of 17.4 ± 10.9 years. According to the Nordic musculoskeletal questionnaire, LBP during the last 12 months was present in the first and the second group in 30.8% and 14.3% of participants, respectively.

The proportion of respondents with high levels of psychological distress (K6 score of 13 or greater) in the first and the second groups was 10 % and 9.4% of participants, respectively. The presence of low back pain during the last 12 months was significantly associated with a high score of K6 in the second group (p < 0.05).

From the results of this study, we conclude that LBP was associated with psychological distress when the job tenure is high. Therefore, the prevention of LBP should go through programmes to build ergonomically safe working conditions to enhance the mental health of electricians.

None Declared

Only a few cases of primary anterograde amnesia with confabulation after severe complex brain damage have been described in the literature.

To describe a case of anterograde amnesia with confabulation in a patient with severe and extensive brain damage.

case report

Case presentation: A 48-year-old male patient with a medical history of diabetes mellitus type II, hypertension, presented to a psychiatric clinic for the first time. He was admitted to the hospital due to the manifestation of disruptive aggressive behaviour, aimless wandering, and excessive, impulsive expenditure of financial resources. At the time of hospitalization and during the hospital stay, the patient exhibited a state of elevated mood and anterograde amnesia compounded by the presence of prominent confabulation, easily irritable mood with a tendency to conflict. No physical limitations.

Background: The patient is an active long-distance driver for 15 years. A year before hospitalization in psychiatric clinic, he was travelling to Moscow, he had episode of headache and unconsciousness after which hospitalization. Diagnosed with multiple infarcts of embolic origin in the right frontal lobes, both cortical and subcortical, on the right side at the level of the uncus, in the medial anterior parts of the right occipital lobe, on the left side in the insula and at the level of the capsula externa, in the anterior basal part of the left temporal lobe. After hemodynamic stabilization, he was repatriated to Latvia. Stationary positive SARS-CoV-2 PCR, O2 support therapy required.

The patient develops auditory and visual hallucinations, which do not correct on antipsychotic therapy. Lumbar puncture was performed, which showed positive anti-NMDA antibodies, magnetic resonance - autoimmune limbic encephalitis with damage to the gyrus cinguli of the insula cortex of both temporal lobes and the right subfrontal part with spread throughout the right temporal lobe, bilaterally in the mediobasal structures of the temporal lobes and the right thalamus with progressive changes. The patient receives immunomodulatory therapy, plasma exchange and immune globulin. Hallucinations decrease on the background of therapy. At discharge - moderate ataxia in the legs, disorientation in time, severe short-term memory disorders.

The patient in his mind lives like nothing has happened and the same life continues.

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The long-term prognosis for the patient remains uncertain, given the multifaceted nature of the condition and the extent of brain damage. Continuous monitoring, rehabilitation, and ongoing support will be essential to assess cognitive recovery and improve the patient’s quality of life.

None Declared

Long-term care facilities, such as nursing homes and other assisted living facilities, have been hit particularly hard by the COVID-19. The overall pandemic created an enormous pressure on long-term care workers (LTCWs), making them particularly vulnerable to mental disorders. However, most of the existing evidence regarding the well-being of care professionals has predominantly focused on frontline healthcare workers.

This study aimed to identify long-term psychological needs of LTCWs derived from the COVID-19 pandemic, as part of a project that is developing an intervention to reduce psychological distress in this population group.

We performed a qualitative study with a rapid research approach. Participants were recruited from long-term care facilities located in Catalonia, Spain. Between April and September 2022, we conducted semi-structured interviews inquiring about the most psychologically challenging stages of the pandemic, perceived emotions during those stages, main determinants of those emotions, and their emotional state at the time of the interview. We used a qualitative content analysis method with an inductive-deductive approach.

Thirty LTCWs participated in the study. Mean age was 44 (SD=11,4), 87% were females and one third were from foreign nationalities. The period of the pandemic with highest mental health burden was the outbreak, with almost every worker having experienced some form of emotional distress. Emotional distress persisted over time in more than half of participants, with fatigue and nervousness being the main emotions expressed at the time of the interview. High workload, feeling that pandemic times are not over and poor working conditions that have remained since then, have been the most frequently expressed determinants of such emotions.

Long after the pandemic outbreak, emotional distress is still relevant. The persistent burden of psychological distress points to a need for institutions to take action to improve working conditions and promote employees’ wellbeing.

None Declared