Bipolar Disorder (BD) is a complex psychiatric condition that typically manifests during late adolescence and early adulthood. Over the past two decades, international studies have reported that BD often goes unrecognized and untreated for several years, which can lead to negative clinical and functional outcomes. However, the components of delay in the diagnosis and treatment of BD in adolescents and young adults and various factors influencing those components have not been systematically explored.

To determine the known factors that contribute to delays in the treatment of BD in adolescents and young adults and identify current knowledge gaps.

A conceptual framework based on the Model of Pathways to Treatment by Scott and colleagues was used as a foundation for our search and extraction strategy to ensure all components of delay and potential factors influencing each component are explored. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline (PRISMA-ScR) to systematically search the electronic databases of MEDLINE (OVID), EMBASE, PsycINFO and CINAHL for peer-reviewed original research articles published from January 01, 2000 through March 29, 2023. Inclusion was restricted to studies with quantitative or qualitative data on individuals diagnosed with bipolar spectrum disorders with symptomatic onset or study participation between the ages of 13-24. Grey literature and studies not published in English were excluded due to resource limitations. Two independent reviewers screened the references retrieved by the literature search based on our inclusion criteria. The findings of included studies were summarized in a narrative and tabular form according to component of delay.

Our search yielded 5180 unique citations, of which 44 articles met our inclusion criteria. We present findings on the patient, illness, and healthcare provider/mental health system factors contributing to the delays in illness appraisal, help-seeking, diagnosis, and treatment.

To the best of our knowledge, this is the first systematic scoping review to explore the potential factors that influence delays in the treatment of BD in adolescents and young adults. Findings from this review will inform clinical practice and policy. We also demonstrate the utility of a systematic approach to identifying the components of delay, from symptom recognition through treatment, as a methodology to help identify knowledge gaps to inform future research.

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Insufficient knowledge about the pathophysiological processes in bipolar disorder (BD) leads to difficulties in differentiating this disorder from other affective disorders. Quantitative analysis of serum protein profiles in BD expands our understanding of the pathophysiology of the disease and may aid in subsequent diagnosis. As a result of a previously conducted comparative mass spectrometric study of serum proteins in patients with depression, bipolar disorder and healthy donors, increased expression of Heat Shock 70kDa Protein1A (HSPA1A) and transthyretin was identified.

Determination of HSPA1A and transthyretin concentrations in the blood serum of patients with mental disorders.

Blood serum of 28 patients with bipolar disorder aged 49 years [33;52], 30 patients with recurrent depressive disorder aged 40 years [31; 51] and 130 patients with schizophrenia aged 38 years [31;49], as well as 20 mentally and somatically healthy individuals aged 35 years [31;40] was studied. The amount of Heat shock protein 1A (HSPA1A) and Transthyretin (thyroxine and retinol transport protein) was determined using a Enzyme-linked Immunosorbent Assay Kit from Homo sapiens (Cloud-Clone Corp). Statistical data processing was carried out in the Statistica 12.0 program.

A statistically significant (p = 0.016) increase in the level of HSPA1A was found in patients with BD (0.84 [0.59; 1.09] ng/ml), compared with healthy individuals (0.61 [0.51; 0.77] ng/ml). HSPA1A plays a pivotal role in the protein quality control system, ensuring the correct folding of proteins. It is known that this protein is involved in the embryonic development of the central nervous system, as well as in neuroprotection by preventing the death of neurons due to its anti-apoptotic properties. A statistically significant (p = 0.047) increase in the level of transthyretin was found in patients with BD 21.8 рg/ml, compared with healthy individuals 19.4 pg/ml. Transthyretin plays an important role in ensuring the normal state of the central nervous system and is involved in cognitive processes.

Thus, the HSPA1A and transthyretin are probably involved in the pathogenesis of BD and can be proposed as be proposed as an additional paraclinical criterion for differential diagnosis.

Support by RSF №23-75-00023.

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During the past 2 decades there has been intense interest in the clinical significance of the concurrence of manic symptoms in depressed patients. DSM-5 introduced a mixed features specifier for both bipolar depression and major depressive disorder. Studies of the DSM-5 mixed features specifier have generally found a low prevalence of mixed depression. One approach towards increasing the sensitivity of the DSM-5 mixed features criteria is to lower the classification threshold.

In the present study we examine the impact of lowering the DSM-5 diagnostic threshold from 3 to 2 criteria on the prevalence and validity of the DSM-5 mixed features specifier for depression.

Four hundred fifty-nine psychiatric patients in a depressive episode were interviewed by a trained diagnostic rater who administered semi-structured interviews including the DSM-5 Mixed Features Specifier Interview. The patients were rated on clinician rating scales of depression, anxiety and irritability, and measures of psychosocial functioning, suicidality, and family history of bipolar disorder.

If the DSM-5 diagnostic threshold is lowered from 3 to 2 symptoms, then the prevalence of mixed features based on the DSM-5 majority of episode time frame tripled from 3.9% to 13.1% (n=60). Based on a past week time frame prevalence more than doubled from 9.4% to 22.9% (n=105) going from the 2 and 3 symptom threshold, respectively. There was no difference between the patients with 2 mixed features and patients with 0 or 1 mixed features on family history of bipolar disorder, psychosocial impairment, presence of comorbid disorders, age of onset, history of suicide attempts or psychiatric hospitalization.

The results of the present study do not support lowering the DSM-5-TR diagnostic threshold for the mixed features specifier in depressed patients from 3 to 2.

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Lithium treatment is a proven method for bipolar disorder management, but its narrow therapeutic range and the risk of severe side effects, including lithium intoxication, pose significant clinical hurdles. Lithium intoxication, a potentially life-threatening complication, can occur during treatment, raising ongoing questions about its clinical factors, risk elements, and best practices for management.

Our objective is a comparative analysis between patients who have experienced lithium intoxication and those who have not, aiming to identify influencing factors and enhance clinical care.

We collected demographic data, age at lithium treatment initiation, treatment duration, therapeutic adherence, Mental Health consultations, and lithium level monitoring from 14 individuals requiring clinical attention due to lithium intoxication and 14 patients with similar gender, age, and diagnosis with lithium treatment but without intoxication during four years of follow-up.

Regarding the results, the age of onset of lithium treatment in patients with lithium intoxication was 30.2 years (SD=8), and the duration of lithium treatment averaged 11.1 years (SD=8.8), which did not significantly differ from the control group with ages of onset at 38.1 years (SD=15.1) and treatment duration of 9.27 years (SD=8.8), respectively. Lithium intoxication patients developed severe complications, including hospitalizations in medical-surgical units, the necessity for dialysis, and death, one fatal case. Although therapeutic adherence to lithium, measured through pharmaceutical dispensation, exceeded 90% and was comparable in both groups, patients affected by lithium intoxication exhibited a significantly higher treatment discontinuation rate (OR 32.5; 95% CI, 3.1 to 337.8) during the follow-up period. Patients who experienced lithium intoxication had an average of psychiatric consultations every 11.2 months (SD=13.4), with 35.7% not attending at least once a year, while the control group had an appointment every 5.31 months (SD=2.7) (p > 0.05). Lastly, despite both groups having a similar frequency of plasma lithium level monitoring, occurring approximately every 5.5 months (SD=2.6) and 7.8 months (SD=4.8), respectively, in 28.5% of those who suffered from lithium intoxication did not undergo any monitoring for periods exceeding 18 months (p < 0.05).

Our research highlights the significance of delivering thorough clinical care and continuous monitoring to patients receiving lithium treatment for bipolar disorder. Ensuring effectiveness therapeutic adherence and maintaining strict monitoring of lithium levels are critical factors that significantly enhance treatment safety. Appropriate management has the potential to improve the quality and safety of care for people with bipolar disorder who are dependent on lithium therapy.

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The ASD Therapeutic Day Unit is a tertiary care unit that consists of 20 beds, designed to facilitate the evaluation and treatment of children and adolescents with ASD who present high psychiatric comorbidity with behavioral problems, communication/language problems, sensory, and/or in the management of their repetitive and restricted interests. In addition to diagnosis and genetic counseling and clinical care, we offer the possibility of performing an individualized pharmacogenetic study in order to offer appropriate pharmacological treatment to patients with ASD and comorbidities.

The objective is to promote pharmacological tolerability, avoid unwanted side effects, as well as avoid the use of polypharmacy, in children with a tendency to poor drug metabolism.

A review of the medical history of the patients included in the Blood Extraction Program of the ASD Day Therapeutic Unit is carried out during the year 2022. The existing medications at admission, the results of the pharmacogenetic analyzes carried out, and the pertinent changes in the pharmacological treatment of these children.

37 children were included in the program during 2022. The genes CYP1A2, CYP2C19, CYP2D6, CYP3A4 and 5-HTT were analyzed. The variant studied is described, as well as the observed genotype and the expected phenotype.

Of the 37 patients, 11 maintained the same pharmacological treatment as at the beginning of admission, 5 were not taking pharmacological treatment and 25 underwent a treatment modification.

The most frequently modified treatment was risperidone with aripiprazole (n=10), secondly risperidone with guanfacine (n=5), and thirdly fluoxetine with aripiprazole (n=2).

Furthermore, the degree of pharmacological polytreatment was reduced. 18 patients switched to a single drug, instead of 14. 11 patients 2 drugs (instead of 14), 3 patients 3 drugs instead of 4 and 5 patients remained without drug treatment.

Patients with ASD have worse tolerability to pharmacological treatments than other patients with severe mental disorders.

The use of pharmacogenetics allows improving the cost/effectiveness of medical prescription, avoiding undesirable side effects or lack of effectiveness in the treatment of patients with ASD.

Promoting the implementation of pharmacogenetics in patients with ASD (among others) would improve the clinical situation of these patients more effectively and would improve the economic expenditure derived from erroneous prescription and/or excessive polypharmacy.

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Attention-Deficit/Hyperactivity Disorder (ADHD), once considered a predominantly childhood condition, has increasingly gained recognition as a prevalent and clinically significant concern among adult women. They often display a distinctive symptom profile characterized by high levels of inattention, emotional dysregulation, and difficulties in executive functioning. Diagnosis of female adult ADHD is frequently complicated by gender bias in traditional diagnostic criteria, which may fail to account for the unique ways in which women manifest the disorder.

This comprehensive literature review aims to characterize the unique symptomatology of female adult ADHD, including variations in inattention, hyperactivity, and impulsivity, as well as the presence of emotional dysregulation. It also seeks to explore the diagnostic challenges stemming from gender bias in diagnostic criteria and the role of comorbidity in diagnostic complexity. Additionally, the review assesses the broad spectrum of functional impairments experienced by adult women with ADHD, spanning academic, occupational, interpersonal, and emotional domains.

This literature review comprises a systematic examination of published research articles, clinical studies, and relevant academic literature addressing female adult ADHD. A comprehensive search strategy involving electronic databases, including PubMed, PsycINFO, and Google Scholar, was employed to identify peer-reviewed articles published between 2000 and 2023. The selected studies underwent critical appraisal for quality and relevance to the review’s objectives.

The synthesis of existing literature reveals that female adult ADHD presents a distinctive clinical picture characterized by a higher prevalence of inattention, emotional dysregulation, and comorbid conditions such as mood and anxiety disorders. Diagnostic challenges arise from gender bias in diagnostic criteria and the absence of overt hyperactivity, often leading to delayed diagnosis or misdiagnosis. Functional impairments extend to academic, occupational, interpersonal, and emotional domains, affecting the overall quality of life for affected individuals. Gender-specific factors, including societal expectations and biases in healthcare evaluation, contribute to diagnostic disparities and hinder timely access to appropriate interventions.

The literature review underscores the critical need for enhanced recognition, understanding, and tailored support for female adults with ADHD. The distinct symptomatology, diagnostic complexities, functional impairments, and gender-specific factors contribute to a multifaceted clinical landscape. Advancing gender-sensitive diagnostic criteria, increasing awareness among healthcare professionals, and developing interventions that address the unique needs of this population are essential steps toward improving the quality of life and outcomes for female adults with ADHD.

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Borderline personality disorder (BPD) in youth has the greatest spectrum of psychopathology and is strictly associated with nonsuicidal self-injury (NSSI) and suicidal behaviour [Guile et al. Adolesc Health Med Ther 2018; 9 199-210; Paris Med. 2019; 55(6):223]. The formation of autoaggressive behaviour and suicidal activity is due to the psychopathological features of BPD, which include affective instability, impulsivity and impaired self-identity.

The aim of the study was to investigate the psychopathological features of suicidal behaviour in BPD in youth.

Clinical and psychopathological examination with assessment of suicidal behaviour at the time of, 6 and 12 months later. For additional psychometric examination of patients we used: SCID-II questionnaires, Barratt Impulsiveness Scale (BIS-11), Toronto Alexithymic Scale (TAS), Columbia Suicide Severity Rating Scale (C-SSRS). Sample: N=62 male and female youth males and females in two equal groups of 31, respectively, with an established diagnosis of BPD and the presence of suicidal behaviour. The mean age of first referral in both groups was 19.1±2.2 years.

This study defined 2 variants of suicidal behaviour in patients with BPD in youth: 1) Expansive - with predominance of impulsiveness (BIS-11 70±3), affective instability, associated with psychosocial factors as a trigger of suicidal activity. Suicidal attempts were made at the height of psychoemotional stress. These patients were characterised by moderately high scores of the C-SSRS scale 2±1, in which patients noted the absence of a plan and specific intentions before the attempt, and a lower incidence of repeated attempts after 6 ((N=6 (19.4%) and 12 months N=10 (32.2%). 2) Rationalistic variant of suicidal behaviour was found in patients with predominance of self-identification disorders, dissociative disorders and high level of alexithymia TAS 81±4.2 in the clinical picture. Suicidal ideation was revealed in all patients, often throughout the entire youth period, and attempts were characterised by thoughtfulness and led to severe consequences, including fatal outcome. Patients with rationalistic variant of suicidal activity had higher C-SSRS scale scores of 4±1, with the presence of suicidal intentions and high frequency of attempt recurrence after 6 (N=11 (35.5%) and 12 months (N=17 (54.8%)).

The variant of suicidal behaviour depended on the degree of severity and correlation of the psychopathological structure of BPD in youth. Less favourable prognosis was characteristic of the rationalistic variant due to the high frequency of repeated attempts. The results obtained require further analysis and contribute to the development of differentiated therapeutic strategies.

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In ESCAPE-TRD, esketamine nasal spray (ESK-NS) significantly increased the probability of remission at Week (Wk)8 and being relapse‑free through Wk32 after remission at Wk8 versus (vs) quetiapine extended-release (QTP-XR), in patients (pts) with treatment resistant depression (TRD). Safety data were consistent with established profiles of each treatment, with no new safety signals identified (Reif et al. DGPPN 2022; P-01-04).

To explore weight changes and their impact on treatment discontinuation in ESCAPE-TRD.

ESCAPE‑TRD (NCT04338321) was a randomised, open-label, rater-blinded, phase IIIb trial comparing efficacy and safety of ESK-NS vs QTP-XR in pts with TRD. Safety analyses were conducted on pts who received ≥1 dose of study treatment. Treatment-emergent adverse events (TEAEs) were defined as occurring at or after the first dose of study treatment and within 14 days/30 days (non-serious/serious) of the last dose. A ≥7% increase/decrease in weight from screening was considered for evaluation as a TEAE. Weights were measured and are reported as observed, with no missing data imputation.

336 and 340 pts were randomised to ESK-NS and QTP-XR; 334 and 336 were included in the safety population. Over the 32-week study, a TEAE of weight increase was reported in fewer pts treated with ESK-NS than QTP-XR (9 [2.7%] vs 42 [12.5%]), leading to treatment discontinuation in 0 vs 6 (1.8%) pts, respectively. Incidences of weight increase TEAEs were balanced across pts categorised as normal, overweight or obsese by baseline body mass index (BMI; Figure). A weight decrease TEAE was reported in 7 pts (2.1%) in the ESK-NS arm vs 0 pts in the QTP-XR arm. Mean (standard deviation [SD]) weight at baseline was 76.4 (16.2) kg (ESK-NS; n=334) vs 79.1 (16.9) kg (QTP-XR; n=336). At Wk32, mean weight was maintained (76.5 [16.3] kg) in ESK-NS treated pts (n=249; mean [SD] change from baseline: 0.1 [4.0] kg) and increased (80.7 [15.6] kg) in QTP-XR treated pts (n=203; mean [SD] change from baseline: 2.5 [5.1] kg).

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Increase in weight was uncommon with ESK-NS; weight increases were more common with QTP-XR and resulted in more treatment discontinuations. Weight increase was independent from baseline BMI.

We thank the patients who participated. Funding: Janssen, medical writing: Costello Medical, UK

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Health science students in post-secondary institutions experience high levels of depression and anxiety due to increased stress levels, workload, low socioeconomic status, and history of family mental illness, among other factors. Given the significant negative impact that depression and anxiety can have on undergraduate health science students, it is essential to understand the prevalence and correlation of these conditions in this population.

This scoping review aims to identify, document and analyze the literature on the prevalence and determinants of anxiety and depression among undergraduate health sciences students and identify gaps in knowledge for future research.

The scoping review was planned and executed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the Scoping Reviews statement. A comprehensive and systematic search was carried out for five databases, namely MEDLINE, Scopus, EMBASE, CINAHL and PubMed.

From the literature identified by our search strategy, the lowest prevalence for anxiety was 5.8%, and the highest was 82.6%, with a median of 44.25%. The prevalence of depression ranged from a high of 88.8% to a low of 2.1%, with a median value of 34.8%. Our analysis revealed that correlates of anxiety and depression among health science students include sociodemographic factors such as age, sex, gender, relationships, ethnicity and family history, personal health conditions, and academic and socioeconomic issues.

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With the high incidence of anxiety and depression among health science students, there is an increasing need to find practical remedies to support these students. It is also essential for policymakers and university authorities to implement interventions such as supportive text messages and other strategies geared toward providing support and improving the psychological well-being of health science students.

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The comorbidity between depression and anxiety is a common occurrence. The DSM-5 introduced the “anxious distress” (AD) specifier that can be applied to any depressive episode – both in major depressive disorder (MDD) and bipolar disorder (BD) – when symptoms such as feelings of tension, restlessness, difficulty concentrating, and fear that something awful may happen or to lose control are present. Longitudinal data showed that the AD specifier may be an effective predictor of chronicity, time to remission, and functional disability in depressive disorders. In addition, evidence on AD proved its association with increased depressive symptom severity.

Available literature seems to suggest that AD occurs in a specific subgroup of patients, thus enabling a peculiar clinical profile to be outlined. To expand knowledge in this field, we performed a cross-sectional study aimed at identifying clinical correlates of AD in people with major depressive episodes.

Adult people admitted to two psychiatric inpatient units in the northern area of the Metropolitan City of Milan from May 2020 to December 2022 were screened for a major depressive episode and relevant specifiers using the Structured Clinical Interview for DSM-5 (SCID-5). Data on socio-demographic and clinical variables were collected. The severity of depressive and manic symptoms was assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS), respectively. Univariate comparisons between participants with and without AD were conducted, and two multiple logistic regression models were arranged to investigate the association between AD and candidate explanatory variables.

We included 206 inpatients with a major depressive episode (mean age =48.4 ± 18.6 years; males = 38.8%), of whom 155 diagnosed with MDD and 51 with BD. AD was present in 137 participants (66.5%). Mixed features (p=0.049), higher YMRS scores (p=0.004), psychotic features (p<0.05), and a diagnosis of MDD (p<0.05) were found to be associated with AD in the multiple logistic regression analysis.

Notwithstanding some limitations, such as the cross-sectional design and the inclusion of inpatient only, our study highlights the association of AD with mixed and psychotic features, as well as with MDD. Clinical implications of these results include the possible contribution in delineating a specific symptom profile in people with AD during a major depressive episode.

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Parkinson’s disease (PD) is a neurodegenerative condition that is predominantly characterised by its motor symptoms. Nevertheless, it is important to note that non-motor symptoms, particularly depression often occur concurrently, exerting a substantial influence on the progression of the disease and the overall well-being of individuals affected by it.

The objective of this study is to examine the influence of depression on the advancement of Parkinson’s disease (PD) from a psychiatric perspective. This analysis will involve an assessment of the common neurobiological pathways involved and the potential implications for clinical treatment and care.

A comprehensive assessment of the literature was conducted, focusing on clinical observations, neurochemical interactions, and neuroimaging investigations that provide insight into the concurrent presence of depression and Parkinson’s disease (PD). This study aimed to investigate the potential impact of depression on the severity of Parkinson’s disease symptoms, the course of the disease, and the responsiveness to treatment.

Depression in Parkinson’s disease (PD) is not only a reactive occurrence, but rather it may be attributed to common pathophysiological mechanisms, such as changes in dopamine and serotonin pathways. The coexistence of depression among individuals with Parkinson’s disease (PD) has been linked to heightened severity of motor and cognitive symptoms, accelerated development of the disease, and diminished effectiveness of therapy interventions. Furthermore, the presence of depression in individuals with Parkinson’s disease intensifies the psychosocial difficulties experienced by both patients and their carers.

The recognition and management of depression in individuals with Parkinson’s disease (PD) is of utmost importance in order to enhance treatment approaches and enhance the overall well-being of patients. The establishment of interdisciplinary collaboration between neurologists and psychiatrists is necessary in order to guarantee a holistic approach to patient care.

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The use of cannabis is associated with developing psychotic disorders, especially for those with a pre-existing vulnerability and elevated familial risk for psychosis.

To assess cannabis use during first episode psychosis and its relationship with patients’ clinical symptoms and functioning.

We assessed 50 patients hospitalized for first episode psychosis using three scales: CAST test (Cannabis Abuse Screening Test), Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF).

The sex ratio of our population was 4 men to 1 woman. The average age was 25.6±6.16 years. About 60% of the patients used cannabis. The average duration of untreated psychosis was 10 months, with extremes ranging from one week to 24 months. Forty-four patients were antipsychotic-naïve (88%). For patients who used cannabis, the mean score of CAST test was 11.3±4.16, with extremes between 4 and 18. The risk of dependence was high in 81% of cannabis users. The PANSS total scale showed a mean score of 58.29±12.90 with extremes between 35 and 91. The average score at GAF scale was 30 with extremes between 20 and 70. Duration of untreated psychosis was significantly correlated to negative scale of PANSS (p=0,012 ; r=0,420), PANSS total score (p=0,011 ; r=0,424) and GAF levels (p=0,012 ; r=-0,420).

There was no association between age of onset of psychosis and cannabis use (p=0,181) nor CAST scores (p=0,747). There was no correlation between CAST and GAF scores (p=0,641).

However, there was a significant and positive correlation between CAST scores and positive scale of PANSS (p=0,04 ; r=0,432).

Cannabis use is neither necessary nor sufficient to cause psychosis on its own. However, it has an influence on the prognosis. Early intervention programs should address cannabis and substance use problems early in the course of illness.

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Substance use disorder is a common comorbidity with bipolar disorder, having implications on its diagnosis, treatment adherence, and number of hospitalizations. Understanding the particular characteristics of this population is of the utmost importance to improve clinical outcomes.

Our aim is to analyze the sociodemographic characteristics of the patients in the inpatient unit of a tertiary hospital and to reflect on its impact on treatment. Our study looks over a 3-year period, and all patients analyzed have a dual diagnosis of both bipolar disorder and substance use disorder.

We collected, retrospectively, data from the hospital platform and analyzed it on SPSS Statistics 26, along with a literature review.

In the analyzed period of 3 years, there were 2384 hospitalizations in the Coimbra’s University Hospital psychiatric ward, and 88 hospitalizations were coded with a dual diagnosis of bipolar disorder and substance use disorder.

Regarding gender distribution, 41% of the patients were female and 49% of the patients were male, with a mean age of 47 years.

There were 12 patients who were re-hospitalized once (7 of them were men) and 6 who were re-hospitalized twice (4 of them were men) during the analyzed period.

At the time of hospitalization, 60.5% of male patients were single, 21.1% were divorced, and only 15.8% were married, while female patients were mainly married (35.7%) and only 28.6% were single.

Female patients had more frequent support from social and community institutions (17.9% vs 5.3% in men) while 2.6% of men had no support from family or institutions.

Regarding education, more men accomplished high school education (21.1% vs 17.9% in women) and university education (18.4% vs 14.3%). In our sample, there were 3.6% of women who were illiterate.

During their lifetime, female patients were hospitalized around 5 times and men around 3.7 times, despite the fact that the mean age of female patients on their first hospitalization was 36 years, and in male patients, it was 34 years.

Treatment adherence is more significant in female patients (70.3% vs 69.2% in men), even though women maintain active substance abuse more frequently (42.9 vs 39.5%).

Male and female patients have different backgrounds and different support either in spouses, family, or social institutions. These nuances may play an important role in the number of re-hospitalizations, treatment adherence, and maintenance of abstinence.

Taking these aspects into consideration may help improve clinical outcomes.

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Cerebrovascular insult (CVI) in patients with psychiatric diseases is to a large extent more prevalent and is accompanied by a worse prognosis after a incident. Despite the higher mortality, these patients are less frequently subjected to CT angiography and interventional intervention on the blood vessels of the brain.

To show the frequency of cerebrovascular insults in patients with schizophrenia (SCH), bipolar affective disorder (BP), and depression, depending on age, gender, socioeconomic characteristics, professional qualifications, and dietary habits.

A total of 1200 patients with SCH, BD and depression were treated over a period of five years.

11.1% SCH patients had CVI and 3,7% a cases of bipolar afective diseases. CVI was most often experienced by patients who were married, employed, or retired, and who lived in urban areas. Smoking, elevated blood pressure values, elevated BMI do not have a significant impact on the occurrence of CVI in all groups. Patients with elevated values of glucose, total cholesterol and LDL cholesterol and CRP had a higher incidence of cerebrovascular insult.

It is necessary to work on raising the awareness of people suffering from psychiatric diseases regarding lifestyle and eating habits, and to conduct periodic health examinations. It is important to recognize high-risk patients and educate them about preventive measures.

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Several studies have demonstrated a high prevalence of sleep-related complaints in subjects with an addiction to psychoactive substances (alcohol, cannabis, nicotine, cocaine)

Sleep disorders negatively influence the quality of life of subjects suffering from addiction and increase the risk of relapse

To assess the prevalence of sleep disorders in patients with problematic use of psychoactive substances as well as associated factors

This is a descriptive and analytical cross-sectional study carried out among 100 patients followed at Ar-Razi hospital Salé in Morocco for problematic use of psychoactive substances from June 1 to August 30, 2023

A questionnaire was used assessing the socio-demographic and clinical characteristics of our population

Sleep quality was assessed by the Pittsburgh Scale (PSQI)

There were 100 patients, with ages ranging from 18 to 56 years old and the majority of whom were males.

History of somatic pathology was reported in 36% of patients

The majority of patients had an associated anxiety disorder (60%)

The most consumed psychoactive substances were tobacco (95%), followed by cannabis, benzodiazepines and alcohol.

75% of patients reported poor sleep quality

There was a statistically significant difference between the risk of relapse and the reduction in sleep quality

The prevalence of poor sleep quality in patients with disorders linked to psychoactive substance use is high, hence the importance of early detection in order to improve treatment.

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As a result of the notable progress in HIV / AIDS prevention and treatment globally, the HIV epidemic is considered controlled to the extent that individuals living with HIV manage to have a similar life expectancy to HIV-negative individuals and a good level of health. However, the “epidemic” related to the stigma of HIV-positive individuals, particularly of Men who have Sex with Men (MSM), still remains an issue, while it has been associated with a profound negative impact on individuals’ mental health.

The present study aimed to compare anxiety, depression, social support, loneliness, and psychological resilience between MSM with and without HIV. Furthermore, the study investigated the correlates of HIV related stigma in MSM with HIV.

The sample of the study comprised a total of 139 adult MSM. According to their self-report 84 individuals were HIV-negative (age in years: M = 24.58, SD = 5.55), while the remaining 55 individuals were HIV-positive (age in years: M = 38.99, SD = 10.95). Furthermore, the majority of individuals in both groups reported Greek nationality. Participants completed a questionnaire on socio-demographic characteristics, the Hospital Anxiety and Depression Scale to assess anxiety and depression, the UCLA Loneliness Scale to measure loneliness, the Brief Resilience Scale (BRS) to evaluate psychological resilience, and the Multidimensional Scale of Perceived Social Support (MSPSS) to assess social support. HIV-positive individuals additionally completed the HIV Stigma Scale-Brief Version, a brief scale measuring social stigma related to HIV.

According to the findings, MSM with and without HIV did not differ in anxiety (p = 0.908), depression (p = 0.904), social support (p = 0.657), loneliness (p = 0.086), and psychological resilience (p = 0.600). Furthermore, it emerged that among HIV-positive MSM, stigma was positively associated with anxiety (r = 0.479, p < 0.001), depression (r = 0.479, p < 0.001), and loneliness (r = 0.532, p = 0.001), while the correlation was negative with social support (r = -0.456, p < 0.001) and resilience (r = -0.400, p < 0.003). No significant association was found between stigma and age in HIV-positive individuals (r = 0.099, p = 0.474).

In conclusion, the findings of this study identified possible risk factors as well as protective factors for the mental health of HIV-positive MSM. As long as stigma associated with HIV continues to be a risk factor for the development of psychosocial problems in those living with HIV, it is advisable for both policymakers and the research community to take more proactive steps in order to offer the necessary support and attention to those who are living with HIV and experiencing multiple forms of stigma.

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Type 2 diabetes mellitus (T2DM) is a prevalent, chronic metabolic disorder that exerts diverse effects on individuals’ physical and psychological well-being.

Our aim was to investigate the potential correlation between personality traits and self-care aspects among individuals living with T2DM.

We conducted a thorough search in PsycINFO, CINAHL, and PubMed/Medline for peer-reviewed articles from inception to January 9, 2023. Following PRISMA guidelines, two reviewers independently screened, extracted data, and assessed bias. We used random-effects meta-analysis for pooling estimates

We identified 23 studies meeting our inclusion criteria. Openness, conscientiousness, and agreeableness were linked to better foot care compliance (OR = 2.53, 95% CI = 1.49-4.28; OR = 1.84, 95% CI = 1.10-3.08; and OR = 2.07, 95% CI = 1.23-3.48, respectively). Openness was also associated with improved overall self-care behaviors (OR = 2.00, 95% CI = 1.17-3.41), while conscientiousness reduced smoking likelihood (OR = 0.96, 95% CI = 0.93-0.99), and agreeableness enhanced medication adherence (OR = 1.68, 95% CI = 1.34-2.31). However, extraversion and neuroticism were linked to lower medication adherence (OR = 0.77, 95% CI = 0.61-0.96 and OR = 0.51, 95% CI = 0.40-0.65, respectively). Neuroticism also negatively affected overall self-care behaviors (OR = 0.67, 95% CI: 0.55-0.81).

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Personality traits should be considered when addressing self-care in T2DM patients.

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Liver transplantation (LT) is a crucial treatment for end-stage alcoholic liver disease, the most common liver disease in developed countries. Personality traits and cognition, a relatively stable characteristics, are known to be significantly associated with quality of life (QoL). However, how they impact QoL in long-term LT survivors is unclear.

The study aimed to assess the associations between personality traits and cognition and their impact on the QoL in long-term LT survivors.

First time LT recipients due to end-stage alcohol liver disease without long-term complications were consecutively included during standard outpatient care. Sociodemographic and clinical data was collected. Personality traits were assessed using 50-item International Personality Item Pool of the Five-factor model (IPIP), cognition using Mini Mental State Examination (MMSE), and QoL using EuroQoL-5D (EQ-5D) questionnaire.

Eighty-three participants were included (mean age 62.9±7.03y, 90.6% male). Median MMSE score was 27±2.00, and median years since LT 5±2.91. Significant positive associations were found between IPIP dimensions Extraversion (B=0.297, p<0.01), Agreeableness (B=0.384, p<0.01), Conscientiousness (B=0.511, p<0.01), and Emotional stability (B=0.432, p<0.01) with EQ-5D visual analogue scale (EQ VAS). IPIP dimension Conscientiousness (B=0.338, p<0.01) and Emotional Stability (B=0. 379, p<0.01) were significantly associated with descriptive dimension of EQ-5D (EQ-5D-3L). MMSE score was significantly associated with QoL (EQ-VAS B=0.291, p<0.01; EQ-5D-3L B=0.283, p<0.05, respectively). However, MMSE score was not shown to be a statistically significant predictor of QoL, whereas Consciousness was a significant predictor of EQ-VAS (β 1.404, t 3.125), and Emotional stability of EQ-5D-3L (β 0.011, t 2.132).

Some personality traits predicted QoL in long-term LT survivors. Therefore, assessment of personality traits should be considered as a part of pre-LT evaluation within a regular psychiatric clearance evaluation.

S. Medved: None Declared, B. Aukst Margetić: None Declared, A. Ražić Pavičić: None Declared, T. Filipec Kanižaj : None Declared, V. Medved Grant / Research support from: This work was done as a part of the “Genetic Background of End Stage Alcoholic Liver Disease and Liver Transplantation” study supported by the University of Zagreb, Croatia grant 2017 and 2018.

Adolescents and young adults have particularly been impacted by the COVID-19 pandemic, leading to a rise in the incidence of mental health issues. Increased exposure to traumatic events may lead to decreased resilience and subsequently increased likely PTSD.

This study sets out to examine the predictors and prevalence of likely PTSD and determine the level of resilience among adolescents and young adults.

A cross-sectional study using an online survey questionnaire was adopted to collect sociodemographic and clinical information from the subscribers of MoreGoodDays. The PTSD Checklist Civilian (PCL-C) and the Brief Resilience Scale (BRS was respectively used to assess likely PTSD and resilience Data was analyzed with SPSS version 25 using chi-squared tests and multivariate logistic regression analysis.

343 of MoreGoodDays subscribers who participated in the survey were about 343. Most were female (79.0%), and 13.7% were male. Overall, 95 (45.7%) of respondents had likely PTSD and 109 (51.7%) had likely low resilience. Approximately 176 (51.3%) respondents had received mental health counselling, and 64 (35.4%) expressed the desire to receive mental health counselling. When all other variables are controlled in the regression model, respondents who have received mental health counselling in the past year were 13.7 times more likely to experience likely PTSD (OR = 13.70; 95% CI: 1.23- 142.86) and 15.15 times more likely to experience low resilience than those who did not (OR = 15.15; 95% CI: 1.46- 166.67). Again, those who would like to receive mental health counselling were 20.8 times more likely to experience PTSD than those who did not (OR = 20.76; 95% CI: 2.61- 165.401) and 29.4 times more likely to experience low resilience than those who did not (OR = 29.42; 95% CI: 3.31- 261.445). Finally, those with four or more ACE scores were 6.2 times more likely to experience likely PTSD than those who had zero scores (OR = 6.24; 95% CI: 1.46- 26.67).

MoreGoodDays subscribers were disproportionally affected by likely PTSD and low resilience, reflecting the devastating effect of the COVID-19 pandemic. Increased ACE has been linked to low resilience, which may also lead to a rise in mental health issues. Strategies to promote resilience may reduce the incidence of likely PTSD. Educational institutions may adopt innovative mental health interventions, including psychological interventions such as mobile text technology, to support the mental health of this cohort. Policymakers and government agencies are encouraged to give the mental health of young adults and youth more prominence on their agenda.

None Declared

The mental health of the people who featured in Pornographic Productions (PP) is underexamined. However, PP frequently involve unsimulated violent acts mostly experienced by women. Furthermore, some women participating in PP also report being coerced into unwanted sexual acts. Therefore, featuring in a PP could be experienced as a traumatic event, and could be associated with negative mental health disorders.

Our study examines mental health indicators among Women who have participated in at least one PP (WPP), and who consulted clinical psychologists, after referral by WPP support groups.

Thirty-six women were recruited by two clinical psychologists during an individual consultation. Participants completed the French versions of the post-traumatic stress disorder (PTSD) Checklist for DSM-5 (PCL-5), the Dissociative Experiences Scale (DES), as well as the 13-item Beck Depression Inventory (BDI-13). Data on socio-demographic characteristics, lifetime experience of sexual violence prior to participating in a PP, as well as the perceived effect of participating in a PP were also measured.

The mean age of participants was 31.2 (std=7), and the average age at first participation in a PP was 23.4 (std=6). The majority (78%) of participants reported lifetime experience of sexual violence prior to participation in a PP. Thirty women (83%) had a PCL5 score over 33 indicative of probable PTSD, and 28 women (78%) had a DES score of 30 or more indicating high levels of dissociation. Further, 16 participants (44%) reported a BDI-13 score over 16 indicating severe depression.

This study highlights the high prevalence of PTSD, dissociative experiences, and depressive symptoms in a clinical population of women who featured in at least one PP. Further studies are needed to better understand the scale of the problem and optimize care interventions.

None Declared