Social isolation and feelings of loneliness are recognized as major contributors to suicidal behavior among the elderly.

We aimed to explore the relationship between perceived loneliness and suicidal risk in older adults followed in outpatient psychiatry.

A cross-sectional study was conducted among patients aged 65 years and older attending psychiatric consultations. Data collection included self-reported measures of loneliness, the 3-point Loneliness Scale and social isolation assessed through the Social Isolation Scale, which comprises a Social Link Index (ILS) quantifying social connections and a Close Relationship Index (IRE) evaluating the qualitative dimension of interpersonal bonds. Suicidal history and characteristics were explored in detail and complemented by the Ducher Suicide Risk Scale.

Seventy-three patients were included (male/female ratio = 1.08). A high prevalence of loneliness was observed, with 72% of participants reporting feeling lonely “often” or “sometimes.” More than half (51%) stated they had felt lonely during most of the past week, and 58% reported intensified loneliness during specific periods of the year, particularly in the evening (44%) and during summer holidays (23%).

The median score on the 3-point Loneliness Scale was 5 (IQR = 3–7). Regarding social isolation, 33% of participants were classified as socially isolated according to the ILS, while only 34% reported having close relationships (IRE).

According to the Ducher Suicide Risk Scale, 40% of patients expressed no death-related thoughts, whereas the remaining 60% showed varying degrees of suicidal ideation, from transient thoughts to active intent.

A significantly higher suicidal risk was correlated with greater subjective loneliness (p < 0.0001), higher scores on the 3-point Loneliness Scale (p < 0.0001), increased social isolation (p < 0.0001), and the absence of close relationships (p < 0.0001).

Loneliness was highly prevalent among elderly psychiatric outpatients and appeared closely intertwined with suicidal risk. The predominance of impulsive and reactive suicidal behaviors underscores the need for systematic screening of social isolation and emotional distress in this vulnerable population.

None Declared

Prolonged benzodiazepine (BZD) use in elderly individuals has been associated with an increased risk of suicide.

This study aimed to investigate the relationship between BZD addiction and suicidal risk in older adults.

A cross-sectional study was conducted among patients aged 65 years and older attending outpatient psychiatric consultations. Data collected included benzodiazepine use and detailed assessment of suicidal history. Suicidal risk was assessed using the Ducher Suicidal Risk Scale, and benzodiazepine dependence was evaluated with the Benzodiazepine Attachment Scale (ECAB).

Seventy-three patients were included (male/female ratio = 1.08). Among the 51 patients who used benzodiazepines, 41 (80%) met the criteria for dependence. Nearly half of the patients (49%) reported a history of suicide attempts, with an average of 1.86 attempts (range: 1–4) and a mean interval of 24.9 years since the last episode (range: 2–43). Most attempts (58%) were described as impulsive rather than premeditated.

The most frequently reported motives were negative emotions (22%), family conflicts (19%), delusional ideas (17%), and hallucinations (11%). The most common method was intentional drug ingestion (28%), followed by strangulation (17%) and defenestration (17%); anxiolytics were involved in 60% of drug ingestions.

In 86% of cases, the act occurred when the patient was alone, most often at home (67%), predominantly during nighttime hours (20:00–04:00; 44%) and more frequently in autumn (39%). The suicidal act was mainly reactive in nature (44%).

According to the Ducher Suicide Risk Scale, 40% of patients expressed no death-related thoughts, whereas the remaining 60% presented a range from transient thoughts to active suicidal ideation.

BZD-dependent patients had significantly more frequent histories of suicide attempts (p = 0.01), a shorter duration between the last suicide attempt and the current evaluation (p = 0.03), and more frequent suicidal acts motivated by interpersonal conflicts or psychotic symptoms (delusions, hallucinations) (p = 0.045). They also presented suicidal ideation at the time of the interview (p = 0.045) and had higher scores on the Ducher scale compared to non-dependent patients (p = 0.005).

BZD addiction represents an independent risk factor for suicidality in the elderly. Systematic screening for suicidal risk iscommended in patients with chronic BZD use or dependence.

None Declared

Suicide in older adults is a growing public health concern, especially among those receiving psychiatric care. A comprehensive understanding of the clinical, psychosocial, and personality-related determinants of suicidal risk in this population is crucial for improving early detection and targeted prevention strategies.

This study aimed to identify the factors associated with increased suicidal risk among elderly psychiatric patients.

A cross-sectional study was conducted among patients aged ≥65 years attending psychiatric consultations. Clinical, familial, and psychosocial histories were also collected. Suicidal risk was assessed using the Ducher Suicide Risk Scale, while depression, anxiety, and impulsivity were measured using standardized scales: the Hospital Anxiety and Depression Scale – Depression subscale (HADS-D), the Hospital Anxiety and Depression Scale – Anxiety subscale (HADS-A), and the Barratt Impulsiveness Scale – 11th version (BIS-11).

Seventy-three patients were included (male/female ratio = 1.08). According to the Ducher Suicide Risk Scale, 60% of patients showed varying degrees of suicidal ideation, from transient thoughts to active intent.

Univariate analysis revealed that higher suicidal risk was significantly associated with depressive symptoms (HADS-D, p < 0.001), anxiety (HADS-A, p = 0.003) and impulsivity (BIS-11, p < 0.001). Other significant correlates included lack of religious practice (p = 0.03), history of violence (p = 0.01) or trauma (p = 0.001), legal history (p < 0.001), family history of psychiatric disorders (p = 0.025), suicide attempts (p = 0.002), or substance use (p = 0.017). Personality disorders (p < 0.001), previous suicide attempts (p < 0.001), absence of regret following a prior attempt (p = 0.001), and current suicidal ideation (p < 0.001) were also strongly associated with elevated suicidal risk.

In multivariate analysis, lack of religious practice (p = 0.029) and depressive symptoms (HADS-D, p = 0.018) emerged as independent predictors of suicidal risk.

Among elderly psychiatric patients, depressive symptoms and absence of religious practice are the strongest independent predictors of suicidal risk. The findings highlight the multifactorial nature of suicidality in late life, emphasizing the need for integrated screening of affective, psychosocial, and existential dimensions in geriatric psychiatric care.

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Depression and anxiety are common in elderly psychiatric patients and are often associated with cognitive decline and behavioral dysregulation. Understanding the relationships between mood symptoms, impulsivity, and cognitive performance is crucial for tailored interventions in this vulnerable population.

We aimed to identify the associations between depressive and anxiety symptoms, impulsivity traits, and cognitive functioning in older adults receiving psychiatric care.

A cross-sectional study was conducted among patients aged 65 years and older attending outpatient psychiatric consultations. Psychometric assessments included the Hospital Anxiety and Depression Scale for anxiety (HADS-A) and depression (HADS-D), the Barratt Impulsiveness Scale – 11th version (BIS-11) for impulsivity, and the Mini-Mental State Examination (MMSE) for cognitive function. Correlations between mood symptoms, impulsivity, and cognitive performance were analyzed.

Seventy-three patients were included (male/female ratio = 1.08). The mean MMSE score was 22.63 (range: 11–30), indicating cognitive impairment in 42 patients (58%).

The median HADS-D score was 10/21 (IQR = [6–14]; range: 2–18), with depressive symptoms (HADS-D ≥ 11) observed in 39 patients (53%).

The median HADS-A score was 9/21 (IQR = [6.5–12]; range: 3–19), with anxiety symptoms (HADS-A ≥ 11) present in 49 patients (67%). The median BIS-11 score was 84 (IQR = [65.5–97.5]), with values ranging from 41 to 112.

Significant positive correlations were observed between depression scores (HADS-D) and impulsivity (BIS-11) (p = 0.005), as well as between anxiety scores (HADS-A) and impulsivity (BIS-11) (p < 0.01), indicating that higher levels of mood symptoms were associated with increased impulsivity. Additionally, depression (HADS-D) and anxiety (HADS-A) were negatively correlated with cognitive performance (MMSE) (p = 0.005 and p < 0.01, respectively), suggesting that higher mood symptom severity was linked to greater cognitive impairment.

In elderly psychiatric patients, depressive and anxious symptoms are associated with increased impulsivity and reduced cognitive function. These findings highlight the need for comprehensive assessment and integrated management of mood, behavior, and cognition in this population to improve clinical outcomes.

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Chronic use of benzodiazepines (BZD) among the elderly is a major public health concern due to the risk of dependence, cognitive decline, and psychiatric comorbidities.

We aimed to describe the consumption patterns and dependence profile of elderly psychiatric outpatients using BZD.

A cross-sectional study was conducted among patients aged 65 years and older attending outpatient psychiatric consultations. Data collected included benzodiazepine use, attempts at withdrawal, concomitant medications, and substance use. Psychometric assessments were performed using the Benzodiazepine Attachment Scale (ECAB), the Hospital Anxiety and Depression Scale (HADS-A and HADS-D), and the Mini-Mental State Examination (MMSE) to assess cognitive function.

Seventy-three patients were included (male/female ratio = 1.08). Psychoactive substance use was reported by 81% of patients, and polysubstance use by 41%. BZD consumption was found in 69% of cases (n = 51), with a mean duration of use of 23.3 years (range: 2–40 years). The most frequently used molecule was lorazepam, reported in 61% of cases. During the six months preceding the study, BZD use was daily in 92% of cases. Among the 51 BZD users, 31 patients (61%) had attempted withdrawal; among them, 27 (87%) reported failure. The main reasons for withdrawal failure were withdrawal syndrome (48%) and reappearance of initial symptoms (44%).

Among the 51 patients who used BZD, 41 (80%) met the criteria for dependence. A significant association was observed between BZD dependence and living in urban or semi-urban areas (p = 0.04). Clinically, dependence was significantly linked to the presence of personal somatic history (p = 0.021), depressive and bipolar disorders (p = 0.024), younger age at onset of psychiatric illness (p = 0.05), and longer illness duration (p = 0.035).

Regarding substance use, BZD dependence correlated with caffeine use (p = 0.021), stimulant use (p = 0.024), and polysubstance use (p = 0.038). Strong associations were also found with the duration (p < 0.001) and frequency (p = 0.021) of BZD use, as well as with failed withdrawal attempts (p < 0.001). On psychometric assessment, dependent patients showed significantly higher HADS-D (p = 0.001) and HADS-A (p = 0.005) scores, indicating more severe depressive and anxious symptomatology. Regarding cognitive performance, a negative correlation was observed between age (in years) and MMSE score among dependent patients (p = 0.001), while this association was less pronounced in non-dependent patients (p = 0.016).

BZD dependence in the elderly is associated with marked anxiety-depressive symptoms and cognitive decline. These findings highlight the importance of systematic assessment of dependence, mood, and cognitive function in elderly BZD users, to implement integrated, gradual, and tailored management strategies for this vulnerable population.

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Physical activity has been consistently associated with improved cognitive functioning in older adults. However, the underlying biological and psychosocial mechanisms through which these benefits are realized remain only partially understood. Previous studies were limited by methodological shortcomings or an overreliance on experimental designs, thus constraining the generalizability of their findings to broader populations.

This systematic review aimed to critically evaluate and synthesize the existing literature on the mediating and moderating mechanisms that explain the relationship between physical activity and cognitive performance in adults aged 60 years and older.

A comprehensive search of PubMed and Scopus databases was conducted from their inception through April 2025. Eligible studies quantitatively assessed physical activity, reported cognitive outcomes, and included analyses of mediation and/or moderation effects. Study designs encompassed randomized controlled trials, longitudinal, cross-sectional, and experimental approaches. Data extraction was performed independently by two reviewers, and methodological quality was assessed based on seven established criteria.

Fifty-six studies met inclusion criteria: 44 examined mediation effects, 10 explored moderation, and 2 addressed both. Strong evidence identified depression and sleep quality as robust mediators of the PA–cognition relationship. In contrast, support for neurocognitive and physiological pathways ranged from limited to moderate. Moderating factors such as genetic predispositions (e.g., APOE genotype), age, comorbidities, and psychosocial context demonstrated inconsistent or weak evidence. Notably, 93% of the included studies were rated as high quality.

Physical activity influences cognitive functioning in older adults through multiple, interrelated mechanisms. Among these, depression and sleep quality emerged as particularly consistent mediators. Future research should prioritize integrative and longitudinal methodologies to unravel causal pathways and guide the development of targeted interventions aimed at preserving cognitive health in aging populations.

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Aging involves gradual changes in physical, cognitive, and emotional functions, often leading to social isolation, anxiety, and reduced life satisfaction. Positive memory therapy, or nostalgia, has emerged as a non-pharmacological intervention that reconnects older adults with meaningful past experiences, enhancing psychological well-being, social engagement, and emotional stability. Previous studies highlight nostalgia’s role in improving mood, social interaction, and sense of security.

This study aimed to

1. (1) assess the level of nostalgia among older adults in a Bethlehem nursing home,

2. (2) measure their sense of belonging and tranquility,

3. (3) examine nostalgia’s predictive capacity in enhancing belongingness and tranquility,

4. (4) explore differences by gender and length of stay.

A descriptive correlational design was used. The population included 70 older adults, with a random sample of 40 participants. Data were collected using a validated and reliable 46-item questionnaire covering nostalgia, belongingness, and tranquility. Responses were scored on a five-point Likert scale. SPSS was used for descriptive statistics, t-tests, and simple regression analyses.

Participants exhibited high levels of nostalgia (M = 4.56, SD = 0.31) and belongingness (M = 4.65, SD = 0.22). Nostalgia significantly predicted belongingness (R² = 0.116, p = 0.032) and tranquility (R² = 0.255, p < 0.001). No significant differences were observed based on gender or length of stay, indicating equal benefits of nostalgia therapy across demographic groups.

Nostalgia effectively enhances belongingness and tranquility among older adults. Recalling positive memories provides emotional support, strengthens social connections, and promotes psychosocial stability, making it a valuable intervention in nursing home settings.

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Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder characterized by obsessions and compulsions. The boundary between OCD and psychotic disorders has been debated, with certain subtypes demonstrating overlapping features. In cases where compulsions are excessively dominant, the persistent reinforcement of perceived threats may create fertile ground for paranoid ideation. This paper examines the contribution of compulsive dominance to paranoid cognition through neurobiological, cognitive, and psychodynamic perspectives, and discusses clinical observations and therapeutic strategies.

This article explores how excessive dominance of compulsive behaviors in obsessive-compulsive disorder (OCD) may contribute to the development of paranoid ideation.

Through literature review and clinical observations, the cognitive, neurobiological, and psychodynamic mechanisms linking compulsive symptoms with paranoia are examined.

Compulsive dominance in OCD may evolve into paranoid ideation, representing a distinct clinical subgroup. Serotonergic deficits, dopaminergic hyperactivity, CSTC dysfunction, and impaired reality testing all contribute to this transformation. Clinical observations support the progression from compulsive behaviors to paranoid beliefs.

In conclusion, compulsive-dominant OCD with paranoia requires tailored interventions. Pharmacological management should combine SSRIs with antipsychotic augmentation, while psychotherapeutic strategies must address both compulsive rituals and paranoid schemas within an integrated framework.

None Declared

Cognitive models of obsessive-compulsive disorder (OCD) have indicated that perfectionism constitutes one of the dysfunctional cognitive patterns contributing to the disorder’s etiology. Perfectionism represents a multifaceted psychological construct that is frequently associated with childhood trauma.

The present study aimed to investigate the specific impact of childhood traumatic experiences and perfectionism tendencies on the severity of OCD symptoms.

This case–control study included 76 outpatients who presented to the Department of Mental Health and Diseases at Turgut Özal Medical Center and were diagnosed with OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. The control group consisted of 80 individuals with no prior history of psychiatric disorders, who were comparable to the patient group in terms of sociodemographic characteristics. Both groups completed a series of assessment instruments, including the Yale–Brown Obsessive–Compulsive Scale – Self-Report Form, the Frost Multidimensional Perfectionism Scale, and the Childhood Trauma Questionnaire.

When compared with the control group, the patient group demonstrated significantly higher scores in the perfectionism subdimensions of concern over mistakes, parental criticism, and doubt about actions, as well as in maladaptive perfectionism and total perfectionism scores. In addition, the patient group showed significantly higher scores in emotional abuse, emotional neglect, physical abuse, and total childhood trauma compared to the control group.A significant positive correlation was observed between the total childhood trauma score and the perfectionism subdimensions of concern over mistakes, parental criticism, and doubt about actions. Furthermore, OCD symptoms also demonstrated significant positive correlations with the same perfectionism subdimensions.In the organization subdimension, a non-significant negative correlation was observed, which appeared only within the patient group.

The observation that significant positive relationships among childhood trauma, OCD symptom severity, and specific perfectionism subdimensions were also present in the control group suggests that these associations may be more closely related to symptom severity rather than being disorder-specific. On the other hand, the non-significant negative correlation observed in the organization subdimension, which was present only in the patient group, appears to reflect an OCD-specific characteristic. This finding implies that the absence of adaptive perfectionism may play a role in the onset or maintenance of psychopathology in individuals with OCD. Overall, the study emphasizes the need for future research with larger samples and causal model testing to better elucidate the nature of these complex relationships.

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Introduction- Cervical spine neuropsychiatric results are important causes of morbidity. Among of theme are the obsessive-compulsive disorders (OCD).

Aim-Aim of this study is to present cases with obsessive-compulsive disorders as a result of cervical spine injuries in geriatric patients

Material-Methods-10 patients are presented.9 males (90%) and 1 females (10%) Range of age between 70-80years old . All of theme (10-100%) were evaluated, with clinical and radiological exam(ct,mri) plus diagnostic tests for Obsessive-compulsive disorders

Results-Good results in 6 cases (60%) and moderate in 4 (40%). Collaboration between various medical disciplines is essential in order to achive optimal results and clarify the theory,the etiology, and treatment effectiveness..

Conlusions-Premorbid status can be obtained by structured psychiatric interviews, and traumatic brain lesions can be defined with advanced neuroimaging techniques.

None Declared

Introduction- Traumatic brain injury neuropsychiatric results are important causes of morbidity. Among of theme are the obsessive-compulsive disorders (OCD).

Aim-Aim of this study is to present cases with obsessive-compulsive disorders as a result of traumatic brain injuries in middle age people

Material-Methods-10 patients are presented.7 males (70%) and 3 females (30%) Range of age between 50-65 years old. All of theme (10-100%) were evaluated, with clinical and radiological exam(ct,mri) plus diagnostic tests for Obsessive-compulsive disorders

Results-Good results in 8 cases (80%) and moderate in 2 (20%). Collaboration between various medical disciplines is essential in order to achive optimal results and clarify the theory,the etiology, and treatment effectiveness.

Conclusion-Premorbid status can be obtained by structured psychiatric interviews, and traumatic brain lesions can be defined with advanced neuroimaging techniques

None Declared

Body dysmorphic disorder (BDD) stands at the intersection of psychiatry and the silent language of the body, where the mirror reflects not reality but an unrelenting distortion. Patients often perceive themselves as disfigured or abnormal and sometimes have perceptions that brush into quasi-persecutory experiences, blurring the boundary with psychotic disorders. This sense of disfiguration can become magnified into an intolerable flaw, challenging clinicians to distinguish structural reality from psychopathological amplification.

Describe the case of a patient with an overwhelming preoccupation with mandibular retrognathism, who resorted to wearing a mask to hide what he perceived as unbearable deformity. Moreover, explore the diagnostic limbo between BDD and potential primary psychotic disorder.

Comprehensive psychiatric assessment, including family interviews and detailed mental state evaluation, with particular attention to the patient’s persecutory-like ideation—specifically, his conviction that others were staring at or commenting on his mandibular appearance. Diagnostic formulation carefully weighed BDD against the possibility of psychosis-spectrum pathology.

Initially, the patient arrived persistently wearing a mask, symbolizing self-protection and self-image issues. He exhibited depressed mood, anhedonia, restricted affect, and rigid attribution of blame toward his mother for his perceived mandibular retrognathism. Psychotic phenomena, including persecutory ideation and possibly auditory-verbal due to inappropriate head turns and facial expressions, could not be excluded. Family engagement illuminated premorbid personality traits, mannerisms and the evolution of the symptoms.

This case underscores the fragile threshold between BDD and psychotic-spectrum pathology, where distorted reflections of self manifest in both behavior and interpersonal relationships. Recognising such overlap is vital, as treatment relies on a multimodal intervention, integrating psychotherapy, pharmacotherapy, and family support are essential. The mask, rather than offering relief, symbolised the split between external concealment and internal torment.

None Declared

Obsessive–compulsive disorder (OCD) involves intrusive thoughts (obsessions) and rituals (compulsions) performed to reduce distress. Recent studies highlight the role of executive dysfunction in sustaining obsessive–compulsive symptoms. Another key cognitive bias is thought–action fusion (TAF), where simply having a thought is regarded as equivalent to carrying it out. Although both executive dysfunction and thought–action fusion are recognized as important features of OCD, their relationship remains underexplored.

This study aimed to examine the relationship between executive dysfunction and thought–action fusion in adults diagnosed with obsessive-compulsive disorder.

The study included 81 participants: 27 adults with an ICD-11 diagnosis of OCD (M = 29.9, SD = 7.87) and 54 controls without psychiatric history (M = 20.7, SD = 2.44). Instruments included the Yale–Brown Obsessive Compulsive Scale (CY-BOCS), Stroop Test, Thought–Action Fusion Scale–Revised (TAFS-R), and the Executive Skills Questionnaire–Adult Version (ESQ–A). Data were analyzed using Pearson correlations and multivariate analysis of covariance (MANCOVA) in Jamovi.

The study tested whether dimensions of thought–action fusion (moral, likelihood-other, likelihood-self) mediated the relationship between executive dysfunction and obsessive–compulsive symptoms. The analysis revealed a significant main effect of group membership on executive function scores, F(13, 63) = 37.238, p < .001, η² = .885. Regarding the TAF dimensions, moral TAF and TAF likelihood-other were not significant predictors, whereas TAF likelihood-self (fusion regarding one’s own thoughts) was statistically significant, V = .3105, F(13, 63) = 2.183, p = .021, η² = .311. Higher endorsement of TAF likelihood-self was linked to poorer metacognition, reduced flexibility, and impaired inhibition. Group differences remained significant for attention (F(1, 75) = 11.747, p < .001), planning (F(1, 75) = 9.158, p = .003), flexibility (F(1, 75) = 8.365, p = .005), and Stroop performance (F(1, 75) = 365.871, p < .001). These findings suggest that biased appraisals of one’s own thoughts as dangerous or morally significant may contribute to executive dysfunction in OCD, particularly in domains of flexibility and inhibition.

The findings suggest that executive dysfunction in OCD cannot be explained solely by symptom severity but is closely linked to maladaptive cognitive biases, particularly thought–action fusion of one’s own thoughts. Biased appraisals of personal intrusive thoughts appear to exacerbate deficits in metacognition, cognitive flexibility, and inhibitory control. This suggests that targeting both executive processes and cognitive distortions may be essential in developing more effective interventions for OCD. Future research should explore their role in treatment response.

None Declared

Obsessive–Compulsive Disorder (OCD) is a chronic and often treatment-resistant condition that significantly affects functioning and quality of life. OCD affects an estimated 1–2% of the general population in Europe. Patients with OCD experience persistent, unwanted thoughts (obsessions) and/or repetitive behaviors or rituals (compulsions), which frequently cause significant distress and impairment in daily life. . Despite the efficacy of serotonin reuptake inhibitors (SRIs), a group of patients show only partial response, requiring augmentation strategies. Cariprazine, a dopamine D3/D2 receptor partial agonist with preferential D3 affinity, has been shown to improve motivational and cognitive symptoms in schizophrenia and depression. Its potential role in OCD treatment remains under investigation.

Presentation of three clinical cases of patients with OCD who were treated with cariprazine as an augmentation strategy to SSRIs.

Case Descriptions:

• - one female 24 years old with OCD diagnosis, previous treatment with Sertraline, Quetiapine and current treatment with Sertraline 200mg Cariprazine 3 mg for 4 months and an outcome of improvement in depressive and anxiety symptoms, reduction in frequency and intensity of obsessions.

• - one male 50 years old with OCD diagnosis, previous treatment with Sertraline, Fluoxetine, Paroxetine, Aripiprazole and current treatment Paroxetine 30mg, Cariprazine 3mg for 5 months and an outcome of reduction of anxiety symptoms and obsessions and mild sexual dysfunction.

• - one male 36 geras old with OCD, previous treatment with Escitalopram, Fluoxetine, Olanzapine, Aripiprazole and current treatment with Fluoxetine 60mg, Cariprazine 4,5mg for 12 months and an outcome of marked reduction of stress and health related obsessions.

All three patients showed clinically meaningful improvement in obsessive–compulsive and anxiety symptoms, as well as overall functioning. A statistically significant reduction in Y-BOCS scores was observed in all three cases after the initiation of cariprazine treatment. Cariprazine was well tolerated: only one patient reported mild sexual dysfunction. No extrapyramidal or metabolic adverse effects were observed.

These cases suggest that cariprazine may be an effective augmentation option for patients with OCD who show inadequate response to SSRIs or other augmentation strategies. The improvement in cognitive symptoms observed in these cases may relate to cariprazine’s D3-preferring pharmacodynamic profile.

Cariprazine appears to be a promising adjunctive treatment for OCD, particularly in patients with residual anxiety, depressive, or motivational symptoms. Its favorable tolerability profile and potential benefits on cognitive and affective domains make it a candidate for further research.

None Declared

Muscle Dysmorphic Disorder (MDD) is a complex mental condition most commonly observed in men, characterized by a distorted perception and excessive preoccupation with muscularity and body size. MDD is formally recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a specifier of Body Dysmorphic Disorder, which falls under the Obsessive-Compulsive and Related Disorders category, highlighting its compulsive and intrusive nature (APA, 2022). While previous research has primarily treated MDD as a unidimensional construct, a multidimensional approach is necessary to identify distinct predictors of its dimensions: drive for size, appearance intolerance, and functional impairment

This study employed a biopsychosocial framework to examine how bio-physiological (age, body mass index-BMI), psychological (self-esteem, self-compassion), and socioenvironmentally shaped (exercise identity) factors differentially explain the three dimensions of MDD among men engaged in recreational sports activities.

A convenience sample of 200 Israeli men (Mage = 39.46, SD = 12.46) who engage in recreational sports activities completed structured self-report questionaries.

Drive for size was exclusively predicted by bio-physiological factors, with younger men and those with lower BMI reporting higher levels of drive for size. Appearance intolerance was associated with higher BMI and lower self-esteem and self-compassion. Functional impairment was predicted by self-compassion and by exercise identity.Image 1:

Conclusion: This study highlights the distinct biopsychosocial mechanisms underlying MDD dimensions, emphasizing the need for dimension-specific theoretical and practical approaches. These insights may contribute to the refinement of theoretical models and inform targeted prevention and treatment strategies.

None Declared

Late-onset obsessive-compulsive symptoms are less common than early-onset forms and can indicate disruptions in fronto-subcortical circuits from neurodegenerative,vascular or other organic etiologies. This case study highlights the intersection of obsessive-compulsive phenomenology and parkinsonian features, focusing on a patient with subtle motor signs.

The primary objective of this case study is to elucidate the diagnostic and clinical challenges encountered in managing late-onset obsessive-compulsive symptoms with parkinsonian features, emphasizing the importance of suspecting an underlying cause.

The case study was developed through comprehensive psychiatric and neurological assessments during the patient’s outpatient follow-up, supplemented by a targeted literature review on PubMed using “late-onset obsessive-compulsive disorder” and “parkinsonian features” as keywords.

The patient, a 60-year-old male, was a functional adult with chronic anxiety and subclinical obsessive-compulsive traits until approximately two years prior when he began exhibiting symptoms of late-onset obsessive-compulsive phenomenology. His symptoms progressively evolved from intrusive catastrophic thoughts to rigid, stereotyped motor rituals impacting daily activities (e.g., dressing, gait, feeding), interpreted as corrections for bodily misalignment. As the condition worsened, insight was partially preserved but resistance waned, leading to significant functional impairment without classic obsessive-compulsive disorder (OCD) forms like washing or checking, and with comorbid depression. Neurological examination revealed hypomimia, psychomotor slowing, and subtle parkinsonian gait without rigidity; Mini-Mental State Examination (MMSE) scored 30/30. Cranial computed tomography (CT) showed frontal-predominant microangiopathic leukoencephalopathy, and due to suspicion of underlying pathology, magnetic resonance imaging (MRI) confirmed vascular changes without additional findings. Prior treatments encompassed standard selective serotonin reuptake inhibitors (SSRIs), venlafaxine, clomipramine, and atypical antipsychotics; current management involves high-dose fluvoxamine with low-dose antipsychotic augmentation and frequent evaluations in ambulatory.

This case illustrates the importance of integrated neuropsychiatric assessment with longitudinal monitoring in patients presenting late-onset obsessive-compulsive symptoms. The presence of stereotyped motor rituals emerging in adulthood with parkinsonian features warrants screening for neurodegenerative or vascular pathology rather than assuming primary obsessive-compulsive disorder. This multifaceted approach is crucial in addressing the complex needs of patients with late-onset obsessive-compulsive phenomenology at the neuropsychiatric interface.

None Declared

Research highlights the role of emotional processing in Obsessive-Compulsive Disorder (OCD). This study examines differences in perceived emotional threat among individuals with varying obsessive-compulsive (OC) symptom levels in a nonclinical sample.

To examine Perceptions of Threats from Emotion Questionnaire (PTEQ, 2006) subscale differences between groups with lower and higher OC symptoms, controlling for anxiety, responsibility, somatic awareness, thought–action fusion, education, and age.

Participants (n=460) completed the PTEQ, Padua Inventory (PI, 1988), Beck Anxiety Inventory (BAI, 1988), Responsibility Attitude Scale (RAS, 2000), Self-Awareness Questionnaire (SAQ, 2014), and Thought–Action Fusion Scale (TAF, 1996). Participants were split in two groups (below/above mean), and PTEQ subscale differences were examined controlling for BAI, RAS, SAQ, TAF, education, and age.

A statistically significant difference was found in PTEQ subscale scores based on participants’ PI scores, controlling for covariate measures and demographic factors (Wilks’ Λ=0.700, F(8,233)=12.47, p<.001; see Table 1). Covariate measures and demographics also significantly affected responses across emotional subscales (Table 2). Univariate tests showed significant group differences on Sadness (F=65.29, p<.001), Happiness (F=31.59, p<.001), Anger (F=34.10, p<.001), Fear (F=34.75, p<.001), Disgust (F=34.07, p<.001), Guilt (F=50.02, p<.001), Lust (F=22.41, p<.001), and Strong Emotion (F=60.73, p<.001).Table 1.

Multivariate Tests for Group Differences on PTEQ Subscales

Individuals with higher OC symptoms (>mean PI score) exhibit increased perception of emotional threat compared to those with lower symptoms (<mean PI). They reported significantly greater threat linked to sadness, happiness, anger, fear, disgust, guilt, lust, and strong emotion. Findings suggest a link between obsessionality and emotion dysregulation, underscoring the relevance of perceived emotional threat in OCD, taking into account anxiety, interoceptive awareness, responsibility beliefs, thought–action fusion, and demographic factors.

None Declared

MM120 (lysergide D-tartrate, LSD, CAS 32426-57-6) is under development as a potential treatment for generalized anxiety disorder and major depressive disorder. MM120 may elicit profound lasting psychological changes through interaction with brain 5-HT1A, 1B, 2A, 2C, 6 and 7 receptors, among others, while the complete mechanism is not clear.

The study was performed to determine receptor occupancy and receptor density for 5-HT2A and 5-HT1A receptor in rats after chronic administration of MM120.

Rats were administered MM120 (0, 0.5, 2.0, 6.0 mg/kg) daily or weekly (6.0 mg/kg) for 13-weeks and tested for toxicity, neurological safety (functional observational battery [FOB]) or physiological states. 5-HT2A and 5-HT1A ex vivo receptor occupancy (RO) was measured by incubation of brain sections with [3H]8-OH-DPAT or [3H]Ketanserin and quantification of binding. Receptor density was then measured in cortical and hippocampal washed membranes.

Chronic dosing showed no changes in body temperatures or FOB at week 13. Body weight changes were lower for 6 mg/kg daily group, but not weekly. Receptor density showed significantly lower binding of [3H]Ketanserin at 6 mg/kg daily (p < 0.05), compared to vehicle and 6 mg/kg weekly groups, indicating a lower 5-HT2AR density. 5-HT1AR density revealed with [3H]8-OH-DPAT binding was significantly lower in 6 mg/kg daily (p < 0.05) group, while other groups were unaffected. in vitro receptor binding and functional activity was evaluated and compared to other drugs of abuse. Chronic administration of MM120 at all doses significantly downregulated 5-HT2ARs in cortex and hippocampus, while 5-HT1ARs were affected only at the 6 mg/kg dose.Image 1:

The study demonstrates that 5-HT2AR downregulation may be responsible for the tolerance development after the repeated dosing and reduced abuse potential of MM120.

J. Tripp Shareolder of: 100%, Employee of: 100%, G. Smagin Shareolder of: 100%, Employee of: 100%

MM120 (lysergide D-tartrate, a formulation of LSD) is under development as a potential treatment for generalized anxiety and major depressive disorders. How psychedelic drugs interact at the TrkB receptor, a key target of neuroplasticity, is not reported.

The study evaluated binding and functional activity of known serotonergic psychedelic compounds and SRI fluoxetine at the TrkB receptor.

Activation of TrkB by brain-derived neurotrophic factor (BDNF) was assessed by measuring inositol monophosphate 1 (IP1) accumulation. NIH/3T3 cells stably expressing human TrkB were used. BDNF was added, followed by incubation with Anti-IP1-Cryptate and IP1-d2. IP1 formation was determined by Homogeneous Time-Resolved Fluorescence (HTRF). We tested LSD, psilocin, N,N-dimethyltryptamine (DMT), mescaline, 2,5-dimethoxy-4-iodoamphetamine (DOI),N-2-methoxybenzyl-phenethylamine (25B-NBOMe), 4-bromo-2,5-dimethoxyphenethylamine (2C-B), methylenedioxyamphetamine (MDA), and the selective serotonin reuptake inhibitor fluoxetine. Activation potencies (EC50) were derived from the concentration-response curves using nonlinear regression.

BDNF was highly potent at the TrkB receptor, activating it in the sub-picomolar range (EC50 0.2 pM). LSD, 25B-NBOMe, and fluoxetine activated TrkB (EC50 of 811, 26370, and 6040 pM respectively) with low maximal efficacies (40, 57, and 60% respectively). All remaining drugs did not activate the TrkB at concentrations <1 mM. Cotreatment with BDNF and a fixed concentration of LSD increased the BDNF-induced TrkB activation potency (EC50 0.06 pM) and reduced the activation efficacy to 60%. Other drugs reduced the activation potency, as well as the maximal receptor activation.Image 1:

LSD, 25B-NBOMe, and fluoxetine activated TrkB at pharmacologically relevant concentrations as partial agonists, while psilocin, DMT, DOI, MDA, and 2C-B did not. Induced TrkB upregulation may underly and provide evidence for the neuroplastic effects of LSD.

G. Smagin Shareolder of: 100%, Employee of: 100%, J. Tripp Shareolder of: 100%, Employee of: 100%

Impaired cognitive function is common in patients with bipolar disorder (BD), and its pathophysiology has been the subject of multiple theories. Research has aimed to identify neurophysiological biomarkers that reflect cognitive impairment in euthymic bipolar patients.

To identify electroencephalographic specificities of cognitive impairment by analyzing electroencephalogram (EEG) tracings in patients with bipolar disorder type I (TB-1), compared with control subjects, that may serve as biomarkers of cognitive impairment in TB.

This was a cross-sectional, case-control study. It was carried out at the “C” psychiatry outpatient unit at Hedi Chaker University Hospital, Sfax, Tunisia. Fifteen TB-1 patients and fifteen healthy controls were included. All participants were assessed by the Screen For Cognitive Impairment in Psychiatry (SCIP) scale for evaluation of cognitive functions. They underwent standard waking EEG with eyes closed at the Department of Functional Explorations, Habib Bourguiba Hospital, Sfax, Tunisia. Each participant was given a mental arithmetic test during the EEG, and absolute power spectral density (PSD) analysis was performed to compare brain activity at rest and after cognitive stimulation.

Cognitive assessment from EEG data revealed significant differences between bipolar patients and healthy controls. At rest, a notable distinction was observed in beta1 band PSD between right and left temporal regions in bipolar patients, but this difference attenuated after mental exercise. In addition, bipolar patients showed significantly lower PSD values in temporal regions, both at rest and after cognitive stimulation, compared with controls. Linear regression analysis revealed negative correlations between SCIP total score and alpha1 wave PSD in the left frontal and right temporal regions, as well as positive correlations with alpha1 wave PSD in the right frontal region and alpha2 wave in the left temporal region.

This study highlighted significant alterations in electroencephalographic patterns in patients with TB-1. The differences observed in PSD, particularly in the alpha and beta bands, could serve as potential biomarkers for assessing cognitive deficits in TB-1.

None Declared