Smartphone addiction is an emerging behavioral disorder. Its comorbidity with Substance Use Disorders is poorly understood, potentially creating a complex clinical profile.

This study aims to describe the sociodemographic and clinical characteristics of substance use disorder patients with co-occurring smartphone addiction to identify who is most vulnerable.

A cross-sectional study was conducted on 60 patients diagnosed with substance use disorder recruited from the Hope Department for Addiction Care at the Jbel Ouest Health Center. Participants completed a sociodemographic questionnaire and the Smartphone Addiction Scale-Short Version (SAS-SV) in Arabic. Based on established thresholds (≥31 for males, ≥33 for females), patients were categorized into two groups: with smartphone addcition (SAS-SV+) and without smartphone addicition (SAS-SV-). Data from clinical records were also collected. Data was collected and analyzed using IBM SPSS Statistics software, version 27.

Results for the SAS-SV+ Group (n=23): Patients with smartphone addiction had a mean age of 30.0 years (SD=9.0, range: 19-52) and were exclusively male (n=23, 100%). The majority were single (n=15, 65.2%) with a secondary education level (n=17, 73.9%). The most common employment status was day labourer (n=9, 39.1%). A significant minority had a personal psychiatric diagnosis (n=6, 26.1%), with depression being the most reported (n=4, 17.4%). Notably, this group showed high rates of substance use, with cannabis (n=13, 56.5%) and cocaine/crack (n=10, 43.5%) being the most prevalent. Furthermore, a family history of addiction was reported by 39.1% (n=9) of this group.

A significant proportion of substance use disorder patients present with comorbid smartphone addiction, characterized by a distinct sociodemographic and clinical profile. Recognizing this profile is crucial for clinicians to screen for digital addiction and develop integrated treatment strategies that address both chemical and behavioral dependencies.

None Declared

Dual disorders, combining severe mental illness and substance use, represent a major therapeutic and social challenge. Even when psychiatric stabilization is achieved under long-acting antipsychotic treatment, addictive relapses can compromise recovery, autonomy, and social reintegration. These complex cases often lead to repeated psychiatric hospitalizations despite the absence of psychotic symptoms, highlighting the need for more integrated approaches between psychiatric and addiction services.

To describe the clinical course of a dual disorder patient stabilized from a psychotic standpoint but repeatedly hospitalized due to alcohol-related relapses. The aim is to illustrate the therapeutic and social difficulties encountered when addiction remains active despite psychiatric stabilization.

A qualitative single case study was conducted of a male patient with chronic psychotic disorder and severe alcohol use disorder. Data were collected through longitudinal clinical observation during several psychiatric hospitalizations and outpatient follow-up. Clinical stability, addictive behaviors, treatment adherence, and social circumstances were analyzed to identify factors contributing to relapse and social exclusion.

The patient remained psychiatrically stable with no delusional or hallucinatory symptoms and displayed good behavior and engagement in care. However, massive alcohol intoxications led to agitated states, neighborhood disturbances, and an ongoing eviction process. Despite partial awareness of his behavior, the patient showed low motivation for addiction treatment. His recurrent hospitalizations were motivated more by social and behavioral issues than by psychiatric decompensation.

This case highlights the clinical and institutional impasse frequently faced in dual disorder management. Psychiatric stabilization alone is insufficient when addiction persists. Coordinated, multidisciplinary strategies involving psychiatric, addiction, and social care are crucial to prevent chronic institutionalization and social rejection.

None Declared

University entrance is a critical transition for nursing students, who face intense academic, emotional, and social demands that may predispose them to maladaptive behaviors like internet addiction. The growing reliance on digital platforms, especially social media, has heightened risks of compulsive internet use among university populations. However, this phenomenon remains understudied in Tunisia, particularly within healthcare education contexts. This study therefore aims to assess the prevalence of internet addiction among Tunisian nursing students and identify its key associated factors to inform targeted support strategies.

To evaluate the prevalence of social media addiction and its associated factors among nursing students in Tunisia.

A cross-sectional analytical study was conducted in March 2025 among nursing students across selected institutions in Tunisia. Participants completed a self-administered questionnaire capturing socio-demographic characteristics, lifestyle behaviors, and internet use patterns, with internet addiction assessed using the validated 20-item Internet Addiction Test (IAT). Data were analyzed to determine prevalence rates and identify factors significantly associated with internet addiction.

The study population was predominantly female (72.3%) with a mean age of 22 years. The prevalence of social media addiction (IAT score ≥ 31) was 54.9%. Logistic regression indicated that students with internet addiction (IAT ≥ 31) were 2.5 times more likely to sleep fewer than 6 hours per night (aOR = 2.5, 95% CI: 1.4–4.3, p = 0.003)

This study reveals a high prevalence of social media addiction among Tunisian nursing students. Intensive smartphone use, sacrificed sleep to stay connected, and early registration on social media appear as significant risk factors. These findings highlight the urgent need to integrate preventive strategies targeting digital health.

None Declared

The adverse consequences of illicit opioid use (e.g., overdose, infectious disease) have been the focus of intensive research efforts. However, other serious health problems among individuals with OUD have received far less attention. Food insecurity (FI) is 4-7 times greater among individuals with OUD than the general US population and associated with increased drug use, psychiatric distress, sexual and drug risk behaviors and a two-fold risk of premature death.

To evaluate the feasibility, acceptability and initial efficacy of a meal delivery intervention for reducing FI and other areas of psychosocial functioning among adults with OUD.

Participants (n=50) who were enrolled in MOUD treatment and met criteria for FI (>3 on the US Household Food Security Survey (FSS)) were randomized to one of two 12-week conditions. Nutritional Education (NE; n=25) participants received brief NE, a list of FI-related community resources, and assistance contacting resources of interest. NE+Meal Delivery (NE+MD; n=25) participants received NE plus premade, refrigerated meals delivered weekly by a commercial service. Both groups completed monthly assessments of FI, depression, quality of life, and illicit drug use.

Participants were 39.2+7.3 years old, 58% female and 82% white. Participants’ mean baseline FSS score was 8.2+3.1. Following randomization, retention was similar between the groups (88% and 84% in NE+MD and NE conditions, respectively). NE+MD participants demonstrated significantly greater decreases from intake in FSS score vs. controls, with mean scores lower in NE+MD vs. controls at all three post-intake timepoints (p’s<.05). Among NE+MD participants, a total of 2,976 meals were successfully delivered and meal enjoyment and convenience were rated at 81 and 93, respectively (range:0-100).

Pilot data also suggested several potential associations between FI and other areas of functioning. NE+MD participants’ scores on the Beck Depression Index were significantly lower than intake at Study Week 4 and 8 (p’s<.05). No such changes in BDI were observed in NE participants. On the RAND-36 QoL Health Survey, NE+MD participants experienced significant improvements (p’s p<.05) on four subscales, with greater scores on the subscales of Mental Health, Role Emotional, Bodily Pain, and General Health. No changes were observed on any subscales for NE participants. Finally, while there were no significant differences between groups on illicit opioid abstinence during the study, NE+MD participants provided 23% more urine specimens testing negative for illicit opioids on assessment days at which they were FS vs. FI.

Preliminary results suggest the initial feasibility, acceptability and efficacy of this intervention for improving FI and other areas of psychosocial functioning among individuals with OUD.

None Declared

Stigma related to mental illness has been studied primarily in relation to individuals diagnosed with illness. Families, however, encounter stigma in unique and complex ways. Classic definitions of stigma locate it at the intersection of stereotypes, prejudice, and discrimination—processes extensively theorized regarding individuals with mental illness but less so for their families. Further, much of the literature conflates “family burden” with stigma and under-theorizes the distinct mechanisms shaping family experiences. Consequently, family psychoeducation and support services do not address the layered stigma families face.

This paper reconceptualizes family stigma through an expanded framework that moves beyond the prevailing focus on “associative stigma” to consider how the whole family, including diagnosed individuals, is affected by stigma enacted in interpersonal, cultural, and structural processes.

The analysis draws on a literature review and qualitative data from focus groups in Ontario, Canada, involving participants who identified in one or more roles as service providers, family members, and people diagnosed with mental illness. Audio recordings of the focus groups were transcribed verbatim and analyzed using template analysis, which allowed for a flexible yet structured approach to identifying themes.

Three interrelated dimensions of family stigma emerged:

Associative stigma: negative judgments transferred to family members by association.

Intimate stigma: enacted within family relationships, influencing secrecy, belonging, and caregiving.

Structural stigma: embedded in policies, institutional practices, and systemic inequities affecting family resources and supports.

This framework clarifies how stigma affects families, constrains caring relationships, and restricts their pursuit of family wellbeing.

Family stigma is not reducible to “burden” but is a multi-level phenomenon manifesting through associative judgments, intimate dynamics, and structural inequities. By situating family experiences within relational and systemic contexts, this reconceptualization enriches stigma theory and underscores the value of family-centered, culturally responsive, and intersectional approaches. For practice and policy, it calls for explicit integration of anti-stigma content in psychoeducational programming and services to empower family members to support each other in challenging stigmatizing discourses that undermine their wellbeing.

None Declared

One of the most common characters of the ASD phenomenon is the speech difficulties. The diagnostic tools don’t usually explore the origin of the speech problem but rather describe it superficially. Research show that the prevalence of speech problem among ASD is very high. One of the researches found that 63% of the children diagnosed with ASD has Childhood apraxia of speech (CAS). ASD prevalence today is 1:54 in the USA (2020). Based on that, we can conclude that at least 1 percent of the population have severe speech problems.

Since the prevalence of speech motor problems is so high and the importance of speech as a functional tool is high as well, there is a need for a treatment tool which will be able to address the growing need. The VML method was developed and designed to treat CAS focusing on the ASD population. After experiencing over 3000 children in many countries around the world, we have developed an algorithm which represents the VML analysis process. The algorithm includes almost 1000 /If…Then../ conditions and was found reliable with copying the in-person VML evaluation. The algorithm generates a treatment program with 95% accuracy of the elected treatment topics.

Based on the algorithm, we have developed a software which can produce a highly detailed motor speech treatment program. The software is web based, available now in English and soon in other languages as well. The user is required to fill in the speech data using the software interface.

The uniqe software gives families and therapists all over the world the opportunity to use the VML method remotely in minimal cost. The program includes main treatment topics, detailed exercises, picture and videos demonstrating the proposed treatment and general guidelines. The software users are supported by the VML experts around the world.

The MYVML evaluation software is innovation in the field of speech treatment, striving to share the knowledge and give the treatment tool to as many practitioners and families as possible.

This lecture will present the VML method background, software structure, analysis and functionality through demonstrations of the software.

None Declared

Diabetes is a chronic illness that has become increasingly more prevalent in the past three decades. People with severe mental illness are estimated to be three times more likely to develop diabetes than the general population and are also at higher risk of complications. This survey was conducted amongst a cohort of patients under the care of the Recovery and Rehabilitation service in Waterford, all of whom have a diagnosis of a severe enduring mental illness and are treated with psychotropic medications. A number of the patients are diagnosed with type 2 diabetes. A need was identified within the service to improve patient knowledge and management of diabetes.

To assess the effectiveness of a structured education session in improving patients’ knowledge of managing diabetes.

A pilot survey was completed to assess the effectiveness of a diabetes education intervention. The rehabilitation team had developed a diabetes handbook in collaboration with staff and patients, that gave information on diabetes and how it is managed. Patients with type 2 diabetes were identified and they completed a questionnaire to assess their baseline knowledge of diabetes and its management. They were then invited to complete an information session given over two days, based on the handbook. They were then asked to complete a second survey post session to measure any change in knowledge.

20 patients were identified that meet the inclusion criteria. 14 patients participated in both sessions, while 6 patients attended only one session. The mean questionnaire score at baseline for the patients who attended both sessions was 8. The score improved to 9.2 after the second session. Results are provided in Table 1.Image 1:

This survey showed that a short teaching programme can be effective in improving diabetes knowledge among psychiatric patients under the rehab service. Regular diabetes education incorporated into the rehabilitation programme would likely help both support self-management and improve long term health outcomes.

None Declared

Background: Individuals in the recovery phase of schizophrenia often face persistent challenges including residual symptoms, emotional dysregulation, cognitive deficits, and high relapse rates. Mindfulness-Based Cognitive Therapy (MBCT), effective in mood disorders, shows promise as an adjunctive intervention but requires rigorous evaluation in schizophrenia recovery.Background: Individuals in the recovery phase of schizophrenia often face persistent challenges including residual symptoms, emotional dysregulation, cognitive deficits, and high relapse rates. Mindfulness-Based Cognitive Therapy (MBCT), effective in mood disorders, shows promise as an adjunctive intervention but requires rigorous evaluation in schizophrenia recovery.

This study examined the efficacy of MBCT in improving psychological functioning and reducing relapse risk among individuals with schizophrenia during the recovery phase.

A randomized controlled trial (RCT) was conducted with 80 clinically stable outpatients diagnosed with schizophrenia. Participants were assigned to either an 8-week MBCT program plus treatment-as-usual (TAU) (n=40) or TAU alone (n=40). Primary outcomes included relapse rates (measured over 12 months), symptom severity (PANSS, SANS), and mindfulness skills (FFMQ). Secondary outcomes encompassed depression/anxiety (HADS), cognitive functioning (MoCA), and quality of life (SQLS). Assessments occurred at baseline, post-intervention, and 6/12-month follow-ups.

The MBCT group demonstrated significantly lower relapse rates (15% vs. 37.5%, p<0.01) and greater reductions in negative symptoms (SANS: p=0.003) and emotional distress (HADS-depression: p=0.008) compared to TAU at 12 months. Significant improvements in mindfulness skills (FFMQ-Observe, p<0.001; FFMQ-Nonreact, p=0.002), attention regulation (MoCA, p=0.015), and quality of life (SQLS, p=0.004) were also observed post-intervention and sustained at follow-up. No adverse events were reported.

MBCT is a feasible and effective adjunctive therapy for individuals recovering from schizophrenia, enhancing mindfulness, mitigating negative symptoms and emotional distress, improving cognitive function, and reducing relapse risk. Integration of MBCT into recovery-phase care may promote long-term stability and functional outcomes.

None Declared

Minority stress remains a central factor in the mental health of sexual and gender minorities often resulting in elevated distress, anxiety, depression, suicidality, and substance misuse (Moorhead, B., Lewis, H.K. & Arnull, L., 2024.). Building on insights from previous research, the Mental Health Support Programme BOJE (Colours) was launched to offer comprehensive support tailored to the needs of LGBTQIA+ individuals within the Croatian public mental healthcare system.

The aim is to present a group processes, with a focus on the development of cohesion, within the BOJE programme - which includes group psychotherapy in structured three-month cycles and ongoing support groups.

In October 2023, a multidisciplinary team at the University Psychiatric Hospital Sveti Ivan in Zagreb, Croatia, formed a Mental Health Protection Programme BOJE which consists of a counseling center, an outpatient clinic and a three-month therapeutic and educational cycle for LGBTQIA+ users. Over time, the programme has expanded to include support group, psychotherapeutic with families and a platform was provided for training healthcare professionals in LGBTQIA+ affirmative practice. In our experience, the programme’s main components are the three-month structured group cycle — combining psychoeducation, group psychotherapy and art therapy — and the ongoing support group.

To date, we have carried out more than 1,200 interventions — including counseling, psychiatric consultations, reviews, and psychotherapy. Four cycles of closed-group workshops have been completed with a very low dropout rate, and a fifth cycle is currently underway. The support group now brings together participants from all previous cycles. In both types of groups, we observed rapid development of cohesion, stronger interpersonal support, more active participation, better outcomes, and consistently low dropout rates.

The BOJE programme was established in the Croatian healthcare system to address the impact of minority stress and support the mental health of LGBTQIA+ people. Our experience shows that group cohesion forms rapidly when participants share both an LGBTQIA+ identity and the programme framework. This reflects research demonstrating that shared identity can transform vulnerability into resilience, belonging, and mutual support.

None Declared

Clinicians have often been criticised for excluding psychotic patients from decisions about their own treatment. While shared decision-making (SDM) is widely promoted, its use in psychiatry is still under-researched and sometimes contested. Some studies suggest SDM hasn’t delivered the expected benefits in general healthcare and may even leave patients feeling abandoned. This makes it important to look more closely at which kinds of SDM actually help patients feel more in control and empowered—especially in an inpatient, psychosis setting, where agency can be harder to support.

This study explores how clinicians can foster agency in psychotic patients during treatment planning. We focus on inpatient consultations where patients actively express a desire to be involved in treatment decisions.

The study draws on four months of ethnographic fieldwork by the first author (KS) in a Danish mental health ward. During this time, she observed and/or recorded 58 doctor-patient conversations. For this analysis, we zoom in on consultations where patients showed a wish to participate in treatment decisions, using discourse analysis to unpack how these moments unfolded.

In the inpatient setting, patients mainly tried to be involved in decisions about hospitalisation status—sometimes indirectly—while clinicians tended to focus on decisions about medication. Clinician responses to patient agency fell into three broad patterns:

1. 1. Ignoring the patient’s expressed or insinuated wish for treatment.

2. 2. Acknowledging the wish but discouraging agency by asking the patient to put trust in the clinicians or medicine.

3. 3. Fostering agency by identifying patient resources and encouraging patients to reflect on them.

Clinicians can better support patient agency by 1) recognising patients’ treatment preferences and 2) actively identifying and discussing their coping strategies and goals. As psychiatric hospitals face challenges with frequent readmissions, helping patients mobilise their own resources may be one way to improve long-term outcomes.

None Declared

Mental disorders pose a major global health burden, yet a persistent treatment gap leaves most people in need without adequate, timely and evidence-based treatments, especially psychotherapies. Despite two decades of WHO-led initiatives to scale up and invest in mental health services, progress remains limited. Most countries have not met mental health service targets due to chronic underinvestment, and have failed to scale up evidence-based psychosocial treatments to match population-level needs.

To describe Finland’s First-Line Therapies (FLT) initiative, a nationwide system-level initiative launched in 2020 to close the treatment gap through strengthening and digitally augmenting primary care mental health services.

FLT was implemented as a change-management initiative within Finland’s sweeping 2023 health and social systems reform, emphasizing process redesign and digitalization over new treatments or increase of resources. Key strategies included a localized stepped-care model, digital tools for assessment and treatment, and a national e-learning platform for workforce competence development.

FLT was rapidly scaled up nationwide. Key components include a digital triage tool (Finnish Therapy Navigator, FTN), over 50 online self-help and guided self-help programs, a nationwide internet-based CBT service, and a national e-learning platform to train thousands of clinicians annually in evidence-based therapies.

The FTN is used by over 2% of the population annually, standardizing initial assessments to under 30 minutes and saving clinician time, with over 90% patient and 95% provider acceptance. The stepped-care model ensures low-intensity interventions are used first if appropriate, with higher-intensity therapy provided as needed. The nationwide iCBT service enables patients to start therapy within one week at no cost to them. A new e-learning platform has trained ca 16 000 thousand professionals in several brief evidence-based psychotherapies, greatly expanding workforce competence. Notably, these improvements in access and efficiency were achieved with minimal new spending.

The FLT joins a growing list of models aiming to improve early access to evidence-based psychosocial treatments, spearheaded by the UK IAPT / NHS Talking therapies model. The Finnish experience shows that digitally augmented system reform can in some cases also narrow the mental health treatment gap without major new increases in staff. By focusing on scalable interventions and embedding changes into existing services, FLT addresses key barriers such as implementation failure, limited scalability, and underinvestment, and offers a WHO-aligned framework for reform that can be of intrest to other countries (including low-resource settings) in expanding access to evidence-based treatments within existing systems.

None Declared

Metacognitive Therapy (MCT) targets maladaptive metacognitions and the cognitive attentional syndrome (CAS) (Wells 2009). Transdiagnostic interventions are increasingly encouraged to address comorbidity efficiently and to improve cost-effectiveness (McEvoy et al. 2009). However, structured brief group protocols with long-term follow-up remain limited.

This pilot study developed and tested an 8-session manualized transdiagnostic group MCT protocol for adults with mixed anxiety and depressive symptoms, examining both immediate and 6-month outcomes.

Twelve participants (gathered from 3 groups) completed the intervention. The protocol included detached mindfulness, attention training, and modification of maladaptive beliefs. Outcomes were assessed at baseline, post-treatment, and 6-months: Clinical Global Impressions Severity (CGI-S), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), CAS-1, and Outcome Rating Scale (ORS). Within-group analyses were performed with paired tests.

Significant pre- to post-treatment improvements were observed across all primary measures, with large to very large effect sizes (Table 1). At 6-month follow-up, reductions in depression, anxiety, and CAS, and improvements in functioning were maintained. Comparisons between post-treatment and follow-up were not significant (p = 0.191–0.949), suggesting stability of gains.Table 1.

Key outcomes (Mean ± SD) and effect sizes

An 8-session transdiagnostic MCT group protocol was feasible, well accepted, and associated with robust reductions in distress, maladaptive metacognitions, and CAS, alongside improvements in functioning. Gains were sustained at 6 months, with no significant decline or further improvement, highlighting stability of effects. Despite encouraging outcomes, the small and uncontrolled nature of this study limits generalizability. Larger randomized controlled trials are required.

None Declared

Internet-delivered cognitive behavioral therapy (iCBT) has become a promising alternative to face-to-face CBT, yet its long-term effectiveness across psychiatric disorders remains unclear. While numerous studies have examined short-term outcomes, it is essential to understand how iCBT compares with traditional CBT over extended periods and which conditions benefit most.

This review aims to analyze RCTs that compare iCBT and face-to-face CBT within the same clinical trials, reducing potential effect size inflation and providing clearer insights into iCBT’s long-term effectiveness (12 months or more).

RESEARCH QUESTIONS

1. 1. What are the long-term effects of iCBT compared with traditional CBT in reducing symptom severity in individuals with anxiety, depression, and eating disorders?

2. 2. How do dropout rates differ between iCBT and face-to-face CBT across various psychiatric disorders, and what factors are most predictive?

3. 3. Which psychiatric disorder among anxiety, depression, and eating disorders shows the most significant symptom improvement when treated with iCBT?

A systematic search of PubMed, Embase, MEDLINE via EBSCO, PsycINFO via APA, Scopus, and Cochrane Library (CENTRAL) was conducted up to May 21, 2025. Randomized controlled trials (RCTs) comparing the long-term effects of iCBT and face-to-face CBT for depression, anxiety disorders, and eating disorders were included. The random-effects model was used to calculate the standardized mean difference (Hedges’ g), and a chi-square test assessed adherence differences.

Eleven RCTs (1,272 participants) met the inclusion criteria. Pooled analysis showed no significant difference in long-term effectiveness between iCBT and face-to-face CBT (Hedges’ g = −0.07, 95% CI: −0.36 to 0.21). Depressive disorders responded best to iCBT, while anxiety disorders showed mixed results, and eating disorders had the least favorable outcomes. Adherence was higher in face-to-face CBT (86.68%) than in iCBT (70.06%), with therapist-guided iCBT improving completion rates (79.09%) compared with self-guided formats (48.17%).Image 1:

iCBT is a promising alternative to traditional face-to-face CBT, demonstrating treatment effectiveness even in the long term. However, dropout rates are higher in iCBT, particularly in unguided formats, suggesting that therapist support may be crucial for ensuring participant adherence. Future research should optimize iCBT delivery, tailor it to specific disorders, and develop strategies to improve engagement.

None Declared

University students, as Gen Z, are particularly vulnerable to elevated stress, anxiety, and emotional dysregulation during the emerging adulthood period. This phenomenon may have negative effects on academic performance, social interaction, and overall well-being. However, preventive and experiential mental health interventions remain underdeveloped in higher education settings.

This study aimed to evaluate the effects of a psychodrama group intervention on anxiety, coping strategies, and socio-emotional competencies among university students.

This mixed-method quasi-experimental study utilized pre-test, post-test, and follow-up measurements (quantitative) and sociometric techniques in the second and tenth sessions of both groups (qualitative). Participants in the intervention group (n=9) attended ten weekly psychodrama sessions between October 2024 and January 2025, while the control group (n=11) received no intervention. The control group later received the intervention in March–May 2025. Quantitative data were analyzed using Mann-Whitney U (between-group) and Friedman tests with post-hoc Wilcoxon and Bonferroni correction (p<.0167). Thematic analysis (tree game) and content analysis (sociometric spectrograms) were employed to analyze the data.

Quantitative data demonstrated that, compared to the control group, the intervention group demonstrated significant improvements in emotional expressivity, decline in anxiety (BAI), and enhanced coping strategies as Adjustment, and Self-Punishment subscales, with sustained changes in Self-Help at follow-up. Qualitative analysis revealed eight themes, “Growth and Separation from Roots”, “Ability to Build New Bonds”, “Inner Evolution” and “Self-Sufficiency” from tree games”; “Emotion Regulation”, “Socio-Emotional Contact”, “Self-Awareness” and “Flexibility” from sociometric spectrograms.

Integrating quantitative and qualitative findings demonstrates that psychodrama positively impacts students’ emotional, cognitive, and social functioning. The safe and structured group environment enabled authentic emotional expression, discovery of personal resources, and exploration of adaptive coping strategies. These findings support the use of experiential group-based programs in university mental health services. Future large-scale and longitudinal studies are needed to evaluate sustainability, generalizability, and mechanisms of change.

None Declared

Treatment-resistant depression remains a major clinical challenge, with many patients experiencing relapse despite advances in medication and psychotherapy. Esketamine offers rapid relief from depressive symptoms, while psychotherapy helps patients build lasting skills to manage their condition. Despite their individual effectiveness, little is known about how these treatments work together in real-world outpatient settings, particularly in non-Western populations.

This study seeks to contribute to this underexplored area by evaluating the combined use of esketamine and psychotherapy in a real-world outpatient clinic in the United Arab Emirates. By examining changes in symptom severity, as well as therapist and patient perspectives on treatment and relapse planning, the research aims to provide practical, culturally relevant insights into the integration of pharmacological and psychological interventions.

Five adult patients receiving concurrent treatment were included. Quantitative data, such as depression and anxiety scores (PHQ-9, GAD-7) and treatment histories, were extracted from clinical records. Semi-structured interviews with patients and therapists explored experiences, treatment effectiveness, engagement, and relapse-prevention strategies. Interviews were transcribed and analyzed using reflexive thematic analysis.

Preliminary qualitative findings suggest that esketamine may increase emotional openness and cognitive flexibility, helping patients engage more fully in psychotherapy. Therapists reported improved responsiveness during sessions, while patients emphasized the role of psychotherapy in sustaining improvements beyond medication effects. Quantitative data analysis is ongoing and will be presented alongside qualitative insights.

To our knowledge, this is the first study examining the integration of esketamine and psychotherapy in a Middle-Eastern clinical population. By combining clinical outcomes with patient and therapist perspectives, the study offers culturally relevant insights into real-world psychiatric care. These findings have important implications for relapse prevention, therapeutic alliance, and individualized treatment planning.

None Declared

Exposure to odors with different emotional valences activates key brain regions involved in emotion. The emotional impact of odors is modulated by factors such as personality, current emotional state, and attentional focus. Distinct alterations in brain regions involved in emotion processing and regulation are caused by burnout. Frontal alpha asymmetry (FAA), as a well-established electrophysiological marker for emotional processing, has been extensively studied as a potential biomarker for depression and stress, but findings across the literature are mixed.

We aimed to investigate the impact of burnout on the odor-induced neurodynamic responses.

142 participants (female and male) aged 18 to 24 years with no documented manifestations of rhinal pathologies (Taras Shevchenko National University of Kyiv students) were recruited. EEG was registered during the rest state (3 min) and under passive odor stimulation (10 min) with sandalwood essential oil (SEO) (n=37) and izoamilacetate (IA) (n=54). The control group included 51 participants. We estimated the spectral power density (SPD) of all frequencies from 0.2-45 Hz. Frontal EEG asymmetry (asymmetry index) was calculated using subtracting the natural logarithm of spectral power density of alpha band of the left-side channels from the right-side ones (L-R). The 84-item Boyko’s Syndrome of Emotional Burnout Inventory was used detecting the severity of emotional burnout before the registration of EEG.

The Resistance stage of burnout was detected in 23 (control group), 16 (izoamilacetate group) and 13 (sandalwood group) volunteers. We demonstrated that odor-specific olfactory-evoked neurodynamics depending on the burnout severity. Sandalwood essential oil and izoamilacetate were perceived as weakly activating stimuli by all participants and more pleasant by the participants with an unformed resistance stage. A higher left frontal activity under SEO was observed at the first minute of odor presentation while IE leads to a higher right frontal activity. Formation of the Resistence stage of burnout was characterized by a higher left frontal activity during the second minute of exposition to both odors.

Under non-directed attention conditions of passive odor perception, topographical reorganization of brain activation reflects information and emotion-activating processes. We detected that unique odor-induced responses are influenced by the formation of burnout.

None Declared

Catatonia is a multifaceted neuropsychiatric condition characterized by both motor and affective disturbances. While existing neurobiological frameworks have largely emphasized cortical and cerebellar dysfunctions to explain its sensorimotor and behavioral features, the contribution of the limbic system remains less investigated. Given its central role in emotional regulation and motivational processes, emerging evidence suggests that limbic alterations may represent a crucial mechanism underlying catatonia, potentially offering a more comprehensive explanatory model and guiding therapeutic innovation.

This review aims to synthesize current knowledge on structural and functional abnormalities of the limbic system in catatonia. Specific objectives include mapping the implicated limbic regions, clarifying their possible role in symptom expression, and considering how these insights may inform targeted clinical interventions.

The review was carried out according to PRISMA guidelines. Systematic searches were performed in MEDLINE, Web of Science, PsycINFO, and Scopus without temporal restrictions. We included studies involving patients with a standardized diagnosis of catatonia who underwent biological or instrumental investigations of limbic regions. Extracted data encompassed study design, sample characteristics, diagnostic framework, type of investigation, and limbic findings at the structural or functional level. Methodological quality was appraised using Joanna Briggs Institute tools, with disagreements resolved by discussion or external consultation.

The search strategy yielded 1792 records; after screening, 54 full texts were reviewed and 14 fulfilled eligibility criteria. Hand-searching of references added 5 further studies, resulting in 19 included articles: 7 case reports and 12 observational investigations, most of which applied neuroimaging to assess limbic involvement in catatonia. The anterior cingulate cortex emerged as the most consistently implicated area, with findings of altered gyrification, reduced grey matter, and perfusion changes associated with clinical manifestations. The orbitofrontal cortex - though not strictly part of the limbic system but functionally related - was also frequently reported as altered. Evidence concerning the amygdala, hypothalamus, and other structures was more heterogeneous, ranging from volumetric abnormalities to biochemical dysregulation linked to genetic or acquired factors.

The review supports a significant contribution of limbic dysfunction to catatonia, adding to prevailing models centered on cortical and cerebellar pathology. Nevertheless, heterogeneity in diagnostic criteria, methodological limitations, and small sample sizes constrain the strength of current evidence. Future research with more rigorous designs is essential to clarify the role of limbic networks in catatonia and to advance treatment perspectives.

None Declared

Scientific literature from the 19th and 20th centuries indicates that approximately two-thirds of all people reported experiencing déjà vu and various similar states.

The aim of this 25-year study was to investigate the prevalence and incidence of deja vu, jamais vu and synesthesia symptoms in modern society.

Fifth-year medical students of RUDN University aged 22-24 years +/- 2.4 participated in this study annually from 2001 to 2025. A total of 2860 students were included in the study.

The prevalence of déjà vu at the beginning of the observation (2001–2004) was 82% (95% CI: 79–85%), then consistently increased by 2015 reaching 98.5% (95% CI: 97–99%) and remains at this level to this day. For most respondents, déjà vu occurs quite rarely (from 2 to 10 times over many years), mainly in childhood and adolescence.

A consistent increase in the incidence of synesthesia in students was noted, as a stable feature that is not subject to significant changes and persists throughout life, from 12.6% (95% CI: 11-16%) in 2000-2015 to 22.3% (95% CI: 20-25%) in 2016-2025 (χ2 = 41.7, p < 0.001).

The jamais vu phenomenon was relatively rare: in 2001-2017, the frequency was 3% (95% CI: 2-5%), and in 2018-2025. increased to 5% (95% CI: 3–8%) (χ2=6.7, p<0.01). Lifetime prevalence of jamais vu remained consistently low – 1–3 cases in 96% of respondents who answered positively.

This study demonstrates a significant increase in the incidence of deja vu, jamais vu and synesthesia over the past 25 years and requires further investigation.

None Declared

This paper presents an analysis of three clinical cases treated with two versions of the bio-psycho-social model:

1. 1. Model with Biological Prevalence: The treatment of choice is pharmacological, complemented by psychotherapy and supportive sociotherapy. The aim is to reduce the severity of symptoms, but this results in a reduction of the capabilities of the patient.

2. 2. Model with Psychological Prevalence: The treatment of choice is psychotherapy, with psychopharmacotherapy as a supportive measure. The aim is to increase awareness of maladaptive relational rules that generate symptoms to facilitate the decision to modify them.

The objective of this work is to demonstrate that the bio-psycho-social model with psychological prevalence facilitates the understanding of the psychotic patient, leading to increased treatment efficiency.

In the integrated treatment approach, the method applied is a unique intervention model that seeks to identify the stable rules of functioning of the patient and their family. This model guides interventions, which are focused on awareness and decision-making, across all settings of the care community:

• - Individual, family, group psychotherapy and body therapy

• - Sociotherapy: Workshops with four levels of increasing autonomy

• - Psychopharmacotherapy: To reduce the pain of awareness and decision-making

• - Supervision: To develop common guidelines and integration of interventions

The results achieved from this approach include:

• - Symptom reduction

• - Reduction in voluntary and compulsory medical treatments

• - Reduction in psychopharmacotherapy (dosage and costs)

• - Affective autonomy and work-related autonomy

In conclusion, we highlight the opportunity to develop the different forms of the bio-psycho-social model with psychological prevalence.

None Declared

Exosomes offer a unique window into central insulin signaling through vesicles that can be isolated from peripheral blood. While peripheral insulin resistance has been associated with mood and metabolic disorders, the contribution of neuronal insulin signaling to affective psychopathology is less well understood. Clarifying whether insulin-related abnormalities in the brain contribute to depression and bipolar disorder, particularly across the lifespan, may reveal mechanisms of persistence and recurrence not explained by peripheral measures alone.

This study aimed to determine whether levels of phosphorylated IRS1 (pIRS1) in neuron-derived exosomes are associated with psychiatric diagnostic status in the Netherlands Study of Depression and Anxiety (NESDA). A further objective was to assess whether such associations vary as a function of age and whether they remain independent of peripheral metabolic markers.

Data were obtained from NESDA, a large, well-characterized psychiatric epidemiology cohort. Diagnostic groups included healthy controls, individuals with current major depressive disorder (MDD), remitted MDD, anxiety without MDD, and bipolar disorder. Multinomial logistic regression models evaluated associations between exosomal pIRS1 and diagnosis, adjusting for batch effects, age, sex, education, and metabolic indices including waist circumference, triglycerides, BMI, and fasting insulin.

Individuals with MDD or bipolar disorder were older, more often female, and displayed less favorable metabolic profiles relative to controls. Overall, pIRS1 was not associated with diagnosis. However, a significant interaction with age showed that higher pIRS1 was linked to increased odds of current MDD, remitted MDD, and bipolar disorder compared with controls, whereas no such association was observed for anxiety disorders. Importantly, these associations persisted after controlling for peripheral metabolic measures, suggesting that the observed effects were not reducible to peripheral insulin resistance.

The findings indicate that central insulin signaling abnormalities, as reflected in exosomal pIRS1, may underlie an age-dependent vulnerability to depression and bipolar disorder. By capturing aspects of insulin dysregulation that peripheral measures cannot, exosomal biomarkers provide novel insight into the biological persistence of affective disorders and may help identify subgroups of patients at heightened risk for recurrence or chronicity.

None Declared