Gambling disorder is a rising concern among young adults, highlighting the need for effective screening to offer appropriate support and intervention.

This study aims to characterize gambling disorder among young adults (ages 18-25) in Portugal.

A quantitative cross-sectional study was conducted using a self-administered online questionnaire completed by young adults.

This study included a population of 554 participants, 166 of whom were gamblers. Among the gamblers, the prevalence was as follows: 63% did not show signs of pathological gambling, while the remaining participants exhibited gambling addiction at varying levels: 25% mild, 9% moderate, and 3% severe. The typical profile of a gambler was identified as a male university student with an average age of 23.5 years, of a middle economic status and residing in an urban area. The preferred types of gambling were sports betting and online casino games. Most online gamblers had previously engaged in offline gambling at the age of M=19.25. The primary attractions of online gambling for these individuals were accessibility, the variety of games, and the potential for economic gains. The main encouragements to gamble online were friend´s influence and online advertising. No significant differences were observed in depression (PHQ-9) and anxiety scores (GAD-7) between gamblers and non-gamblers (p > 0.05). However, among gamblers, a strong positive correlation was found between higher levels of addiction (assessed by DSM-V gambling disorder criteria) and both depression and anxiety scores (r = 0.732, r = 0.681; p < 0.01). Furthermore, severe gambling cases were associated with a higher prevalence of prior formal diagnoses of psychiatric disorders, such as ADHD, anxiety, and depression, although this association was not statistically significant (p > 0.05). All gamblers showed a higher prevalence of substance abuse (p < 0.01). However, this trend did not extend to alcohol consumption (p > 0.05). The Jacobs Dissociative Experiences Scale was used to assess the presence of dissociative symptoms in relation to the severity of gambling addiction, revealing a strong positive correlation (r = 0.721; p < 0.01). Gamblers reported negative impacts on their family and romantical relationships. In contrast, they did not perceive their gambling behavior as having an adverse effect on their friendships or work performance. The majority (71.4%) of high-severity gamblers did not seek professional help and were not receiving any psychopharmacological therapy.

This study features the critical need for effective screening and intervention strategies for gambling disorder among young adults, given its correlation with mental health disorders and substance abuse. Addressing these challenges is essential for enhancing support and improving outcomes for individuals with gambling disorder.

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Precision of language in neuropsychiatry is vital for the accurate understanding of complex psychopathological phenomena. Many expressions used in psychiatry, especially those of German origin, reflect nuanced descriptions of patient behaviors, cognitive impairments, and emotional states that are not easily captured by modern terms. These linguistic tools provide a window into the intricate dynamics between the mind and body, helping clinicians interpret and navigate the subtleties of neuropsychiatric conditions.

This review aims to explore how specific expressions in neuropsychiatry, derived from clinical German terminology, contribute to a deeper understanding of patient experiences and enhance the precision of clinical assessment. By examining these linguistic elements, the paper seeks to illustrate their relevance in diagnosing and treating neuropsychiatric disorders, particularly where conventional language falls short.

Through a conceptual analysis, this review delves into the historical development and clinical application of several key terms originating in German psychiatry. Terms such as “Gegenhalten,” which describes paradoxical resistance in catatonia, and “Weltschmerz,” a term encapsulating existential despair, are examined within clinical contexts. The review also discusses other terms such as “Mitgehen,” referring to automatic obedience, and “Vorbeireden,” which highlights disorganized speech patterns. The review draws upon classical psychiatric literature and modern clinical observations to demonstrate how these terms inform diagnosis and treatment strategies.

The use of these specific linguistic constructs offers neuropsychiatrists valuable insights into the subjective experiences of patients, often highlighting behaviors and emotional states that would be otherwise overlooked. For example, “Gegenhalten” allows for the differentiation of motor dysfunction in catatonia, while “Weltschmerz” provides a unique framework for understanding a type of depression that transcends typical diagnostic boundaries. Similarly, “Vobeirreden” aids in the recognition of cognitive disorganization, and “Mitgehen” underscores deficits in volitional control. These terms provide clinicians with greater clarity and precision in diagnosis and therapeutic approaches, bridging the gap between patient experiences and clinical evaluation.

This review underscores the importance of language in the accurate interpretation of neuropsychiatric disorders. It demonstrates how these terms enrich the diagnostic process and offer deeper clinical insights into patient behaviors and symptoms. The nuanced language of neuropsychiatry not only enhances understanding but also serves as a tool for more targeted and effective interventions. Ultimately, this approach encourages clinicians to consider the broader impact of linguistic precision in both diagnosis and treatment planning.

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Major depressive disorder (MDD) is a severe mental disorder with a prevalence rate of 10%. Approximately 30-40% of patients suffering from MDD show higher levels of proinflammatory cytokines, associated to low response to pharmacotherapy. Thus, modulation of immune system might have a key role in the management of MDD.

This study is aimed to: 1) assess the interrelation between immune hyperactivation and neuronal plasticity; 2) assess how non-pharmacological treatments impact on the immune hyperactivity in patients suffering from MDD; 3) identify biological makers able to predict the course of MDD and the effectiveness of treatments.

Immune4Plasticity is a longitudinal, multisite trial funded by Italian Ministry of Health. Preclinical analyses aimed at investigating the interrelation between immune hyperactivation and neuroplasticity as well as the identification of biological markers of MDD will be carried out at National Institute of Health in Rome. Clinical part of the study will be performed at the Department of Psychiatry of University of Campania, Naples, and at the Vita-Salute San Raffaele University, Milan. Seventy patients aging 18-65, with a diagnosis of MDD according to the DMS-5 criteria without psychotic symptoms, scoring more than 14 at the 17-item Hamilton Depression Rating Scale and able to release informed consent will be included. Thirty-five participants will attend a lifestyle psychosocial intervention in Naples; thirty-five will undergo light-therapy sessions in Milan. Assessments of both groups will be performed at recruitment (T0), after 3 months (T1) and after 6 months (T2), by using standardized psychometric tools and blood samples. The project will be carried out for 24 months.

This multidisciplinary, translational study will shed more light on the complex interrelationship between MDD, immune system and neuroplasticity by investigating the role of psychosocial intervention and light therapy as ‘modulators’. This will make it possible to develop innovative therapeutic strategies by integrating non-pharmacological approaches with anti-inflammatory drugs and to identify new peripheral markers to assess the response to treatment of patients with MDD.

MDD is a complex mental disorder associated with higher expression of inflammation. Sometimes, it is not adequately responsive to pharmacotherapy. Understanding the effect of non-pharmacological treatments as “modulators” of the inflammatory pattern of MDD may be an important strategy to optimize clinical management of this disorder.

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Major depressive disorder (MDD) presents as episodes lasting at least two weeks, affecting mood, cognitive, and neurovegetative functions, leading to significant distress [1]. Remission is challenging, with rates of only 30-50% after 6-8 weeks of antidepressant treatment [2]. The STAR*D study shows that 30-40% of patients achieve remission with first-line treatment, and a third fail even after four trials [3]. Recurrence risk is high, reaching 90% after three or more episodes [4][5].

The study aims to identify predictive factors for recurrence in major depressive disorder patients at Arrazi Psychiatric Hospital in Salé and to assess the impact of sociodemographic, biological, psychological, socio-environmental, and treatment-related factors on recurrence risk.

This retrospective, descriptive, and analytical study will collect data from medical records of major depressive disorder patients at Arrazi Psychiatric Hospital in Salé, including sociodemographic, clinical, and therapeutic details. Standardized data extraction ensures anonymity, and factors will be analyzed through univariate, bivariate, and multivariate statistical methods (logistic regressions), with adjusted odds ratios calculated for significant factors and a p-value threshold of < 0.05 applied.

The study shows that women represent approximately 60-70% of patients, with an average age of 30-40 at the first episode and often limited social support in 50-60% of cases. About 40% present psychiatric comorbidities, and 20-30% have physical comorbidities. Nearly 50% of patients have recently experienced stressful events, and 30-40% live in precarious conditions. Therapeutic adherence is insufficient for 30-40% of cases, and 25-35% discontinued treatment prematurely. Meanwhile, those who benefited from combined therapy represent 50-60%, showing a lower recurrence risk.

The recurrence of major depressive disorder poses a major clinical challenge, impacting long-term patient management. Identifying risk factors can enhance preventive interventions and therapeutic follow-up, while an integrative approach considering sociodemographic and psychological factors may help reduce relapse rates. These findings underscore the need for further research into the mechanisms of recurrence in major depressive disorder.

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Diet-related support is urgently needed for people with serious mental illness underlying the role of nutrition in a biopsychosocial approach. Integrating healthy lifestyle practices such as a balanced diet and physical exercise could supplement and amplify the effects of existing pharmacotherapies and psychotherapies. Despite its considerable role, nutritional literacy of mental health professionals appears scarce. Specific nutrition training courses for mental health professionals are needed in order to increase awareness on nutrition as a well-being contributing factor in the biopsychosocial model.

The aim of this study is to investigate insight and attitudes on nutrition in mental health among a sample of psychiatrists and psychologists resident in Italy.

The survey was conducted from May to June 2024 and the questionnaire was anonymous and self-rated, accessible via Google forms. The sample comprised 110 Italian mental health professionals (adult and child psychiatrists, psychologists) who voluntarily completed the on‑line questionnaire.

110 participants (61 psychologists, 46 adult psychiatrists and 3 child psychiatrists) agreed to participate to our survey. 89.2 % (n= 91) of them worked in southern Italy.The majority of participants were female (77.98%) and reported working in a Mental Health Centre (n= 41, 37,27%), followed by psychiatric residential facilities (n=22, 20%), private practice (n= 19, 17.27%), hospital (n= 14, 12.73%), university research centre (n=4. 3.64%), other non specified institute (n=10; 9.09%). The numer of years of working as mental health professional was 19.27 ± 11.27 years. Adopting “sometimes” nutritional approach for the treatment of the patients was the answer mostly reported (n= 56, 51.4%) followed by “most of the time” (n= 28, 25.69%), “always” (n=11; 10.09%), “never” (n= 7, 6.42%), “almost never “(n= 7, 6.42%).

Despite the scientific evidence and some treatment guidelines in support of this relationship, the implementation of nutritional psychiatry into routine clinical practice remains limited. Integrating nutrition into the clinical practice of psychologists and psychiatrists and providing evidence-based nutritional advice represent an interesting mental health challenge to address in the coming years.

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The consumption of alcohol, cannabis, cocaine, or heroin causes alterations in the central nervous system, affecting mood, perception, and behaviour. Despite the harmful effects of these substances, they remain widely used. Younger individuals tend to consume cannabis and cocaine, while older adults more commonly use alcohol and prescription medications. Ageing brings changes in consumption patterns and has both physical and mental health consequences

This study aims to analyze how age influences the clinical characteristics of patients with Substance Use Disorder (SUD), comparing differences between older and younger users.

A total of 297 SUD patients participated in this study. They were divided into two groups: those aged 55 and older (G1) n= 88, and those younger than 55 (G2) n= 209. The SF-36 questionnaire was used to assess quality of life, the BIS-11 for impulsivity, the ASRS v1.1 for ADHD, the STAI-R for anxiety, and the AQ for autistic traits. All participants provided informed consent, and the study adhered to ethical guidelines.

G1 showed better social functioning (SF-36) but a significant physical decline compared to G2. G1 also demonstrated lower levels of impulsivity (BIS-11), aggression, anxiety (STAI-R), and ADHD symptoms (ASRS), though higher autistic traits (AQ) were observed in G1.

Ageing reduces impulsivity, aggression, anxiety, and ADHD symptoms in individuals with SUD, but worsens physical health and may increase social isolation and autistic traits. These findings underscore the need to adapt SUD treatments according to age, addressing both physical and psychosocial challenges specific to each group.

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Chronic pain is very prevalent in the population, with an estimated prevalence of 20.5% of the adult population experiencing pain every day or most days. Chronic pain is one of the main factors that generate dysfunctionality in patients, and it can even lead to dependence in activities of daily living. Chronic pain is strongly associated with depression, and can induce a major depression which, due to its characteristics, will become chronic. Several studies have shown that intravenous ketamine can be effective in the treatment of chronic pain. Major depression associated with chronic pain has a worse outcome and is more frequently associated with resistance to pharmacological treatment, making the management of these patients a clinical challenge.

The present study shows the response in a series of cases with major depression and chronic pain treated with inhaled esketamine, showing their evolution through the Montgomery-Asberg Depression Rating Scale (MADRS) and Fibromyalgia Impact Questionnaire (FIQ) as main outcomes.

The main objective of this study is to describe the use of inhaled esketamine in patients with major depression and chronic pain in real clinical practice, using the MADRS and FIQ as main outcomes to show the evolution.

Retrospective descriptive study with a sample selected by non-probabilistic consecutive sampling, retrospective type, in a time interval of 2 years. The patients selected were those who completed treatment with inhaled esketamine and had a diagnosis of major depression and a diagnosis of chronic pain at Hospital Universitario Infanta Elena. A descriptive analysis was performed. Mean and standard deviation were calculated for quantitative variables and N and percentage for categorical variables.

A total of 5 patients with a diagnosis of major depression and chronic pain (n: 5) all treated with inhaled esketamine were included in the study. The efficacy of inhaled esketamine was high in the reduction of pain during the months of treatment with it, presenting an improvement in the MADRS and the FIQ. At the end of treatment, there was a significant difference between patients who had made changes in their daily life habits (sport, improved daily activities, improvement in the quality of life) and those who had not made changes in their daily life habits.

This study shows that inhaled esketamine may be a useful drug in the treatment of major depression associated with chronic pain. Treatment with esketamine improved depressive symptoms and also chronic pain. A significant influence of changes in lifestyle habits was observed in maintaining the response to pain relief once treatment with esketamine was finished. Longitudinal studies must be carried out to confirm this hypothesis.

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Autism spectrum disorders (ASD) are underdiagnosed in women due both to diagnostic bias, and the quieter, less visible signs and symptoms of female autism. Distress generally only becomes manifest during mid childhood and adolescence, when mental illness gets misidentified as the primary cause. The symptomatic overlap of ASD and Borderline Personality Disorder (BPD) has been noted and at the cognitive level, ASD includes difficulties in reading others emotions and core cognitive features of BPD also include altered social cognition.

The aims of this paper are to present a case report of a patient diagnosed with BPD and ASD and to provide a summary of the current literature concerning this double diagnosis.

A description of the case is made and relevant articles were identified by searching the following terms: “borderline personality disorder” and “autism/autism spectrum disorders”. Research was restricted to articles concerning humans and published between 2014 and 2024 in English.

The case report describes a young female of 19 years old that was evaluated in an emergency context due to suicidal ideation and was then referred to both psychiatry and psychology. She was diagnosed with BPD and ASD in adolescence while she was seeing a child psychiatrist. In the consultations she reports marked emotional dysregulation, irritability, difficulties in tolerating some textures and increased sensitivity to noise and light, as well as frequent worries about peer relationships and self-image with a need to do things differently to fit in.

Despite some controversial results and lack of homogeneity in the methods used for the diagnostic assessment, subjects with BPD reported higher scores on tests evaluating the presence of ASD compared to a non-clinical population and hypothesized the presence of unrecognized ASD in some BPD patients or vice versa, while also describing a shared vulnerability towards traumatic events.

This case illustrates a common and complex clinical challenge, where the double doses of emotional dysregulation and disrupted social interchange overwhelm either ASD or BPD approaches considered separately. Diagnostic differentiation is crucial toward targeted therapeutic interventions (psychopharmacological and psychosocial). It is still difficult to draw accurate conclusions based on the recent literature. Research in sex/gender difference is still limited, with heterogeneous results, and further studies are needed to enlighten the clinical similarities and diagnostic overlap between ASD females and BPD.

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Nomophobia among university students is recognized as an addictive issue, as their attention is often difficult to divert from smartphones, especially during class. This issue is increasingly evident among nursing students, who frequently check their smartphones during class (p < 0.001), making nomophobia an important concern.

We conducted an umbrella review aimed at assessing the prevalence of different psychological and behavioral symptoms among nursing students, including nomophobia, anxiety, sleep disturbances, fear, and stress.

This meta-synthesis combined evidence from 20 systematic reviews and meta-analyses, incorporating 354 primary studies. Publication records were retrieved from PubMed, CINAHL, PsycINFO, and Scopus. The methodological quality of each meta-analysis was assessed using the AMSTAR-2 tool. Reporting followed the PRISMA guideline checklist.

Our synthesis revealed that 28% (95% CI: 24%–33%) of nursing students experience psychological and behavioral symptoms. Nomophobia/smartphone addiction was observed at 30% (95% CI: 12%–49%). Other prevalent symptoms included anxiety at 29% (95% CI: 17%–40%), sleep disturbances at 48% (95% CI: 5%–91%), stress at 27% (95% CI: 17%–37%), and fear at 41% (95% CI: 7%–75%).

Our findings suggest that nursing students are increasingly involved in nomophobia. As smartphones play a central role in daily life, digital detoxification is not easy. Although our research did not explore the relationship between nomophobia and other symptoms, the presence of issues such as anxiety, sleep disturbances, fear, and stress in nursing students warrants further investigation.

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Social deficits are a significant impairment in adult ASD, leading to difficulties in socio-emotional cognition, communication, and relationships. Effective social skills interventions are crucial during the transition to adulthood. The UCLA PEERS® (Program for the Education and Enrichment of Relational Skills) for young adults is a prominent and well-researched intervention, implemented in over eighty countries and translated into numerous languages. This program includes concurrent sessions for young adults and their parents, aiming to improve social skills and reduce ASD-related social issues

The current study aimed to test the effectiveness of a culturally adapted Persian -translated version of PEERS® for young adults with ASD without intellectual disabilities.

Three psychiatrists and two psychologists underwent PEERS® training and translated the manual into Farsi, adapting it culturally for Iran. Twenty-four young adults with ASD and their parents participated in the study, randomly assigned to a treatment group or a control group. Inclusion criteria were males aged 18-30 years with an ASD diagnosis, predominant social difficulties, motivation to participate, and a family member acting as a social coach. Exclusion criteria included intellectual disability, major psychiatric conditions, and significant verbal or literacy difficulties.

Participants attended 16 weekly 90-minute group sessions, covering topics like conversations, humor, electronic communication, dating etiquette, conflict management, and bullying. Sessions were led by a PEERS-certified psychologist and an assistant behavioral coach. Weekly meetings were held to align session content and address potential issues.

The culturally adapted Persian -translated version of PEERS® was perceived as beneficial by young adults with ASD and their caregivers, improving social skills and quality of life. However, quantitative measures did not show significant changes, indicating a need for further refinement and investigation to achieve measurable improvements in social functioning.

While qualitative feedback indicates that both young adults with ASD and their caregivers found the caregiver-assisted social skills intervention to be beneficial in improving social skills and overall quality of life, the quantitative measures did not show significant changes. This suggests that while the intervention may have positive perceptual impacts, further refinement and investigation are needed to achieve measurable improvements in social functioning.

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Psychosis is characterized by hallucinatory and delusional experiences. Although, it was mostly considered to be present among clinical populations, there is strong evidence it can also be found in the general population. Limited reviews currently exist on the quality of the assessment methods designed to evaluate psychotic-like experiences in the general population. None of them assessed whether the existing instruments measure the same construct and, consequently, neglected problems associated with the “jingle-jangle fallacy” (Weidman et al., 2017; Flake and Fried, 2020). This fallacy might account for contradictions in the literature, as well as, issues with generalizability of the results.

The goal of our study is to better understand the agreement between various instruments used to assess hallucinations and paranoia-like experiences.

We conducted a systematic search of the scales assessing hallucinations and paranoia-like experiences among the general population. Labels for the content analysis were created based on their definition in literature by the first authors and revised by another researcher. Three researchers coded each item independently of each other. We then estimated to which extent any item overlaps with any item from the other scale included in the analysis. We used Jaccard index to assess similarities between sets (from 0 with no overlap among scales) to 1 (complete overlap). The analysis was done in R and Excel.

For 263 items from 11 hallucination scales, we estimated 38 labels with a mean overlap of 0.19 (very weak). CAPS demonstrated the highest mean overlap of 0.26. The highest overlaps were observed between MUSEQ and CAPS (0.5), MUSEQ and SPQ (0.4), and between LSHS-R and RHS (0.4). For the paranoia scales, the analysis of 183 items drawn from 12 scales resulted in 18 labels. The mean overlap across these labels was 0.30 - a weak association. The PIQ exhibited the highest mean overlap at 0.42, whereas the PSQ displayed the weakest overlap with a value of 0.17.

The overlap between hallucination scales was very weak. This disparity may be due to different instruments adopt varying interpretations of the hallucination continuum (Laroi, 2012). The weak overlap in paranoia scales may be less problematic, as theoretical models and empirical data suggest a more clear continuum of suspiciousness within the general population (Freeman et al., 2005) that maps our results. It is necessary to establish certain common grounds regarding what experiences represent which sides of the continuum, both in their variability, and severity in the field.

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Euthanasia is an ancient theme that, especially since individual autonomy became the health paradigm in contemporary societies, has sparked profound reflections and declared dissensions between different socio-ideological quadrants. The experience of the countries where it is decriminalised shows a tendency to broaden the clinical, age and legal assumptions for its access. Older adults with psychiatric disease, a clinically and socially idiosyncratic group, where physiological weaknesses and social losses accumulate, and the chronological proximity to death becomes progressively more self-aware, are a group of particular concern.

Our research aimed to reflect on the Constitutional feasibility of Euthanasia in Portugal, make available a validated psychometric instrument to assess attitudes towards euthanasia and do a multidimensional study of the attitudes towards euthanasia of older adult patients with mixed anxiety-depressive disorder.

The field research study applied a paper questionnaire composed of a sociodemographic section and a battery of scales (to assess depression, anxiety, cognitive performance, suicide risk, therapeutic adhesion, functionality, loneliness, attitude towards euthanasia, decision pattern, personality, empathy and health status) in the Psychogeriatric Unity of Senhora da Oliveira Hospital in Portugal. The sample was collected by convenience. The multidimensional study included 114 patients and 25 controls of the same age. Six months later, a reassessment was conducted. Patients and controls were compared using descriptive statistics and a multiple-regression model.

The Constitution of the Portuguese Republic does not prohibit medically assisted death. The results support the validated scale’s usefulness and validity. Eighty-one point six per cent of patients had four or fewer years of schooling. Contrary to controls, they presented mild depressive and anxiety symptoms, loneliness feelings, worse cognitive performance, a more fragile personality, higher personal distress and a poorer health state. No statistically significant differences were found between controls and patients regarding their attitudes towards euthanasia. Patients more favourable to euthanasia had higher empathic concern, conscientiousness and fantasy and lower personal distress.

When addressing euthanasia in older adult patients with mixed anxiety and depressive disorder, it is crucial to ensure they are fully self-determinate and that all the necessary treatment and support are available. It may not be the case when the educational level is low and mild disease persists, significantly affecting their well-being and cognitive performance.

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The social skills of the chronic schizophrenia is an important factor in assessing the prognosis of patients with schizophrenia.

The object of this study was to investigate the effects of group integrative arts therapy based on social skill training on communication, social adaptive function, and subjective well-being in inpatients with chronic schizophrenia.

Among the 125 patients who had been hospitalized in the mental hospital after being diagnosed with schizophrenia by psychiatrists according to DSM-5, 72 patients were selected by inclusion criteria and 48 patients were randomly assigned into an experimental group(n=16), comparative group(n=16), and control group(n=16). During this study, 4 patients from each groups dropped out. The final subjects of each groups were 12 patients. The experimental group followed a 60 minutes long social skill training based on group integrative arts therapy program for twice a week and 20 times in total. The Comparative group followed a social skill training program only for 60 minutes twice a week for 20 times in total. The control group received no treatment. To assess the social adaptive function, empowerment, subjective well-being of the subjects, Communication Competence Scale(CCS), Empowerment Scale(ES) and Korean Modification of Subjective Well-Being Scale(KmSWN) were used as subjective measuring. Assertiveness Observation Evaluation Scale(AOES), Social Adaptive Functioning Scale(SAFS), and Nurses’ Observation Scale of Inpatient Evaluation-30(NOSIE-30) were also used as objective measuring that were rated by nurses or social workers at the mental hospital.

There was no statistically significant difference except non-verbal communication of CCS among three groups in homogeneity test of sociodemographic and clinical variables. The group integrative arts therapy based on social skill training was found to significantly increase the communication, assertiveness, social adaptive functioning and empowerment of experimental group more than comparative group, and that of comparative group more than the control group. The group integrative arts therapy based on social skill training was found to significantly increase the NOSIE-30 of the experimental group and the comparative group more than control group. NOSIE-positive and irritability of NOSIE-30 in the comparative group was increased more than those of the experimental and the control groups.

The group integrative arts therapy based on social skill training is found to significantly enhance the social adaptive function and empowerment of inpatients with chronic schizophrenia than social skill training. These results suggest that group integrative arts therapy could be utilized as effective mental rehabilitation intervention program for inpatients with chronic schizophrenia.

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Burnout and mental health issues have become increasingly prevalent among psychiatry trainees and early career psychiatrists, posing significant challenges to their well-being. This presentation explores the multifaceted relationship between psychiatry training environment and the occurrence of burnout, characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. Factors contributing to the severe burnout in psychiatry trainees include long working hours, lack of supervision, and not having regular time to rest (Jovanović N. et al., 2016). Other potential factors described include the high demands of clinical responsibilities, emotional strain from patient interactions, and inadequate support systems. Encountering possible suicidal patients and coping with patients’ violence are other factors that can have a strong influence on psychiatry trainees and early career psychiatrists’ clinical activity, especially in the absence of appropriate training in the field and supervision (Chumakov E. et al., 2022; Longo G. et al., 2023). Studies indicate that a significant proportion of psychiatry residents experience symptoms of mental distress (Pitanupong J. et al., 2024; Toni F. et al., 2024) with depression being an important source of impaired mental well-being. Furthermore, the stigma surrounding mental health within the medical community often discourages trainees from seeking help, exacerbating feelings of isolation and distress. There’s no question that poor mental health can affect not only psychiatry trainees and early career psychiatrists’ personal health but also their professional development and patient outcomes. In this presentation the implications of these issues for the psychiatry field will be discussed. There’s a growing demand for advocacy for comprehensive training programs that integrate wellness strategies, enhance supervision, and promote open conversations about mental health. By fostering a supportive environment and prioritizing self-care, the psychiatry community can mitigate the risks of burnout and mental disorders among peers, ultimately leading to a more resilient workforce and improved patient care. This presentation underscores the need to support the mental health of future psychiatrists and ensure the integrity of mental health services.

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Opioid dependence is a complex condition that often requires long-term treatment and care. Methadone, a synthetic full opioid agonist, and buprenorphine, a partial agonist at the opioid receptor, are commonly used in substitution therapy for opioid dependence, typically administered as an oral liquid or sublingual tablet. Transitioning from high-dose methadone to buprenorphine for the treatment of opioid use disorder (OUD) poses a risk of precipitated withdrawal. This risk arises from introducing a high-affinity partial agonist (buprenorphine) at the mu-opioid receptor after it has been occupied by a lower-affinity full agonist (methadone). As a result, this transition is usually only performed for patients on low doses of methadone (<30-40 mg). Microdose induction has been proposed as a potential solution to facilitate a smoother transition to buprenorphine.

To present a case report of a rapid transition from high-dose methadone to buprenorphine depot, highlighting both the benefits and challenges of this process.

This case report describes a patient who was switched from 150 mg of methadone to 32 mg of sublingual buprenorphine using microdosing, and subsequently transitioned to a weekly 160 mg buprenorphine depot injection.

The patient was successfully transitioned to sublingual buprenorphine and later to buprenorphine depot without experiencing withdrawal symptoms. Even later, the patient reported no signs of withdrawal and was satisfied with the buprenorphine dosage. The patient attended monthly check-ups with the doctor; however, 15 days after the transition, he began consuming alcohol and soon after, started using cocaine.

This report supports the use of microdose induction for initiating buprenorphine, particularly for patients stabilized on high doses of methadone who may struggle with traditional buprenorphine induction methods. Although the patient remained abstinent from opioids, he quickly relapsed with alcohol and cocaine, issues that had not been present during his methadone treatment. Regular and more frequent therapeutic assessments are very important for many patients to prevent relapse.

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Case-based learning holds a crucial place in psychiatric education. Through methods such as written scenarios, video presentations, patient simulations, or observing real patients, students are expected to gain clinical reasoning skills by observing psychiatric cases.

This study aims to generate case scenarios using ChatGPT-4 and create multiple-choice questions based on these cases.

A prompt was developed based on the literature to generate case scenarios for 12 psychiatric diagnoses, along with five related questions for each case (Figure) (Kıyak. Rev esp educ méd 2023; 4(3)). The scenarios and questions were organized into six forms, each containing two cases and ten questions.

A total of 12 psychiatrists, (5.33 ± 1.31 years of practice) evaluated each form in pairs. The results of the case evaluations are presented in Table 1, and the question evaluations in Table 2.

The evaluation confirmed that the case scenarios were typical for the respective disorders and included appropriate mental status examinations for diagnosis (23/24). The cases were deemed suitably challenging for medical students (20/24) and effective in assessing clinical reasoning skills (21/24). However, the questions did not meet certain criteria, such as appropriate difficulty (75/120), the presence of a single correct answer (86/120), and the plausibility of distractors (91/120). It is suggested that further work on the prompt is needed to improve the quality of the questions. While ChatGPT is suitable for generating case scenarios, the questions should be reviewed before use.

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Jonathan will present the impacts of smoking on physical and mental health, the impact of smoking cessation on mental health and the need to reduce doses of some psychotropic medications after cessation in order to prevent toxicity. He will set out the low population coverage of evidence-based interventions for smoking cessation and prevention uptake particularly for people with mental health conditions, and the reasons for this. He will then outline implementable opportunities to scale up coordinated coverage of interventions by different sectors

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Adult Attention Deficit Hyperactivity Disorder (ADHD) has been recognized as a condition with profound psychosocial implications, including a higher likelihood of encountering legal problems.

To characterize temperamental characteristics and risk factor for legal problems in a group of ADHD patients.

The study involved patients (>18 years) from the adult ADHD outpatient service of the Psychiatric Clinic of Ancona.ADHD was diagnosed using the Diagnostic Interview for ADHD in adults (DIVA5.0). The following rating scale were administered: Temperament Evaluation in Memphis, Pisa and San Diego(TEMPS-M), Coping Orientation to the Problems Experiences-new Italian version (COPE-NVI), Temperament and Character Inventory-Revised (TCI-R).

76% (n=170) of screened patients were diagnosed with ADHD in adulthood. Among them, 10.2% (n=17) reported legal problems. Men with ADHD were more likely to have legal issues (χ²=7.851; p=0.005). These patients often reported school failures(χ²=3.033; p=0.082) and being tutored by a support teacher(χ²=15.165; p<0.001). Legal issues were more common in those with a childhood diagnosis of ADHD (χ²=4.880; p=0.027) and in those who were admitted to a psychiatric ward (χ²=7.205; p=0.007).Additionally, those who smoked (χ²=6.695; p=0.035) or used substances (χ²=16.399; p<0.001) had more legal issues. Higher use of cannabinoids (χ²=14.311; p<0.001) and stimulants (χ²=12.445; p<0.001) in those who had legal problems are also reported. Generally, those with legal problems have lower schooling (p=0.005), more high school failures (p=0.047), smoke more cigarettes per day (p=0. 008) and have higher scores in the problem-solving subscale of the COPE-NVI (p=0.024), the ambitious subscale of the TCI-R (p=0.058), and the self-transcendence subscale of the TCI-R (p=0.078) and lower mean score in the self-acceptance subscale of the TCI-R (p=0.054). Logistic regression analysis showed to ascertain the effects of all TCI-R subscales, on the likelihood of developing legal problems. The logistic regression model was statistically significant, ▫▫2(1)=4.020, p=0.045. The model explained 14.6% (Nagelkerke R2) of the variance in patients with ADHD who have legal problems and correctly classified 91.9% of cases.Having legal problems was significantly predicted by TCI-R spiritual acceptance subscale (exp(B)=1.150, p=0.045).

The study highlight the significant psychosocial burden of ADHD in adulthood, particularly the increased likelihood of legal problems.Key risk factors include lower educational attainment, substance use, and specific temperamental traits, such as elevated problem-solving and self-transcendence tendencies, alongside lower self-acceptance.

None Declared

The high prevalence of mental health disorders makes investigating their etiology a fundamental activity. Factors influencing their physiology include genetic predisposition, substance use, environmental factors, etc. Among these, weather and atmospheric pollutants are two of the least studied. The biologically active agents in the atmosphere interact with living beings, disrupting their homeostasis and leading to alterations in both physical and mental health. This interaction was already noted in the Corpus Hippocraticum in the 4th century BC.

The objective is to analyze the impact of various environmental factors and atmospheric pollutants on daily emergency hospital admissions for mental disorders in the healthcare area of the province of León from 2011 to 2022.

An observational, retrospective, ecological, longitudinal, and time series study is conducted. Admission data is sourced from the coding office at the Complejo Asistencial Universitario de León, meteorological data from the Agencia Estatal de Meteorología, and pollutant data from the Junta de Castilla y León. A combined database in Excel is created for statistical analysis, both descriptive and analytical (Poisson regression), using the SPSS statistical package.

It was observed that hospital admissions for mental disorders are significantly related to sunlight hours, ozone, precipitation, average wind speed, CO, NO2, maximum atmospheric pressure, NO, and PM10.

The findings of this study show that meteorological factors and atmospheric pollutants are related to hospital admissions for mental disorders. Applying this information in psychiatric emergencies could improve forecasting and resource management during periods of higher demand.

None Declared

Achieving excellent sport performance is based both on physical strength and mental endurance. Research demonstrated that children experiencing early maltreatment and traumatization are at an increased risk of high-risk behaviours, bullying, and mental and somatic disorders lasting into adulthood effecting academic and sport performance, relations and life management. Research found that individuals with a history of trauma had a significantly lower chance of being diagnosed with depression or anxiety if they had participated in team sports as adolescents. Also later in life, sport is very beneficial to cope with stressful life events.

We aimed to explore occurrence of early traumas in elite athletes and a control group using the Childhood Trauma Questionnaire (CTQ) and the Early Trauma Inventory Self Report-Short Form (ETISR-SF).

The sample included 57 subjects, 50.9% elite athletes and 49.1% leisure time athletes (controls). Participants (64.9% males, 35.1% females) provided demographic data (age 18-58 years, mean age = 31.96 years, SD = 8.920) and completed the ETISR-SF and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Analysis of Fisher’s Exact Test was performed for evaluating the occurrence of early traumatization.

The ETISR-SF and CTQ subscales scales did not show significant difference in any type of traumas in elite athletes compared to the control group (general traumas p=0.092, emotional abuse p=1.000, physical abuse p=0.592, sexual abuse p=0.297). Occurrence of each trauma type in the two groups were as follows. Elite athletes: sexual trauma (10.34%), physical trauma (55.17%), emotional trauma (44.83%), general trauma (55.17%); Controls: sexual trauma (21.43%), physical trauma (64.29%), emotional trauma (46.43%), general traumas (78.57%).

The occurrence of different type of trauma in our sample is in line with the literature. Physical and emotional abuse among athletes is high. Presumably, those athletes perform better who experience less trauma. The best way to produce resilient athletes is to provide a challenging and supportive sport environment, where athletes feel physically and psychologically safe in their experiences of success and failure.

None Declared