Risperidone is a widely prescribed atypical antipsychotic. Hematological adverse effects, although well documented with clozapine, are rarely associated with risperidone. We present a case of recurrent risperidone-induced agranulocytosis in a young patient with schizophrenia.

To describe a rare case of risperidone-induced agranulocytosis in a young patient with schizophrenia, to explore its possible immuno-allergic mechanism, and to highlight the importance of hematological monitoring during antipsychotic treatment.

A 23-year-old Moroccan male with a 5-year history of schizophrenia and no relevant medical history was treated with risperidone after inadequate response to olanzapine. The dose was increased from 2 to 6 mg within four days, with good initial efficacy. Clinical monitoring and serial complete blood counts (CBC) were performed throughout treatment and rechallenge.

Six weeks after risperidone initiation, progressive leukopenia and neutropenia were observed, with neutrophils falling to 750/μL after two months, leading to drug discontinuation. Chlorpromazine was also stopped, and aripiprazole (15 mg/day) was introduced, resulting in hematological recovery but poor clinical response. Risperidone rechallenge under daily CBC monitoring caused a more rapid recurrence of neutropenia within one week, supporting an immune-allergic mechanism. Alternative explanations such as ethnic neutropenia, margination, or concomitant medications (chlorpromazine, hydroxyzine) were excluded. A literature review identified 27 similar cases of risperidone- or paliperidone-induced neutropenia. This case illustrates the rare but serious risk of risperidone-induced agranulocytosis. The accelerated recurrence upon rechallenge strongly suggests hypersensitivity rather than dose-related toxicity. Although considered rare by pharmacovigilance reports, this adverse effect may lead to severe infectious complications if unrecognized.

Baseline and follow-up CBC monitoring should be performed after risperidone initiation, even though hematological toxicity is uncommon. The use of long-acting risperidone formulations should be delayed until tolerance to the oral form is established.

None Declared

Stress management is a predictive factor of adherence to hemodialysis regimen.

The aim of this study was to explore the association of stress management and adherence to hemodialysis regimen among hemodialysis patients.

In this pilot study, forty-seven (n=47) patients on hemodialysis completed the questionnaires: i) Brief Cope for the assessment of stress management ii) GR Simplified Medication Adherence Questionnaire (GR-SMAQ-HD) for the assessment of adherence iii) A questionnaire about demographic characteristics. Spearman correlation coefficients (rho) were used to explore the association of two continuous variables. Multiple linear regression, in a stepwise method, was used to find the factors associated with adherence. Analyses were conducted using SPSS statistical software (version 26.0).

The results of this pilot study showed that greater behavioral disengagement was associated with lower overall adherence to hemodialysis regimen (p<<0,001). Additionally, higher substance use was significantly associated with reduced overall adherence (p<0,029). Furthermore, increased expression of negative emotions was linked to lower adherence to medications (p<<0,001), diet/fluid restrictions(p<<0,001), and overall adherence (p<<0,001).

The use of positive thinking could be recommended to improve adherence among hemodialysis patients, since it can emphasize positive aspects of patients’ lives and training strategies for improvement their physical and mental capabilities.

None Declared

Beyond cognitive and behavioral difficulties, Attention-Deficit/Hyperactivity Disorder (ADHD) is often accompanied by stigma, including negative public attitudes, self-stigmatization, and poor mental health literacy. Such factors may compromise well-being during adolescence and young adulthood, a critical period for identity formation.

This study investigated the associations between ADHD-related traits, stigma, and well-being in Hungarian adolescents and young adults, focusing on how inattention and hyperactivity/impulsivity traits relate to emotional, social, and psychological well-being, and whether stigma components act as mediators.

A cross-sectional community sample (N = 1295, age 14-25) completed validated measures: SWAN (Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale), MHC-SF (Mental Health Continuum - Short Form), ASQ (ADHD Stigma Questionnaire), RIBS (Reported and Intended Behaviour Scale), and MAKS (Mental Health Knowledge Schedule). Correlations, linear regressions, and mediation analyses were performed.

Inattention traits were negatively associated with all well-being domains (r = 0.27-0.41, p < 0.001), while hyperactivity/impulsivity showed weaker but significant associations (r = 0.18-0.23, p < 0.001). In multiple regression models, inattention (β = -0.32, p < 0.001) and mental health knowledge (β = 0.12, p < 0.001) emerged as significant predictors of psychological well-being, with internalized stigma (ASQ negative self-image; β = -0.13, p < 0.001) exerting an additional negative effect. Emotional and social well-being were significantly predicted by inattention (β = -0.09 to -0.27, p < 0.01) and mental health knowledge (β = 0.09-0.27, p < 0.01). The final model predicting psychological well-being explained 17.5% of the variance (Adj. R² = 0.175, F(3,694) = 50.124, p < 0.001). Mediation analyses revealed limited but significant indirect effects of inattention on emotional well-being through stigma and knowledge.Image 1:

ADHD-related inattention traits and mental health literacy are key determinants of youth well-being, while internalized ADHD-related stigma directly undermines eudaimonic well-being, which is closely related to good functioning and self-realization. Findings underscore the importance of psychoeducation and stigma-reduction efforts, even in non-clinical populations with elevated ADHD traits.

None Declared

Across medicine, accurate prognosis can inform clinical decision-making about management and resource allocation. Several such models have been developed and validated in psychiatry, including those estimating risk of psychosis onset and relapse, and other key adverse outcomes, such as suicide and violence. Reliable risk estimation for these outcomes could inform follow-up intensity, continuity of care, collaborative safety planning, and risk management.

This presentation will provide an overview of prognostic models for violence in people with mental illness. I will outline the predictive performance, acceptability, and impact of new models, which have been translated into clinical risk assessment tools. I will show promising findings for these new models, which could be included in clinical guidelines. Further research is required to study whether and how they supplement and augment decision-making in different clinical settings.

None Declared

According to the 2023 Migration and Asylum Report from Agência para Integração Migrações e Asilo (AIMA), the foreign population in Portugal increased by 33.6% compared to the previous year. The most frequent nationalities include Brazil, Angola, Cape Verde, the United Kingdom, and India. Migration is well established as a risk factor for psychosis. Importantly, literature suggests that 15–30% of psychotic symptoms are shaped by the patient’s cultural background.

To explore cultural variations in psychosis phenotypes.

Clinical case report and literature review. Searches were conducted in PubMed and other databases using keywords such as migration, phenotypes, and psychosis.

A 35-year-old Nepali male, living in Portugal for two years and employed as a builder, was admitted after a suicide attempt. During hospitalization, he presented persecutory delusions towards his flatmates and auditory hallucinations in the form of laughter. He was diagnosed with schizophrenia and discharged on intramuscular risperidone 100 mg monthly and oral lorazepam 2.5 mg. One month later, he was readmitted with recurrence of psychotic symptoms, now including mystic delusions and behavioural disorganization (e.g., staying undressed in the hospital chapel). According to his flatmate, he had not been religious before. Risperidone was rescheduled to 21-day intervals, and haloperidol 10 mg was added, with no improvement. Communication was hindered by the linguistic barrier—he spoke only Nepali—and there was a constant struggle to distinguish pathology from culturally comprehensible behaviour.

There is an important ethnical variability in the expression and content of psychotic symptoms influenced by social and cultural norms of a specific society, but also, as recent research shows, by genetic differences between populations. Moreover, many of the diagnostic tools we have available were developed in Western societies, meaning that defined symptoms of psychosis are deeply linked to the cultural background of Western psychiatry, and so the way we evaluate patients from other cultural backgrounds might not be the most adequate. Psychosis should therefore not be treated as a homogeneous entity; cultural background must be carefully considered in both diagnosis and management.

None Declared

Mindfulness, defined as present-focused, non-judgmental awareness, has gained attention in schools for its potential to reduce stress, enhance attention, and support emotional resilience in students (Kabat-Zinn, 1994).

This study critically reviews empirical evidence on school-based mindfulness programs, assessing their effectiveness in improving students’ emotional regulation, cognition, and well-being, while considering contextual and ethical challenges of implementation.

A comprehensive review of systematic reviews and meta-analyses published between 2014 and 2023 was conducted, focusing on mindfulness-based interventions across educational levels from preschool to university. Key studies included Zenner et al. (2014), Zoogman et al. (2015), Mettler et al. (2023), and Volanen et al. (2016). Moderator analyses, methodological quality, effect sizes, and contextual factors such as facilitator expertise, developmental stage, and intervention design were examined.

Mindfulness-based programs showed small to moderate positive effects on attention, cognitive performance, emotional resilience, and school adjustment, with stronger outcomes in clinical populations and older adolescents. Program efficacy was influenced by facilitator expertise, intervention design, and contextual alignment. Effects on interpersonal skills and teacher-reported behavior were minimal. Methodological heterogeneity, short follow-ups, and limited school-context adaptation reduced generalizability. Ethical considerations regarding cultural sensitivity and pathologizing systemic issues were noted.

Mindfulness shows promise as a school-based intervention when programs are well-designed, context-sensitive, and targeted to students most likely to benefit. Evidence supports improvements in emotional regulation and well-being, but mindfulness should not be applied universally. Future research should focus on personalized, developmentally appropriate approaches integrated into broader systemic strategies. Careful and critical implementation remains essential.

None Declared

Obesity and depression are major public health concerns due to their high prevalence and related morbidity and mortality.

This study aimed to assess the prevalence of obesity, identify associated risk factors, and explore its association with depression among Tunisian adults

A population-based cross-sectional study was conducted in 2023 among Tunisian-adults aged ≥18 years. Obesity was defined as BMI ≥30 kg/m2 and classified into class I (30.0–34.9), class II (35.0–39.9), and class III (≥40.0). Depression was assessed using the the validated Patient-Health-Questionnaire-9(PHQ-9), with scores ≥20 indicating severe depression.

The total of 3,074 participants included 1,941 females (63.1%), 1,504 married individuals (48.9%), 2,716 urban residents (88.4%), and 2,357 with university-level education (76.7%). Chronic diseases were reported in 797 participants (25.9%). The mean age was 36.3 ± 13.6 years. Lifestyle behaviors included energy drink consumption (n=1,554; 50.6%), frequent copious dinners (n=1,335; 43.4%), chronic alcohol use (n=317; 10.3%), active smoking (n=439; 14.3%), and regular physical activity (n=735; 23.9%).

Obesity was found in 378 individuals (12.3%), with 318 in class I (84.1%) and 16 in class III (4.2%). Depression affected 173 participants (5.6%). Obesity was significantly associated with being married (OR=2.4; p<0.001), energy drink consumption (OR=1.3; p=0.02), chronic disease (OR=2.2; p<0.001), copious dinners (OR=1.6; p=0.001), and depression (OR=1.7; p=0.005). University education (OR=0.6; p<0.001) and regular physical activity (OR=0.3; p<0.001) were identified as protective factors against obesity

Obesity was significantly associated to depression as well as unhealthy lifestyle habits. Targeted health interventions are needed to promote healthier lifestyles.

None Declared

Suicidal behaviour is a major public health concern. After hospital discharge, the probability of recurrence is particularly high, underlining the importance of structured follow-up care. Telephone-based interventions have emerged as an accessible and cost-effective strategy to provide continuous support to individuals at risk. These programmes have shown potential to reduce reattempts and improve engagement with treatment, although adherence often remains a challenge.

The present study examines the effects of a 12-month telephone follow-up intervention as a secondary prevention strategy and explores the clinical and sociodemographic factors associated with adherence in adults with a previous suicide attempt.

A coordinated, multi-centre randomised controlled clinical trial was conducted to test telephone-managed secondary prevention programmes to prevent suicide compared to treatment as usual (TAU), as a part of a prospective cohort of individuals presenting a suicide attempt (SURVIVE project). The primary outcome was the subsequent suicide attempts. The secondary variables were adherence to the telephone intervention programme; characteristics of the suicide attempt; sociodemographic variables; impulsivity; adherence to pharmacological treatment; and acquired capacity for suicide, among others. A total of 600 participants were recruited, n = 300 in the telephone management intervention group and n = 300 in the control group (TAU). The protocol has been approved by the ethics committees (EC) of each participating centre.

The results of the study provide relevant information on adherence to a suicide prevention programme based on telephone follow-up and its effects on the recurrence of suicidal behaviour. In general, it was observed that adherence to the telephone intervention is moderated by sociodemographic and clinical variables.

Understanding which factors predict adherence to telehealth interventions following a suicide attempt is essential to assess both their feasibility, long-term applicability, and effectiveness. Exploring clinical and psychosocial profiles linked to treatment engagement among individuals discharged from the emergency department after a suicide attempt could provide valuable insights and foster improvements in clinical practice.

L. Comendador Vázquez Grant / Research support from: This study was supported by the Instituto de Salud Carlos III-FIS research grants (PI19/00236, PI19/00569, PI19/00685, PI19/00941, PI19/00954, PI19/01027, PI19/01256, PI19/01484, PI20/00229 and PI23/00147, PI23/01483, PI23/00822, PI23/00614, PI23/00085, PI23/00707, PI23/01469, PI23/01277, PI23/01367, PI23/01066), co-funded by the European Regional Development Fund (ERDF) “A Way to Build Europe”., A. I. Cebrià: None Declared, A. Sanz: None Declared, D. J. Palao Consultant of: D.P. has received grants and served as a consultant or advisor for Rovi, Angelini, Janssen, Lundbeck and Servier., M. Diaz-Marsá: None Declared, M. Elices: None Declared, I. Grande Consultant of: I.G. has received grants and has served as a consultant, advisor or CME speaker for the following entities: ADAMED, Angelini, Casen Recordati, Esteve, Ferrer, Gedeon Richter, Janssen Cilag, Lundbeck, Lundbeck-Otsuka, Luye, SEI Healthcare, Viatris outside the submitted work. She also receives royalties from Oxford University Press, Elsevier, Editorial Médica Panamericana., M. P. López-Peña Grant / Research support from: P.L.P. in the last 5 years has received collaborations in the form of registration fees for courses and congresses from the following industries: Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Angelini, Novartis, Rovi, Takeda., Á. Palao-Tarrero: None Declared, A. Pedrola-Pons: None Declared, M. Ridao: None Declared, M. Ruiz-Veguilla: None Declared, P. Saiz Consultant of: P.S. has been a consultant to and/or has received honoraria or grants from Adamed, Alter Medica, Angelini Pharma, “laCaixa Foundation”, CIBERSAM, Ethypharm Digital Therapy, European Commission, Government of the Principality of Asturias, Instituto de Salud Carlos III, Johnson & Johnson, Lundbeck, Otsuka, Pfizer, Plan Nacional Sobre Drogas, Rovi, Servier, and Viatris España outside the submitted work., A. de la Torre-Luque: None Declared, V. Perez-Sola Consultant of: V.P. has been a consultant to or has received honoraria or grants from AB-Biotics, AstraZeneca, Bristol-Myers-Squibb, CIBERSAM, FIS- ISCiii, Janssen Cilag, Lundbeck, Otsuka, Servier and Medtronic.

Eating habits and body image are two interrelated dimensions with major implications for women’s health. Irregular eating patterns, frequent snacking, or restrictive dieting may contribute to weight fluctuations, while body image concerns are strongly influenced by cultural and social ideals. In Tunisia, young women are increasingly exposed to social media and changing lifestyles, which may foster unhealthy eating behaviors and body dissatisfaction. Despite the growing importance of these issues, few studies have explored them in the Tunisian female context.

This study aims to describe the eating habits and body image perception of Tunisian women using validated instruments.

We conducted a cross-sectional descriptive study from October 1 to November 30, 2024. Participants were Tunisian women aged 18 years and older, recruited online through Facebook, Instagram, and TikTok. Data were collected using a questionnaire in Tunisian dialect, including sociodemographic variables, eating habits (number of meals, snacking, diet history, nutritional follow-up), body mass index (BMI), and psychosocial factors. Body image was assessed with the Arabic validated version of the Body Appreciation Scale-2 (BAS-2).

A total of 365 Tunisian women participated in the study, with a mean age of 33.7 ± 8.9 years (range: 18–66). Most participants (90.0%) had a university-level education.

In terms of lifestyle habits, 36.2% of participants reported practicing regular physical activity. Tobacco use was reported by 14.3% of women, with 46.2% smoking 5–10 cigarettes per day, 30.8% more than 10, and 23.1% fewer than 5. Alcohol consumption concerned 13.4% of participants, mostly occasional (74.0%), while 22.0% reported weekly consumption.

Regarding eating habits, 57.3% reported consuming three main meals per day, 32.9% two meals, 5.2% only one meal, and 4.7% more than three meals. More than half (58.6%) reported snacking between meals. About one-third (35.3%) had consulted a nutritionist for weight management, most often only once (45.9%), while 32.6% were currently following a diet. Among those on a diet, 74.6% reported weight changes, and 68.5% were dieting without professional supervision.

Concerning body image, 65.2% reported a positive or very positive body image, while 11.0% reported a negative perception.

This study provides descriptive insights into the eating habits and body image of Tunisian women, emphasizing the need for culturally sensitive interventions that promote healthy eating and positive body perception.

None Declared

With the rapid shift to ageing society, the number of elderly individuals living alone has been steadily increasing. This population is particularly vulnerable to psychiatric disorders including suicide. Jeju Island is a region where the entire population was collectively exposed to trauma, specifically the 4·3 Incident, a large-scale civilian massacre. The incident inflicted historical trauma on the entire community, with its psychological sequelae affecting not only survivors but also subsequent generations of bereaved families. Elderly individuals living alone, who lack both internal and external resources, may be especially susceptible to such psychiatric conditions including suicide.

This study aimed to classify elderly individuals living alone in Jeju into four groups based on their psychiatric status: a healthy group, a PTSD symptom group, a depressive symptom group, and a comorbid PTSD and depressive group. By comparing the effects of social support on suicide risk across these groups, this study proposes targeted suicide prevention strategies for elderly individuals living alone in Jeju.

A complete enumeration survey of elderly individuals living alone in Jeju to examine the prevalence of suicide risk across four psychiatric groups-a healthy group, a PTSD symptom group, a depressive symptom group, and a comorbid group- and to compare the impact of social support on suicide risk among these groups. Of 5,138 eligible individuals, 4,680 participated in face-to-face interviews using structured questionnaires. PTSD symptoms were assessed with the PC-PTSD-5, depressive symptoms with the SGDS-K, suicide risk with the MINI-Plus, and social support with the MOS-SSS. Multivariate logistic regression was performed to find the effect of social support on suicide risk.

Among 4,680 participants, 7.8% reported PTSD symptoms, 40.4% reported depressive symptoms, and 5.8% had comorbid symptoms. Prevalence of suicide risk was 10.2% overall, with the highest rate observed in the comorbid group (29.5%), followed by the depressive (17.1%) and PTSD symptom groups (12.8%). Social support was significantly associated with lower suicide risk in the healthy (OR = 0.976, p < 0.001), depressive (OR = 0.980, p < 0.001), and comorbid groups (OR = 0.979, p < 0.001), but not in the PTSD symptom group (OR = 0.957, p = 0.179).

Developing more tailored social support systems is essential to prevent suicide among individuals living alone who are vulnerable to psychiatric illness.

None Declared

Breast cancer remains one of the most prevalent malignancies affecting women globally, with millions diagnosed each year. While medical advancements have significantly improved survival rates, the psychological burden of breast cancer remains substantial. Anxiety and depression are among the most common mental health disorders experienced by breast cancer patients, triggered by the uncertainty of diagnosis, invasive treatments, body image changes, and fear of recurrence. Unfortunately, anxiety and depression are frequently underdiagnosed and insufficiently addressed in clinical oncology practice, leading to poorer health outcomes.

• - Determine the rates at which anxiety and depression occur within the breast cancer patient population.

• - Explore the demographic and clinical characteristics that are associated with increased psychological distress.

• - Provide a comparative analysis of anxiety and depression prevalence across a selection of recent studies.

A systematic review was performed. Used instruments were Hospital Anxiety and Depression Scale and the Patient Health Questionnaire-9. Relevant data including sample sizes, prevalence rates, and patient demographics were collected and organized. The analysis focused on assessing anxiety and depression rates in relation to factors such as patient age, cancer stage, treatment modalities, and levels of social support.

The prevalence of anxiety among breast cancer patients ranged from 28% to 45%, while depression rates varied from 22% to 33%. Elevated psychological distress was most notable during diagnosis and active treatment phases, especially chemotherapy.

Anxiety and depression are common psychological conditions affecting individuals with breast cancer, significantly influencing their overall health and quality of life. Early and ongoing mental health screening should be an integral part of cancer care protocols. Incorporating a range of psychological support services, such as counseling, cognitive-behavioral therapy, and medication management, can effectively address these challenges.

None Declared

Psychiatrists have limited ability to predict near-term risk of suicidal behavior, and the positive predictive value of algorithms is not much better than chance. Insomnia is now a recognized risk factor for suicidal phenomena in persons with mood disorders or psychotic disorders. Hyperarousal is one explanation for the link between insomnia and suicide risk, and laboratory evidence of physiological hyperarousal can be shown with assays of the autonomic nervous system, including measurement of the pupillary light reflex or heart rate variability. We hypothesize that elevated levels of physiological arousal impair executive decision making and put a person at risk of suicidal behavior. These observations lead to the premise that treating insomnia may reduce suicidal ideation or behavior. Published studies show that improving insomnia in people with mood disorders or psychotic disorders is associated with reduced suicidal ideation. Both psychotherapy and medications that improve insomnia may have a role in reducing suicidal ideation. More research is needed to examine the impact of reducing insomnia on suicidal behavior.

W. McCall Grant / Research support from: Axon Medical Technologies, Consultant of: Axon Medical Technologies; Haleon; Carelon; Sigma Stim, Speakers bureau of: Idorsia.

Psychiatric diagnoses traditionally rely on symptom-based classifications, which, despite providing a shared clinical and research framework, show weak alignment with underlying neurobiology. In response, data-driven, biologically informed approaches have emerged, yet most still depend on group-level comparisons that assume homogeneity and obscure individual variability. Normative modeling (NM) offers a promising alternative, quantifying individual deviations from population-derived normative distributions and enabling the detection of neurophysiological alterations at the single-subject level (Marquand et al. Biol Psychiatry 2016; 80:552-561).

This study aims to present a framework for clustering based on deviations from normative electrophysiological trajectories to identify transdiagnostic subtypes of neurodevelopmental and psychiatric disorders. The approach leverages a large, harmonized HD-EEG dataset to uncover biologically grounded brain–behavior profiles that transcend traditional diagnostic boundaries.

We analyzed a multisite EEG dataset comprising 1,701 participants, including healthy controls, and individuals with attention-deficit/hyperactivity disorder, autism spectrum disorder, anxiety, learning disorders, and their comorbidities. Normative models were built for a comprehensive set of EEG features (n = 1957), and individualized deviation scores were computed. These multivariate deviation profiles were then clustered using similarity network fusion to identify subgroups with distinct electrophysiological patterns. The resulting clusters were subsequently characterized in terms of diagnostic composition and behavioral profiles.

We identified three neurophysiological subtypes that did not align neatly with traditional diagnostic categories (Fig. 1). Electrophysiologically, C2 (predominantly HC) showed deviation scores close to normative EEG trajectories, whereas C1 (internalizing symptoms) and C3 (externalizing diagnoses) exhibited more pronounced and often opposing deviations across key features. Behavioral comparisons revealed significant differences across behavioral domains (Fig. 2). C1 showed deficits in executive function and elevated emotional reactivity; C3 had higher hyperactivity-related scores; C2 showed the lowest scores across most domains, reflecting a broadly normative profile. Finally, EEG features significantly predicted cluster-specific behavioral traits (Fig. 3).Image 1:

Our EEG-based, data-driven stratification revealed transdiagnostic subtypes with distinct electrophysiological signatures, behavioral phenotypes, and brain-behavior associations. These biologically grounded profiles, which transcend traditional diagnostic boundaries, provide a principled framework to advance transdiagnostic research in psychiatry.

None Declared

Priapism is a rare but potentially serious urological emergency, defined as a prolonged and painful erection unrelated to sexual stimulation. Although uncommon in children and adolescents, it can cause significant morbidity if not promptly recognized and treated. Among pharmacological causes, antipsychotics are relevant triggers, mainly due to alpha-1 adrenergic receptor blockade. In youth with Autism Spectrum Disorder (ASD), atypical antipsychotics such as risperidone, aripiprazole, and olanzapine are frequently prescribed for irritability and behavioral symptoms. Despite widespread use, reports of priapism in this population are scarce, limiting risk estimates and clear management guidance.

To present a case of antipsychotic-induced priapism in an adolescent with ASD and review available evidence on risk factors, management, and clinical implications.

Clinical information was obtained from medical records and caregiver interviews. A narrative literature review was conducted in biomedical databases using terms related to priapism, antipsychotics, children, adolescents and ASD.

A 16-year-old male with ASD, on long-term risperidone (4.25 mg/day), was prescribed olanzapine (2.5mg/day) for insomnia. Four days after daily use of olanzapine, he presented to the emergency department with priapism requiring surgical intervention. Both risperidone and olanzapine were discontinued, and aripiprazole plus benzodiazepines were initiated, leading to favorable clinical outcome without recurrence. Caregivers were counseled on warning signs and the need for urgent medical evaluation.

The literature indicates that priapism risk is linked to alpha-1 affinity: risperidone, quetiapine, ziprasidone, and chlorpromazine are considered higher-risk, while aripiprazole and olanzapine have lower but not negligible risk. Cases with risperidone have been reported even after long-term exposure or in combination with other psychotropics. Aripiprazole, due to its low alpha-1 affinity, is often viewed as a safer alternative. Reports emphasize that priapism can occur without immediate temporal association to treatment initiation, highlighting the need for continuous vigilance. Clinical monitoring should be proactive in ASD, given communication barriers that may delay detection. Professional guidelines stress education of caregivers and urgent referral to urology when symptoms arise.

Antipsychotic-induced priapism in adolescents with ASD is rare but clinically significant. The presented case illustrates the importance of early recognition, prompt discontinuation of the offending agent, and transition to lower-risk alternatives such as aripiprazole. Continuous monitoring, caregiver education, and collaboration between psychiatry, pediatrics, and urology are essential.

None Declared

Multidomain programs have demonstrated efficacy in preventing cognitive decline and dementia. Additionally, technological solutions show potential for cognitive interventions and the promotion of healthy aging. This study investigated the implementation of an innovative multidomain program in a Portuguese community setting, inspired by international multidomain models and supported by technological interventions.

To evaluate the effect of a multidomain program on adherence, satisfaction, and outcomes in cognitive, affective, social, and quality of life domains.

The program consisted of 26 sessions, held twice per week, combining robot-assisted therapy, augmented reality, computerized cognitive training, and psychoeducational sessions. Sociodemographic data and adherence records were collected, and a multidimensional assessment battery was administered before and after the intervention, along with a satisfaction questionnaire.

The study included 504 older adults (mean age = 76 ± 9.47 years), mostly women (80.36%). Significant improvements were observed in all assessed domains (p < 0.001): cognitive (+2.6 points ACE-R), affective (–1.1 points GDS-15), social (+3.9 points ESSS), and quality of life (+1.2 points WHOQOL-BREF). Adherence was 89%, and satisfaction was 98%.

The program was effective, as evidenced by the multidimensional health gains achieved. The integration of innovative technological interventions, combined with a multidomain approach, appears promising for the prevention of cognitive decline. Future studies with control groups could strengthen the robustness and sustainability of these results.

None Declared

Coronary artery bypass grafting (CABG) is among the most frequently performed interventions globally for the treatment of coronary artery disease (CAD). Anxiety and depression are common among patients undergoing coronary artery bypass graft (CABG) surgery and are associated with poorer recovery and quality of life.

Psychosocial interventions are increasingly used to address mental health needs in cardiac populations, but evidence regarding their effectiveness in CABG patients remains limited and inconsistent. This study sought to clarify their impact through systematic review and meta-analysis.

A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered in PROSPERO database (No: CRD420251022254). Randomized controlled trials (RCTs) published within the last 10 years were retrieved from nine databases. Eligible studies evaluated psychosocial interventions targeting anxiety and/or depression in CABG patients. Risk of bias was assessed using the Cochrane RoB 2 tool. A random-effects model was used to calculate pooled effect sizes (Hedges’ g).

Seven RCTs (n = 1,371) were included. Interventions comprised psychoeducation, web-based support, and relaxation-based methods. Meta-analysis showed a significant reduction in anxiety symptoms (Hedges’ g = –0.51, p = .004; I² = 72.9%), indicating a moderate effect. For depression, the pooled effect was not statistically significant (Hedges’ g = –0.38, p = .059; I² = 51.4%), although some studies reported delayed or subgroup-specific improvements.

Psychosocial interventions appear effective in reducing anxiety in CABG patients, while their impact on depression is less clear and may depend on longer-term or tailored approaches. The evidence supports a paradigm shift toward integrated, multidisciplinary care for CABG patients, where psychosocial health is addressed as a core component of recovery alongside physical rehabilitation.Further rigorous trials are needed to establish their role in routine post-CABG care.

None Declared

Multiple sclerosis (MS) is a chronic neuroinflammatory disorder frequently associated with psychiatric comorbidities such as depression, anxiety, bipolar disorder, and psychosis. However, dissociative disorders in MS are rarely reported and remain underexplored. Dissociative amnesia accompanied by regressive behaviors is likely influenced by both the psychological burden of MS and neurocognitive vulnerabilities.

To present a rare case of MS with dissociative amnesia and prominent regressive features, and to discuss its clinical relevance in the context of psychiatric comorbidities of MS.

We report the clinical course, psychiatric evaluation, neuroimaging findings, and treatment of a 24-year-old woman with MS, diagnosed at age 16 and without prior psychiatric history. Symptom severity was measured with the Dissociative Symptoms Scale-Brief (DSS-B).

The patient developed acute transient loss of consciousness, and retrograde amnesia. Neuropsychological findings included prosopagnosia, agnosia, anomia, puerile speech, la belle indifference, and childlike behaviors. The DSS-B score was 30, indicating a high level of dissociative symptoms and consistent with clinically observed amnesia and regressive behaviors. MRI revealed chronic periventricular plaques and a new hyperintense lesion at C4; however, the location of this lesion does not account for the acute dissociative and regressive symptoms observed. Psychosocial stressors included ongoing divorce proceedings and financial strain related to her spouse’s gambling. She was prescribed fluoxetine (20 mg/day) and trifluoperazine (1 mg/day). Two weeks later, she was re-evaluated, and her symptoms persisted with no noticeable improvement. This duration is longer than typically observed in dissociative amnesia. She subsequently discontinued treatment.

This case demonstrates the rare occurrence of dissociative amnesia with regressive features in MS, highlighting the potential contribution of both neurocognitive and psychosocial factors. The prolonged duration of symptoms emphasizes the atypical nature of this presentation and suggests the need for careful multidisciplinary assessment.

None Declared

Manic episodes arising de novo in late life are rare and often indicate underlying organic pathology. Diagnosis is further complicated by overlapping psychiatric symptoms, neurodegeneration, and psychosocial stress. This report presents a first manic episode in a 66-year-old woman with a 25-year history of depression, recently diagnosed with Alzheimer’s disease and exposed to major psychosocial stress. The case highlights the challenge of distinguishing primary psychiatric illness from organic, iatrogenic, or reactive causes in geriatric psychiatry.

- To present a case of late-onset mania in a patient with Alzheimer’s disease and a longstanding depressive disorder

• - To explore potential etiological factors contributing to the manic episode

• - To highlight the diagnostic challenges related to Alzheimer’s disease, depression, mania, and personality disorders, and emphasizes the importance of a holistic approach in understanding complex psychiatric cases

A descriptive case report method was used, gathering data through clinical interviews, psychiatric evaluation, neurological assessments, imaging, and collateral information from family and medical records. Mental status examinations were conducted throughout the inpatient stay.

The patient, born in 1959, was hospitalized for a first manic episode marked by elevated mood, psychomotor acceleration, reduced need for sleep, and pressured speech. She had no previous manic or hypomanic episodes but had received outpatient treatment for multiple depressive episodes for over 25 years, starting after her son’s suicide attempt. About four months before admission, her son suffered a serious work injury that left him unable to work—an event she found highly distressing. The manic symptoms began around the same time, suggesting a possible temporal link. She was also diagnosed with Alzheimer’s disease following cognitive decline and neurological assessment; donepezil treatment started shortly before the manic episode. During hospitalization, based on anamnesis and her interpersonal relationships, combined with marked emotional reactivity and longstanding affective instability, a clinical suspicion of underlying personality pathology was raised.

This case illustrates the multifactorial origin of late-onset mania in a patient with Alzheimer’s and chronic depression. Contributing factors include the potential manic effects of donepezil, acute stress from her son’s injury, and cumulative psychological and interpersonal trauma. Diagnosing mania in older adults with neurodegenerative disease requires careful consideration of iatrogenic, psychosocial, and biological factors. This case highlights the need for interdisciplinary assessment of behavioral changes in the elderly, and for heightened awareness of possible mood destabilization following cholinesterase inhibitor treatment.

None Declared

As per the MMBS course, we are required to partake in an external elective in the fourth year, lasting four weeks. I chose to do my elective under the guidance of a consultant psychiatrist with the goal of participating in research.

Primary Objectives:

1. 1. One published article as first author

2. 2. One published article as an additional author

Secondary Objectives

Assist the consultant in progression of his projects, aiming towards a mutually beneficial elective

1. Enhance my own skillset for my future aspirations as a researcher

The plan involved writing a poster abstract for a journal, satisfying a first author publication. The other objective would be achieved by working in tandem with the consultant on either finalising a write-up for his concluded project, or by writing up a research protocol.

In addition to this, there were opportunistic experiences during the placement, such as the ability to peer-review two studies awaiting journal publication, and critically appraising two published articles.

2 Journal reviews

2 Critical appraisals

Contributed to finalising a paper for publication

Co-wrote a research protocol

Submitted a poster abstract

The elective offered several experiences and opportunities for me to be involved in a variety of projects, in different aspects of the research process, from forming an idea and writing up a protocol, to reviewing finalised research projects. I believe this experience has enhanced my skillset, offered me unique insight into the world of research and provided a solid foundation to start my research career. This experience has also anecdotally shown me the importance of mentorship in supporting personal growth and development of the skills involved in research.

None Declared

The hippocampus is regarded as the primary site of dysfunction in schizophrenia and offers a promising target for therapeutic intervention (Lodge and Grace, TIPS 2011). Hippocampal hyperexcitability is thought to play a key role in the pathophysiology of schizophrenia. As none of the currently available antipsychotics (APs) affect hippocampal activity, they are unlikely to alleviate cognitive dysfunctions or negative symptoms, as these are controlled by nuclei above the basal ganglia.

Evenamide, a voltage-gated sodium channels modulator, attenuated stimulated release of glutamate in an in vivo microdialysis rat model; due to its higher affinity for the inactivated state of the channels, it reduces neuronal hyperexcitability. Recently, evenamide was investigated by Uliana et al (NPP 2025) in the MAM (methylazoxymethanol acetate, a DNA alkylating agent) neurodevelopmental animal model of schizophrenia which revealed that evenamide exerts its action in the hippocampus.

To provide new insights into evenamide’s mechanism of action

To interpret clinical findings from phase 2/3 trials in light of the results obtained with MAM model

Electrophysiological recordings in the MAM model assessed the effects of evenamide on neuronal activity in the hippocampus and ventral tegmental area (VTA). Behavioral outcomes were evaluated using the novel object recognition (cognitive function) and social approach (negative symptoms) tests.

MAM-treated pups as adults show features consistent with schizophrenia: loss of hippocampal parvalbumin neurons, hippocampal hyperactivity, hyperdopaminergic state, impaired cognitive function and social deficits (Lodge and Grace, TIPS 2011). Evenamide normalized hippocampal pyramidal neurons hyperactivity and reduced dopaminergic (DA) activity in the VTA of MAM rats; interestingly, effects persisted long after administration of evenamide despite its rapid pharmacokinetic profile. Additionally, evenamide restored impaired recognition memory and improved social interaction.

These results are in line with data from clinical trials, in which evenamide add-on treatment was associated with significant improvement of positive and also negative symptoms (PANSS subscales) in patients with inadequate response to APs (Anand et al, Neuropharm 2025). Moreover, persistence of effects is consistent with long-lasting benefits observed in a 1-year open-label trial in patients with TRS (Anand et al, IJNP 2025); long-term efficacy of evenamide compared to standard of care will be confirmed in the ongoing phase 3, 1-year, double-blind ENIGMA-TRS 1 trial.

Evenamide’s distinct mechanism of action targeting the hippocampus differentiates it from all available APs. By modulating upstream glutamatergic dysregulation, evenamide may provide broader and more durable efficacy across various schizophrenia symptom domains.

R. Anand Consultant of: Newron Pharmaceuticals SpA, A. Turolla Employee of: Newron Pharmaceuticals SpA, G. Chinellato Employee of: Newron Pharmaceuticals SpA, F. Sansi Employee of: Newron Pharmaceuticals SpA, R. Hartman Consultant of: Newron Pharmaceuticals SpA