Sleep problems are highly prevalent in adults with neurodevelopmental disorders, with evidence of sex- and age-specific patterns. In women with ADHD, hormonal fluctuations across the reproductive lifespan interact with executive dysfunction, increasing vulnerability to sleep and cognitive disturbances. Women with ADHD report more severe sleep problems than men, including higher rates of insomnia and hypersomnia. Sleep disruption is also highly prevalent in autism spectrum disorder (ASD), affecting up to 80% of women, who are particularly prone to insomnia, circadian rhythm disturbances, and heightened sleep reactivity. Recent findings suggest poorer subjective sleep quality and more fragmented sleep, in autistic women, although age-related data remain limited. Menopausal transition may further compound these difficulties.

To illustrate how perimenopausal hormonal transitions exacerbate sleep difficulties in women with ADHD and ASD through a case-based approach. To integrate clinical and scientific evidence highlighting the need for age- and sex-sensitive strategies in the management of neurodevelopmental disorders across the female lifespan.

This clinical vignette describes a 46-year-old woman with combined-type ADHD and ASD, who was referred for evaluation of persistent sleep difficulties during the perimenopausal transition. Diagnostic assessment included the DIVA-5, ADOS-2, RAADS-R, developmental history, collateral informant report, structured questionnaires (HSDQ, mood and anxiety), actigraphy, and clinical evaluation of hormonal status.

The patient had longstanding ADHD and autistic traits. Perimenopause was marked by worsening insomnia, delayed sleep phase, and nocturnal awakenings with hot flushes. Actigraphy confirmed circadian disruption and frequent awakenings. Cognitive testing showed decline in working memory and planning. Sleep disturbance amplified anxiety, irritability, and neurodevelopmental symptoms. Methylphenidate improved attention but worsened sleep; lisdexamfetamine was better tolerated. Melatonin improved sleep timing but not maintenance. Menopausal hormone therapy (transdermal oestradiol, oral micronised progesterone) improved vasomotor symptoms but not sleep fragmentation.

This case illustrates how perimenopause can exacerbate sleep problems in women with ADHD and ASD. Literature supports high rates of insomnia and circadian rhythm disruption in both groups, with female-specific vulnerabilities. Recognition of reproductive transitions as periods of heightened risk is essential. Age- and sex-sensitive strategies may improve cognition, emotional wellbeing, and quality of life in women with neurodevelopmental disorders.

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The application of artificial intelligence (AI) to resting-state electroencephalography (EEG) data represents a burgeoning frontier in schizophrenia diagnostics. However, the inferential validity of findings is frequently compromised by methodological heterogeneity. This systematic review rigorously evaluates the diagnostic efficacy and methodological robustness of AI-generated EEG biomarkers by implementing the Prediction model Risk Of Bias Assessment Tool for Artificial Intelligence (PROBAST+AI).

Following PRISMA guidelines, a systematic search of PubMed, Scopus, and Web of Science identified 43 primary studies encompassing 3,420 patients with schizophrenia or first-episode psychosis and 3,164 healthy controls (total N = 6,584). Methodological quality and validation strategies were assessed using the 34 signaling questions of the PROBAST+AI framework.

The aggregate mean diagnostic accuracy across the literature was 93.38%, with deep learning architectures demonstrating superior metrics relative to classical machine learning (96.83% vs. 87.68%). Critically, external validation was restricted to 4.7% of the included studies. A pronounced performance discrepancy was observed between subject-wise (88.22%) and segment-wise (98.14%) validation protocols, indicating pervasive data leakage. Overall, 76.7% of the analyzed studies were characterized by a high risk of bias, predominantly stemming from suboptimal data partitioning and inadequate independent verification.

Contemporary diagnostic accuracies appear to be artifactually elevated due to structural methodological deficiencies and data leakage. Consequently, current evidence does not support the immediate clinical implementation of AI-EEG biomarkers in schizophrenia. To facilitate translational progress, we propose a standardized methodological framework optimizing validation strategies.

Obsessional jealousy is described in DSM-5 under Other Specified Obsessive-Compulsive and Related Disorders, yet operationalized criteria and clinical characterization are lacking. This study aimed to develop and field-test provisional research criteria for obsessional jealousy and describe the clinical features of individuals meeting these criteria.

Provisional research criteria were developed based on DSM-5 descriptions and applied in a self-referred sample of individuals reporting problematic jealousy (n = 58). Participants underwent structured clinical assessment, including best-estimate diagnostic procedures, evaluation of differential diagnoses, and measures of functional impairment. Participants’ views on introducing a formal jealousy diagnosis were explored.

Among the participants, 34 (59%) met the provisional research criteria. The criteria showed strong sensitivity but modest specificity, reflecting a deliberately conservative threshold to avoid over-pathologization. All individuals meeting criteria were judged to meet DSM-5 and ICD-11 definitions of mental disorder. Obsessional jealousy was typically recurrent across relationships, with onset in mid-adolescence and clinical significance emerging in early adulthood. Participants showed generally good insight; comorbidity was common with mood and anxiety disorders. Many reported prior help-seeking and ongoing need for treatment. Participants expressed balanced views regarding formal diagnosis, citing both potential benefits and risks.

These findings identify a group of individuals with pervasive, recurrent obsessional jealousy that is distressing, impairing, and not readily explained by existing diagnostic categories. The proposed criteria provide an initial framework for research and clinical development but require further refinement and validation in more representative community and clinical samples, with careful attention to diagnostic boundaries, transcultural aspects, and stakeholder perspectives.

Perinatal depression affects 20–28% of women globally, with prevalence rates significantly higher among those with comorbid Attention-Deficit/Hyperactivity Disorder (ADHD), with self-reported symptoms exceeding 50% in clinical samples. Hormonal fluctuations during pregnancy and the postpartum period can exacerbate both ADHD symptoms and depressive episodes, leading to increased symptom severity. ADHD is linked to higher depression burden and greater risk of antidepressant treatment resistance in general. Despite this elevated risk, pharmacological guidelines specifically for treating perinatal depression comorbid with ADHD are lacking.

In the absence of specific pharmacological guidelines, current evidence on the pharmacological treatment of perinatal depression in general has shown that selective serotonin reuptake inhibitors (SSRIs)—specifically sertraline- are the first-line pharmacological treatments due to their favourable safety profiles during pregnancy and lactation. In severe or treatment-resistant depression, emerging neuroactive steroids like brexanolone and zuranolone offer rapid symptom relief, though long-term data remain limited.

Clinicians must weigh the small absolute risks of antidepressant use—such as preterm birth and lower APGAR scores—against the significant risks of untreated depression. Management requires individualised risk-benefit analysis. Furthermore, pregnancy-related pharmacokinetic changes may necessitate therapeutic drug monitoring and dose adjustments to maintain therapeutic efficacy. Clinically, this supports closer monitoring and a low threshold for adjusting or augmenting antidepressant treatment.

Pharmacotherapy for comorbid ADHD and perinatal depression involves greater uncertainty. The safety and efficacy of continuing stimulant or non-stimulant ADHD medications during pregnancy are under-researched and not well established. The safety of the adjustment of stimulant dosage during pregnancy has not been proven. Consequently, the concurrent use of ADHD medications and antidepressants requires scrutiny and a multidisciplinary, individualised approach.

Regarding breastfeeding, sertraline and paroxetine are considered compatible; however, due to the indeterminate safety profile of ADHD medications in lactation, decisions regarding their continuation must be made on a case-by-case basis.

Future research is critically needed to establish the safety of combined antidepressant and ADHD medication regimens to improve outcomes for this high-risk population.

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Psychotherapy is a core competence in psychiatry, but training experiences among Early Career Psychiatrists (ECPs) remain highly variable across countries, institutions, and supervisors. Some trainees have structured curricula and regular supervision, while others rely on informal mentorship, external courses, or personal effort and finances. This variability is noteworthy where expectations are high and global but pathways are unclear and local. Across settings, recurrent barriers emerge, such as limited protected time, heavy clinical workloads, scarce or inconsistent supervision, unequal access to courses and resources, and financial constraints. Another layer is cultural and institutional context—what is feasible, acceptable, and sustainable in one system may not translate directly to another. At the same time, there are important opportunities. Scalable, low-cost models, Balint groups, structured workshops, and online/hybrid models can broaden access to learning. Competency-based approaches and logbooks can support transparency and standardization.Also, new tools, such as artificial intelligence, may offer additional educational support if used carefully and ethically. This workshop brings together international perspectives to reflect on current practice, and discuss what a feasible, high-quality psychotherapy training pathway for ECPs could look like.

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Psychotherapy is crucial in mental healthcare, and clinical guidelines highlight the need for trainees to acquire core psychotherapeutic skills. Although many programs specify minimum training requirements, implementation varies widely due to resource constraints. In our recent systematic review, we examined early-career psychiatrists’ (ECPs) global perspectives on psychotherapy training (PT) and the key strengths and challenges of training opportunities. We conducted a systematic search of MEDLINE, Scopus, and PubPsych to identify survey-based studies investigating ECPs’ perspectives on PT, following the PRISMA framework. From an initial pool of 31,281 records, 56 studies met the inclusion criteria. Results were analyzed thematically and synthesized narratively. Studies were from Europe (50%), the Americas (26.7%), the Western Pacific (12.5%), South-East Asia (7.2%), the Eastern Mediterranean (1.8%), and Africa (1.8%), with a total of 8,305 participants. Thirty-one studies on ECPs’ interest in PT found that 57–80% were interested in psychotherapy and that 67–92% viewed being a psychotherapist as part of their identity as a psychiatrist. Training opportunities varied across countries and institutions, with cognitive behavioral therapy and psychodynamic psychotherapy as the primary modalities. Strengths included available supervision, structured rotations, and integrative approaches combining multiple modalities. The most frequent challenges were inadequate supervision, insufficient protected time, and limited exposure to diverse modalities, as well as a shortage of trained supervisors and variability in training delivery. Recommendations underscored the need for coherent curricula, stronger supervision, greater institutional support, and improved access to training resources. Improving access to evidence-based, culturally adapted PT is essential, and training institutions and professional organizations play a key role in supporting ongoing professional development.

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Psychotherapy training is often based on models developed within specific cultural and institutional contexts, which may not readily translate across diverse settings. This presentation explores key challenges in implementing psychotherapy training in varied cultural, social, and healthcare environments, including differences in values, language, resources, and institutional structures. It highlights practical adaptation strategies that balance fidelity to evidence-based psychotherapies with cultural relevance and feasibility. Emphasis is placed on culturally responsive, competency-based training approaches to strengthen the global psychotherapy workforce.

None Declared

The European Psychiatric Association (EPA) undertook a study to investigate treatment preferences of European psychiatrists towards Bipolar Disorder (BD), as part of the Ambassador programme series of surveys.

We conducted a cross-sectional online survey among psychiatrists and psychiatry trainees from 40 European countries. The questionnaire contained clinical vignettes of different phases of BD including manic, rapid cycling, mixed, hypomanic, and depressive episodes, for both initial and subsequent treatment strategies.

The final sample consisted of 654 participants, from Central and Eastern Europe (CEE), Southern Europe (SE), Northern Europe (NE), and Western Europe (WE). The majority preferred pharmacotherapy, most commonly as a combination of two or three drugs to treat all phases of the BD, with lithium being the most preferred option in all phases.

Among antipsychotics, olanzapine and quetiapine were the most commonly chosen. Antidepressants were applied in almost 20% of responses for the depressive phase. Psychosocial interventions were not systematically implemented, particularly during manic and mixed episodes, but when recommended, the most common approaches included psychoeducation, cognitive behavioural therapy (CBT) in up to 40% in depressive phase, and lifestyle recommendations. However, latent class analysis identified four different classes of prescribers.

Psychiatrists showed broadly similar pharmacological treatment preferences for BD, with frequent use of lithium-based combination therapies and limited implementation of psychosocial interventions, although latent class analysis revealed distinct prescribing profiles. These findings support the need for enhanced dissemination of evidence-based guidelines and greater integration of psychosocial approaches in BD care.

Artificial intelligence (AI) is increasingly entering mental health care and education, raising important questions about its role in training the next generation of psychiatrists. This talk explores whether and how AI can meaningfully contribute to psychotherapeutic education for early career psychiatrists, while maintaining core human values such as empathy, clinical judgment, and therapeutic alliance.

Drawing on current developments and practical examples, the presentation discusses potential benefits of AI-assisted learning, including personalized training, simulated clinical scenarios, feedback on therapeutic skills, and improved access to educational resources across global contexts. At the same time, ethical considerations, limitations, and risks—such as over-reliance on technology, bias, and impacts on professional identity—are critically examined.

By situating AI within the broader goals of improving quality of care and expanding horizons in mental health education, this talk aims to provide a balanced perspective on how AI can support, but not replace, human-centered psychotherapy training.

None Declared

Childhood maltreatment (CM) has been linked to poor emotional intelligence (EI) and psychosocial functioning (PSF) in patients with bipolar disorder (BD). However, no study has investigated whether EI mediates the relationship between CM and PSF in patients with BD. Here, we aimed to assess the association of CM with EI and PSF in euthymic patients with BD compared with healthy controls (HCs).

We assessed 124 euthymic participants with a BD diagnosis and 124 HCs by means of the Mayer–Salovey–Caruso Emotional Intelligence Test, the Functioning Assessment Short Test and the Childhood Trauma Questionnaire. Linear regression models were constructed using CM categorized as no-CM, low/moderate-CM and high-CM. We subsequently assessed whether EI mediates the relationship between CM and PSF.

Compared with HCs, patients with BD reported higher rates of CM and lower rates of PSF and EI. In the BD group, subjects who exhibited low/moderate CM obtained lower levels of PSF and EI than those with no-CM and high-CM levels. The regression models demonstrated that, compared with the no-CM category, the low/moderate CM category was inversely associated with EI strategic area scores in patients with BD. However, EI did not mediate the relationship between CM and PSF.

Low/moderate-CM was associated with the worst EI scores in BD. However, we did not observe any mediating effect of EI on the relationship between CM and PSF. Our results emphasize the importance of assessing CM in mental health and suggest that targeted therapies should be administered to affected patients.

The management of elderly patients receiving polypharmacy represents a major interdisciplinary challenge in clinical routine due to various aspects, including the age-related physiological changes, the physical comorbidities, and the elevated for drug-drug interactions (DDIs). Rational psychopharmacology based on standardized assessment tools, including blood level assessments of medications, known as therapeutic drug monitoring (TDM), allow for treatment optimization in this highly vulnerable patient subgroup. Here we explicitly present the benefits of TDM assessments in the personalized management of elderly patients receiving polypharmacy. Such benefints include identification of DDIs, but also management of adherence issues and adverse drug reactions.

G. Schoretsanitis Consultant of: consultant for Dexcel Pharma, HLS Therapeutics, Lundbeck and Thermo Fisher, Speakers bureau of: speaker’s fees from HLS Therapeutics, Lundbeck and, OM Suisse, Sadalax.

Prolonged war-related adversity places Ukrainian university students at heightened risk of psychological distress. Scalable, low-intensity interventions such as WHO Self-Help Plus (SH+) show promise, yet evidence of their implementation and short-term effectiveness during active conflict is limited.

A multicenter longitudinal study was conducted across five universities. Students with mild-to-moderate distress (PSS-10) joined a 5-week offline Acceptance and Commitment Therapy-based SH+ course led by trained non-specialist facilitators. Outcomes included psychological distress (PHQ-9, GAD-7, PCL-5), well-being (WHO-5), daily functioning (WHODAS 2.0), and resilience (CD-RISC-10), assessed at baseline (T1), post-intervention (T2), and 3-month follow-up (T3). Analyses used non-parametric longitudinal tests on 297 completers.

SH+ participation significantly reduced perceived stress, depression, anxiety, and post-traumatic stress from T1 to T2. Well-being and daily functioning improved, with all gains sustained at T3. Resilience remained stable. Implementation barriers included security threats, power outages, and exam overlaps, contributing to attrition.

WHO SH+ is an effective, scalable first-line psychosocial intervention for university students in wartime. It alleviates distress, enhances functioning, and maintains benefits over 3 months. SH+ can be rapidly deployed by non-specialists within stepped-care university frameworks during humanitarian crises. Flexible delivery and alignment with academic schedules are essential to overcome conflict-driven barriers.

Drug–drug interactions (DDIs) are significant pharmacokinetic and pharmacodynamic consequences of concomitant treatment with two or more agents. DDIs are categorized as potential or clinically relevant. While many DDIs are identified as potential, only approximately 5% become clinically relevant. Various strategies—including the use of DDI checking tools, collaboration with clinical pharmacists, and systematic medication reviews—can reduce the occurrence of potential DDIs and, consequently, the risk of clinically significant DDIs. The speaker will present basic methods for detecting potential DDIs using a clinical case and will discuss the most recommended approaches to reducing clinically relevant DDIs in everyday clinical practice.

None Declared

Suicide represents a major public health challenge worldwide. Despite the availability of evidence-based treatments, many individuals at risk face significant barriers to accessing timely, personalized, and continuous psychological support. Digital interventions offer a promising opportunity to expand access to care; however, many currently available tools show limited personalization, variable engagement, and high dropout rates, reducing their potential clinical impact.

MoshiMoshi is an innovative project integrating clinical research and digital technology to deliver a tailored, multi-component psychological intervention for individuals experiencing suicidal ideation or with a history of suicide attempts. The program lasts seven weeks and is delivered through a mobile application within a blended-care framework. It combines psychoeducation and experiential exercises informed by cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT), mindfulness-based approaches, and interpersonal psychotherapy (IPT). All participants complete a core module focused on understanding and managing suicidal ideation. Additional modules—addressing depression and anxiety, burnout, chronic pain, relational difficulties, and lifestyle problems—are assigned based on individualized screening and clinical assessment to ensure a personalized treatment pathway. The intervention is anchored by two in-person clinical sessions dedicated to safety planning at the beginning and relapse prevention at the end of the program, while digital modules are completed autonomously between sessions. Ongoing assessments and daily ecological check-ins are embedded in the app to monitor risk and engagement.

Development and preliminary testing were conducted through two pilot studies involving university students. Pilot 1 and Pilot 2 evaluated feasibility, usability, and acceptability. Satisfaction and usability ratings were high in both studies. Participants particularly appreciated daily monitoring questions and guided meditation exercises. Although engagement fluctuated over time and dropout rates were consistent with those typically reported in digital mental health research, overall feedback supported the intervention’s feasibility. A controlled trial is currently underway to evaluate the efficacy of MoshiMoshi compared with treatment as usual in a clinical sample.

By integrating clinical expertise, individualized module selection, structured safety components, and digital delivery, MoshiMoshi seeks to strengthen suicide prevention efforts through accessible, personalized, and engaging psychological support.

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Classical suicidology conceptualizes suicide as an attempt to escape from unbearable psychological pain (psychache), rather than as a movement toward death. Suicide emerges when emotional suffering becomes intolerable and consciousness itself is experienced as painful, driven by persistent negative emotions and self-referential internal dialogue. In such conditions, individuals may perceive the cessation of consciousness as the only viable relief from anguish.

Beyond intrapsychic distress, childhood maltreatment represents a major vulnerability factor for suicidal behavior, contributing to long-term susceptibility to psychological pain. In contemporary societies, particularly among adolescents and young adults, these established risk factors may be further influenced by the pervasive role of social media. Digital environments can intensify psychological suffering through social comparison, cyberbullying, exposure to self-harm–related content, and reinforcement of negative self-concepts, while simultaneously limiting opportunities for emotional regulation and interpersonal containment.

This presentation examines suicide risk from theoretical and empirical perspectives, focusing on the relationship between psychological pain, childhood trauma, and suicidal behavior, with specific attention to younger populations exposed to online social contexts. Emerging evidence suggests that social media may act as a contextual amplifier of psychological pain in vulnerable youth, particularly in those with prior trauma or affective dysregulation, while also representing a potential avenue for early identification and prevention. An empathic, developmentally informed understanding of suffering remains essential for suicide risk reduction, underscoring the clinician’s role in recognizing and modulating psychological pain within both offline and digital environments.

M. Pompili Consultant of: M Pompili wishes to disclose that in the last 5 years, he has received lectures and advisory board honoraria or has engaged in clinical trial activities with Angelini Pharma, Allergan, Johnson&Johnson, Lundbeck, Merck Sharp and Dohme, Otsuka, Rovi, Pfizer Inc, Fidia, Viatris, Recordati, Newron, Neopharmed Gentili, EG Stada, Boehringer Ingelheim and Teva, all of which are unrelated to this presentation.

Suicide is a leading cause of premature mortality worldwide and a major public health concern, particularly among individuals recently discharged from emergency departments after a suicidal crisis. Safety planning is currently considered a gold-standard brief intervention to mitigate short-term suicide risk, yet its implementation and use in real-world settings face important barriers related to accessibility and continuity of use outside clinical encounters. Digitalization offers a promising opportunity to extend and enhance safety planning by delivering just-in-time, scalable, and user-centered preventive tools that patients can activate during suicidal crises in their daily lives.

To assess whether activating a digital safety plan integrated into the MeMind app reduces subsequent emergency department visits for suicidal ideation or attempts after an index suicide-related visit; this study is part of the Smartcrisis project for suicide behavior prevention conducted in Madrid, Spain.

A one-year follow-up was conducted with patients presenting to the emergency department with an initial suicidal behavior episode (N=78), who were provided with a mobile-based digital safety plan and instructed to activate it during future suicidal crises.

At one year, patients who activated the digital safety plan showed an approximately 50% lower likelihood of returning to the emergency department for suicidal behavior compared with those who did not activate it.

Activation of digital safety plans may represent a brief, scalable, and easily accessible secondary prevention strategy for suicidal behavior in emergency care settings

None Declared.

Suicide and non-suicidal self-injury (NSSI) remain critical public health challenges. Traditional clinical assessments are often limited by recall bias and a failure to capture the dynamic fluctuations of suicidal thoughts and behaviors. Ecological Momentary Assessment (EMA) has emerged as a solution, though most research is limited by short follow-up periods that fail to capture long-term clinical trajectories.

Investigate the real-time associations between suicidal ideation (SI) and NSSI using long-term smartphone monitoring

This prospective study utilized a smartphone-based EMA to monitor high-risk psychiatric outpatients (N≈100) over an extended period of 6 to 12 months. Participants received daily prompts with 2–4 randomized questions assessing suicidal ideation (SI), desire to self-harm (DSH), negative affect, and interpersonal experiences. Mixed-effects models were used to analyze within-person variability and temporal trends.

SI and NSSI are significantly associated with negative affect and interpersonal difficulties. High within-person variability was observed, suggesting that risk is a fluctuating state rather than a stable trait. Notably, the extended follow-up allowed for the identification of temporal slopes; for instance, while restlessness and sadness decreased over time in NSSI patients, passive SI and anxiety showed increasing trends—nuances often missed in typical 2–4 week studies.

Long-term EMA is a feasible, less invasive methodology that provides a superior understanding of suicidal behavior. The primary advantages include the drastic reduction of recall bias and the unique ability to capture proximal, real-time predictors over a clinically meaningful duration. This longitudinal perspective is vital for transitioning from simple monitoring to actionable, personalized mHealth interventions.

None Declared