Language impairments are common in affective and psychotic disorders, yet their patterns and underlying pathomechanisms remain insufficiently understood. A transdiagnostic perspective provides a framework for identifying shared and disorder-specific language alterations across diagnostic boundaries. Combining natural language processing (NLP) with network analysis enables the investigation of complex associations between linguistic, cognitive, and psychopathological features.

Spontaneous speech from N = 372 participants (119 MDD, 27 BD, 48 SSD and 178 HC) was elicited using four Thematic Apperception Test pictures (~12 min per participant). NLP models were applied to extract latent linguistic variables across various levels, including lexical diversity, syntactic complexity, semantic coherence, and disfluencies. Network analysis was used to relate linguistic variables, psychopathology (SAPS, SANS, HAM-A, HAM-D, YMRS, TLI, GAF), and cognitive performance (attention, verbal memory, recognition, and verbal fluency).

Linguistic variables formed the densest network cluster, with type–token ratio, mean length of utterance, and syntactic complexity emerging as central nodes. Psychopathology variables were less cohesive, while TLI “Impoverishment”, coherence mean, and executive functioning bridged linguistic, cognitive, and psychopathological domains. Network comparison tests revealed no significant differences in linguistic–cognitive network structure across HC, MDD, BD, and SSD.

Linguistic networks show high structural consistency across healthy individuals and patients, whereas psychopathological symptom networks reflect transdiagnostic profiles. These findings support a dimensional and transdiagnostic framework underscore shared language–cognition mechanisms, and highlight executive functioning as key cross-domain connection, which opens up new avenues for dimensional research into the pathophysiological and etiological mechanisms underlying language dysfunctions.

Amid ongoing mental healthcare reforms in Belgium, federal authorities initiated a significant transformation of inpatient care for individuals with severe mental illness from 2020 onwards, leading to the transition of 31 psychiatric units across Belgium into high-intensive care (HIC) units (Bruffaerts et al., 2025). In this presentation we discuss (1) clinical and sociodemographic profiles of patients admitted to HIC units in Belgium; (2) findings on the role of HIC units in the provision of appropriate care for patients in severe crisis (including met and unmet needs for treatment and the extent to which HIC patients have been treated in a crisis care pathway); (3) pre-/post comparisons in patients’ outcomes. Using a value-based framework, we provide preliminary evidence on the role HIC units may play in the development of a delivery system for people in crisis.

None Declared

In the Netherlands, the High and Intensive Care model has been developed to enhance the quality of care and reduce coercion on acute psychiatric wards, with staff recognized as a crucial factor in its successful implementation. However, high staff turnover threatens both sustainable implementation of the model and the well-being of patients and healthcare professionals.

To inform strategies for staff retention and recruitment, this study explores the motivations of professionals working on High and Intensive Care wards.

We used an innovative arts-based method known as the “confession booth” to collect data that uncovers deep motivations and encourages individuals to reflect anonymously. The confession booth, a designated room on the ward, invited staff to send voice messages via WhatsApp, in response to three prompts: 1) What impressed them most during their shift 2) What made them most proud, and 3) What frustrated them most. The confession booth operated simultaneously across eight High and Intensive Care wards in the Netherlands over the course of two weeks.

Thematic analysis identified four overarching themes, each comprising multiple subthemes: meaningful engagement, professional agency, collaborative competence, and security. Participants emphasized that High and Intensive Care work is driven by a deep sense of compassion and a strong commitment to supporting patient recovery. The complexity of the work, along with active involvement in clinical decision-making, was described as both meaningful and professionally rewarding. Effective teamwork, particularly within a flexible, skilled, familiar team, was seen as essential to both job satisfaction and safety. Feeling safe emerged as a crucial prerequisite for all aspects of the work in which effective collaboration and adequate support from law enforcement were essential to maintaining this safety.

To safeguard care quality, the persistent vicious cycle of insufficient attention to staff retention must be broken through structural investment in well-being, recognition, and reward. Retention is shaped by meaningful work, opportunities to apply expertise, effective teamwork, and safe working conditions. The confession booth provided a flexible and anonymous space for reflection, offering valuable insights. These findings present a strong foundation for improving retention and recruitment within High and Intensive Care settings.

None Declared

The period of transition from adolescence to adulthood is critical for continuity of psychiatric care. Discontinuity of treatment, loss of follow-up, can severely affect outcome of psychiatric conditions. As indicated by a survey among European mental health professionals, fragmented delivery and disruption of care is perceived as one of the barriers in access to mental health services. Currently, we are facing big surge of mental health problem among children and adolescents. This is also evidenced by the sharp increase in consumption of psychotropic drugs. The number of young people (under age of 17 years) in the Czech Republic, who were prescribed antipsychotics, went up between 2015 and 2025 by 25%. The same pattern can be observed in other countries, as well. Antipsychotic treatment of adolescents requires close scrutiny, especially in those who are at risk of transition to psychosis. The data indicate that antipsychotics may not be more effective in psychosis prevention than other interventions, both pharmacological and non-pharmacological. Moreover, antipsychotics, typically off-label, have much broader variety of indications in children adolescents than just psychotic disorders (e.g., mood disorders, disruptive behavioral disorders, autism spectrum disorders, etc.). Although the spectrum of side effects induced by antipsychotics in youngsters and adults is similar, young patients may be more sensitive, especially to metabolic and endocrine adverse events. Another controversial issue is the use of long-acting formulas in this population. Antipsychotic treatment between adolescence and adulthood thus requires both continuity and careful deliberation of right indication, as well as taking into consideration its different tolerability and safety.

None Declared

Epidemiological evidence on the incidence and remission of anxiety and depressive disorders is limited. We estimated age- and sex-specific incidence and remission rates of moderate-to-severe anxiety and depressive symptoms using the illness-death model.

The German National Cohort (NAKO) is a cohort of over 200,000 participants aged 19–74 at baseline. Prevalence of probable cases, estimated with the Generalized Anxiety Disorder Scale and the Patient Health Questionnaire data 2014–2019 across five regions, was related to general mortality rates and disorder-specific mortality rate ratios in the illness-death model. The partial derivative of prevalence was modeled as a function of incidence and remission, with parameters estimated via least-squares optimization through 2,000 bootstrap resamples.

The highest incidence rates (per 1,000 person-years) occurred at ages 19–21 for anxiety symptoms: 4.07 (95% CI: 0.00–7.57) in women and 2.55 (0.00–4.94) in men; and at ages 28–34 for depressive symptoms: 4.41 (0.00–9.81) in women and 3.30 (0.00–7.34) in men, all in Hamburg. Remission rates (per 100 person-years) were highest at older ages. For anxiety symptoms, rates peaked at 71.8 years in women (4.10 [0.00–11.94]) and 64.2 years in men (3.00 [0.00–9.23]) in Freiburg. For depressive symptoms, the highest observed was at 74.0 years, both among women (6.61 [0.00–15.50] in Münster) and men (3.58 [0.00–11.51] in Berlin).

Incidence and remission rates of anxiety and depressive symptoms can be estimated from prevalence and mortality data, revealing regional, sex-, and age-related variation. Validation with longitudinal data is warranted.

The transition from adolescence to adulthood represents a critical developmental period associated with increased vulnerability to the persistence or worsening of eating disorders (EDs). Pharmacotherapy, though not first-line for most EDs, plays a complementary role in addressing core symptoms, psychiatric comorbidities, and medical complications.

To summarize current evidence on the efficacy, safety, and clinical considerations of pharmacological treatments for anorexia nervosa (AN), bulimia nervosa (BN), and binge‑eating disorder (BED) during the transition age (approximately 16–25 years).

A narrative synthesis of clinical trials, recent systematic reviews and guideline recommendations with established or emerging evidence..

Evidence for pharmacotherapy in transitional-age patients remains limited. For AN, no medication has robust efficacy in weight restoration; however, atypical antipsychotics—particularly olanzapine—may support weight gain and reduce cognitive rigidity, though metabolic risks require close monitoring. In BN, selective serotonin reuptake inhibitors (SSRIs), especially fluoxetine at higher doses reduce binge–purge frequency and mood symptoms. BED pharmacotherapy is better supported: lisdexamfetamine demonstrates significant reductions in binge frequency, while topiramate reduce binge episodes and weight but with cognitive side‑effect risks. Comorbid anxiety, depression, and obsessive–compulsive symptoms often guide adjunctive medication. Developmental considerations are essential in treatment.

Pharmacotherapy can play a valuable adjunctive role in treating ED during the transition from adolescence to adulthood. Evidence remains insufficient for AN. Careful monitoring for metabolic, cardiovascular, and neuropsychiatric adverse effects is crucial. Integrated, developmentally informed models of care. Supporting continuity between child/adolescent and adult services are needed to optimize medication. Further controlled trials are required.

HIMMERICH, H. et al.:The WFSBP Task Force on Eating Disorders. WFSBP guidelines update 2023 on the pharmacological treatment of eating disorders. The World Journal of Biological Psychiatry. 2023. DOI: 10.1080/15622975.2023.2179663.

Supported by Ministry of Health, CR NU23-04-00381, Cooperatio Program (Neuroscience and Health Sciences).

None Declared

Ketamine and esketamine produce rapid and sustained antidepressant effects in persons with treatment-resistant depression (TRD). Although it is posited that these effects are largely attributed to N-methyl-D-aspartate receptor antagonism, the potential involvement of the opioid system remains unclear. This systematic review investigates whether ketamine and esketamine antidepressant efficacy is mediated through the opioid system.

We conducted a systematic search of preclinical and clinical studies investigating the potential involvement of the opioid system in the antidepressant effects of ketamine and esketamine. Database searches on PubMed, Cochrane Library, Embase and PsycINFO occurred from inception to September 27, 2025.

16 studies were identified: 12 clinical (n = 790) and 4 preclinical studies. Clinical designs included randomized controlled trials, case reports, pre-post studies and observational cohort studies. Preclinical studies utilized animal models of depression. Only one study examined esketamine. Naltrexone (nonselective opioid antagonist) attenuated ketamine’s effects in three studies, while four reported no such effect and one reported mixed evidence. Genetic markers of opioid receptor subtypes (i.e., OPRM1 and OPRD1) were examined in three studies, but results were inconclusive, potentially due to limited evidence. Separately, opioid use was not associated with ketamine response. Few studies directly examined opioid receptor subtypes.

The reported mixed findings suggest that the opioid system may exert a partial mediating effect of ketamine in TRD. However, given the inconsistent attenuation of ketamine’s antidepressant effects by opioid receptor antagonists, the opioid system likely functions as a context-dependent modulator rather than a primary mediator, particularly at standard antidepressant doses.

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.

Volumetric changes in the superior temporal gyrus and anterior cingulate cortex have been repeatedly reported in studies on schizophrenia. Tractography and functional magnetic resonance imaging studies have suggested that alterations in connectivity involving the superior temporal gyrus and the anterior cingulate cortex are relevant to psychotic symptoms of schizophrenia.

We analyzed nanometer-scale three-dimensional structures of brain tissues of the superior temporal gyrus and the anterior cingulate cortex in eight schizophrenia and eight control cases and evaluated structural parameters of their neurons. We then examined the relation between the neuronal parameters and clinical information including auditory hallucination score.

The obtained results indicated that 1) neurites become thin and tortuous in schizophrenia and that 2) somata become small in schizophrenia. The frequency distribution of neurite curvatures had a broad profile in the schizophrenia cases, whereas the control cases showed sharp peaks. In the scatter diagram of the standard deviation of neurite curvatures, the schizophrenia and control cases formed separate clusters, indicating that all 16 cases analyzed in this study can be assigned to either the schizophrenia or control group simply by using the diagram. The cingulate/temporal ratio of the standard deviation of neurite curvatures showed a strong positive correlation with the auditory hallucination score.

The structural alteration of neurites observed in the schizophrenia cases should influence the function of affected brain areas by hindering communication between distant neurons. We suggest that the interplay of the temporal and cingulate cortices in the whole-brain network is relevant to auditory hallucination.

Bipolar disorder (BD) involves immune-inflammatory dysregulation. This systematic review and meta-analysis assessed complete blood count-based inflammatory indices – neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), and platelet-to-lymphocyte (PLR) ratios – in BD versus healthy controls (HCs), major depressive disorder (MDD), and across BD mood states.

Databases were searched through June 2025 for observational studies reporting at least one ratio in adults with BD and including as comparators either HCs, MDD, or within-BD mood-state contrasts (mania, bipolar depression, euthymia). Quality was appraised using BIOCROSS. Random-effects meta-analyses, sensitivity analyses, and meta-regressions were performed. GRADE was adapted to rate evidence certainty.

Fifty-one studies (38,309 participants) met the inclusion criteria. Compared to HCs, BD showed higher NLR (SMD = 0.44, p < 0.001) and MLR (SMD = 0.28, p < 0.001). In mania, NLR (SMD = 0.62, p < 0.001), MLR (SMD = 0.51, p < 0.001), and PLR (SMD = 0.18, p = 0.014) were all elevated versus HCs. Depression showed lower PLR (SMD = –0.14, p < 0.001) and euthymia higher NLR (SMD = 0.37, p = 0.002). Compared to MDD, BD had higher NLR (SMD = 0.21, p < 0.001) and MLR (SMD = 0.18, p < 0.001). Similarly, mania showed higher NLR (SMD = 0.53, p < 0.001) and MLR (SMD = 0.41, p < 0.001), while bipolar depression lower PLR (SMD = –0.15, p < 0.001). Mania had higher NLR (SMD = 0.32, p < 0.001), MLR (SMD = 0.32, p < 0.001), and PLR (SMD = 0.14, p = 0.028) than depression and higher MLR than euthymia (SMD = 0.44, p = 0.027), while depression had lower NLR (SMD = –0.28, p = 0.012) and PLR (SMD = –0.22, p < 0.001). Evidence certainty was mixed.

NLR, MLR, and PLR emerge as non-specific, group-level correlates of immune-inflammatory dysregulation in BD, however offering limited discrimination between bipolar and unipolar depression. Notwithstanding their potential role as trait- and state-related markers in BD, further studies are needed to support translation into clinically useful biomarkers.

Chronic benzodiazepine (BZD) prescribing remains a debated issues in psychiatry, balancing clear short-term benefits against substantial long-term risks. This presentation reviews historical developments, current epidemiology, pharmacology, risks, and potential clinical roles for long-term BZD therapy, with a particular focus on emerging evidence and ongoing controversies.

Benzodiazepines replaced barbiturates in the mid-20th century because of their wider therapeutic window, rapid onset, dependable effects, and usefulness across anxiety, insomnia, and seizures. They remain widely prescribed across Europe, although use has declined over the last two decades, especially among younger patients. Prescription data show that BZD and Z-hypnotic use increase sharply with age, and that a substantial proportion of the population—particularly older adults—receive at least one annual prescription.

Despite therapeutic benefits, long-term BZD use carries well-documented risks. These include psychomotor impairment, cognitive decline, falls and fractures, paradoxical anxiety and insomnia, dependence, and interactions with alcohol or opioids that markedly increase overdose mortality. In schizophrenia, concomitant BZD treatment has been associated with elevated mortality rates (Tiihonen et al., 2011). Evidence regarding dementia risk is mixed, and tapering studies in psychogeriatric populations show limited cognitive reversibility after cessation.

Nevertheless, some patients may benefit from stable, long-term use, particularly those with treatment-resistant anxiety disorders, severe insomnia, epilepsy, or complex psychiatric comorbidities. Recent findings suggest that forced, rapid discontinuation can increase emergency visits and mortality (Maust et al., 2023), supporting a more individualized approach. This tension highlights the need for nuanced prescribing: minimizing unnecessary initiation, but recognizing that long-term therapy may be appropriate in selected cases.

Emerging clinical strategies include substitution programs—such as an ongoing Norwegian trial replacing illicit, high-potency BZDs with diazepam or oxazepam in opioid-agonist treatment—to reduce harm in high-risk populations.

The presentation concludes with practical guidance for prescribers: prioritize non-pharmacological treatments, avoid out-of-hours initiation, document clear treatment plans, schedule regular reviews, and closely monitor risk factors such as driving, polypharmacy, and signs of dependence. Prescribers’ own habits—including age-related differences in prescribing patterns—also shape national trends.

None Declared

Climate change constitutes an increasingly important context for understanding contemporary mental health problems. Its impact on mental health can be conceptualized across several interrelated domains.

Gradual climate and environmental changes, including rising temperatures, biodiversity loss, and transformation of familiar landscapes, are associated with experiences described as solastalgia, eco-anxiety, climate depression, ecological grief, and broader environmental distress, commonly linked to anxiety, depressive symptoms, hopelessness, and a sense of loss.

Acute climate-related natural disasters, such as floods, heatwaves, and wildfires, produce both immediate and long-term psychological consequences, including trauma-related disorders, and persistent disruptions of social functioning and community cohesion.

Human-driven environmental degradation, including deforestation and ecosystem destruction, often generates anger, sense of helplessness, and moral distress, particularly when individuals and local communities feel powerless in the face of intentional environmental harm.

At the interface of psychiatry and the natural environment, ecotherapeutic and nature-based interventions (forest therapy, therapeutic ornithology) support mental health through structured contact with natural environments, contributing to emotional regulation, stress reduction, improved mood, and cognitive functioning. A study published in Poland in 2025 indicated that approximately 60% of psychiatrists consider nature-based interventions to be beneficial for mental health, both in clinical and non-clinical populations.

None Declared

In the last decade, UN bodies and the WHO call for the abolition of coercion in psychiatry. Studies provide some evidence for interventions to reduce the use of coercion, but it is unclear whether the use of coercion is decreasing in real-world practice. The aim of this study was to gather longitudinal ecologic data on the use of coercive interventions in European countries and to depict trends over time.

For each country, inclusion required access to ecologic datasets spanning a minimum of four years, pertain to a defined population (country or federal state level), and allowing the necessary elements to calculate both the proportion of psychiatric admissions affected by involuntary admissions (IAs) and coercive measures (CMs) and the rate per 100,000 inhabitants. Country experts were accessed via a European network of experts (FOSTREN group).

Data were obtained from Austria, England, Germany, Norway, Sweden, and Switzerland, and covered periods between 4 and 10 years. In no country, an absolute decrease in IA and the use of CM could be observed. Rates of IA per 100,000 inhabitants changed between −5.4% (Sweden) and +37% (Germany). Rates of admissions exposed to any kind of CM changed between +11% (Austria) and +86% (Norway).

The findings suggest a persistence or rise in coercive practices despite national and international policy commitments. An increase in involuntary admissions suggests reasons outside psychiatric hospitals, whereas a disproportionate increase in coercive measures may indicate a change of practice in in-patient psychiatry. Further research is needed to explore the reasons from clinical and societal perspectives.

Considerable effort has been devoted to investigate the neuroimaging correlates and predictors of antidepressant response to ketamine, yet inconsistency in the location and nature of the regional brain effects makes it difficult to unify this research. Despite the revolutionary notion that psychiatric therapeutics show network-level brain representations, investigations into network localization of brain functional effects of ketamine treatment are still lacking.

We initially identified the locations of longitudinal brain functional alterations (increase and decrease separately) induced by ketamine treatment from 16 published studies with 508 depressed patients. By integrating these affected brain locations with large-scale functional MRI datasets from 1113 healthy and 255 depressed individuals, we then leveraged a novel functional connectivity network mapping approach to construct ketamine-induced hyper-functional and hypo-functional networks respectively.

The hyper-functional network mainly involved the subcortical (caudate nucleus and thalamus) and default (medial prefrontal cortex) networks, while its hypo-functional counterpart predominantly implicated the limbic (temporal pole), subcortical (hippocampus and amygdala), and default (lateral temporal cortex) networks.

Our findings may shed light on the neurobiological effects of ketamine from a network perspective, which might represent a crucial step toward fostering the clinical application of ketamine in antidepressant treatment.

Extreme weather events associated with climate change, such as the recent DANA (Depresión Aislada en Niveles Altos) floods in the Valencian Community, pose significant challenges not only to physical infrastructure but also to population mental health. Understanding how mental health professionals perceive and respond to such crises is essential to inform preparedness and policy.

We conducted a qualitative study using a focus group methodology during the annual conference of the Asociación Española de Neuropsiquiatría (AEN) held in Valencia. Participants included psychiatrists, psychologists, and other mental health professionals directly or indirectly involved in the response to the DANA-related crisis. The discussion explored perceptions of institutional preparedness, political response, clinical impact, and preferred models of psychosocial intervention. Data were analyzed thematically.

Participants highlighted that the magnitude of psychosocial impact was not solely attributable to the natural disaster itself, but was significantly shaped by broader structural factors. Climate change was identified as an escalating contextual determinant increasing the frequency and severity of such events. Additionally, insufficient institutional preparedness and a perceived lack of timely and coordinated political response during the acute phase of the crisis were considered key contributors to the overall impact on affected communities.

Regarding professional response, participants valued most positively the opportunity to integrate into first-line community support and relief networks during the emergency. Strengthening pre-existing community mental health services and creating flexible psychosocial support units embedded within affected territories were perceived as more effective and sustainable strategies than the deployment of highly specialized trauma-focused units. While trauma-informed care was recognized as important, there was consensus that community-based, network-oriented interventions better addressed the complex and evolving needs of the population.

The findings underscore the need to frame mental health responses to climate-related disasters within a broader socio-political and structural context. Strengthening community mental health networks, improving institutional preparedness, and integrating mental health professionals into coordinated first-line response systems may enhance resilience and reduce long-term psychosocial impact in future climate emergencies.

None Declared

Climate change has contributed to an increase in the frequency and intensity of extreme weather events such as droughts, floods, and wildfires. Literature reported that that climate change contributed to approximately 93% of the 152 extreme heat events studied, 56% of the 126 precipitation or flood events, and 68% of the 81 drought events. Similarly, climate change has been shown to contribute to an increase in the area affected by wildfires in seasonally dry forests due to rising seasonal temperatures, prolonged dry summer periods, low winter precipitation, and early snowmelt.

Climate change is a global crisis that affects mental health both directly and indirectly. Extreme heat, air pollution and natural disasters create biological and psychological stress, while secondary effects such as displacement, economic loss and uncertainty are associated with increased depression, anxiety, post-traumatic stress disorder and substance use. Individuals with serious mental illness are at higher risk due to both their physiological vulnerability and social disadvantages. In this respect, the climate crisis is a structural public health issue that requires psychiatric associations to redefine their scientific, ethical, and social responsibilities.

Among these institutional responsibilities are the development of evidence-based guidelines, training modules, and disaster preparedness protocols addressing the effects of climate change on mental health, and the standardisation of clinical recommendations for protecting individuals with serious mental disorders from risks such as heat waves, air pollution, and displacement; taking steps to establish emergency plans that will ensure continuity of care in health institutions, presenting frameworks for telepsychiatry and community-based care models, and carrying out public policy activities that focus on mental health.

None Declared

Psychiatric comorbidities are common in first-episode psychosis (FEP) and hinder recovery. Problem gambling (PBG), despite potentially serious clinical consequences, remains under-investigated in this population. This study aimed to estimate the incidence of PBG in FEP and identify predictive factors.

This prospective cohort study was conducted at two FEP programmes in Quebec, Canada. Individuals aged 18–35 years diagnosed with FEP between November-1-2019 and January-31-2023 were screened for PBG using the Problem Gambling Severity Index through May-1-2023. The primary outcome was incident PBG. Time-varying Cox regression models were used to estimate hazard ratios (HRs) for candidate predictors.

Among 520 individuals without prior PBG (mean age = 24.6±4.0 years; 28.8% women), 18 developed PBG during a mean follow-up of 478 days, yielding an incidence rate of 2.6 cases/ 100 person-years. In site-adjusted analyses, white ethnicity (HR = 9.7; 95%CI = 1.3–74.8), incomplete high school education (HR = 2.8; 95%CI = 1.1–7.2), stimulant use disorder (HR=2.8; 95%CI = 1.0–7.3), use of D2/D3-5-HT1A partial agonists (HR = 4.6; 95%CI = 1.5–14.1), and prior non-problematic gambling (HR = 3.1; 95%CI = 1.1–8.4) predicted increased risk. Thirteen cases occurred during aripiprazole treatment, which remained associated with increased PBG risk after multivariable adjustment (adjusted HR = 4.7; 95%CI = 1.6–13.9).

Despite the limited number of incident cases, these results suggest that PBG is relatively common PBG and is associated with potential risk factors, including white ethnicity, incomplete high school education, stimulant use disorder, prior non-problematic gambling, and treatment with D2/D3-5-HT1A partial agonists, particularly aripiprazole. These findings underscore the importance of routine screening for PBG and risk-informed antipsychotic prescribing in FEP.

Dual diagnosis—co-occurring mental illness and substance use disorder—poses substantial challenges for healthcare systems. Individuals affected by both conditions experience markedly elevated morbidity and mortality compared with patients who suffer from only one disorder. This presentation will clarify key concepts and delineate which conditions should be considered within, and outside of, the dual-diagnosis framework. We will demonstrate that comorbidity is highly prevalent: patients with substance use disorders frequently meet criteria for one or more mental disorders, and conversely, individuals with psychiatric illness often develop substance-related problems.

After outlining definitions, we will present data on prevalence from different populations and countries. Attention will be given to the fact that patients who enter specialist addiction or mental health services tend to represent the more severely affected segment of the population. As a result, clinical samples often show disproportionately high rates of dual-diagnosis conditions, which may unintentionally lead to overestimation of both prevalence and associated health risks when compared with community samples.

We will subsequently highlight morbidity and mortality patterns across several dual-diagnosis constellations, drawing on findings from epidemiological and clinical studies. Towards the end of the lecture, we will focus specifically on substance-induced psychosis, an important and complex subgroup. This condition illustrates the considerable health burden associated with dual diagnosis, including heightened risks for acute complications, chronic illness trajectories, and premature death.

None Declared