The vulnerability–stress framework guiding gene–environment interaction (GxE) research overlooks the role of positive experiences. The Differential Susceptibility (DS) model offers a broader perspective, suggesting that individuals vary in sensitivity to both negative and positive environments. This study aimed at replicating previous DS research by examining interactions between polygenic scores for environmental sensitivity (PGS-ES) and positive and negative early exposures on subclinical psychosis and internalizing psychopathology, functioning, and wellbeing.

The sample consisted of 638 twins from the first wave of the TwinssCan study, a general population twin cohort. PGS-ES and adversity, bullying and positive experiences in childhood were collected, along with assessments of psychotic, affective, functioning, and positive mental health. GxE interactions were tested under a competitive–confirmatory approach.

DS effects were found for the interactions between PGS-ES and all environmental exposures on schizotypic eccentricity and functioning. Adolescents with high genetic sensitivity were rated as more eccentric and less functional under childhood adversity but were rated as less eccentric and better adjusted under childhood favorable conditions. DS also resulted from the interaction between PGS-ES and positive childhood on social coping. No significant models emerged for internalizing or wellbeing.

Findings overall supported DS, indicating that genetic sensitivity to the environment operates in a “for better and for worse” manner depending on the quality of environmental exposures. It extends initial evidence that DS applies to nonclinical psychosis expression and highlights the importance of considering the full spectrum of environmental conditions to understand both risk and opportunity factors in GxE.

Treatment units for gender dysphoria show an increased number of people with neurodiversity compared to the general population. Similarly, outpatient units for autism show a high percentage of people who also suffer from gender dysphoria. The causes for this clustering are unknown, altohugh it has now been etablished as a fact in research. Studies show that people with both conditions experience particularly high levels of psychological stress and concomitant psychiatric disorders. Treating people with neurodiversity and gender dysphoria requires special expertise in both areas. Surveys of experts using the Delphi method resulted in guidelines about how specific features need to be taken into account, and how both condition sshould be addressed at the same tine. it is ethically unacceptable to deny people with neurodiversity access to gender reassignment mesures. However, they often need more support during the assassement and transition process,

None Declared.

Chemsex describes the intentional use of psychoactive substances to facilitate or enhance sexual experiences, most commonly reported among men who have sex with men (MSM) in urban settings. Substances frequently involved include methamphetamine, γ-hydroxybutyrate/γ-butyrolactone (GHB/GBL), mephedrone and other synthetic cathinones, often used in combination and in prolonged sexual sessions. Digital platforms have facilitated network formation and access to drugs, contributing to the expansion and normalization of the phenomenon in certain subcultures. While chemsex may be perceived by participants as enhancing intimacy, pleasure and connectedness, it is increasingly recognized as a complex biopsychosocial issue with significant psychiatric and somatic implications.

From a clinical perspective, chemsex is associated with elevated rates of substance use disorders, mood and anxiety disorders, trauma-related symptoms and personality vulnerabilities. Acute psychiatric presentations may include intoxication syndromes, agitation, psychosis, suicidal ideation and impaired judgment. Repeated use, particularly of stimulants and GHB/GBL, carries risks of dependence, withdrawal syndromes, cognitive impairment and persistent affective instability. Polysubstance use and sexualized drug injection (“slamming”) further increase the likelihood of overdose, blood-borne infections and other medical complications. High-risk sexual behaviors contribute to increased transmission of HIV and other sexually transmitted infections, despite advances in preventive strategies such as PrEP.

Clinicians face specific challenges, including stigma, underreporting, fragmented care between addiction, sexual health and mental health services, and the need for culturally competent, non-judgmental approaches. Routine assessment should integrate sexual health, substance use patterns, psychiatric comorbidity and psychosocial stressors. Emerging perspectives emphasize harm reduction, community-based interventions, trauma-informed care and integrated service models that bridge psychiatry, addiction medicine and infectious disease care.

Chemsex represents a paradigmatic interface between sexuality, substance use and mental health. A nuanced understanding of its motivations, risks and clinical trajectories is essential for developing tailored prevention and treatment strategies within contemporary European psychiatric practice.

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Sex differences in psychosis pathoetiology are insufficiently understood. This study explores how childhood adversity (CA) and coping mechanisms relate to psychosis expression (PE) across males and females in the general population.

Data from the TwinssCan project (males: n = 312; females: n = 478) were used. The Childhood Trauma Questionnaire assessed CA domains. The Utrecht Coping List assessed coping strategies. Psychosis expression was assessed using the Community Assessment of Psychic Experiences (CAPE). Mixed linear regression analyses examined sex-stratified associations of CAPE scores with CA, coping strategies, and their interactions.

Emotional abuse (EA) was associated with increased total CAPE scores (T-CAPE), explaining the greatest variance among CA across sexes. Sex-specific effects showed that sexual abuse (SA) and physical abuse (PA) were linked to higher T-CAPE in females, whereas physical neglect (PN) was linked to higher T-CAPE in males. Passive-reacting was associated with increased T-CAPE, explaining the greatest variance among coping styles across both sexes. Sex-specific effects showed that, in females, seeking social support was linked to decreased T-CAPE, while emotional expression increased it. The only sex-shared interaction effect was between reassuring thoughts and emotional neglect (EN), associated with decreased T-CAPE. In females, social support (× PA/PN/EA), reassuring thoughts (× PA/PN), and palliative-reacting (× PN/PA) were associated with decreased T-CAPE, while passive-reacting (× EN) increased it. In males, avoidance (× SA/PA) and passive-reacting (× PN) were associated with increased T-CAPE.

Sex differences in the associations of PE with CA and coping underscore the necessity for sex-specific interventions that promote adaptive coping strategies.

Sexual and gender minorities often face stigma and discrimination from the time they start exploring their identities, even if they don’t choose to diclose this to others. They may experience negative attitudes in almost all social contexts, starting from the closest one including the family, if they don’t conform with the expected gender roles. Finallly, even if they work hard not to reveal their identity in their appearance, behavior or attire, in addition to the mental effort load related to this nonstop effort, they have to carry the burden of the expected stigmatization and discrimination. In many contexts, nondiclosure may appear protective mentally; it has been shown to be so especially in societies with higher levels of stigmatization. But in all social contexts, concealment of an identity comes with a burden, especially when its control is not on the individual but it is forced on the individual by the social environment. Mental health professionals should be famiiar with the threats existing in the society for the individual, but also should have the capacity to work on the individual’s use of concealment as a defense strategy. Since when it is used excessively and rigidly, this defense can itself be a source of stress. Furthermore, it may lead to missing the authentic potential of the individuals in their personal, interpersonal, and professional domains. In addition to increasing the capacity to use disclosure and concealment interchangeably and to the benefit of the individual, the professional should work on possible resources of psychological resilience for the individual. These efforts often involve the improved relationships with peers from the same or similar minorirty groups, peers from the general population, and family members.

None Declared

Social cognitive impairments are a fundamental aspect of schizophrenia, exerting a substantial influence on patients’ functional outcomes. However, to date, there have been no meta-analyses of comprehensive pharmacological interventions covering all domains of social cognition. The aim of the present study was to address this knowledge gap by conducting a network meta-analysis, a comprehensive approach that systematically compares the efficacy of pharmacological interventions across all domains of social cognition.

A literature search for randomized controlled trials (RCTs) was conducted using PubMed, Embase, the Cochrane Central Register of Controlled Trials, PsycINFO, ClinicalTrials.gov, and the International Clinical Trials Registry Platform. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed.

A total of 8,752 records were screened, and 60 RCTs involving 4,270 subjects were included in the systematic review. Thirty-six pharmacological interventions were extracted, but no compounds had a significant ameliorative effect on social cognition in comparison with placebo. In each domain of social cognition, the following compounds were identified as the most probable candidates for treatment selection: selective glycine uptake inhibitor (standardized mean difference [SMD], 0.46; 95% credible interval [CI], −0.52 to 1.44) and stimulant (SMD, 0.44; 95% CI, −0.57 to 1.45) for emotion perception in comparison with placebo. In the context of emotion processing, γ-aminobutyric acid (A) α2/α3 partial agonist (SMD, 0.33; 95% CI, −0.53 to 1.19) emerged as the top compound.

To date, no pharmacological interventions have demonstrated efficacy for social cognitive impairments in schizophrenia.

Refugees and asylum seekers experience elevated exposure to pre‑migration trauma, dangerous migration journeys, and post‑migration stressors, all of which contribute to increased vulnerability to suicidal behaviour.

The presentation will give a summary of recent meta analyses, systematic reviews and global health analyses and will present an outline on the implications on global mental health.

Rates of suicidal behaviour across displaced populations vary widely with significant heterogeneity across settings and methodologies. Asylum seekers consistently show higher suicide risk in comparative studies. Risk is also heightened among subgroups, including unaccompanied minors, and individuals facing prolonged detention, insecure residency, or disrupted access to care. In contrast, suicide rates in refugees with residence permits in high-income countries have in several studies reported to be lower than in the host population. Protective factors include social support, family cohesion, and individual coping strategies.

Forced displacement has created unprecedented global mental health burdens. Refugees and asylum seekers experience higher rates of depression, PTSD, psychosis, and suicidality due to adversity at each stage of migration. Barriers to mental health care—including language differences, stigma, restricted service access, and disrupted continuity of care—further increase suicide risk. Existing prevention strategies remain limited by insufficient evidence, with reviews highlighting gaps in data on comorbidities and intervention efficacy. Strengthening global mental health strategies will require coordinated, culturally grounded, evidence‑based approaches aimed at early identification, accessible care, and multisectoral suicide prevention.

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People with psychotic disorders have high cardiometabolic risk, yet prediction tools are rarely validated outside early-intervention settings. We externally validated and recalibrated the UK Psychosis Metabolic Risk Calculator (PsyMetRiC) in a Dutch cohort of young adults with psychotic disorders in long-term care.

We used data from the PHAMOUS registry. Individuals aged 16–35 years, without metabolic syndrome (MetS) at baseline (prevalence 21.2%), were included. MetS incidence over approximately 6 years (last assessment 1–6 years; cumulative incidence 29.1%) was defined using international criteria. Full (biochemical + clinical) and partial (clinical only) PsyMetRiC models were applied to 10 multiply imputed datasets. Discrimination, calibration, and decision-curve analysis (DCA) were assessed before and after logistic recalibration of intercept and slope.

In external validation, C-statistics were about 0.69 for the full and 0.67 for the partial model. Both systematically underpredicted MetS risk; recalibration yielded calibration intercepts near 0 and slopes near 1, while discrimination was unchanged. DCA suggested that, across risk thresholds of 0.10–0.35, using recalibrated PsyMetRiC could provide higher net benefit than “treat all” or “treat none.”

In this chronic-care cohort, PsyMetRiC showed moderate discrimination and improved calibration after logistic recalibration. The recalibrated models may support more targeted metabolic monitoring and prevention, but interpretation is limited by registry design, variable follow-up times, reliance on multiple imputation, and modest power for subgroup analyses.

Alexithymia is a multifaceted, transdiagnostic trait characterized by challenges in emotion processing. Affecting up to 10% in the general population, it represents a risk factor for various mental and physical health conditions. Recent neuroimaging studies have elucidated the neural substrates of alexithymia, providing initial insight into altered functional connectivity within key emotional, attentional, and interoceptive networks, potentially impairing emotion processing and everyday functioning. However, no large-scale study has yet confirmed these network alterations.

Resting-state functional magnetic resonance imaging from 575 individuals (ages 29–60, 334 women) in the population-based SHIP-TREND cohort, using regions of interest covering major functional networks across the whole brain, was paired with the 20-item Toronto Alexithymia Scale (TAS-20) to investigate the signature of alexithymia. The analysis accounted for technical variables, sociodemographic factors, lifestyle, and current depressive symptoms.

Higher TAS-20 scores were associated with altered functional connectivity within the frontoparietal network and between the dorsal attention and salience networks. Specifically, the subscale “difficulties identifying feelings” was associated with functional alterations between and within attentional, salience, and sensorimotor networks, indicating a divergent pattern within the salience network.

These findings underscore the widespread impact of alexithymia on brain networks involved in emotional attention, interoception, and somatosensory processing. Controlling for lifestyle factors, current depressive symptoms, and other health indicators supports the specificity of these patterns. This supports the view of alexithymia as a personality trait that affects large-scale network functioning, potentially hampering emotional regulation and self-awareness processes, contributing to mental and physical health risks.

Recent studies indicate an increased risk of suicide among refugees compared to the native population. In this context, scientific research is focusing on the significance of postmigrative stress factors. One factor that is receiving particular attention is the residence status. The correlation between an uncertain residence status and increased psychological distress has been shown by many studies. However, the extent to which fear of deportation influences the suicidal behaviour of refugees has received comparatively little attention, so far. This presentation provides an overview of current research, completed by data from the stepped-care project refuKey (founded by NTFN Psychosoziale Zentren gGmbH and the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology). RefuKey aims to improve the needs-based care of mentally distressed refugees in Germany. Four-fifths of the refuKey patients live with an uncertain residence status. Also, many patients report suicidal ideations at the beginning of treatment. Although the level of postmigrative stress that is experienced by refuKey patients stays high, the amount of suicidal ideations decrease significantly during the treatment. Finally, the possibilities and limitations of treating suicidal refugees who are in fear of deportation will be discussed.

None Declared

The network theory of mental disorders posits that associations between symptoms activate other symptoms to maintain a disorder over time. Network analytic approaches therefore may inform treatment targets. In the present study, we compared baseline OCD symptom networks among treatment responders to non-responders and examined how network structure and connectivity changed from before to after exposure and response prevention (ERP) treatment.

Community adults with OCD (n = 712) who underwent intensive outpatient treatment were assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS) at admission and discharge. Network comparison tests were used to (a) examine differences in baseline symptom network structures between treatment responders versus non-responders and (b) examine changes in network structures from pre- to post-treatment.

Pre-treatment network structures and global connectivity did not differ significantly between treatment responders and non-responders. However, post-treatment networks exhibited greater global strength (i.e., stronger associations between OCD symptoms) and significantly different network structure (i.e., different patterns of associations between OCD symptoms) relative to the pre-treatment network.

Findings showed that network structure and connectivity in OCD may be more informative as a marker of therapeutic change than in discriminating treatment responders from nonresponders using baseline symptoms. After ERP treatment, associations between obsessions and compulsions demonstrated significantly greater global network strength and altered network structure, thus underscoring the potential for network approaches to identify mechanisms of change throughout OCD treatment. Future studies incorporating session-by-session data may clarify when and how these network shifts occur over the course of therapy to help identify treatment targets.

Wars, social upheavals and climate changes cause refugee wawes and shape migration flows affecting the situation of refugees and other migrants in many countries. Changes in migration policies in the host countries have been introduced and wider changes are announced for the coming years. It is vital for researchers and clinicians to reflect on the possible impact of this development on migrants’ health, help-seeking behaviour and the encounter with healthcare.

The author will present material from literature reviews and official statistics. There will be an overview of current research on a number of themes:

• - Risk factors related to migration policies for mental ill-health, suicidal behaviour, and suicide in migrants;

• - cultural and social factors affecting help-seeking behaviour of migrants;

• - experiences of access to mental healthcare as well as the care encounter, including legal restrictions as well as attitudes of and the impact on clinicians.

The varying conditions of migrants in different European countries, especially regarding access to care and reports of discrimination will be sampled from official statistics.

The aim of the presentation is to stimulate and facilitate the formulation of research questions and the planning of continued documentation and continued studies over time. Further, the aim is to enable clinicians to have a deeper understanding of suicidality in their migrant patients, including the impact of social conditions not always known to healthcare staff.

None Declared

This systematic review evaluates specialized psychosocial and complex interventions for early bipolar disorder (BD), early borderline personality disorder (BPD), early depression, early psychosis, and first-episode mental illness in general (FEMI).

We included systematic reviews and randomized controlled trials (RCTs) of interventions with psychosocial components, excluding trials that focused on pharmacological-only interventions and stand-alone psychotherapies. Searches were conducted in January 2023 across five databases. Review quality was assessed using AMSTAR-2 and risk of bias for RCTs using the Cochrane tool.

Ten studies met the inclusion criteria: seven reviews and three RCTs. High-to moderate-quality evidence supports complex psychosocial interventions combined with pharmacotherapy for early psychosis. The most robust effects were reductions in relapse and improvements in psychosocial functioning; additional benefits were observed for symptom burden, remission, treatment discontinuation, and hospital admissions. Benefits were most sustained in longer-duration, community-based programs. For early BD, limited evidence suggests that combining pharmacotherapy with family-focused therapy or structured psychoeducation may improve the course of illness and treatment satisfaction. One RCT in early BPD reported improved engagement with a developmentally tailored program. Two FEMI RCTs found that nurse-led psychoeducation and psychosocial programs improved in-patient duration, symptoms, insight, self-efficacy, quality of life, and engagement. No eligible studies addressed early-stage depression, indicating a notable evidence gap for multimodal psychosocial interventions.

Complex psychosocial interventions are strongly supported for early psychosis. Preliminary data in BD, BPD, and FEMI suggest consistent benefits for engagement, but further rigorous trials – especially in early depression – focusing on different outcomes – are required.

Negative symptoms are a core dimension of schizophrenia spectrum disorders and are frequently detectable during emerging psychosis, including clinical high-risk states and first-episode psychosis. Accumulating longitudinal evidence indicates that early negative symptoms are among the strongest predictors of poor functional outcomes, limited symptomatic remission, and long-term disability, often exceeding the prognostic impact of positive symptoms. Despite their clinical relevance, negative symptoms remain difficult to treat and are frequently under-recognized in early intervention settings.

This talk aims to examine the prognostic value of negative symptoms in emerging psychosis and to discuss their relevance as potential therapeutic targets during the prodromal and early phases of illness. It will integrate evidence from prospective cohort studies, first-episode trials, and intervention research, with particular attention to the distinction between primary and secondary negative symptoms, measurement strategies, and clinically meaningful change.

The presentation will highlight that persistent negative symptoms in early psychosis are associated with poorer social and occupational functioning, reduced engagement with treatment, and less favorable recovery trajectories. While antipsychotics remain essential for the management of positive symptoms, their impact on negative symptoms is limited, underscoring the need for adjunctive and non-pharmacological approaches. Furhermore, evidence shows that early stages may represent a period in which negative symptoms are less entrenched and more responsive to interventions. The characteristics of this potential critical window and related therapeutic options will therefore be discussed.

None Declared

Healthcare workers (HCWs) are recognized as a high-risk group for mental health problems. This has been more widely acknowledged since the COVID-19 pandemic, given HCWs’ frontline role and sustained exposure to occupational and pandemic-related stressors. Although numerous cross-sectional studies have reported elevated symptoms among HCWs, longitudinal evidence—particularly studies incorporating pre-pandemic data—and comparisons with other populations remain limited.

To examine long-term changes in HCWs’ mental health using evidence from studies with pre-pandemic baseline assessments and to contextualize these changes relative to other high-risk and general population groups.

We synthesized evidence from longitudinal studies including baseline mental health assessments conducted prior to 2020 to examine changes in HCWs’ mental health during COVID-19. To contextualize these findings, we analyzed harmonized data from six European cohorts (n=2,882) from the Netherlands, France and Germany, compiled within the EU-funded RESPOND project. We investigated changes in anxiety and depression symptoms—assessed using different validated scales across cohorts and standardized for comparability—before and during the pandemic among individuals in the general population and those with pre-existing psychiatric conditions, another group at elevated risk for adverse mental health outcomes. Participants were eligible if they had data from at least one assessment conducted before 2020, as well as two assessments during the pandemic.

HCWs’ mental health trajectories indicated symptom worsening during the pandemic. However, substantial variability was observed, including symptom improvement in some subgroups, gender‑specific patterns, an absence of greater deterioration compared with other occupational groups, and more stable trajectories among individuals with higher pre-pandemic symptom levels. In the harmonized cohort analyses, most individuals in the general population exhibited decreasing symptoms over time, including those with higher initial severity. A smaller subgroup maintained consistently low symptoms. Among individuals with pre-existing psychiatric conditions, approximately half improved from moderate symptom levels, whereas the remainder showed persistently high or low symptoms.

Across groups, mental health trajectories reflected both resilience and vulnerability rather than uniform deterioration. HCWs did not consistently show worse long-term outcomes than other groups, emphasizing the role of baseline symptoms and individual heterogeneity. These findings support targeted, flexible mental health support during future public health emergencies.

None Declared

Bipolar disorder is a recurrent and disabling condition, with a critical clinical need to prevent transitions from euthymia or depression (normal or low activation states) to mania (a high activation state). This study investigates how disruptions in sleep–wake and circadian rhythms may trigger these high activation states, to inform more effective relapse prevention strategies.

We developed a computational agent-based model integrating empirical evidence, clinical expertise, and lived experience to simulate how 24-hour sleep–wake behaviors (SWBs) influence manic episodes. Individual characteristics were drawn from the Brain and Mind Youth Cohort (N = 2,330), and multiple scenarios were simulated to assess how SWB dynamics affect the emergence and course of mania.

In the absence of all irregularities, no individuals experienced a manic episode. Removing behavioral feedback loops resulted in a substantial reduction in manic episodes and delayed onset. In contrast, eliminating light–dark entrainment slightly increased the frequency of manic episodes, suggesting that seasonal adaptation plays a stabilizing role. When examining components of SWB separately, removing sleep irregularities alone had only a modest effect on mania rates, whereas reducing activity irregularities led to the largest benefit: a significant drop in mean manic episodes, a delay in onset, and preventing mania in 65% of the simulated agent population.

Our findings highlight the value of computational modeling for uncovering causal dynamics in mental health. These specific findings demonstrate how daily irregularities in sleep–wake behavior may be a necessary condition for mania. Targeting behavioral regularity may offer a powerful pathway for prevention and early intervention.

Since 2020, hundreds of studies have analysed the mental health of doctors and nurses worldwide. Initial causal claims of pandemic-related effects were hindered by the scarcity of comparable pre-pandemic studies. To address this gap and ensure continued surveillance, the World Health Organization Regional Office for Europe launched a survey for all doctors and nurses practising in the EU, Iceland and Norway (MeND).

We compare the prevalence of depressive symptoms and suicidal thoughts from 2020 through 2025, in a sample of doctors and nurses from Czechia, Italy, the Netherlands, and Spain.

We conducted a repeated cross-sectional study. Data was obtained from the HEROES (2020-2021) and MeND (2024-2025) cohorts. We used self-reported measures of depressive symptoms (i.e, PHQ-9) and suicidal thoughts, and key occupational exposures (working hours, support from colleagues, managing anger from patients and relatives, and exposure to workplace violence). We compared the proportion of individuals across exposures and outcomes between the two periods through multivariate regression analyses.

We included 39,533 respondents (5,184 from HEROES and 34,349 from MeND). Most participants were from Italy, followed by Spain, Czechia and, finally, the Netherlands. Compared to 2020-2021, individuals reported fewer weekly working hours, greater exposure to angry patients and/or relatives, lower exposure to general violence, and similar levels of colleague support in 2024-2025. The prevalence of depressive symptoms and suicidal ideation was higher in 2024-2025 compared to 2020-2021.

Doctors and nurses in Europe report higher levels of depressive symptoms and suicidal thoughts than they did in 2020-2021. Despite the limitations of repeated cross-sectional designs, these findings highlight the need for continued monitoring of healthcare workers’ mental health and for scalable support interventions at individual, interpersonal, and organisation levels to inform policy and practice.

None Declared

High turnover and mental health problems among healthcare workers (HCWs) pose a serious threat to healthcare system stability, workforce sustainability, and the quality of patient care, with risks further amplified by the COVID-19 pandemic.

We aimed to examine how baseline and changing mental health indicators, as well as protective and workplace factors, predict turnover intention among Czech HCWs.

We analysed data from the HEROES-CZ cohort. A longitudinal subsample of 668 HCWs was assessed at three timepoints, while a larger cross-sectional sample included 1,149 respondents in 2022. Depression (PHQ-9), psychological distress (GHQ-12), burnout, anxiety, and post-traumatic stress were examined as predictors of turnover intention. Logistic and multinomial regression models tested associations, adjusting for sociodemographics, occupation, physical illness, COVID-19 exposure, workplace trust, stigma, aggression, colleague support, and resilience.

In the cross-sectional sample, 37.6% of HCWs reported considering leaving healthcare. Women, younger respondents, and nurses were overrepresented, and this group had higher all measured mental health variables. Lower resilience, reduced colleague support, workplace stigma, and exposure to aggression were also associated with turnover intention. In the longitudinal analysis, higher baseline depression and distress predicted subsequent turnover intention, while changes over time did not. Older age was protective, whereas nurses reported higher turnover intention. Moderate workplace trust was linked to increased odds of turnover, while resilience protected against frequent turnover intention.

Poor baseline mental health is a robust predictor of turnover intention, underscoring the importance of early identification and intervention. Resilience appears protective, and workplace trust, support, and stigma reduction are promising targets for retention strategies. Future longitudinal research should further clarify causal pathways.

None Declared

Registry-based studies can inform suicide prevention by identifying mental disorders with the highest risk. Previous studies focused on severe disorders and suicide, with limited data on non-lethal self-harm or population impact. We quantified individual- and population-level associations of 32 mental disorders with non-lethal intentional self-harm (NLISH) and suicide.

Registry-based cohort study representative for all residents of Catalonia (Spain) aged ≥10 years (2014–2019; n = 645,571). Cause-specific Cox models estimated individual (hazard ratios [HRs]) and population-level (population attributable fractions [PAFs]) associations with NLISH and suicide, stratified by sex and adjusted for age, socioeconomic status, and nationality.

Individual-level associations with NLISH were strongest for borderline personality disorder (BPD; females HR = 26.9 [95%CI 24.9–29.0]; males HR = 18.9 [95%CI 16.7–21.4]). Associations with suicide were strongest for BPD in females (HR = 40.9 [95%CI 28.5–58.8]) and obsessive-compulsive disorder in males (HR = 17.4 [95%CI 5.3–56.5]). Associations with suicide were stronger among females, and those aged 10–44 across mood, substance use, dissociative, borderline personality, and psychotic disorders. Substantial proportions of outcomes were associated with common disorders: depressive episodes (PAFs 29.8–49.8%), substance use disorders (PAFs 25.1–48.7%), mixed anxiety-depressive disorders (PAFs 19.7–53.2%), and adjustment disorders (PAFs 10.6–44.6%).

Depressive, anxiety, adjustment, and substance use disorders are associated with large shares of self-harm and suicide, whereas BPD confers particularly high individual risk. Our findings support multilevel prevention strategies, especially among young people, including improved risk assessment, collaborative care, and timely access to specialized interventions.