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IntroductionIn South Korea, all men at the age of 18 or older are required to serve at military for a certain period as an obligation. These recruits should be able to withstand psychological stress and pressures of rapid adaptation of the unique and new environment in military. The number of military recruits facing adaptation issues has been on the rise, necessitating an evaluation for active service. In our previous study (Park et al., in press 2023), we classified the military recruits with mental issues according to latent profile analysis (LPA) and examined the treatment response during six months.ObjectivesIn this study, we further examined clinical characteristics over the next six months.MethodsNinety-two participants were analyzed with LPA using MMPI-2 clinical profiles in the previous study. The three classes were identified: mild maladjustment (Class 1, n=14), neurotic depression and anxiety (Class 2, n=36), high vulnerability and hypervigilance (Class 3, n=42). At 12 months, Clinical Global Impression-Severity and Global Assessment of Functioning were assessed to test their long-term changes.ResultsWhile Class 1 and 2 significantly improved over 6 months, Class 3 showed little or no improvement even with more medications in our previous study. During the 6-month follow-up period, 50% of Class 1, 38.9% of Class 2, and 41.5% of Class 3 were dropped. It was during this period that their level of military service was decided. Class 1 and 2 which showed marked improvement up to initial 6 months, did not demonstrate substantial further improvement during follow-up period with a considerable portion stopped visiting hospital. Subjects in Class 3, who showed little or no improvement during initial 6 months, demonstrated continued improvement in this study, although their symptoms still appeared relatively severe.ConclusionsThis study suggests clinical implications for treatment plan and intervention of each subgroup classified based on MMPI-2 clinical profiles of military recruits who might show maladjustment to serve. The long-term continuous treatment for Class 3 patients will be needed, even after exemption from active duty.Disclosure of InterestNone Declared

IntroductionIn the last 30 years, Switzerland has been established as a destination country for psychiatric trainees. The needed competences for the work as a trainee deviate regarding colleagues from foreign countries though, hindering a viable solid development professional without specific on-boarding program. A similar approach to the figure of tutor anchored in the Spanish postgraduate medical training is still missing in the Swiss medical System. Hereby we performed a survey in the new colleagues who are part from the medical team in an observer status before beginning with the responsibilities as a trainee.ObjectivesRecognizing competences and needs of the onboarding in current trainees that are still allocating because of the work conditions as stated in the following paper, (Bischof et al. Swiss Arch Neurol Psychiatr Psychother. 2021;172:w03198)MethodsSurvey with open questions collecting needs and competences expected to fulfil in Switzerland were distributed in 5 different medical colleagues in an observer status between August 2022 and September 2023.ResultsResponse rate was 62,5 %. Main reasons for the migration were considering better perspectives in education and professional development in the goal country, coming push factors as the current work situation in the original country to the fore. Support regarding the local language and an overview of the interprofessional communication were outlined as the advantage of the internship prior to the duties as a psychiatric trainee.ConclusionsAn structured on-boarding program is a demand for the newcomers - majority of trainees from foreign countries - to step in better in the Swiss health system. Elements of the Spanish trainee system could be adapted for a suitable allocation and integration process in the goal country.Disclosure of InterestNone Declared

IntroductionMany researchers are likely to use the BFI-2 as a measure of the Big Five personality factors. The HEXACO-60 Honesty-Humility factor has no direct counterpart in the Big Five system; however, it should show modest positive correlations with Big Five Agreeableness.ObjectivesThe study aimed to examine the BFI-2 in relation to a similar-length version of the HEXACO-60.MethodsParticipants were 1536 undergraduate students (960 women 576 men) at Kuwait university who completed the personality questionnaires. Participants aged 18–23-years-old mean age = 21.26 ± 1.20. The Arabic versions of HEXACO-60 and the BFI-2 instruments were administered in paper-and-pencil format in research laboratories.ResultsCronbach’s alphas ranged from 0.75 to 0.88 for the BFI-2 Domains and 0.70 to 0.75 for the HEXACO-60 Domains denoting good internal consistency. Regarding cross-inventory correlations, these were high for the two inventories variants of Openness (0.77), Conscientiousness (0.75), and Extraversion (0.71). BFI-2 Agreeableness correlated 0.56 with HEXACO-60 Agreeableness. The HEXACO-60 Honesty-Humility was weakly related to the BFI-2 scales, showing only modest correlation with Agreeableness (0.48). In addition, the BFI-2 Neuroticism correlated 0.53 with HEXACO-60 Emotionality, −0.33 with HEXACO-60 Extraversion, and −0.30 with HEXACO-60 Agreeableness.ConclusionsThe BFI-2 scales captured well the variance of the HEXACO-60 scales apart from Honesty-Humility. In particular, the BFI-2 accounted for about as much variance in the HEXACO Openness, Conscientiousness, Extraversion, and Agreeableness scales as the HEXACO-60 scales accounted for in the BFI-2 scales of the same names. The results confirm the BFI-2 and HEXACO-60 are heavily overlapping.Disclosure of InterestNone Declared

IntroductionDiogenes Syndrome (DS) is an uncommon neurobehavioral syndrome characterized by social isolation, extreme neglect of personal care and a tendency to excessively accumulate useless objects in the home, usually leading to unsanitary living conditions. It is further characterized by a lack of insight into the condition, leading to a refusal to seek assistance.ObjectivesTo outline the clinical features of primary DS, unassociated with other psychiatric conditions, emphasizing key risk factors contributing to its development.MethodsDescriptive report of a case of DS, based on an interview with the patient, review of his clinical file, and a non-systematic literature review using the PubMed database.ResultsWe report a case of a 62-year-old man, widowed since the age of 33, without children, living alone in a rural area in the north of Portugal. Currently retired, he worked as a Philosophy Professor. He had no known psychiatric history until 2015, when he attended two psychiatric appointments, due to anxiety and changes in sleep pattern. He has since lost psychiatric follow-up and in May 2022 he was brought to the emergency department by his neighbor, due to changes in his behavior. He was seen several times rummaging trough trash and he didn’t leave the house for a few weeks, resulting in a cluttered and unsanitary living space. He looked malnourished, unkempt and dirty. Despite not recognizing his behavior as problematic, he accepted hospitalization. No obsessive-compulsive, depressive or psychotic symptoms were detected, nor were dysfunctional personality traits. Reversible causes of dementia were excluded, a cranioencephalic CT scan revealed no abnormal findings and a neuropsychological assessment showed no changes in cognitive functions. Post-discharge, local health services provided home support, with meal delivery and house cleaning. However, he did not buy the medication and canceled the home support service several times, ending up being hospitalized again. After this second hospitalization in August 2023, he went to live with his brother in another city and has remained stable, medicated with an SSRI and low dose Aripiprazole.ConclusionsPrimary Diogenes Syndrome is rare and and its etiopathogenesis remains poorly understood. It is known that there is no distinction between genders, profession or socioeconomic status, and that it is more common in the elderly, single people, widowers and people with poor or non-existent social links with their local community. Familiarity with DS characteristics enables earlier recognition of such individuals, thereby facilitating prompt provision of social and clinical support in order to reduce morbidity, mortality, and enhance public health.Disclosure of InterestNone Declared

IntroductionChronic inflammation in depression is associated with decreased levels of neurotrpohic factors and suppressed neurogenesis. We have previously shown that intranasal therapy with soluble factors from M2 macrophages polarized by interaction with apoptotic cells in serum deprivation conditions (M2(LS); LS - low serum) and characterized by anti-inflammatory and pro-regenerative activity leads to the correction of the behavioral pattern in mice with a depression-like state.ObjectivesThe present study focuses on the effect of M2(LS) macrophages on neuronal density in the frontal cortex and hippocampus of depression-likemice.MethodsDepressive-like state was formed in passive male mice (CBAxC57Bl/6)F1) as a result of repeated experience of defeat in agonistic interactions with aggressive partner during 20 days (the sensory contact model). Depression-like mice were then treated intranasally with M2(LS) macrophages conditioned medium for 7 days. After that, the number of mature neurons in the frontal cortex and hippocampus was assessed using Nissl staining.ResultsThe neuronal density in the pyramidal layer of the frontal cortex was significantly lower in depression-like mice than that in the intact control group of mice (p=0,047). At the same time, the number of neurons in the experimental group of mice that received soluble M2(LS) factors, was higher than that in depressive-like untreated control mice (p=0,003) and was comparable to that in the intact group of mice. At the same time the neuronal density in the CA1 and CA3 hippocampal areas did not change in depression-like mice following intranasal treatment with conditioned medium of M2(LS) macrophages.ConclusionsThe data obtained may indicate the neuroprotective effect of M2(LS) macrophages in the stress-induced depression model, which is realized through soluble factors and manifests itself in an increase of the pyramidal neurons density in the frontal cortex.Disclosure of InterestNone Declared

IntroductionRuminations are a cognitive style of “thought recycling”, which involves passively and repeatedly focusing on disorder and distress symptoms, or their causes, without attempting to alleviate them. They are a significant indicator of cognitive vulnerability, predicting the emergence, maintenance, and recurrence of depressive symptoms.ObjectivesTo estimate the impact of the ruminative thought style on the maintenance and escalation of depressive mood.MethodsThe research sample consisted of 60 students between the ages of 19 and 30 (M = 23), divided into two experimental groups with 30 participants each. The participants took part in a 5-minute experiment that involved recalling an autobiographically sad event, assessing their mood on the Scale for Self-Assessment of Emotions (EAS) before and after the induction, and then splitting into two groups of 30 participants for random ruminating or distraction. The Beck Depression Inventory-II, the Ruminative Response Scale, the Ruminative Thought Style Questionnaire, and the EAS were used as research instruments. The progressive group relaxation approach was used at the end of the experiment with all participants to promote relaxation and lessen the psychophysical tension brought on by the experimental induction (10 minutes total).ResultsThe experimental groups did not differ in mood intensity prior to the induction of sadness. Both experimental groups experienced significant impacts on depressed mood following the induction of sadness (F (1,58) =92.05, p<0.001): participants who ruminated demonstrated persistence in their negative mood, whereas participants who engaged in distractions demonstrated a decrease in their negative mood, even below the initial level (F (2,116) =12.69, p<0.001).ConclusionsThis result provides an additional experimental validation of the phenomenon of maintaining a depressive mood through ruminations. An essential psychotherapy goal should be the treatment (metacognitive therapy, rumination-focused CBT, mindfulness, cognitive bias correction, etc.) of such mechanisms, recognized as crucial for the maintenance of depression.Disclosure of InterestNone Declared

Introduction Most of the research explored the attrition rate and predictive factors for the smartphone application of emotion monitoring in bipolar disorder patients. However, there is less focus on the efficacy of maintaining the retention rate if the incentive system is employed. Objectives The aim of our research is to evaluate the efficacy of two different kinds of incentive systems on improving frequency of using the Smartphone Mood Relapse Warning application (MRW-APP) (Su et al., 2021) in bipolar patients. Methods A one-group pretest-posttest pilot study was conducted. Participants with bipolar disorder (n = 63) recorded their moods and symptoms through MRW-APP for 29 weeks with the attrition rate of 44%. Two different kinds of incentive systems, reward and lottery, were implemented. To know whether incentive implementation could play a role in motivating the participants to better adhere to the app, we used Friedman’s test and paired sample t-test to analyze the participants’ app-using frequency in the corresponding weeks. Results There was no significant difference in the participants’ app-using frequency (p>.05) before and after we implemented the first incentive system, reward (n=63). For the second incentive system, lottery (n=41), a significant difference in app-using frequency was still not observed (p>.05) after the intervention. But, for those who both had experienced two kinds of incentive systems (n=35), there were significant changes in their app-using frequency (p<.05). Table 1. Demographics (n=63) Variables All (n=63) Mean SD Age (n=55) 36.4025.27 11.10 Onset age (n=48) 9.35 n % Gender (n=54) Female 33 61.1 Educational level (n=54) Above undergraduates 40 74.1 SD= Standard deviation Image: Image 2: Conclusions This research found the two incentive systems, award and lottery, may help increase the using frequency of the smartphone monitoring app for participants with bipolar disorder. The results from our study can be a reference for mood monitoring apps development in the future, and it also suggested that incentive system has its potential on encouraging patients’ adherence to e-healthcare. Disclosure of Interest None Declared

Introduction Selective serotonin reuptake inhibitors (SSRI group antidepressant drugs) are not significantly different from tricyclic antidepressants and other antidepressants in terms of efficacy, but provide significant advantages in terms of side effects and toxicity. One of the most important side effects of antidepressant drugs is weight gain. However, there is not yet enough study on weight gain mechanism. Nutrition and hunger-satiety circle are occured under the control of neuropeptids and hormones that are synthesized and secreted from the hypothalamic arcuate nucleus (ARC), adipose tissue and the pancreas. In this study, we examined how escitalopram affects the body weight, the body mass index, the serum lipid profile, the liver function tests, the underlying molecular mechanisms of weight change, the relationships these mechanizms and the hypotalamic nutrition regulatory neuropeptides such as POMC, NPY, leptin, CCK and insülin that is a pancreatic hormone. Objectives In order to understand the relationship between antidepressants and metabolic risk factors such as diabetes and obesity and to understand the underlying mechanisms, body weight, waist and hip circumference, POMC and NPY levels from hypothalamic nutrition regulating neuropeptides, CCK from peripheral neuropeptides, a pancreatic hormone insulin, and the effects of escitalopram use on these parameters were investigated. Methods In this prospective study, 30 patients, who were decided to have escitalopram treatment and who met the inclusion criteria and continued the treatment for 12 weeks, were included in the study. Results Weight, waist circumference increase and waist-hip ratio decreased significantly after 12 weeks. The decrease in neuropeptide level in POMC was significant. Conclusions In our study, according to the insignificant change in lipid parameters it was thought that the use of escitalopram does not cause a metabolic change that would increase the risk in terms of metabolic syndrome and cardiovascular disease, despite the short study period. The decrease in POMC levels due to escitalopram use; It was thought that it may lead to weight gain by modulating eating behavior modulation. Disclosure of Interest None Declared

Introduction Recent research on Schizophrenia (SCZ) suggests that reduced sleep spindle and slow wave density could be particularly informative of underlying thalamocortical and cortical synchronization mechanisms and dysfunctions. Although sleep disturbances are also highly prevalent across all stages of Bipolar Disorder (BD), the objective evaluation of sleep macrostructure and microstructural oscillatory activity remains understudied in this population. Objectives We aimed to investigate sleep EEG activity in BD, with a focus on sleep architecture, sleep spindles and slow waves. Methods We recorded high-density EEG (64–channel BrainAmp, Brain Products GmbH, Germany) during sleep in 18 euthymic patients with BD and 18 age/gender-matched healthy control (HC) subjects. After sleep scoring and EEG artifact rejection, several parameters of sleep spindles (12-16 Hz), including density and amplitude, and slow waves (0.1-4 Hz) were identified for the first cycle of sleep using automated algorithms and compared between groups using non-parametric statistics. Results BD subjects showed significantly higher Wake After Sleep Onset and lower Sleep Efficiency (Table 1). Total (12 - 16 Hz), slow (12 - 14 Hz) and fast (14 - 16 Hz) sleep spindle parameters of density (Image 1) and amplitude did not differ significantly between groups. On the other hand, slow wave density was reduced in a large frontal cluster of electrodes in the BD group (Image 2). Table 1 BD (n = 18) HC (n = 18) Difference (p value) WASO (min ± sd) 140,61 ± 74,23 84,34 ± 59,84 0,017 Sleep efficiency (% ± sd) 72,47 ± 14,33 82,43 ± 11,58 0,028 Image: Image 2: Conclusions The absence of sleep spindle deficits in the BD group suggests that the systems involved in generating and maintaining these thalamocortical oscillations are presevered during periods of clinical stability in Bipolar Disorder. Conversely, reduced sleep slow wave density points to an altered cortical synchronization, which might represent a common neurophysiological feature shared with Schizophrenia. Further research is needed to confirm these preliminary observations in all–night recordings and with a direct comparison of larger cohorts of patients with both diagnoses. Disclosure of Interest None Declared

Introduction Anemia due to iron deficiency is a highly prevalent medical condition in women and children. Iron deficiency presents with fatigue, low mood, anxiety, restlessness, palpitations, and headache. Poor nutritional intake can be the reason of iron deficiency in underprivileged populations. It can lead to behavioral symptoms that can manifest as chronic psychiatric ailments. Objectives Our objective is to consolidate manifestations of iron deficiency anemia concerning psychiatric ailments. We will figure out if it impacts the severity of psychiatric symptoms. We aim to find out if there are any underlying factors that impact the correlation of iron deficiency with psychiatric disorders like depression, anxiety, sleep disorders, and restless leg syndrome. Methods Detailed literature review conducted using PUBMED, OVID, GOOGLE SCHOLAR with the search terminologies [iron] OR [sleep disorders] OR [depression] OR[deficiency] OR [anxiety] OR [ADHD] OR [VITAMINS] OR[PICA] OR [CHILDREN] OR [women] OR [antidepressants] OR [sleep medicine] OR [antipsychotics] that yielded 150 results that were narrowed down to be focused on our research area. Inclusion criteria included studies with participants with iron deficiency anemia regardless of age group, gender, economic and social background. Exclusion criteria included patients with normal hemoglobin levels. Results Results yielded a positive impact of treating iron deficiency anemia in patients with psychiatric ailments. The symptoms of low mood, fatigue, anxiety, anhedonia, and sleeplessness get better as iron deficiency improves. According to the search, some physicians misdiagnose iron deficiency as depression. Antidepressants were found to be working better when added with iron supplements. Restlessness and palpitations can also be the manifestations of iron deficiency. Patients with underlying iron deficiency are more predisposed to developing psychiatric disorders. According to published data, restless leg syndrome was found to be associated with iron deficiency. Some psychiatric drugs can lead to iron deficiency and can provoke underlying iron deficiency even more. Iron deficiency impacts memory areas of the brain like the hippocampus and prefrontal cortex. Conclusions It is much needed more than ever before that proper consideration to the diagnosis of iron deficiency anemia must be given with the assistance of predesigned guidelines. Misdiagnosis of iron deficiency anemia as a psychiatric disorder can be misleading toward the insidious usage of psychiatric medications. Proper attention must be provided to this neglected area so that management of iron deficiency is tailored in the right direction and it is diagnosed at less severe stages. It will be helpful for general physicians and practicing psychiatrists in the field. Keywords: Iron deficiency, Psychiatric Disorders, Anxiety, depression. Disclosure of Interest None Declared