In this workshop we aim to discuss the ins and outs of publishing in psychiatry with practical guidance from both sides of the couch. The executive editors of the European Journal of Psychiatry (Dr Asilay Seker, Dr Mário J. Santos, and Dr Luís Afonso Fernandes) will talk about their experience of starting a journal from scratch with very limited resources and share practical tips with the participants about publishing for early career psychiatrists to early career psychiatrists.

None Declared

In this workshop we aim to discuss the ins and outs of publishing in psychiatry with practical guidance from both sides of the couch.

The executive editors of the European Journal of Psychiatry (Drs Asilay Seker, Mário J. Santos, Luís Fernandes) will talk about the experience of starting a journal from scratch with very limited resources and share practical tips with the participants about publishing for ECPs by ECPs.

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World Psychiatry, the official journal of the World Psychiatric Association, was founded in the year 2002. From the very beginning, its aims have been: a) to reach as many psychiatrists as possible worldwide, disseminating information on recent significant clinical, service and research developments, using a language that can be assimilated by most of them; b) to give voice to psychiatrists of all regions of the world, encouraging submission of research papers, commentaries and reports on innovative service modalities. The two main criteria by which an article submitted to the journal is evaluated have been from the beginning: a) its relevance to everyday clinical practice of the average psychiatrist; and b) its usefulness to foster the average psychiatrist’s professional growth. From its first issue, the journal has been freely available online. In the year 2008, World Psychiatry received its first impact factor, that was 3.896. On that same year, the publication of the Spanish edition of the journal was started. The impact factor of World Psychiatry has then increased year after year, up to the value of 79.683 reached in July 2022. For the eighth consecutive year, World Psychiatry has been no. 1 in the Clarivate’s category of Psychiatry, and for the fifth consecutive year no. 1 in the entire Clarivate’s Social Science Citation Index. All the issues of the journal are now freely available both on the PubMed system and on the WPA website. The journal reaches now, in its online or printed edition, more than 60,000 mental health professionals worldwide. One of the main factors explaining the success of the journal is the continuing attempt to identify in advance topics which are going to become very visible in the international literature and relevant to ordinary clinical practice. The journal has been recently praised by the World Health Organization for the representation of members from low/middle income countries in its Advisory Board, which was at that time 32.3%, while among the other top ten psychiatric journals it was 1.9%. Furthermore, every issue of the journal includes contributions from all continents.

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The prolongation of life expectancy has considerably increased the prevalence of chronic diseases and therefore the concomitant presence of these, this usually predicts a more reserved prognosis for both conditions and can lead to greater complications, more complex treatments (4,5) and therefore more expensive and with considerable delays in recovery.(6)

The comorbidity of physical and mental illnesses is common, as both are often interrelated.

One of the ways to ensure handling comprehensive and personalized comorbidity should be detected especially at the first level of care for timely treatment, It is the inclusion of mental health topics in the curricula of doctors in training in a specialty.

Establish which programs of the medical and surgical specialties include topics related to mental health in their academic training, in order to strengthen the recovery process of patients

A descriptive study of the academic programs of Medical specialization in 50 countries. The questions we asked ourselves were:

1. 1. What medical specialties contain mental health topics in their training program?

How many medical specialties have included the following mental health topics in their regular graduate program: affective disorders, anxiety disorders, psychosomatic disorders, substance use disorders, violence and palliative care?

What other mental health topics are included in the different medical specialties?

The results obtained indicate the importance of mental health in different states of physical health and especially to be taken into account by decision makers in health policies. Comorbidity in current medicine should be taken into consideration more objectively and thus favor the reduction of the suffering of the sick person. We know that an associated mental and physical condition can give atypical presentations that hinder diagnosis, clinical severity, and response to treatment and therefore may lead to increased utilization of health services. However, the fragmentation of medicine into increasingly limited specialties restricts the ability to see the patient holistically and therefore the decrease in the quality of medical care, increase in costs and delay in the recovery process.

None Declared

Emerging epidemiological data have indicated associations between maternal smoking during pregnancy and a range of negative outcomes in children. Nevertheless, there is scant evidence reporting adverse effects on lower academic performance during adolescence.

To examine the association between maternal smoking during pregnancy and the risk of lower academic performance in adolescent children.

Data were obtained from the New South Wales (NSW) Perinatal Data Collection, which included all live births in the Australian state of NSW from January 2003 to December 2005. This was linked with NSW admitted data collection and National Assessment Program for Literacy and Numeracy (NAPLAN). A total of 168, 528 mother-offspring pairs were involved in the final analysis. Maternal smoking during pregnancy was assessed using self-reports of smoking during pregnancy. NAPLAN was used to assess the educational performance of the offspring. A logistic regression model was used to explore the association.

The findings show that exposure to cigarette smoke in utero was associated with an increased risk of poor academic performance in adolescent offspring in all domains, including numeracy [OR, 2.43 (95%CI 2.30-2.58)], reading [OR, 2.49 (95%CI 2.37-2.62)], writing [OR, 2.97 (95%CI 2.84-3.11)] and spelling [OR, 3.12 (95%CI 2.98-3.26)]. In our sensitivity analysis by gender, maternal smoking during pregnancy demonstrated stronger effects on the academic achievements of females in all domains.

The results show that exposure to cigarette smoke in utero was associated with an increased risk of lower educational achievements in adolescent children with greater effects in female than male children in all domains. The findings suggest the potential for targeted screening and early intervention of academic performance in exposed offspring.

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Numerous studies point to the comorbidity between gambling disorder (GD) and attention deficit hyperactivity disorder (ADHD). However, there is a lack of research exploring how ADHD symptoms might influence psychological treatment outcomes for GD.

Therefore, we aimed to explore differences between patients with GD with and without ADHD symptoms regarding psychopathology, personality, sociodemographic and especially treatment outcome measures.

This longitudinal study included n=170 patients with GD receiving 16 sessions of cognitive behavioral therapy (CBT) in a specialized unit of a public hospital. Multiple self-reported instruments were used to assess GD severity, personality, ADHD and other symptoms and sociodemographic measures prior to treatment.

A clinical profile characterized by greater GD severity, higher psychopathology and impulsivity, and less adaptive personality features was observed in patients with self-reported ADHD symptoms compared to those without. No significant differences in treatment response (measured by dropout and relapse rates) were reported between the two groups. However, patients with ADHD symptoms described more severe relapses (more money gambled) and GD patients who relapsed scored higher on measures of ADHD, particularly inattention.

Individuals with GD and ADHD may experience more severe relapses following treatment, suggesting a need for more vigilant follow-up and interventions for patients with this comorbidity.

C. Vintró-Alcaraz: None Declared, G. Mestre-Bach: None Declared, R. Granero: None Declared, M. Gómez-Peña: None Declared, L. Moragas: None Declared, F. Fernández-Aranda Consultant of: Novo Nordisk and editorial honoraria as EIC from Wiley, M. Potenza Consultant of: Opiant Pharmaceuticals, Idorsia Pharmaceuticals, AXA, Game Day Data, Baria-Tek and the Addiction Policy Forum; has been involved in a patent application with Yale University and Novartis; has received research support (to Yale) from Mohegan Sun Casino and Connecticut Council on Problem Gambling; and has consulted for and/or advised gambling and legal entities on issues related to impulse-control/addictive disorders, S. Jiménez-Murcia: None Declared

Tramadol abuse has become a crisis in Egypt and many other Middle Eastern countries. Tramadol abuse is associated with sexual dysfunction and male infertility, according to recent animal and human studies.

The objective of this study was to compare tramadol abuse patients and healthy controls regarding free testosterone and prolac-tin levels and semen analysis.

Sixty patients with opiate use disorders attributed to tramadol (OUD-T) based on Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) diagnostic criteria and 30 healthy controls were included in the study. Sociodemographic and clinical data and urine, blood, and semen samples were collected from patients and controls for assessment.

Compared with controls, OUD-T patients had higher prolactin and lower free testosterone levels. Patients with OUD-T were more likely to have lower sperm count and higher abnormal motility and forms of sperms compared with controls.

Patients with OUD-T were found to be more likely to have lower free testosterone levels and lower sperm counts and vitality, and higher prolactin levels and sperm abnormal forms compared with controls.

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Phubbing with smartphones becoming an integral part of life and sociotelism behavior has emerged as an important academic concern (Chotpitayasunondh et al.,CHB,2016; 63, 9-18). Expectation of social support in social networks: It can be defined as “When the individual is emotionally intense, he/she shares about this situation and emotions and expects to be paid attention to, sincere and friendly approach from the people on social networking sites, and hopes that an environment of support and trust will be created with social networks by seeing that he/she is not alone with more emotional support.” (Uzakgiden et. al., JASR 2019;2 20-24)

In the nursing profession, in addition to using the internet for professional requirements, being a member of online social networking sites and spending time on these platforms are increasing.It is important to know the status of phubbing, which damages face-to-face communication understand its effect on patient-nurse communication and nurses communication within the team. Due to the intensity of work life in the nursing profession and the length of hours spent at work, the effort to meet the need for social support virtually may increase phubbing behavior.

The aim of this study was to examine the relationship among phubbing, online social support and trait anxiety, and the related factors in nurses.

The population of the research consists of nurses who actively use their social media accounts. Nurses were accessed by snowball method on online Whatsapp groups, Instagram and Facebook platforms through a digital survey between May and November 2021. Data collected by using an individual descriptive characteristics form, generic scale of phubbing, online social support scale, trait anxiety inventory. Mann-Whitney U, Kruskal-Wallis H tests, t-test and pearson correlation coefficient was used for data analysis.

The phubbing scores of the nurses ranged from 15 to 98; the trait anxiety levels of the nurses were at a moderate level. It was observed that marital status, presence of WhatsApp groups with teammates, and being warned about the frequency of phone use from teammates was related to phubbingg (p<0.001). There was a positive moderate correlation between the phubbing score and the online social support score; a weak positive correlation was found between the general phubbing score and the trait anxiety score.

It was determined that social support from social media significantly affected the phubbing behavior of nurses and that trait anxiety mediated this relationship. In future studies, researchers can conduct extensive research on the effect of sociotelism on nurse-patient communication and care. This study was also important in terms of making significant contributions to the literature, where there are only a limited number of studies on phubbing.

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Mixed results have been reported on the association between prenatal cannabis exposure and preterm birth.

This systematic review and meta-analysis aimed to examine the magnitude and consistency of associations reported between prenatal cannabis exposure and preterm birth.

This review was guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We performed a comprehensive search of the literature on the following electronic databases: PubMed, EMBASE, SCOPUS, Psych-INFO, and Web of Science. The revised version of the Newcastle-Ottawa Scale (NOS) was used to appraise the methodological quality of the studies included in this review. Inverse variance weighted random effects cumulative meta-analysis was undertaken to pool adjusted odds ratios (AOR) after sequential inclusion of each newly published study over time. The odds ratio and 95% confidence interval (CI) limits required for a new study to move the cumulative odds ratio to the null were also computed.

A total of 27 observational studies published between 1986 and 2022 were included in the final cumulative meta-analysis. The sample size of the studies ranged from 304 to 4.83 million births. Prenatal cannabis exposure was associated with an increased risk of preterm birth [pooled Adjusted Odds Ratio (AOR) = 1.35, 95% CI: 1.24-1.48]. The stability threshold was 0.74 (95%CI limit 0.81) by the end of 2022.

Offspring exposed to maternal prenatal cannabis use was associated with higher risk of preterm birth and it is strongly unlikely that any new epidemiological studies will change this conclusion. It is also plausible that avoiding cannabis intake during the prenatal period can reduce the risk of preterm birth.

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The Central Mental Hospital Dundrum, is Irelands only secure forensic hospital. It is unclear if there were changes in the need for security or urgency of need for admission prior to admission; before, during and after the covid-19 pandemic.

We examined any changes in need for security and urgency of need for admission among those admitted to the CMH Dundrum from 2018 to 2022. We also examined the need for seclusion due to immediate risk to others at the time of admission. Covid precautions were not managed with seclusion.

This is a retrospective cohort study of all patients admitted from 1st January 2018 to 31st August 2022. Demographic data and diagnosis, capacity to consent to medication and hours in seclusion during day 1, week 1 and month 1 were collated. Need for therapeutic security (Dundrum-1) and urgency of need for admission (Dundrum-2) were rated prior to admission and collated by the research team. Data were gathered as part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST). (Davoren et al., BMJ Open (2022) 12(7): e058581)

During the 68-months there were 76 admissions. Mean age was 35.9 years, SD 9.9, males (80.3%). The most common diagnoses were schizophrenia (57.9%), schizoaffective disorder (15.8%), intellectual disabilty or autistic spectrum disorder (3.9%). 53.9% required seclusion on admission. There was no overall change in security need over the study period, but scores on triage urgency item 2 ‘mental health’ increased. Time on the waiting list correlated with increasingly urgent mental health needs. On logistic regression, higher (worse) scores on ‘mental health’ need predicted hours of seclusion on day 1 (B=6.3, p<0.001) and week 1 (B= 25.5, p<0.001) but not month 1. Prolonged seclusion in prison prior to admission predicted hours of seclusion on day 1 (B=3.1, p<0.001) week 1 (B=16.7, p=0.003) and month 1 (B=51.5, p=0.003). Higher scores on life time institutional behaviour (DUNDRUM-1 item 10) (B=53.2, p<0.001) also predicted hours of seclusion in month 1.

We found increasing severity of mental health needs during the period studied. Seclusion early in the course of admission to the forensic service was closely linked to mental health needs. Continuing to require seclusion later in the admission was more closely linked to institutional behaviour such as having a history of coordinating disturbances or challenging behaviour whilst in prison services.

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There is evidence that early traumatic experiences may have a negative impact on critical components of psychosocial adjustment, while they may also adversely affect mental health during adulthood.

The aim this study was to investigate the association of early traumatic experiences and in particular sexual abuse with well-being, self-esteem, resilience and close relationships during adulthood.

The study included 499 individuals (76.2% women), with a mean age of 24.2 years. Participants completed Early Trauma Inventory-Short form for early traumatic experiences’ assessment, Brief Resilience Scale for resilience evaluation, Mental Health Continuum-Short Form to assess well-being and Experiences in Close Relationships-Revised scale for adult romantic attachment assessment.

The majority of participants (98.2%) responded positively to at least one statement related to early traumatic experiences while 235 individuals (47.1%) reported that they had experienced sexual abuse. Furthermore, individuals who had experienced sexual abuse displayed lower levels of well-being (p<0.001), self-esteem (p<0.001) and resilience (p<0.001), but higher levels of anxious adult attachment (p<0.001) compared to individuals without such traumatic experiences.

The findings of the present study highlight the importance of timely detection and holistic and integrated management of psychological needs of individuals who have experienced early traumatic experiences and especially sexual abuse.

None Declared

There are high rates of treatment resistant psychoses and medical complexity among patients in secure forensic hospitals (Basrak et al., BJPsych Open (2021) 7, e31,1-7). Patients with schizophrenia in secure settings have a lower life expectancy compared to community peers of approximately 16 years. Evidence suggests patients in secure settings often gain significant amounts of body weight during their in-patient stays, many of whom develop complex obesity presentations.

To ascertain changes in Body Mass Index (BMI) among patients in a secure forensic hospital setting over a 3.5 year period.

A prospective longitudinal study of repeated measures of BMI for all (n=91) patients in a National Forensic Mental Health Service (CMH Dundrum, Dublin, Ireland). BMI was measured six-monthly, giving up to seven time points for each patient. Generalized Estimating Equations (GEE) analysis was conducted to ascertain changes in BMI over time. This study formed part of the DUNDRUM Forensic Redevelopment Evaluation Study (D-FOREST) (Davoren et al., BMJ Open (2022) 12(7): e058581).

A total of 91 patients were included in the study, mean age 33.46 years (SD 9.23). Mean length of stay was 8.09 years (SD 9.23). The most common diagnosis was schizophrenia (67%), followed by schizoaffective disorder (17.5%) and Autistic spectrum disorder (6.2%). Using GEE with BMI as the dependent variable, for the complete patient cohort, BMI changed significantly with diagnosis (Wald X2=5817.58, df=7, p<0.001). Those with severe mental illnesses (psychoses) had the highest BMI of the group, and BMI tended to increase over time (p=0.109). Among patients who were in the secure hospital for four years or less, their weight gain was significant over time (Wald X2 =10.0, df=1, p=0.002).

We have shown high rates of obesity particularly in patients with psychoses and we have shown weight gain is significant during the first four years after admission to a national forensic service. This is a significant health concern and an area of unmet treatment need which is likely generalizable across secure hospitals in the EU.

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The development of the 11th edition of the International Classification of Diseases has rekindled the research interest surrounding diagnostic classification systems (DCSs). According to expert consensus, the main purpose of DCSs is to provide guidance in clinical practice. There are no reviews in the international literature, however, assessing what mental health practitioners believe is the main purpose of DCSs.

The aims of this systematic review were to assess what mental health professionals think is the single most important purpose of DCSs and how they rate DCSs’ utility for various purposes. All DCSs were considered.

Two separate searches were conducted in Medline Via Ovid and PsycInfo: one for articles assessing the main purpose of DCSs according to mental health professionals and one for studies on how practitioners rate the utility of DCSs for various purposes. The first search revealed eight articles on the main purpose of DCSs and the second three articles on how practitioners rate their utility for various purposes. The total number of participants from all included studies for the first search was 9,276 and for the second 2,363. The studies included clinicians from a wide range of world regions, languages, and income-level countries.

The results of the meta-analyses for the first search showed that 44% (95%CI=38-49%) of the responders believe that the main purpose of the DCSs is facilitating inter-clinician communication, 20% (4-35%) to inform treatment decisions, 14% (11-16%) to aid the communication between clinicians and patients, 11% (4-18%) to reflect on aetiology/pathogenesis, 9% (2-16%) to facilitate research, 4% (2-7%) to provide a national statistical base and 1% (0.1-2%) to indicate prognosis. Regarding how responders rate the utility of DCSs for various purposes, the highest ratings were given for meeting administrative requirements and inter-clinician communication in the two of the three included studies, and clinical diagnosis and training in the third.

“Inter-clinician communication” was the most voted purpose of DCSs and was rated relatively high in the tier of DCSs’ clinical utility. In contrast, “inform management decisions”, even though it was voted as the second most popular purpose of DCSs, was placed on the bottom of the rating tier of DCSs’ clinical utility. Interestingly, none of the included studies asked the responders whether “making a diagnosis” is the main purpose of DCSs. Further research is needed to assess what mental health professionals expect from DCSs, so as to improve their clinical utility in the future.

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A significant global increase in immigration has been reported due to humanitarian crisis around the world. Trauma exposure related to migration process is usually multiple and maintained in long-term which could provoke a cumulative effect. Moreover, several meta-analysis describe increased risk for psychosis in immigrant population. Despite this increase, there is a lack of research in non-refugee immigrants specially within those with psychotic disorder.

The aim of the study is to describe and compare cumulative lifetime trauma between immigrants and locals with psychotic disorder.

Patients who have presented, according to DSM-V criteria, one or more non-affective psychotic episodes, were recruited in Acute and Chronic inpatients units at Hospital del Mar (Barcelona) from November 2019 to June 2021, leading to a total sample of 199 patients. Demographic characteristics of patients, clinical data and main pharmacological treatment were recorded through a questionnaire. Database information was completed with electronic medical records. Cumulative trauma Scale was used as instrument to assess lifetime trauma exposure frequency and distress. Comparative analysis was performed with IBM SPSS Statistics (Chicago INC) using Chi-Square Test for qualitative variables and t-Student test for continuous variables. Covariate adjustment with demographic and clinical variables was performed by ANOVA test. Study received local ethics committee approval “CEIC” (No. 2019/8398/I).

From a total of 198 patients, 99 (50%) were immigrants and 99 (50%) locals. Immigrants were exposed on average 3 times more to lifetime traumatic events (16.12) when compared to locals (5.39). Likewise, distress intensity caused by trauma exposure had a mean of 97.13 in immigrants compared to 27.24 in locals. Traumatic events more present in immigrants’ group were “uprooting” (82.8%), “physical abuse” (76.8%), racial discrimination (74.7%), threat of death (74.7%) and life-threatening to close friend (72.2%) and in local group was school failure (42.4%), serious disease (38.4%), accidents (36.4%), physical abuse (36.4%) and interpersonal relationship rejection (36.4%).

According to our results there are important differences in cumulative traumatic events between immigrants and locals with psychotic disorder. Immigrants showed three times more lifetime traumatic events than locals. Likewise, immigrants presented significant higher level of distress caused by lifetime trauma and the nature of traumatic events was more severe. These results should be considered in order to offer better assessment and treatment to this population considering this comorbidity.

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Functional impairment (FX) screening tools could potentially be used in resource-limited settings to identify adolescents who need mental health support.

Culturally adapted, isiXhosa versions of FX questions and the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) were used to assess depression (MDD) and anxiety (GAD) among adolescents (10-19 years) in South Africa.

Adolescents were recruited from the general population and from nongovernmental organizations working with those in need of mental health support. The PHQ-9 and GAD-7 were previously culturally adapted, translated into isiXhosa, and administered to 302 adolescents (10-19 years old, 56.9% female), and three culturally adapted items were asked to assess functional impairment regarding problems that 1) interfere with activities/relationships at home, 2) interfere with activities at school/work, and 3) cause any issues with peers. FX items were dichotomized into at least some impairment (“sometimes” and “often”) and no impairment (“rarely” and “never”). The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) was administered by trained clinicians as the gold standard measures for MDD, GAD, and FX. To assess criterion validity against a clinician’s diagnosis, we used total PHQ-9 and GAD-7 scores as well as combined FX and PHQ-9 and GAD-7 scores to construct receiver operating characteristic curves, and calculated the area under the curve (AUC) for each test as well as other psychometric properties.

In the sample, 32.1% and 17.9% of adolescents screened positive for moderate to severe MDD and GAD respectively with the culturally adapted PHQ-9 and GAD-7. Among adolescents, 39.7%, 37.1%, and 29.1% reported at least some impairment at home, school, and among peers respectively. Spearman correlations between the three items (Cronbach’s Alpha = 0.69) ranged from 0.35-0.53, and kappa statistics ranged from 0.18-0.47. For the culturally adapted PHQ-9, the AUC was 0.86 for the full sample. A score of >=10 had 97% sensitivity and 75% specificity for detecting MDD. For the culturally adapted GAD-7, the area under the curve was 0.69, and cutoff scores with an optimal sensitivity-specificity balance were low (>=6) and had 76% sensitivity and 69% specificity for detecting GAD. For the combination of the culturally adapted PHQ-9 with the FX questions, the AUC was 0.80 for the sample, and a score of >=10 had 77% sensitivity and 83% specificity for detecting adolescents with MDD. For the combination of the culturally adapted GAD-7 with the FX questions, the AUC was 0.68, and a score >=6 had 70% sensitivity and 76% specificity for detecting adolescents with GAD.

While the culturally adapted FX questions didn’t enhance the assessment of MDD and GAD among adolescents in South Africa, these items still provide an opportunity to measure FX in different settings.

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Culturally validated neurocognitive measures for children in Low- and Middle-income Countries are important in the timely and correct identification of neurocognitive impairments. Such measures can inform development of interventions for children exposed to additional vulnerabilities like HIV infection. The Battery for Neuropsychological Evaluationo f Children (BENCI) is an openly available, computerized neuropsychological battery specifically developed to evaluate neurocognitive impairment.

This study adapted the BENCI and evaluated its reliability and validity in Kenya.

The BENCI was adapted using translation and back-translation from Spanish to English language. The psychometric properties were evaluated in a case-control study of 328 children (aged 6 – 14 years) living with HIV and 260 children not living with HIV in Kenya. We assessed reliability, factor structure, and measurement invariance with respect to HIV. Additionally, we examined convergent validity of the BENCI using tests from the Kilifi Toolkit.

Internal consistencies (0.49 < α < 0.97) and test-retest reliabilities (-.34 to .81) were sufficient-to-good for most of the subtests. Convergent validity was supported by significant correlations between the BENCI’s Verbal memory and Kilifi’s Verbal List Learning (r =.41), the BENCI’s Visual memory and Kilifi’s Verbal List Learning (r = .32) and the BENCI’s Planning total time test and Kilifi’s Tower Test (r = -.21) and the BENCI’s Abstract Reasoning test and Kilifi’s Raven’s Progressive Matrix (r = .21). The BENCI subtests highlighted meaningful differences between children living with HIV and those not living with HIV. After some minor adaptions, a confirmatory four-factor model consisting off flexibility, fluency, reasoning and working memory fitted well (χ2 =135.57, DF = 51, N = 604, p < .001, RMSEA = .052, CFI = .944, TLI =.914) and was partially scalar invariant between HIV positive and negative groups.

The English version of the BENCI formally translated for use in Kenya can be further adapted and integrated in clinical and research settings as a valid and reliable cognitive test battery.

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There is a paucity of research examining the patterning of socioeconomic disadvantages and mental health problems across multiple generations. The significance of research on multigenerational processes is based on a concern with if and how (dis)advantages are generated and sustained across generations, and how socioeconomic, mental health, and gender inequalities evolve over a longer period of time.

The current study therefore aimed to investigate the interconnected transmissions of socioeconomic disadvantages and mental health problems from grandparents to grandchildren through the parents, as well as the extent to which these transmissions differ according to lineage (i.e., through matrilineal/patrilineal descent) and grandchild gender.

Drawing on the Stockholm Birth Cohort Multigenerational Study, the sample included 21,416 unique lineages by grandchild gender centered around cohort members born in 1953 (parental generation) as well as their children (grandchild generation) and their parents (grandparental generation). Based on local and national register data, socioeconomic disadvantages were operationalized as low income, and mental health problems as psychiatric disorders. A series of path models based on structural equation modelling were applied to estimate the associations between low income and psychiatric disorders across generations and for each lineage-G2 gender combination.

We found a multigenerational transmission of low income through the patriline to grandchildren. Psychiatric disorders were transmitted through both the patriline and matriline, but only to grandsons. The patriline-grandson transmission of psychiatric disorders was partially operated via low income of the fathers. Furthermore, grandparents’ psychiatric disorders influenced their children’s and grandchildren’s income.

We conclude that there is evidence of transmissions of socioeconomic disadvantages and mental health problems across three generations, although these transmissions differ by lineage and grandchild gender. Our findings further highlight that grandparents’ mental health problems could cast a long shadow on their children’s and grandchildren’s socioeconomic outcomes, and that socioeconomic disadvantages in the intermediate generation may play an important role for the multigenerational transmission of mental health problems.

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Mental Health Knowledge specific to symptom recognition, treatment efficacy, help-seeking, and employment can facilitate understanding when communicating with clinicians and reduce personal stigma. Better knowledge of mental illness has also been shown to decrease fear and embarrassment when interacting with people with mental illnesses. Thus, knowledge can play a key role in influencing behaviors and attitudes associated with stigma.

The objective of this study was to evaluate mental health knowledge among Tunisian students

This cross-sectional study was conducted on 2501 Tunisian students from different academic institutions. They anonymously filled in a questionnaire circulated online through social networks in pages and groups of each university. The validated Arabic version of the “Mental Health Knowledge Schedule” (MAKS) was used to assess the knowledge about mental illnesses.

The median MAKS score was equal to 45 out of 60, ranging from 30 to 56. In our study, 60.2% of the participants answered “don’t know” or “neither agree nor disagree” to item 1 indicating that “Most people with mental health problems want to have paid employment.”. Exactly 83.7% of the participants thought they knew what advice to give a friend to get professional help and 90% thought that psychotherapy could be effective in treating a person with a mental illness. In addition, 57.1% of participants thought that medication could be effective and 68.8% thought that people with severe mental health problems could make a full recovery. People with mental health problems do not seek professional help according to 39% of participants. About 90% were considering depression, schizophrenia, and bipolar disorder as mental illnesses. Stress and drug addiction were considered mental illnesses according to 71% and 63% of participants respectively. Finally, 52.9% answered that grief was a mental illness.

In Tunisia, anti-stigma programs are almost nonexistent. Our results would allow us to take a baseline assessment of mental health knowledge and could be the starting point for anti-stigma interventions. We should combine these findings with a behavioral and attitudinal assessment to better address stigma.

None Declared

The traditional Patient Health Questionnaire (PHQ-9) cut-off score of ≥10 has been found to balance best sensitivity and specificity when used in patient populations. Depression screening has been recommended in general population surveys, however, in comparison to patient population a few studies have suggested different optimal cut-off values to detect possible depression.

Aim of this research involving country-representative general adult population sample was to identify which PHQ-9 cut-off score distinguishes individuals with and without depression.

This was a cross-sectional observational epidemiological survey CoV2Soul.rs (registration number NCT04896983) using in-person interviews and multistage household probabilistic sampling in mid-2021 to recruit representative adult sample (N=1203; age 43.7 (SD 13.6); 48.7% male; mean education 12.7 (SD 2.9)). Current mental disorders were observer-rated on the Mini International Neuropsychiatric Interview (MINI Standard 7.0.2.). The PHQ-9 was self-rated by the participants and research assistants were not aware of their self-scoring. Sensitivity, specificity, and likelihood ratio tests for predicting current major depressive episode were evaluated at various cut-off points of the PHQ-9.

The mean PHQ-9 score was 3.2 (SD 3.8). The value is highly comparable with other general population studies. At the cut-off score of 8, sensitivity was .85 and specificity was .91. At the cut-off value of 10, sensitivity dropped to .74, suggesting that the optimal cut-off score was 8. ROC analysis showed that the area under the curve was .95, indicating that the Serbian PHQ-9 can discriminate very well between persons with and without depression (Figure 1).Table 1.Sensitivity, specificity and likelihood ratio tests at various cut-off points of the PHQ-9

PHQ-9 is a highly useful screening tool, but the same cut-off score might not be appropriate in all settings. In European countries, studies of the general population that determine optimal cut-off PHQ-9 value against a validated interview to detect depression are rare. We demonstrated that the cut-off of ≥8 balances best its sensitivity and specificity when assessed against the structured diagnostic interview in the general population.

This work was supported by the Science Fund of the Republic of Serbia, grant number #7528289. The special research program on Covid-19 is financed by a World Bank loan through Serbia Accelerating Innovation and Entrepreneurship Project – SAIGE.

None Declared

Over a quarter of U.S. children have at least one immigrant parent. Mental health disparities in children need to be assessed to better identify disproportionate burdens and promote health equity.

To assess the associations between race, ethnicity, and parent-child nativity, and mental health conditions in the U.S.

Data were from the 2016-2019 National Survey of Children’s Health (n=114,476 children aged 3-17 years), a nationwide, cross-sectional survey. Outcome variables included three mental health conditions (depression, anxiety, and behavior or conduct problems) reported by the parent/guardian. Additional measures included questions about healthcare access and use, demographics, and nine household challenge adverse childhood experiences (ACEs) used to quantify a total ACE score (0-9). Information on nativity was used to define immigrant generation (1st, 2nd, and 3rd+). Weighted logistic regression was used to assess the associations between race/ethnicity (Asian, Black, Hispanic, White, and Other), household generation, and outcome variables, among children who reported access to or utilized health services, adjusting for demographics. Multiple imputation was used to handle missing data.

Asian, Black, Hispanic, and White 3rd+ generation children had increased odds of depression compared to their 1st generation counterparts, same as among White, 2nd generation children. Race/ethnicity was not associated with depression among 1st and 3rd+ generation children, but Asian, Black, and Hispanic children had lower odds of depression compared to White children among 2nd generation children. Asian, Black, Hispanic, and Other-race 3rd+ generation children had increased odds of anxiety compared to their 1st generation counterparts, with similar findings also observed for Black and Other-race 2nd generation children. Being racial/ethnic minorities was generally associated with decreased odds of anxiety among 1st and 2nd generation children compared to White children from the respective generations. Asian, Black, Hispanic, and Other-race 3rd+ generation children had increased odds of behavior/conduct problems compared to their 1st generation counterparts. The observed associations remained significant after adjusting for the modified ACE score.

We found significant differences in several mental health conditions in children by parent-child nativity, race, and ethnicity that could not be explained by demographics, childhood adversity, and healthcare access and use. Lower odds of mental health conditions among minority children could represent differences due to factors such as differential reporting, and higher odds of mental health conditions, including in third- and higher generation children, need further investigation to develop approaches to promote mental health equity.

None Declared