None Declared

Hospital built environment can affect patient clinical outcomes, patient satisfaction with care and treatment, staff performance and wellbeing, and carers/visitors’ engagement with services. Little is known about which urban planning, architecture and interior design characteristics can make environments therapeutic or detrimental for users.

We hope that the audience attending this presentation will i) get a good understanding of the impact of the hospital-built environment on patients, staff and visitors/carers and ii) understand which design elements can improve patient satisfaction with care.

As hospitals are among the most expensive facilities to build, their design should be guided by research evidence. In this presentation, we will review existing research evidence in this field and present our study of 18 psychiatric hospitals in Italy and the United Kingdom. Our findings indicate that out of several hospital built environment characteristics, two have the power to increase patient satisfaction with care.

These are (availability of) mixed-sex wards and rooms to meet family off wards.

We will show vignettes to further explore the role of mixed-sex wards and family rooms and discuss how to implement them when renovating, adapting or building mental health care facilities.

None Declared

DIALOG+ is a digital psychosocial intervention aimed at making routine meetings between patients and clinicians therapeutically effective. This study aimed to evaluate the cost-effectiveness of implementing DIALOG+ treatment for patients with psychotic disorders in five low- and middle-income countries in Southeast Europe alongside a cluster randomised trial.

Resource use and quality of life data were collected alongside the multi-country cluster randomised trial of 468 participants with psychotic disorders. Due to COVID-19 interruptions of the trial’s original 12-month intervention period, adjusted costs and quality-adjusted life years (QALYs) were estimated at the participant level using a mixed-effects model over the first 6 months only. We estimated the incremental cost-effectiveness ratio (ICER) with uncertainty presented using a cost-effectiveness plane and a cost-effectiveness acceptability curve. Seven sensitivity analyses were conducted to check the robustness of the findings.

The average cost of delivering DIALOG+ was €91.11 per participant. DIALOG+ was associated with an incremental health gain of 0.0032 QALYs (95% CI –0.0015, 0.0079), incremental costs of €84.17 (95% CI –8.18, 176.52), and an estimated ICER of €26,347.61. The probability of DIALOG+ being cost-effective against three times the weighted gross domestic product (GDP) per capita for the five participating countries was 18.9%.

Evidence from the cost-effectiveness analyses in this study suggested that DIALOG+ involved relatively low costs. However, it is not likely to be cost-effective in the five participating countries compared with standard care against a willingness-to-pay threshold of three times the weighted GDP per capita per QALY gained.

In Southeast Europe (SEE) standard treatment of patients with psychosis is largely based on pharmacotherapy with psychosocial interventions rarely available. DIALOG+ is a digital psychosocial intervention designed to make routine care therapeutically effective. This trial simultaneously examined effectiveness of DIALOG+ versus standard care on clinical and social outcomes (Aim 1) and explored intervention fidelity (Aim 2).

A hybrid type II effectiveness–implementation, cluster-randomized trial was conducted in five SEE countries: Bosnia and Herzegovina, Kosovo*, Montenegro, North Macedonia, and Serbia. The intervention was offered to patients six times across 12 months instead of routine care. The outcomes were subjective quality of life (primary), clinical symptoms, satisfaction with services, and economic costs. Intervention fidelity was operationalized as adherence to the protocol in terms of frequency, duration, content, and coverage. Data were analyzed using multilevel regression.

A total of 81 clinicians and 468 patients with psychosis were randomized to DIALOG+ or standard care. The intervention was delivered with high fidelity. The average number of delivered sessions was 5.5 (SD = 2.3) across 12 months. Patients in the intervention arm had better quality of life (MANSA) at 6 months (p = 0.03). No difference was found for other outcomes at 6 months. Due to disruptions caused by the COVID-19 pandemic, 12-month data were not interpretable.

DIALOG+ improved subjective quality of life of individuals with psychosis at 6 months (after four sessions), albeit with small effect size. The intervention has the potential to contribute to holistic care of patients with psychosis.

Racial and ethnic groups in the USA differ in the prevalence of posttraumatic stress disorder (PTSD). Recent research however has not observed consistent racial/ethnic differences in posttraumatic stress in the early aftermath of trauma, suggesting that such differences in chronic PTSD rates may be related to differences in recovery over time.

As part of the multisite, longitudinal AURORA study, we investigated racial/ethnic differences in PTSD and related outcomes within 3 months after trauma. Participants (n = 930) were recruited from emergency departments across the USA and provided periodic (2 weeks, 8 weeks, and 3 months after trauma) self-report assessments of PTSD, depression, dissociation, anxiety, and resilience. Linear models were completed to investigate racial/ethnic differences in posttraumatic dysfunction with subsequent follow-up models assessing potential effects of prior life stressors.

Racial/ethnic groups did not differ in symptoms over time; however, Black participants showed reduced posttraumatic depression and anxiety symptoms overall compared to Hispanic participants and White participants. Racial/ethnic differences were not attenuated after accounting for differences in sociodemographic factors. However, racial/ethnic differences in depression and anxiety were no longer significant after accounting for greater prior trauma exposure and childhood emotional abuse in White participants.

The present findings suggest prior differences in previous trauma exposure partially mediate the observed racial/ethnic differences in posttraumatic depression and anxiety symptoms following a recent trauma. Our findings further demonstrate that racial/ethnic groups show similar rates of symptom recovery over time. Future work utilizing longer time-scale data is needed to elucidate potential racial/ethnic differences in long-term symptom trajectories.

Due to increased human activity, the amount of copper in air, soil and water has increased. Copper, at minimum concentrations, is essential for the normal functioning of the organism (cellular respiration, hemoglobin formation, growth and reproduction). At higher concentrations, copper is deposited in the liver, brain tissue, and bone marrow.

To investigate the protective role of the supplement, glutathione (GSH), the S-donor ligand, in conditions of chronic copper intoxication via the parameters of oxidative stress, ie. Alkaline and acidic DNase values in brain tissue in albino rats of Wistar strain.

The model system for testing the effects of copper exposure and the protective effect of GSH was a study on female albino rats of Wistar strain, stored in the vivarium of the Scientific Research Center for Biomedicine, Faculty of Medicine, Niš, Serbia. Endonucleases, alkaline and acidic DNase activities were determined spectrophotometrically from homogenates of brain tissue.

Copper is believed to be a likely cause of oxidative damage to the DNA molecule, as manifested by increased alkaline and acidic DNase activity. The results of this study show that GSH is a potent chelator that binds copper and enables its elimination from the body.

In this experiment, the beneficial role of GSH supplements, which has an antioxidant character, in the prevention and reduction of the adverse effects of chronic copper intoxication was demonstrated. In this way, GSH acts as a powerful protector and antioxidant.

No significant relationships.

Acute and chronic exposure to cadmium (Cd), due to its increased use and application in the industry, can result in the development of atherosclerosis, the occurrence of cardiomyopathy, cerebrovascular stroke, as well as carcinogenesis in some organs. The target for cadmium action is thought to be the vascular endothelium.

The aim of this study is to investigate the occurrence of oxidative stress on blood vessel endothelium induced by subacute administration of cadmium, as well as the protective power of alpha-lipoic acid (α-LA) supplementation on the Wistar strain albino rat model system.

After anesthesia of rats in the vivarium of the Scientific Research Center for Biomedicine, Faculty of Medicine in Niš, blood was collected by cardiac puncture and sent to the Clinic of Nephrology, Clinical Center in Niš, Serbia for determination of hematological parameters.

According to the results of this study, it can be seen that the number of granulocytes is reduced due to cadmium intoxication, which is probably induced by the migration of neutrophils into tissues. The number of lymphocytes was increased due to subacute cadmium intoxication compared to the control group of animals. The positive efficacy of α-LA supplements in combating the adverse effects of cadmium on blood vessels is also confirmed.

Cadmium administration is thought to cause a systemic inflammatory reaction due to the formation of free radicals in the blood vessel endothelium. Administration of α-LA supplement confirms that it can be used as an antioxidant in the clinical management of many diseases and also in cadmium intoxication.

No significant relationships.

Women from ethnic minorities who experience mental health problems during the perinatal period are disproportionately represented in involuntary care. They have poorer access to community care but have higher engagement with services once accessed. Their pathways to accessing perinatal mental health care remain underexplored.

To investigate the pathways to perinatal mental health services for women across different ethnic groups, including number of caregivers encountered and time elapsed between referrals.

Analysis of patient records and routine service data from community and inpatient perinatal mental health services in the United Kingdom. Use of an adaptation of the WHO’s pathway encounter form.

Women from ethnic minority groups experience increased levels of complexity on their journey to accessing perinatal mental health care. We will present a detailed analysis of patient and service characteristics.

Referral pathways to perinatal mental health services need to be optimised for women from underrepresented groups.

Many studies describing print media representations of mental illnesses have showed that these depictions are frequently negative and contribute to consequent stigmatization of people with mental illness. The main objective of this international study was to identify predictors of stigmatizing and nonstigmatizing articles on mental illness in Czech Republic, Croatia and Slovakia.

The study sample comprised all articles pertaining to the topic of mental illness (N=450) chosen from 6 most widely read newspapers and magazines identified during five weeklong periods in 2007. The presence of stigmatization and destigmatization statements was coded and articles were grouped in positive, neutral, mixed and negative clusters. Negative/positive ratio (NPR) was used to assess the predictor value of different features of the article regarding stigmatization.

61.8% of articles contained some stigmatizing statements towards persons with mental illness. The highest NPR was found in articles published in tabloids (6.8), on the front page (3.7) and in the articles where psychotic disorder was mentioned (7.4) and mentally ill person figured as a source of information (1.8). Lowest NPR was found in magazines (0.6), articles in later sections (1.7) that mentioned eating disorders (0.3) and scientific surveys (0.1).

There is a high level of stigmatizing statements in the studied articles. As the strongest predictors of stigmatizing content we have identified articles that are published in tabloids and articles with reference to psychosis. Contrary to this, eating disorders had the least stigmatizing depiction as well as articles containing scientific data.

There is little or no information comparing working experience, including burnout, amongst psychiatry residents internationally. We present preliminary findings from six of the first countries to complete data collection.

To obtain data from psychiatric residents in over twenty countries regarding rates of burnout, depression and suicidality and their associations with working conditions and personality traits.

An online survey incorporating the Maslach Burnout Inventory General Survey (MBI-GS), Areas of Work Life Survey (AWLS), Patient Health Questionnaire-9 (PHQ-9), Suicide Ideation and Behaviour Questionnaire (SIBQ), Big Five Inventory - 10 (BFI-10) and questions on demographics and working circumstances was designed, and checked by national co-ordinators for suitability in each participating country, prior to agreeing the final version. This was then translated and back-translated before being sent to participants. A stratified hierarchy sample methodology was developed and used to obtain the best possible study population in each country. This allowed us to maximise participation despite major differences in ease of access to residents across the study countries. The aim of studying the whole resident population was achieved in a large number of countries. Data was then analysed by the study statistician using SPSS. No funding was received for the study.

Data from Croatia (n=106), France (n=374), Hungary (n=81), Italy (n=180), Romania (n=52) and United Kingdom (n>2000) revealed marked differences between countries in the factors studied including in working circumstances, rates of burnout and suicidality. The associations discovered may help further improve psychiatric training experience internationally.

Croatian Young Psychiatrists and Psychiatric Trainees Section was founded on December 15, 2005. as part of Croatian Psychiatric Association, established to promote different activities using network of young psychiatrists accros the world. In order to indicate activities that could fulfill possible gaps in our educational system, we performed a study among psychiatry residents and young specialists from different Croatian psychiatric centers.

91 participants answered the questionnaire constructed to obtain information about profile of young psychiatrist in Croatia, objective parameters of educational quality to produce competent psychiatrist, evaluation of residency training and suggestions of how to improve the current educational system.

Study results indicate that Croatian psychiatry residents are derived from a pool of average to above average medical students and majority is engaged in postgraduate studies and research acitivities and shows high interest in specific psychiatric fields such as psychotherapy and clinical psychiatry, but low interest in community psychiatry and mental health. Most of participants are only partially satisfied with the current residency training and feel that most problems reside from the lack of practical psychotherapy, the inefficiency of the mentorship system and the lack of opportunities for student's exchanges with other countries.

The results of this study revealed the major problems of psychiatry residents in Croatia. Following those results, we will perform the study that would include mentors and supervizors from different Croatian psychiatric centers. That could enable the developement of specific interventions with aim to improve current residency training in Croatia.

The presence of anxiety and depression has important implications for Inflammatory Bowel Diseases (IBD) management. the aims of our study were to examine the levels of anxiety and depression in IBD patients in remission and compared to those without IBD.

A total of 180 patients with IBD, 88 with Crohn's disease (CD) and 92 with ulcerative colitis (UC), in remission (defined by clinical criteria), aged 19–65, of both genders (96 males and 84 females), without known or evident psychiatric disorders, without other chronic disease or the history of surgical treatment, were enrolled in the study. the control group consisted of 180 subjects without IBD. the levels of anxiety and depression were obtained by the Hamilton Anxiety Rating Scale (HAMA-14) and Hamilton Depression Rating Scale (HAMD-21).

Among IBD patients 56.7% of them had no anxiety, 32.1% had mild anxiety and 11.2% had moderate anxiety. Without depression was 11.1% of patients, mild depression had a 55.6%, 32.2% had moderate depression and 1.1% had severe depression. There was a statistically significant difference in distribution of patients by categories of anxiety (P < 0.01) and by categories of depression (P < 0.01). in the control group, 94% were free of anxiety and 61.1% had no depression.

There was no statistically significant difference between CD and UC.

There was significant difference between control and IBD group by levels of anxiety and depression.