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Anna Jurczak,1 Małgorzata Szkup,2 Krzysztof Safranow,3 Agnieszka Samochowiec,4 Sylwia Wieder-Huszla,1 Joanna Owsianowska,1 Elżbieta Grochans21Department of Clinical Nursing, Pomeranian Medical University in Szczecin, Szczecin, Poland; 2Department of Nursing, Pomeranian Medical University in Szczecin, Szczecin, Poland; 3Department of Biochemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland; 4Department of Clinical Psychology, Institute of Psychology, University of Szczecin, Szczecin, PolandBackground: Psychological stress is a factor which predisposes people to many somatic and mental disorders. Women are at a significantly higher risk of stress than men, and their reactions to stress are stronger. Personality traits are thought to play a special role in the psychology of stress and may be crucial for the choice of a stress-coping strategy. Considering that stress is so common in everyday life, an attempt to understand how stress-coping styles are related to personality and genetic factors acquires special significance.Purpose: The aim of this study was to analyze stress-coping styles and personality traits in healthy late reproductive age women with regard to genetic factors.Patients and methods: The study involved 345 healthy late reproductive age women from northwest Poland, whose mean age was 42.3±4.5 years. The study was conducted using The Coping Inventory for Stressful Situations, The Neuroticism-Extraversion-Openness Five--Factor Inventory, and genetic testing.Results: There were neither statistically significant relationships between personality traits and the genotype distribution of the 30-bp VNTR polymorphism in the MAO-A promoter region, nor between stress-coping styles and the genotype distribution of the 30-bp VNTR polymorphism in the MAO-A promoter region.Conclusion: Based on the results, all personality traits statistically significantly correlated with the choice of task-oriented coping and emotion-oriented coping. Some of personality traits are genetically determined. The choice of a stress-coping style was significantly related to personality traits. A direct influence of genetic factors on the choice of a stress-coping style was not confirmed in our study.Keywords: stress, personality, polymorphism, women

Daria Schneider-Matyka,1 Anna Jurczak,1 Małgorzata Szkup,1 Agnieszka Samochowiec,2 Anna Grzywacz,3 Sylwia Wieder-Huszla,1 Elżbieta Grochans1 1Department of Nursing, Pomeranian Medical University in Szczecin, 2Department of Clinical Psychology, Institute of Psychology, University of Szczecin, 3Department of Psychiatry, Pomeranian Medical University in Szczecin, Szczecin, Poland Abstract: The aim of this study was to establish the relationship between personality traits of postmenopausal women and the presence of the 44-bp VNTR polymorphism in the serotonin transporter (5-HTT) (SLC6A4) promoter region and the 30-bp VNTR polymorphism in the MAO-A promoter region. The study’s aim was also to determine the influence of personality traits on the quality of postmenopausal women’s lives. The study involved 214 postmenopausal women from northwest Poland, with an average age of 56.8±4.08 years. It was performed using the Temperament and Character Inventory-Revised and the Short Form Health Survey. DNA polymorphisms were identified by means of polymerase chain reaction. Analysis demonstrated that the s/s genotype was significantly more common than the l/l genotype in women with higher fear of uncertainty. In a group with higher enlightened second nature and empathy, the l/s genotype was considerably more common than the l/l genotype. There were statistically significant associations between selected aspects of quality of life and personality traits such as enlightened second nature, transpersonal identification, purposefulness, and self-transcendence. The s/s genotype of the 44-bp VNTR polymorphism in the 5-HTT (SLC6A4) promoter region may increase the tendency to avoid harm within the fear of uncertainty dimension. Carriers of this genotype may have predisposition to anxiety and depressive disorders. The l/s genotype of the 44-bp VNTR polymorphism in the 5-HTT (SLC6A4) promoter region contributes to increased expression of enlightened second nature and empathy. Some personality traits may influence the quality of women’s lives. Keywords: menopause, quality of life, personality, 5-HTT, MAO-A

Background: Several studies have shown that social isolation and loneliness are associated with the occurrence of psychotic experiences. However, dynamics of these phenomena in people with subclinical experiences, commonly referred to as psychotic-like experiences (PLEs), remains largely unknown. Therefore, in this study we performed a temporal network analysis to model dynamic predictions between social isolation, loneliness, negative affect, social stress, and PLEs. Methods: A total of 77 drug-naïve individuals with PLEs from a transdiagnostic sample were enrolled. Data were obtained using the experience sampling method (ESM). The ESM questionnaires were delivered during 7 consecutive days (6 assessments per day). Therefore, 3234 data entries were analyzed. Results: Social isolation predicted next-moment emergence of PLEs through the effects on loneliness and negative affect. Also, PLEs appeared to predict next-moment loneliness, but not social isolation, through the effects on negative affect. Social stress did not predict any variables in the network. However, it was predicted by previous-moment PLEs and social isolation. Negative affect had the highest in-strength and out-strength centrality. Conclusions: Findings from the present study indicate that social isolation might predict the emergence of PLEs through the effects of momentary loneliness and negative affect. Also, loneliness might be bidirectionally associated with PLEs. Interventions targeting negative affect and social isolation might be beneficial in people with PLEs.

Abstract Background There is conflicting evidence on impulsivity and its potential relationship with inhibitory control in schizophrenia. This study therefore aimed to identify differences in impulsivity and cognitive and motor inhibition between patients with deficit (DS) and non-deficit (NDS) schizophrenia and healthy controls (HC). We also explored the relationships between impulsivity and different dimensions of inhibitory control in all studied groups. Methods The sample comprised 28 DS patients, 45 NDS patients, and 39 age-matched HC. A neuropsychological battery was used. Results DS patients scored lower in venturesomeness, while those with NDS scored higher in impulsiveness compared to HC. In addition, both groups of patients scored higher on measures of cognitive and motor inhibition, including those relatively independent of information processing speed (although the results were slightly different after adjusting for IQ and/or years of education). Correlations between impulsivity and cognitive inhibition emerged in DS patients, while links between impulsivity and motor inhibition were observed in HC. Conclusions Our results suggest the presence of deficits in experimentally assessed inhibitory control in schizophrenia patients, with predominant impulsivity in the NDS population. In addition, impulsivity may affect the cognitive control of inhibition in deficit schizophrenia. Nevertheless, due to the preliminary nature of these findings, they require further empirical verification in future research.

The authors of this work, noticing that opera is a combination of music and theater, examined the relationship between listening to opera music and mood changes in people over 50 years of age. The study took the form of a quasi-experiment. Recipients were invited to the previously prepared room, where the audiovisual material - a recording of the opera 'La Traviata' - was presented for the first time. This was preceded by the respondents completing the SUPIN C30 and S30 questionnaires and a short survey by the authors. After the presentation of the stimulus, the subjects again filled in the SUPIN S30 questionnaire scale and the GEMS scale. The described procedure was carried out twice, using two different music materials. The procedure remained unchanged, while the audiovisual material changed. The second time, the participants were presented with a recording from the opera 'The Barber of Seville'. The participants of the study were 30 people. In the studied group, there are no significant changes in emotional states in response to the opera 'La Traviata'. In turn, the opera 'The Barber of Seville' has no effect on a positive emotional state. Instead, it caused a statistically significant change in the level of negative emotional states. The results of this study are largely consistent with the results of other studies examining the relationship between music and mood, but there are also limitations - only two pieces of opera music were used and no control group was included. Research has shown that opera, as a specific musical genre, despite its peculiar form, affects mood and emotions., Author(s): Katarzyna Kubinska [sup.1] , Sylwia Michalowska [sup.2] , Agnieszka Samochowiec [sup.2] Author Affiliations: (1) https://ror.org/01xszvp42, grid.466181.c, 0000 0004 4665 9986, Szczecin Academy of Arts, , White Eagle Square 2, [...]

Abstract Background It has been shown that various aspects of clinical manifestation of schizophrenia are strongly related to social functioning. However, it remains unknown as to whether similar factors predict social functioning at various stages of psychosis. Therefore, the present study aimed to compare the effects of interconnections between various domains of psychopathology and neurocognition on social functioning in people during acute phase of psychosis and those during remission of positive and disorganization symptoms using a network analysis. Methods Two independent samples of individuals with schizophrenia spectrum disorders were enrolled (89 inpatients during acute phase and 90 outpatients during remission of positive and disorganization symptoms). Clinical assessment covered the levels of functioning, positive, negative and depressive symptoms. Cognition was recorded using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Data were analyzed by means of the network analysis. Two separate networks of clinical symptoms, social functioning, and cognition (i.e., in patients during acute phase of psychosis and remitted outpatients with schizophrenia) were analyzed and compared with respect to the measures of centrality (betweenness, closeness, strength, and expected influence) and edge weights. Results In both networks, the majority of centrality metrics (expected influence, strength, and closeness) had the highest values for the RBANS scores of attention (the sum of scores from two tasks, i.e., digit span and coding) and immediate memory. In both networks, social functioning was directly connected to positive, negative and depressive symptoms as well as the RBANS scores of attention and language. Additionally, in remitted patients, social functioning was directly connected to the RBANS score of immediate memory. Conclusions Findings from the present study indicate the central role of cognitive deficits, especially those related to attention, processing speed, working and immediate memory in shaping functional impairments regardless of schizophrenia phase. Therapeutic interventions that aim to improve functional capacity need to target these domains of neurocognitive performance.

Dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis has been implicated in the development of psychosis and subthreshold psychotic symptoms commonly referred to as psychotic-like experiences (PLEs). The exact mechanisms linking the HPA axis responses with the emergence of PLEs remain unknown. The present study aimed to explore real-life associations between stress, negative affect, salivary cortisol levels (a proxy of the HPA axis activity) as well as PLEs together with their underlying cognitive biases (i.e., threat anticipation and aberrant salience). The study was based on the experience sampling method scheduled over 7 consecutive days in the sample of 77 drug-naïve, young adults (18–35 years). The saliva samples were collected with each prompt to measure cortisol levels. A temporal network analysis was used to explore the directed associations of tested variables. Altogether, 3234 data entries were analyzed. Data analysis revealed that salivary cortisol levels did not directly predict next-moment fluctuations of PLEs. However, higher salivary cortisol levels were associated with higher next-moment levels of PLEs through the effects on threat anticipation and negative affect. In turn, PLEs appeared to predict cortisol levels through the effects on negative affect and event-related stress. Negative affect and threat anticipation were the most central nodes in the network. There might be bidirectional associations between the HPA axis responses and PLEs. Threat anticipation and negative affect might be the most important mediators of these associations. Interventions targeting these mediators might hold promise for disrupting the connection between the HPA axis dysregulation and PLEs.

Abstract Background Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians’ treatment choices for post-traumatic stress disorder (PTSD). Methods The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148). Results About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct “profiles” of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines. Conclusions Clinicians’ decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.

The digitalisation of mental health care is expected to improve the accessibility and quality of specialised treatment services and introduce innovative methods to study, assess, and monitor mental health disorders. In this narrative review and practical recommendation of the European Psychiatric Association (EPA), we aim to help healthcare providers and policymakers to navigate this rapidly evolving field. We provide an overview of the current scientific and implementation status across two major domains of digitalisation: i) digital mental health interventions and ii) digital phenotyping, discuss the potential of each domain to improve the accessibility and outcomes of mental health services, and highlight current challenges faced by researchers, clinicians, and service users. Furthermore, we make several recommendations meant to foster the widespread adoption of evidence-based digital solutions for mental health care in the member states of the EPA. To realise the vision of a digitalised, patient-centred, and data-driven mental health ecosystem, a number of implementation challenges must be considered and addressed, spanning from human, technical, ethical–legal, and economic barriers. The list of priority areas and action points our expert panel has identified could serve as a playbook for this process.

ObjectivePsychotic-like experiences (PLEs) are increasingly being recognized as subclinical phenomena that might predict the development of various mental disorders that are not limited to the psychosis spectrum. Accumulating evidence suggests that attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) are highly comorbid mental disorders. However, their interactive effect on the occurrence of PLEs has not been investigated so far. Therefore, in the present study we aimed to investigate the effect of interaction between ADHD and PTSD symptoms on the level of psychotic-like experiences (PLEs) in the non-clinical sample.MethodsThe study included 3,000 individuals aged 18–35 years with a negative history of psychiatric treatment. The symptoms of ADHD and PTSD were assessed using self-reports.ResultsThere was a significant association of the interaction between ADHD and PTSD with the level of reporting PLEs. This association remained significant after adjustment for age, gender, the level of education, the current vocational situation, lifetime history of problematic substance use, and depressive symptoms. Post-hoc tests demonstrated significantly higher levels of reporting PLEs in participants with positive screening for both ADHD and PTSD compared to other subgroups of participants. Also, individuals with positive screening for one vulnerability (either ADHD or PTSD) reported significantly higher levels of reporting PLEs compared to those with a negative screening for ADHD and PTSD. In turn, no significant differences between individuals reporting one vulnerability, i.e., between those with positive screening for ADHD and those with positive screening for PTSD, were observed.ConclusionFindings from the present study imply that both PTSD and ADHD symptoms the interaction effect on the level of reporting PLEs that might be of importance for early intervention strategies. However, observed associations require replication in clinical samples.

Psychotic disorders often develop as the continuum of subclinical symptoms that include hallucination-like and delusion-like experiences, and are commonly referred to as psychotic-like experiences (PLEs). To date, a number of neurodevelopmental risk factors of psychosis have been detected, yet their mutual interplay remains unknown. Therefore, we aimed to investigate the additive association of childhood trauma history, reading disabilities and symptoms of attention-deficit/hyperactivity disorder (ADHD) with psychosis proneness. A total of 3000 young adults (58.3% females, aged 18–35 years) with a negative history of psychiatric treatment were recruited to the cross-sectional study through computer-assisted web interview. Self-reports were administered to measure childhood trauma history, ADHD symptoms and reading disabilities. Linear regression analyses revealed significant main associations of childhood trauma history and reading disabilities with higher levels of PLEs. There were no significant main associations of ADHD with the level of PLEs. However, the associations of all possible interactions between neurodevelopmental risk factors with the level of PLEs were significant. Our findings suggest that childhood trauma history and reading disabilities may additively increase a risk of psychosis. The present findings bring new implications for early intervention strategies in psychosis and posit the rationale of recording the accumulation of neurodevelopmental vulnerabilities in clinical practice.

Introduction: Impulsivity is one of the overlapping symptoms common to borderline personality disorder (BPD) and attention deficit hyperactivity disorder (ADHD), but the neurobiological basis of these disorders remains uncertain. This systematic review aims to identify abnormalities in the gray and white matter associated with impulsivity in BPD and ADHD. Methods: We conducted a systematic search of the PubMed, Embase, and SCOPUS databases, adhering to PRISMA guidelines. Studies that investigated gray and white matter alterations in BPD or ADHD populations and their relationship with impulsivity were included. We reviewed information from 23 studies involving 992 participants, which included findings from structural MRI and DTI. Results: The review identified various nonhomogeneous changes associated with impulsivity in BPD and ADHD. BPD was mainly associated with abnormalities in the prefrontal cortex (PFC) and limbic areas, which correlated negatively with impulsivity. In contrast, impulsivity associated with ADHD was associated with structural changes in the caudate nucleus and frontal–striatal pathways. Despite the overlapping symptoms of impulsivity, the neurobiological mechanisms appeared to differ between the two disorders. Conclusions: These findings emphasize the distinct neurostructural correlates of impulsivity in BPD and ADHD. While both disorders show impulsivity as one of their main symptoms, the fundamental brain structures associated with this trait are different. BPD is primarily associated with abnormalities in the prefrontal cortex and limbic system, whereas the alterations seen in ADHD tend to focus on the caudate nucleus and frontostriatal pathways. Further research is needed to clarify these differences and their implications for treatment. [ABSTRACT FROM AUTHOR]

Background: Psychotic-like experiences (PLEs) are low-intensity subclinical phenomena, often transient in nature. The etiology of PLEs primarily involves neurodevelopmental changes, trauma exposure, and maladaptive coping styles. Attention-Deficit/Hyperactivity Disorder (ADHD) is considered to be one of the factors that increase the risk of future psychosis. Furthermore, ADHD symptoms predict a heightened incidence of traumatic experiences, ruminative thoughts, and negative affect (NA). This present study examines whether rumination and NA mediate the relationship between ADHD symptoms and PLEs and whether trauma experiences moderate these pathways. Methods: A total of 188 participants (72% female) aged 18–35 completed questionnaires assessing ADHD symptoms and traumatic experiences and took part in a seven-day experience sampling method (ESM) procedure, completing ratings of PLEs experiences, the intensity of ruminations, and NA. Results: Correlation analysis showed significant relationships between all tested variables. Serial mediation analysis revealed a significant indirect effect of rumination and NA in the link between ADHD symptoms and PLEs. There was no significant impact of trauma experience in this relationship. Conclusions: Our study underscores the important role of rumination and NA in the co-development of ADHD symptoms and PLEs. Future research should consider investigating the intra-individual dynamics of ADHD and trauma using ecologically valid research methods in the context of PLEs to better understand these complex relationships. [ABSTRACT FROM AUTHOR]

Introduction Impairments in executive functions are often observed in schizophrenia. However, previous studies using standard tests show inconclusive and conflicting findings. Objectives The main objective of this study was to compare the performance of schizophrenia patients and healthy controls on classical tasks and a non-immersive virtual reality task, Jansari assessment of Executive Functions (JEF©) Methods A total of 71 schizophrenia patients and 80 healthy controls took part in the study. Executive functions were assessed with JEF© and the following classical tasks: Color Trail Test (CTT), Stroop Color World Test (SCWT), Ruff Figural Fluency Test (RFFT), and computerized tasks from the PEBL battery: Berg Card Sorting Test (BCST), Tower of London (TOL), and Go/No Go task (GNG). The Positive and Negative Syndrome Scale (PANSS) was used to assess psychopathological symptoms. Results Compared to healthy controls, schizophrenia patients scored lower on most of JEF© indices i.e., prioritization, selective-thinking, creative-thinking, adaptive-thinking, multi-tasking, time-based prospective memory, event-based prospective memory, and action-based prospective memory (p < 0.001). Moreover, schizophrenia patients performed poorer on all traditional tasks (p < 0.001), except the GNG task. Conclusions Schizophrenia patients were demonstrated to manifest deficits in executive functions as measured by traditional tests, such as concept formation, problem-solving, cognitive flexibility, planning or cognitive inhibition, and the executive functions measured by the JEF© i.e., those that are used and observed in everyday situations such as working in an office. This research was funded by the National Science Centre in Poland, grant number 2020/04/X/HS6/01920. Disclosure of Interest None Declared

Introduction Chronic subclinical inflammation is considered to be an important contributor to the development of schizophrenia. Meta-analyses confirm the presence of higher levels of inflammatory markers in schizophrenia and its prodromal stages compared to controls, however studies differ in terms of associated cytokines. Obesity is a common problem in patients with schizophrenia and, at the same time, it is recognized as a source of subclinical inflammation in the general population. Objectives The aim of the study was to verify if there is an association between the presence of overweight/obesity and higher levels of CRP and IL-6 in various stages of psychotic disorders and if these factors may influence the course of the disease Methods Study was performed in four study groups: 31 healthy controls (HC), 16 patients with ultra-high risk of psychosis (UHR), 30 with first episode of psychosis (FEP) and 71 with chronic schizophrenia (SCH). The severity of psychopathological symptoms in SCH was assed using the Positive and Negative Syndrome Scale (PANSS). The serum levels of inflammatory markers were measured using sensitive ELISA tests. Results Study groups significantly differed in the levels of CRP and IL-6. The presence of overweight/obesity was associated with significantly higher levels of CRP in CON and UHR and IL-6 in CON, FEP and SCH. IL-6 was positively correlated with the severity of positive symptoms in PANSS in SCH, however neither IM or BMI were associated with other psychopathological symptoms or number and frequency of exacerbations in schizophrenia patients. Conclusions Overweight/obesity is associated with subclinical inflammation in both healthy controls and patients with various stages of psychotic disorders. Subclinical inflammation may be correlated with the course of the disease, however we did not find any direct associations between overweight/obesity and the severity of symptoms. Further studies are needed to verify, if reduction of BMI would be beneficial in reducing levels of inflammatory markers and alleviating disease course. This research was funded by the Polish Minister of Science and Higher Education’s program named “Regional Initiative of Excellence” in 2019–2022, grant number 002/RID/2018/2019 to the amount of 12 000 000 PLN, and the National Science Centre, Poland, grant number 2019/03/X/NZ5/00719. Disclosure of Interest None Declared

Introduction One of the subtypes of schizophrenia is the deficit syndrome (DS). Because of different risk factors, course, response to treatment weak prognosis, researches on this group of patients are important. Etiology of schizophrenia is often hypothesized as the inflammation process. Due to the imbalance of certain cytokines (interleukin-10 (IL-10) -antyinflamation cytokine, among others) changes in the function and structure of central nervous system may occur. That process could stand behind the outbreak of psychotic and deficit symptoms of the illness. Subinflammation can have an impact on the white matter structure. Disturbances in this area can cause impairment of cortical communication and hence, produce psychopathology. One of the structures that seem to have the basis of the deficit syndrome isinferior longitudinal fasciculus (ILF). ILF is a bundle of association fibers with interconnects temporal cortex with ocapital cortex. Objectives The aim of our study was to investigate a relationship between the integrity of ILF and interleukin – 10. Methods 39 schizophrenia subjects divided into two groups DS (16) and non-deficyt sydrome (NDS) (23) and 18 healthy controls (HC) participated in the study. A DTI analysis was performed on all study participants. The psychopathology of schizofrenia was assessed using the Positive and Negative Syndrome Scale (PANSS). The ILF analysis was then conducted using fractional anisotropy (FA) and mean diffusivity (MD) parameters. Blood samples were obtained to analyze serum level of IL-10 level. Results The differences in FA value in left ILF between DS and HC group were confirmed. The difference in values of IL-10 between groups were not confirmed. A negative correlation was found between FA values in left ILF and IL-10 (p = 0.033) among DS group. Conclusions The imparment of the structure of ILF may be involved in ethiopatogenesis of DS. Moreover, changes in IL-10 levels may be related to the microstructure of ILF bundle. Disclosure of Interest None Declared

Abstract By the decision of the Polish Government, all persons arriving in the territory of the Republic of Poland after the commencement of the Russian aggression against Ukraine have free access to public psychiatric assistance, including reimbursement of pharmacological treatment on the same terms as Polish citizens. According to the UHNR data over 4 million displaced people, refugees, came to Poland so far and some of them benefited from such help. Displaced individuals suffer from the consequences of traumatic events, exhibit psychological problems or develop mental disorders, including post-traumatic stress disorder, depressive and anxiety disorders or relapses of psychotic episodes. The lecture will present data from the Interdisciplinary War in Ukraine Research Laboratory by pointing out the most important problems faced by Ukrainian refugees in Poland, why they chose Poland when escaping the war, how they evaluate Polish help, what their integration in Poland looks like. The survey also measured the level of war trauma (RHS-15). The results of the analysis show that most refugees present post-traumatic stress disorder symptoms (76 %), while only 0.15% of this population was treated in public psychiatric facilities. Mental healthcare services are suddenly faced with major challenges and need to develop or expand strategies to address them. The Polish Ministry of Health prepared and started implementation of a reform of the mental health care system for adult as well as children and adolescent psychiatry. This fundamental reform should comprise three main actions, i.e. integration of mental health services into primary healthcare; establishment of community psychiatric services together with the provision of inpatient services in general hospitals; and limitation of the role of mental hospitals to specific tasks only (long-term or specialist treatment). Disclosure of Interest None Declared

Abstract Immediately after Russia commenced aggression against Ukraine, the Polish Psychiatric Association publicly called for humanitarian support for Ukraine and initiated meetings with representatives of Psychiatric Societies operating in Ukraine in order to identify current needs in the war-stricken areas and coordinate aid. The PPA allocated its financial resources to humanitarian aid and, through the EPA, appealed for condemnation of military operations as well as support for Ukraine by individual NPAs. According to the UHNR data over 4 million displaced people, refugees, came to Poland so far and some of them benefited from such help. The Polish Psychiatric Association supports the initiatives of non-governmental organizations supporting refugees and monitors and responds to the needs reported by the Ukrainian side on an ongoing basis. At present, the PPA activities focus on the following priorities: 1. Need-adapted-help: Provision of customized aid - not only medications but also power generators, technical equipment. And so, the PPA shipped to Ukraine some basic equipment, sleeping mats, bedding, mattresses, backpacks, cleaning products, personal hygiene products, as well as tools for renovation and construction. 2. Awareness - highlighting the consequences of Russia’s aggression on people with mental disorders in Ukraine and its impact on the entire population (PTSD, grief ). Inviting and lobbying for dissemination of personal reports of Ukrainian health care workers and patients at international conventions, forums, events 3. Empowerment of personnel - strengthening competences required in provision of assistance in war-related disorders, training, projects of activities both across Poland and Ukraine 4. Supporting and responding to the needs reported by local psychiatric assistance centers facilitating and strengthening the competence of personnel in helping refugees Disclosure of Interest None Declared

Relationship between drugs and microbiota is bilateral. Proper composition thus function of microbiota is a key to some medications used in modern medicine. However, there is also the other side of the coin. Pharmacotherapeutic agents can modify the microbiota significantly, which consequently affects its function. A recently published study showed that nearly 25% of drugs administered to humans have antimicrobial effects. Multiple antidepressants are antimicrobials,. and antibiotics with proven antidepressant effects do exist. On the other hand, antibiotics (e.g., isoniaside, minocycline) confer mental phenotype changes, and adverse effects caused by some antibiotics include neurological and psychological symptoms which further supports the hypothesis that intestinal microbiota may affect the function of the central nervous system. Here we gathered comprehensively data on drugs used in psychiatry regarding their antimicrobial properties. We believe our data has strong implications for the treatment of psychiatric entities. Nevertheless the study of ours highlights the need for more well-designed trials aimed at analysis of gut microbiota function.

Abstract Background The European Psychiatric Association (EPA) is an organization that speaks on behalf of its individual members and members of National Psychiatric Associations (NPAs). The aim of this study to identify and investigate current contents of ethical codes and practices in the countries belonging to EPA. Methods The study is an expert survey sent out to 44 representatives of 30 NPAs covering the following topics: the existence of national bodies dealing with ethical issues in psychiatry, the availability of documents relevant to ethical issues, the types of ethical issues addressed at the national level, and the current and envisaged ethical debates. Results Out of 44 experts invited to participate in the study, 31 NPAs from 30 countries responded (response rate 70.45%). In the majority of countries, the general mission statement serves as the main document covering ethical issues in psychiatry. Most frequently, internal documents were reported to address medical malpractice, workplace bullying, plagiarism, academic fraud, sexual abuse, and discrimination/racism. Furthermore, internal documents cover the ethical assessment of potentially controversial procedures, including psychosurgery, euthanasia, and pregnancy termination. The most important topics for debate at the level of NPAs/EPA were associated with violations of clinical practice standards and human rights. Conclusions NPAs are active in the field of professional ethics, defining ethical standards related to interactions among professionals and services provided by mental health care professionals. Future collaboration of NPAs, under the umbrella of the EPA, could allow to develop a database of local ethical documents that would be translated into English and accessible to all EPA members.