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Introduction The fNIRS is an optical brain monitoring technique which uses near-infrared spectroscopy for the purpose of functional neuroimaging. Using fNIRS, brain activity is measured by using near-infrared light to estimate cortical hemodynamic activity which occurs in response to neural activity. In the aspect of psychiatry fNIRS is a tool that can potentially facilitate the clinical diagnostic process and identify stages of psychiatric illnesses by providing objective and quantifiable evidences of brain changes. However, this will require specific cerebral haemodynamic patterns to be validated in larger clinical populations with specific psychiatric disorders. Objectives Our team decided to set a fNIRS system to find out the difference in prefrontocortical (PFC) activity pattern between healthy and anhedonic population. This abstract has been created for introduce our first findings about the difference in PFC activity under emotionally positively or negatively coloured stimuli in healthy population. Methods We have measured 5 healthy adults, non-anhedonic participants under emotionally different visual and acustic stimuli with the use of NIRX/NIRScout system with the view of our prefronto-temporo-parietal montege. Fig 1 We devided our experimental tools into 4 individual 20 second long parts: Passive neutral visual or acustic stimuli for baseline (watching a black dot or scilence) Passive visual stimuli (watching a single picture) Active visual stimuli (choosing from photo collage) to detect contrast of cortical background activation Passive acustic stimuli (listening sounds) In total, we defined emotionally, two neutral, four positive and four negative stimuli in our experimental setting. Softwares: We used HOMER3 for analyzing our datas and estimate hemodinamic reponse factor (HRF) using general linear matrix (GLM) regression. We used AtlasViewer for reconstructing HRF image onto the Colin27 digitalised brain model. And we also used SPSS for statictical analysis between stimuli types and HRF means. Results Fig 2 Significant HRF differences were measured in the dominant hemisphere dorsolateral prefrontal cortex (DLPFC) between the influence of each emotionally negative and positive stimuli (p

Introduction Anhedonia (loss of ability of experience pleasure) is a transdiagnostic symptom which is presented as a prominent complain in several psychiatric disorders, such as depressive disorders, schizophrenia, bipolar disorder, addictive disorders, certain personality disorders etc. Specific instruments for assessment of anhedonia have been published in the international literature but their Hungarian versions are not available so far, however, the prevalence of affective disorders and suicide are also high in Hungary. The Snaith-Hamilton Pleasure Scale (SHAPS) is an instrument developed in 1995 (Snaith et al. Br J Psychiatry1995;167:99-103) which purposley has been constructed with items that can be easily translated into other languages. Objectives The aim of our study was to translate the 14 items into Hungarian and analyse its reability and sensitivity in a Hungarian sample consists of patinets and control persons. Further aim was to explore the differences of anhedonia profiles among diagnostic categories and subgroup of major disorders. Methods We recruited 170 subjects (101 controls and 59 patients; 78 men and 82 women; mean age=37,9±6,1y) into our study. Among the patients there were 27 subjects with major depressive disorer (MDD), 10 subjects with bipolar disorder (BD), 9 patients with schizophrenia (SCZ), 6 patients with addictive disorder (AD) and 7 patients with anxiety disorder (ANX)±. We created two major subgorups from the dfferent diagnostic categories: affective and psychotic subgroups to compare the anhedonic profiles. Differences of mean values between case and control, men and women and subgroups were analysed by t-tests and diganostic categories by ANOVA tests performing in SPSS 20.0 software. Results Among the MDD, the BD, the SCZ, the AD and the ANX groups, patients with MDD produced the highest score (6.9±3.5; 3.9±2.4; 5.9±3.9; 2.8±2.7;2.3±1.8, respectively), while controls prohibited 1.6±1.3. The case group scored significantly higher on the SHAPS than the control group (5.3± 3.6 vs. 1.6±1.3; p=0.0001). The means of SHAPS did not differ significantly between the affective subgroup and the psychotic subgroup (6.0±3.7 vs. 4.8±3.2; p=0.24). Among the subgroup of women, the age was significantly associated with the SHAPS score (p=0,04), however, this association has been not detected in men. Conclusions The Hungarian version of the SHAPS detected marked difference between cases and controls with good reliability and sensitivity. The instrument can be useful in daily clinical routin becuase subjects could fill it easily and quickly. In case of patients with pronounced anhedonia, treatments with spcifically targeting anhedonia can be preferred (e.g. rTMS as it was demonstrated in our earlier publications, see Lazary et al. Sci Rep 2021,11:8867; Elemery et al. Front Psychiatry 2022, 13:806731). This study was supported by the grant EFOP 5.6.2. Disclosure of Interest None Declared

Introduction Obsessive-Compulsive Disorder (OCD) and Major Depressive Disorder (MDD) are among the ten most disabling disorders, yet only 30-40% of people with the condition seek specialist care (WHO). Considered a relatively new tool in the treatment of OCD and MDD, repetitive transcranial magnetic stimulation (rTMS) was first used by our team 1 year ago. Based on current literature cognitive behavioural therapy (CBT) is effective in 60% of OCD cases, with MDD also having a good response rate of 50-60%. The efficacy of SSRI’s has been demonstrated, but side effects can have a negative impact on adherence in the long term. Prolonged use of certain drugs has adverse reactions that lead specifically to memory impairment, which compromises suitability for psychotherapy. The same problem applies to the use of electroconvulsive therapy (ECT) in a major depressive episode. Objectives Our aim was to study the efficacy of combining rTMS with CBT, to gather clinical experience on how these two different methods work in practice when combined. Methods Patients diagnosed with therapy resistant MDD received rTMS treatment using 50Hz theta burst over 10 sessions. Therapy resistant OCD patients were treated by a 15 sessions rTMS using 1Hz single pulse. These rTMS sessions were combined with CBT, of which we would like to highlight two cases: one of them is a 34 years old woman, who has wide range of sexual, checking and contamination-related OCD symptoms and only received SSRI treatment so far. The other one is a 29 years old man, who suffers from religious obsessions, cleaning compulsions and other repetitive behaviours. Results The positive effects of rTMS treatment on working memory functions, attentional capacity and cooperative skills without significant additive effects suggest exciting possibilities for combining the two treatments, thus the combined treatment has been tested in clinical practice. In our own patient care, an important experience was that patients were committed to the therapy, felt safe and, unlike with medications, did not have to worry about side effects. While medication and ECT can make psychotherapy more difficult in the long term - mainly because of memory problems - rTMS facilitates it. Patients appreciate that we approach their problems in a complex way, and they perceive that the combination of the two very different methods reflects professionalism. Our poster attempts to present the experience of combining rTMS and CBT from the therapist’s perspective through two case studies. Conclusions Based on our experiences it is an effective approach to combine rTMS with CBT in therapy resistant MDD and OCD patients. In the light of these results the revision of the existing guidelines are considerable. Acknowledgements This study has been supported by the Human Resource Development Operating Programme 5.2.6 grant. Disclosure of Interest None Declared