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Introduction: Several studies have called atention to the mental health disorders associated with chemsex -the intentional use of drugs before or during sexual intercourse GBMSM (gay, bisexual and men who have sex with men) population-. Sexualized intravenous drug use is also known as slam or slamsex. There are few studies that analyze the mental health differences between intravenous drug users compared to non-intravenous drug users in chemsex context. Objectives: We aim to analyze the relationship between the practice of slamsex and the development of drug-induced psychosis. Methods: A cross-sectional descriptive analysis of a sample of users attended by the non-governmental organization Apoyo Positivo in the program "Sex, Drugs and You" between 2016-2019 was performed. Results: We included 217 participants. Drug-induced psychosis was found in 80 participants. Drug-induced psychosis was significantly higher in the intravenous drug use group compared to the non-intravenous drug use group (p<0.05). Conclusions: Previous studies have reported that MSM who practiced chemsex were more likely to experience from different mental health disorders, being psychosis one of the most frequent psychiatric diagnoses. In our study, drug-induced psychosis was higher in participants who engaged in intravenous drug use. Further studies analyzing the relationship between slamsex and drug-induced psychosis are needed. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Several studies have called atention to the mental health disorders associated with chemsex -the intentional use of drugs before or during sexual intercourse GBMSM (gay, bisexual and men who have sex with men) population-. Sexualized intravenous drug use is also known as slam or slamsex. There are few studies that analyze the mental health differences between intravenous drug users compared to non-intravenous drug users in chemsex context. Objectives: We aim to describe the mental health outcomes including current and past anxiety disorders diagnosis in a sample of users with sexualized drug use (chemsex) attended by the non-governmental organization Apoyo Positivo in the program "Sex, Drugs and You" and to compare the differences of current and previous diagnosis of anxiety disorders between intravenous drug users compared to non-intravenous drug users. Methods: A cross-sectional descriptive analysis of a sample of users attended by the non-governmental organization Apoyo Positivo in the program "Sex, Drugs and You" between 2016-2019 was performed. Results: We included 217 participants. Current or past diagnosis of anxiety disorders was found in 142 participants. Anxiety disorders were significantly higher in the intravenous drug use group compared to the non-intravenous drug use group (p<0.05). Conclusions: Previous studies have reported that MSM who practiced chemsex were more likely to experience from anxiety. In our study, anxiety disorders where higher in participantes who engaged in intravenous drug use. A multidisciplinary team is necessary to address chemsex and provide care and treatment for mental health problems such as anxiety, depression, suicidal behaviour or drug-induced psychosis. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Several studies have called atention to the mental health disorders associated with chemsex -the intentional use of drugs before or during sexual intercourse GBMSM (gay, bisexual and men who have sex with men) population-. Sexualized intravenous drug use is also known as slam or slamsex. There are few studies that analyze the mental health differences between intravenous drug users compared to non-intravenous drug users in chemsex context. Objectives: We aim to describe the mental health outcomes including current and past depressive disorders diagnosis in a sample of users with sexualized drug use (chemsex) attended by the non-governmental organization Apoyo Positivo in the program "Sex, Drugs and You" and to compare the differences of current and previous diagnosis of depressive disorders between intravenous drug users compared to non-intravenous drug users. Methods: A cross-sectional descriptive analysis of a sample of users attended by the non-govenrmental organization Apoyo Positivo in the program "Sex, Drugs and You" between 2016-2019 was performed. Results: We included 217 participants. Current or past diagnosis of depression was found in 137 participants. Depressive disorders were significantly higher in the intravenous drug use group compared to the non-intravenous drug use group (p<0.05). Conclusions: Our study reports high levels of depression in chemsex users. The participants in our sample who engaged in intravenous drug use presented a higher frequency of depressive disorders than non intravenous drug use participants. Further studies analyzing the relationship between chemsex, slamsex and depresssion are needed. A multidisciplinary team is necessary to address chemsex and provide care and mental health treatment to chemsex users. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Several studies have called atention to the mental health disorders associated with chemsex --the intentional use of drugs before or during sexual intercourse GBMSM (gay, bisexual and men who have sex with men) population-. Sexualized intravenous drug use is also known as slam or slamsex. There are few studies that analyze the mental health differences between intravenous drug users compared to non-intravenous drug users in chemsex context. Objectives: To describe the suicidal behaviour in a sample of users with sexualized drug use (chemsex) attended by the non-governmental organization Apoyo Positivo in the program "Sex, Drugs and You" and to compare the suicidal behaviour between intravenous drug users compared to non-intravenous drug users. Methods: A cross-sectional descriptive analysis of a sample of users attended by the non-governmental organization Apoyo Positivo in the program "Sex, Drugs and You" between 2016-2019 was performed. Results: We included 217 participants. 37 had attempted suicide at least once. The percentage of chemsex users who have attempted suicide were significantly higher in the intravenous drug use group compared to the non-intravenous drug use group (p<0.05). Conclusions: Possible risk factors for suicidal behaviour among chemsex users include slamsex. Other possible risk factors previously described in other studies include adversities experienced due to one's sexual orientation and an increased risk for HIV and other STI infections. Further studies analyzing the relationship between chemsex, slamsex and suicidal behaviour are needed. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. A 12 workshop sexual health program was made in two Drug Dependence Clinics in Madrid. Shame, stigma, homophobia or ignorance of drug services assistance have been describe as barriers by chemsex drug users to accessing services. Facilitators such as creating a safe environment are necessary. Objectives: The objective of this study was to identify barriers and facilitators to the implementation of a sexual health program for chemsex users in two Drug Dependence Clinics in Madrid. Methods: The study is based on a qualitative research approach. We analyze an anonymous on-line survey with chemsex users with open answer questions about barriers and facilitators for implementing the sexual health program. Data analysis was based on thematic analysis of content. Results: Facilitators included: motivated stuff with LGBT cultural competence, close interaction between stuff and the patients, a nonjudgemental and multidisciplinary approach which includes sexual health and mental health. Barriers included: stigma related to attending drug dependence clinics, psychopathology in acute state (psychosis, anxiety), lack of perceived support from public institutions facing the mental and sexual health problems associated with chemsex. Conclusions: Chemsex, a public health problem in some Spanish communities, is a phenomenon that needs a collaborative approach between users and mental and sexual health professionals and other medical stuff. The described program is a pioneering initiative in Spain. [ABSTRACT FROM AUTHOR]

Introduction: The term Chemsex stands for the intentional use of certain psychoactive drugs to enhance sexual relations between gay, bisexual and other men who have sex with men (MSM), usually for long periods of time. Slamming or slamsex defines when drugs are injected intravenously in this context. It has been described psychopathological symptoms in chemsex context, like depression, anxiety or psychosis. "Sex, drugs and You" was created in the ONG Apoyo Positivo in Madrid, in order to offer a multidisciplinary approach to people who practice chemsex. Objectives: To describe the program and the profile and psychopathology of patients attended in the program "Sex, Drugs and You" from 2017 to 2018. Methods: Description of program and the profile and psychopathology of patients attended in the program "Sex, Drugs and You". Results: 138 patients were attended. Median age was 37,46 years. 40% engaged on slamsex and 79,2% were HIV positive. 62 (46,26%) were derived to psychiatric assesment. From these, 100% had a drug-abuse disorder, being the main drugs abused: mephedrone (69,3%), GHB(48,3%), Crystal Meth (32,2%), cocaine(19,3%) and ketamine (4.8%). 54,8% also abused poppers and 35,4% abused erectile disfunction drugs. From this subsample, 82,25% also had a comorbid psychopathological disorder: 30,6% depression, 22,5 % psychosis, 8% anxiety, 8% personality disorders, 4,8% ADHD and 1,6% OCD. Conclusions: The program "Sex, Drugs and You" offers a multidisciplinary approach for people that engage in chemsex. Our sample shows a high prevalence of drug-abuse disorders and other comorbid psychopathology. The role of the psychiatrist to treat disorders related to chemsex is essential. [ABSTRACT FROM AUTHOR]

Introduction: Past studies have investigate the influence of gender in medical and psychiatric disorders in patients with bipolar disorder. The association of gender and comorbidities remains unclear. Objectives: The aim is to identify physical and mental comorbidities of patients hospitalized for bipolar disorder and to analyse them by gender. Methods: Admission data were extracted from national database from 2013(CMBD-H). All patients hospitalized for bipolar disorder as primary diagnosis were included using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). Chi-quare and logistic regresion models were applied to identify the association in comorbidities by gender. Results: The most frequent physical comorbidities found in bipolar inpatients were hypertension, hypothyroidism, diabetes, obesity and asthma. Hypothyroidism was more than 4 times higher in women (OR=4,78), followed by asthma and obesity. Tobacco use disorder, alcohol use disorder and drug use disorder were the top three psychiatric comorbidities followed by personality disorder and suicidability. Women had less odds in all sustance use disorders like tobacco(OR=0.8), drugs(OR=0.3) and alcohol(OR=0.33); higher odds were found in personality disorder and suicidability in women. Conclusions: This study reveals important differences in medical and psychiatric comorbidities in bipolar inpatients. Women had more medical comorbidities than men. Sustance use disorder had higher rates in men. Further research needs to be done in order to investigate de causes and offer and comprehensive treatment. [ABSTRACT FROM AUTHOR]

Introduction: The intentional use of drugs before or during sexual intercourse (chemsex), due to its impact on mental health, is a phenomenon of high importance in men who have sex with men. Objectives: We report the case of a patient with polysubstance acute intoxication, including 2C-B, in order to review the evidence about the mechanisms of action of 2C-B, its efects on sexual pleasure, toxicity, patterns of abuse and somatic and mental health related consequences it may present. Methods: Case report and narrative review. Results: Wepresent the case of a patient using 2C-B as a substance in chemsex practice. As the patient presented in our emergency with psychotic symptoms, he was diagnosed with "stimulant acute intoxication" and "acute psychotic symptoms induced by stimulants". 2C-B increases dopamine (DA) serotonin (5-HT) and norepinephrine (NE) and cause stimulating and hallucinogenic effects. Conclusions: MSM is a group vulnerable to the problematic use of drugs in a sexual context. Several mental health problems have been associated with chemsex users such as psychotic sypmptoms, suicidal ideation, encephalopaty, delirium. Polysubstance use is common in chemsex practice and it can be difficult to identify the drugs used in states of acute intoxication but psychiatrists must explore the use of differents drugs from the "classic chemsex drugs" (mephedrone, GHB and metanphetamine) including 2C-B and other substances such as cocaine, MDMA, ketamine, and other cathinones different from mephedrone. [ABSTRACT FROM AUTHOR]

Introduction: The intentional use of drugs before or during sexual intercourse (chemsex), due to its impact on mental health, is a phenomenon of high importance in men who have sex with men. The main drugs usually described in chemsex related research are methamphetamine, mephedrone and GHB/GBL. Objectives: We present a narrative review of the evidence about the mechanisms of action of different drugs used in chemsex context. Methods: Narrative Review. Results: Different drugs have been associated with chemsex use: stimulants such as cocaine, stimulants with empathogenic properties such as mephedrone, methamphetamine,MDMA; stimulants with a psychedelic effect such as 2C-B; depressants such as GHB/GBL and ethyl chloride; and dissociative hallucinogens such as ketamine. Conclusions: Classical chemsex research includes only mephedrone, metanphetamine and GHB as "chemsex drugs". Recently, different drugs have been described associated with chemsex practice. Clinicians may encounter polydrug chemsex users and the different mecanisms of action, mental health problems related to every drug and polydrug use must be takek into account. [ABSTRACT FROM AUTHOR]

Introduction: The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire. Objectives: To describe the sexual health interventions (including sexual counselling and sexual therapy) for patients with chemsex practices in the NGO Apoyo Positivo in Madrid. We describe the main sexual problems. Methods: Descriptive analysis. Results: The main sexual problems were dissatisfaction in sexual intercourse without substance and difficulties with sexual desire activation (70%); compulsive sexual behaviour (70%), difficulties with sexual orientation and non normative gender expression, difficulties in erection (34%), premature ejaculation (7%) and delayed ejaculation (10%). Conclusions: Chemsex is a phenomenon that needs a multidisciplinary approach and mental and sexual health must be taken into account. "Sexo, Drogas y Tu" is a model of collaborative approach which is a pioneering intervention developed by an NGO in Spain. [ABSTRACT FROM AUTHOR]

Introduction: Neuropsychiatric symptoms are more prevalent in people living with HIV than in general population. Thismay be related to substance use disorders, opportunistic infection, direct effects of HIV infection, and the adverse effects and toxicity of antiretroviral drugs. Dolutegravir (DGV) is one of the preferred antiretroviral agents in first-line combination in the antirretroviral terapy. Objectives:Wereport the case of a patient with living with HIV and treated with Dolutegravir wtih a Brief psychotic episode. Methods: A case reported is presented. A narrative review was performed to analyze the association between dolutegravir and neuropsychiatric symptoms. Results: Neuropyshciatric symptoms in HIV patients treated with dolutegravir have been described such as sleep disorders, anxiety, depression, psychosis, poor concentration, or slow thinking. Rates of discontinuation of dolutegravir because of neuropsychiatric adverse events remains high. Conclusions: More robust research on the association of dolutegravir and neuropsychiatric symptoms is needed. Adverse effects and toxicity of antiretroviral drugs must be taken into in the differential diagnosis when a patient with HIV shows denovo neuropsychiatric symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Intentional use of psychoactive substances before or during sexual intercourse (chemsex) to increase both sexual pleasure and arousal is a phenomenon of special importance in the GBMSM (gay, bissexual and other men who have sex with men) population due to its impact on mental and physical health. Objectives: We report the case of a patient with a suicide attempt diagnosed with a mephedrone and GHB use disorder and a depressive disorder in chemsex context. To review the evidence on associations between chemsex and mental disorders. Methods: A case reported is presented. A narrative review was performed to analyze the association between chemsex practice and mental health disorders. Results: In qualitative research conducted in Europe with participants with chemsex practices, psychiatric symptoms in the context of acute consumption such as irritability, anxiety, aggressive behaviours where described. Memory loss and changes in personality and dependence substance disorders were described as longer-term psychiatric harms. Drug-induced psychosis, encephalopaty, serotonin syndrome and delirium were described in case reports. In quantitative research analyzing data from a 2014 survey of people attending HIV clinics, chemsex was associated with depression/anxiety, and use of other recreational drugs. Conclusions: There is a lack of robust evidence in the association of chemsex with mental health disorders. Research on the impact of chemsex on mental health is essential. Due to the high prevalence of mental disorders in MSM population and the possible harms from drug use, a collaborative approach (including mental and sexual health professionals) could be beneficial with the problems associated with chemsex. [ABSTRACT FROM AUTHOR]

Introduction: The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Mental health disorders such as psychosis, delirium and serotonine syndrome has been described associated with chemsex practices. Other sexual health issues such as difficulties in achieving sober sex or erectile dysfunction has been described. To date, no specific sexual health intervention has been described. Objectives: To describe a sexual health intervention program for patients with chemsex practices. We describe the profile of users according to socio-demographic, medical, psychopathological and drug-related characteristics. On the other hand, we analyze a survey of satisfaction made by users. Methods: Description of the program. Demographics, consumption patterns, other accompanying substances, use of geo-social applications and comorbid medical and psychiatric disease and perceived satisfaction data were described through a online survey. Results: 12 sexual health workshops were done based on behavioralcognitive theory, biopsychosocial and Sex Positive Model. The most common profile was a male of Spanish nationality, 35-45 years old, living with HIV and drug use perceived as problematic. 35% presented a reduction in frequency or amount of drug use. 10% stopped practicing chemsex. 45% presented a reduction in sexual risk behaviour. 60%perceived an improvement in perceived social support and increased awareness of presenting a drug addiction. Conclusions: Interventions in sexual health were perceived as satisfactory and useful by users to improve their sexual health and self-efficacy to change substance use patterns. [ABSTRACT FROM AUTHOR]

Introduction: Inequity on mental healthcare access is a main problem for migrant population. In addition, migration-related factors may function as social determinants for mental health. It is necessary to adapt our services to the needs of this vulnerable population, currently accounted for 3.3 per cent of the world population. Cultural factors have an impact on the way that mental illness is conceptualized and could limit mental health care efficacy, if not taken into account. Objectives: The aim of this study is to offer an international perspective of the different clinical models of mental health care for migrants, and to compare and uncover the specificities of the Transcultural Psychotherapy model in France. Methods: Systematic electronic search of databases (PubMed and PsycINFO). The study included 28 papers. Results: Most initiatives place emphasis on training, supervision or consultation, in an indirect approach not specifically focused on the patient, or offer cultural matching of patient and therapist. Conclusions: Varied models lead to different methods of taking cultural diversity into account. The aim of these methods is to modify the framework of care, that is, the services provided, to search for a compromise between the patient and the therapist, etc. The French transcultural approach, on the contrary, is a complete psychotherapeutic method aimed at patients rather than at the framework of care. This approach is the only one makes the family's culture and its cultural diversity an integral part of the therapy process. [ABSTRACT FROM AUTHOR]

Introduction: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, formally recognized in 2007, is more frequent than any other known paraneoplastic encephalitis. A 77.8% of patients are young female adults. In approximately 40% of the subjects, the disease is associated with an ovarian teratoma. The teratomaassociated cases are significantly more likely to present psychiatric symptoms than those without teratomas. Objectives: We report the case of a 37-year old female patient who was admitted in the Neurology ward after presenting neurological features in combination with symptoms of mood disorder, insomnia and aggressive behavior. We aim to review the clinical features that should lead us to suspect an anti-NMDAR encephalitis in a patient with psychiatric symptoms. Methods: A case reported is presented. A narrative review via scientific database (PubMed) was conducted. Results: Our patient had previously suffered a virus encephalitis. At the beginning, she presented a non-specific prodromal phase with headache and fever, as well as abnormal behavior. She was admitted at the Neurology ward for follow-up. Later on, appeared insomnia, agitation, disorganized thinking, manic symptoms and autonomic instability. Anti-NMDAR encephalitis was confirmed with the detection of antibodies against the GluN1 subunit of the NMDAR in the CSF of the patient and an ovarian teratoma was found and removed. Conclusions: When a patient without any psychiatric history presents a new-onset psychosis, especially in combination with dyskinesias, seizures, memory problems, decreased level of consciousness and/or catatonia, anti-NMDAR encephalitis should always be considered as a differential diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Psychosocial assessment plays a key role along the whole process of heart transplant. This assessment provides the chance to early identify patients in risk of suffering psychopathological issues that may endanger the rehabilitation process. SIPAT Scale (Stanford Integrated Assessment for Transplant) has been proved to be a valid tool to evaluate patients undergoing a heart transplant process. SIPAT assess 20 different and relevant components about patients, classifying candidates with a final score of eligibility. Objectives: The aim of this poster it to review the use of SIPAT Scales in heart transplant, as well as presenting a case of a young woman suffering from congenital heart disease awaiting to be transplantated describing the assessment process that took place by the Mental health Service in liaison with Cardiology Service of a General Hospital. Methods: We review recent literature in medical database PubMed with keywords "heart transplant" AND "assessment". We selected papers for their relevance to the topic. We describe the liaison process between clinical services and explain the assessment process of the patient using SIPAT and clinical tools such as nonstructured Clinical and family interviews. Results: A comprehensive full assessment was carried out by Mental Health Clinicians so the patient could be included in the transplant waiting list. Conclusions: SIPAT is a reliable tool for psychosocial assessment in patients waiting for a heart transplant, although a comprehensive clinical assesment should also be carried out. Liaison among different clinical services in general hospitals is key to the wellbeing and attention to patients. [ABSTRACT FROM AUTHOR]

Introduction: Serotonin síndrome (SS) is a potentially lifethreatening condition caused by excessive serotonergic activity in the nervous system. It is characterized by mental status changes, autonomic instability, and neuromuscular hyperactivity. In patients taking linezolid, an oxazolidinone antibiotic widely used for resistant nosocomial infections, along with seretoninergic antidepressants there is a documented risk for SS. Objectives: We report the case of a difficult-to-control asthma patient, diagnosed with MRSA pneumonia during a prolonged hospitalization for asthma exacerbation, concurrently taking an SNRI (venlafaxine). We aim to review the evidence about the mechanisms of seretonin toxicity when drugs in the MAOinhibitor class (like linezolid) are combined with proseretoninergic agents as well as the current clinical guidelines for the management of patients with concurrent antidepressant treatment requiring linezolid for a new resistant nosocomial infection. Methods: A case report is presented. A narrative review via scientific database (PubMed, Google scholar) was conducted. Results: While SS has not been described in clinical trials of linezolid, several cases have been reported after commercialization of this antibiotic, especially when used concurrently or within close temporal relation to a seretoninergic agent like SSRI/SNRI antidepressants. The mechanism of action is not fully understood. Conclusions: To our knowledge, there are not any guidelines for the adequate management of these cases, with current recommendations for use of linezolid and seretoninergic antidepressants based on risk-benefit personalized analyses. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies have analyzed the influence of gender on demographical and clinical patterns of patients with bipolar disorder. It remains unclear the association between gender and inpatient characteristics in bipolar patients. Objectives: The aim of this study is to investigate the association between gender and demographical and clinical features of patients hospitalized for bipolar disorder. Methods: Admission data were extracted from national database of 2013 (CMBD-H). Patients with primary diagnosis of bipolar disorder were included using International Clasification of Diseases, 9th revision, Clinical Modification (ICD-9 CM). To study the association between gender and qualitative and quantitative variables, Chi-square and T-student tests were applied. Admission rates by gender per 10.000 people were calculated by age-standarized rates obtained by National Statistic database 2013 (INE). Results: The database included 8.384 admissions by 6.846 patients. The number of readmission was higher in men (p<0,05). The mean age in women was higher than men (48 years vs 44 years, respectively; 95% CI p<0,05). Most patients were diagnosed with bipolar disorder type I. Up to 63 % of patients were admitted for manic episodes, the number of episodes was significantly higher (p<0,05) in men than women. It was followed by mix and depressive episodes which were higher in women (p<0,05). Conclusions: This study reveals gender differences in demographical and clinical variables of patients hospitalized for bipolar disorder. It is necessary further research on this topic to understand the causes of this findings. [ABSTRACT FROM AUTHOR]

In recent years, there has been an increase in the practice of chemsex, which is becoming an increasingly serious public health problem. The complex interaction between chemsex and mental health underscores the need to understand the psychological, social, and environmental factors that influence this practice., Methods: A qualitative descriptive phenomenological study was conducted in the community of Madrid, Spain to explore the depth of the chemsex phenomenon through a thematic analysis. Between April and June 2024, interviews were conducted with 15 MSM (gay, bisexual, and other men who have sex with men) who participate in these practices, using purposive and snowball sampling., Results: three main themes were identified, namely, (T1) contextualization of the practice, (T2) factors associated with chemsex, and (T3) strategies and interventions for risk and harm reduction., Conclusion: Chemsex is a phenomenon that combines sexual practices with substance use in complex social environments, presenting significant risks to physical, mental, and sexual health. It is necessary to implement public health interventions to mitigate these risks.

Background: In recent years, there has been an increasing use of sex-related substances (known as "Chemsex") to facilitate, intensify, and prolong the sexual experience of men who have sex with men. This phenomenon poses a public health problem, increasing the risk of sexually transmitted infections (STIs) and mental disorders., Objective: The primary aim of this study was to delve into the correlation between substance use and sexual health, specifically examining the association between different substances used and the risk of sexually transmitted infections (STIs) in the context of Chemsex in Spain., Methods: An observational, descriptive, cross-sectional study was conducted among 563 Spanish participants between January and April 2023. Non-probabilistic purposive sampling was used by the investigators. The researchers administered a questionnaire to men who have sex with men who use substances, especially in the sexual sphere, in all the autonomous communities of Spain., Results: 14.7% reported having practiced slamsex in the last year, and 17.94% were diagnosed with a Sexually Transmitted Infection in the previous 6 months. Of these, 21% were on PREP treatment, with the main STIs being gonorrhea ( p  < 0.001), chlamydia ( p  < 0.001), genital herpes ( p  = 0.020), and syphilis ( p  < 0.001). The 63.7% used methamphetamines as the main drug in the practice of chemsex., Discussion: Chemsex in Spain is linked to a high prevalence of STIs, especially gonorrhea and chlamydia, even among those on PrEP treatment. The use of various drugs during chemsex, such as amyl nitrite, GHB, ecstasy, and others, correlates with higher rates of STIs, highlighting the need for interventions to reduce risk and harm. The drugs most associated with slamsex include ketamine, mephedrone, and methamphetamine, underscoring the importance of addressing the risk behaviors associated with this activity., Conclusion: This study shows that chemsex appears to be associated with a high prevalence among men who have sex with men. Who use multiple substances in a sexual context, and are particularly exposed to sexually transmitted infections (STIs), indicating a particular need for STI prevention and care in this group., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 del Pozo-Herce, Baca-García, Martínez-Sabater, Chover-Sierra, Gea-Caballero, Curto-Ramos, Czapla, Karniej, Martínez-Tofe, Sánchez-Barba, de Viñaspre and Juárez-Vela.)

Background: Sexualized drug use (SDU) has become a public health concern in recent years. This study aimed to estimate the prevalence of SDU in gay, bisexual, and other men who have sex with men living with HIV (HIV + GBMSM) in Madrid during 2019/2020 and compare it with data from 2016/2017 in order to detect changes in patterns., Methods: We analyzed the frequency of SDU in a sample of HIV + GBMSM attending HIV clinics, who participated in an anonymous online survey regarding sexual behavior and recreational drug use. The association between SDU, sexual risk behaviors, and STIs was evaluated., Results: This study included 424 HIV + GBMSM, with a mean age of 40 (10.43) years. Overall, 94% (396) reported being sexually active. Additionally, 33% (140) had been diagnosed with an STI within the previous year. Moreover, 54% (229) had used drugs in the last year, 25% (107) engaged in SDU, and 16% (17) reported engagement in slamsex. After adjusting for confounding factors, SDU was associated with STIs, fisting, unprotected anal intercourse, and having >24 sexual partners in the last year. According to the DUDIT test scores, 80% (81) probably had problematic drug use (≥6 points), and 8% (8) probable drug dependence (≥25 points). When comparing the U-SEX-1 (2016/2017) data with the U-SEX-2 (2019/2020) data, no significant differences were found in the proportion of participants practicing SDU or slamming., Conclusions: The prevalence of SDU among HIV + GBMSM has remained high in recent years and without significant changes. The risk of problematic drug use among those who practice SDU is high. We observed a clear association between SDU, high-risk sexual behaviors, and STIs.

Background : Although evidence shows that engaging in chemsex can be associated with poor mental health, little is known about the relationship between psychological factors and this type of drug use. We aim to explore associations between engagement in chemsex and several psychological variables (adverse life events, attachment styles, emotional regulation skills, self-care patterns) in a sample of gay, bisexual, and other men who have sex with men (GBMSM) with drug-related problems. Methods : A group of GBMSM engaged in chemsex (n = 41) and a control group of GBMSM (n = 39) completed an online survey to assess drug-related problems and the abovementioned psychological variables, in which both groups were compared. All analyses were adjusted for covariates showing significant differences between groups. Results : Compared to the control group, participants engaged in chemsex showed significantly higher frequencies of an avoidant-insecure attachment style and early adverse life events, regardless of all covariates (HIV status, job situation, and place of birth). Poorer emotional regulation and self-care patterns and a higher frequency of sexual abuse were also found in participants engaged in chemsex, though we cannot rule out the influence of HIV status on this second group of variables. Conclusions: Some people with drug-related problems engaged in chemsex might have suffered early adverse events and might have an avoidant-insecure attachment style. Moreover, those who have been diagnosed with HIV might show higher emotional dysregulation and poorer self-care patterns. These variables should be routinely evaluated in this population.

Introduction: Paediatric and adult psychiatric emergency department (ED) visits decreased during the initial COVID-19 outbreak. Long-term consequences of the COVID-19 pandemic will include increases in mental healthcare needs, especially among vulnerable groups such as children and adolescents., Aim: This study examined changes in the number of overall and diagnosis-specific mental health ED visits among patients aged <18 years following the onset of the COVID-19 pandemic in Madrid, Spain., Methods: Using clinical records from all psychiatric ED visits at a major teaching hospital between October 2018 and April 2021, we conducted interrupted time-series analyses and compared trends before and after the day of the first ED COVID-19 case (1st March 2020)., Results: A total of 663 patients were included. In March 2020, there was a marked initial decrease of -12.8 (95% CI -21.9, - 7.9) less monthly mental health ED visits. After April 2020, there was a subsequent increasing trend of 3.4 (95% CI 2.6, 4.2) additional monthly mental health ED visits., Conclusion: After the onset of the COVID-19 pandemic, there was an increase in paediatric psychiatric ED visits, especially due to suicide-related reasons. These data reinforce the crucial role of the ED in the management of acute mental health problems among youth and highlight the need for renovated efforts to enhance access to care outside of and during acute crises during the pandemic and its aftermath., Competing Interests: Conflict of interest The authors report no conflict of interest., (© 2022 Daniel Hernández-Calle, Jorge Andreo-Jover, Javier Curto-Ramos, Daniel García Martínez, Luis Vicente Valor, Guillermo Juárez, Margarita Alcamí, Arancha Ortiz, Noelia Iglesias, María Fe Bravo-Ortiz, Beatriz Rodríguez Vega, Gonzalo Martínez-Alés, published by Sciendo.)

Objective: The health of transgender people is a little studied topic and hospital records can be an opportunity to make an approach. The aim of this study was to describe the cause for admission and the associated comorbidities of transgender people in Spain between 2001 and 2013., Methods: Retrospective observational study with population-based administrative records (Minimum Basic Data Set). The discharges generated by the transgender in Spanish public and private hospitals were selected using one of the following ICD-9-CM codes in any diagnostic field: Trans-sexualism (302.5), Disorders of psychosexual identity (302.6) and Gender identity disorder in adolescents or adults (302.85). The causes of admission and comorbidity according were described. The qualitative variables were described in their frequency distribution according to their number(n) and proportion(%) and the quantitative variables according to their mean and standard deviation (SD) or median (MD) and interquartile range (RIQ) according to their distribution., Results: A total of 2,010 highs were recorded corresponding to 1,878 patients. The mean age was 33 years (SD = 10). 51% were male, 46% female and 3% undetermined or unspecified. The discharges were motivated in 59% by the process of body modification, followed by HIV (4%) and personality disorders (3%). The most common comorbidities were those associated with body modification (49%), mental health problems (40%) and infectious diseases (15%)., Conclusions: It is necessary to address the health of transgender people in a comprehensive way that takes into account their specific health needs, including bodily modification, mental health, HIV and other infections, through strategies that include improve research, tailor health information systems and develop guidelines and training of healthcare providers in this transgender health., Competing Interests: Disclosure The authors report no conflicts of interest in this work.