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Introduction: Given the increasing prevalence of cannabis use among adolescents and its impact on mental health, there is a need to identify those individuals who are more susceptible to its harmful effects. Cognitive reserve (CR) is the brain's capacity to withstand brain damage without manifesting symptoms of impairment. This approach is particularly interesting to identify susceptible individuals during vulnerable stages, such as adolescence. Objectives: To describe the study protocol and preliminary results, assessing CR and overall functioning in a sample of adolescents diagnosed with cannabis use disorder, as well as its influence on psychopathology, functioning and cognitive performance. Materials and Methods: The cross-sectional observational study protocol. The Chi-square test was used for categorical variables related to cannabis consumption, the Mann-Whitney U test for quantitative variables such as severity of the disorder, and Spearman's rho test to explore the correlation between GAF and clinical variables collected in the study. Results: Twelve participants were included, 58.33% females aged 16.5 ± 1.00 years. The majority of the sample fell into the low CR group (90%), with nearly 50% exhibiting low functioning. An association was observed between low global functioning and positive psychotic symptoms, manic symptoms, global clinical severity, and poorer adherence to the Mediterranean diet. Conclusions: The preliminary sample shows a significant low CR in adolescents with cannabis use disorder. Identifying individuals with low CR and a risk of psychopathology could guide more effective and precise preventive and therapeutic programs. [ABSTRACT FROM AUTHOR]

Introduction: The Acute Organic Change of Character (AOCC) is an organic mental disorder subtype in which perception, thought, mood and personality impairment predominate. It consists in a change in the individual's general behaviour or attitude, which is shown to be closely associated with or caused by an underlying organic process, and which is rapidly resolved when the organic noxious agent is eliminated (Pintor et al. Journal of Psychiatry and Psychiatric Disorders 4 (2020): 354-358). Objectives: To describe the importance of taking AOCC diagnosis into consideration and the role of liaison psychiatrists in AOCC management by presenting two AOCC cases admitted to the Hospital Clinic of Barcelona. Methods: We retrospectively reviewed two AOCC cases in patients followed by our hospital's liaison psychiatry unit during the summer of 2023. We also searched for previous case reports of AOCC using a PubMed query. Results: Case 1: A 50-year-old male who suffered a polytrauma with diffuse axonal injury (DAI). His relatives and the referring medical team observed a change in his behaviour consisting in irritability, suspicion, hostility and impatience. No cognitive impairment nor fluctuation in the described symptoms were observed. At the time of discharge character changes were still present due to DAI slow and unpredictable clinical course. Symptomatic treatment with risperidone 6mg/day and quetiapine 100mg/day was administered achieving a satisfactory clinical response. Case 2: A 47-year-old woman with type 2 diabetes who suffered an infectious cellulitis that spread causing sepsis. The patient began to appear disruptive with verbose and tangential speech during her admission. No cognitive impairment nor fluctuation in the described symptoms were observed. Symptomatic treatment with risperidone 10mg/day and olanzapine 5mg/day was administered achieving a satisfactory clinical response. At the time of discharge character changes described before were almost resolved. Conclusions: The clinical presentation of both cases suggested organic mental disorders in which a change in general behaviour predominates. Liaison psychiatrists play a key role in AOCC management by recognizing the clinical pattern, helping if needed with psychopharmacological treatment and ensuring a good understanding of the disorder both by the referring medical team and the patient's relatives. To our knowledge, it would be of great importance to achieve a better understanding of this clinical condition which to date we consider to be underdiagnosed. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: In Spain and other European countries, patients coming to the emergency room (ER) are usually classified as "organic" or "psychiatric" on arrival, but this may be complicated when psychiatric history is present as the focus can be misplaced (Leeman. IJPM 1975;6(4):544-40; Alam et al. Psychiatr. Clin. North Am. 2017;40(3):425–33). Objectives: To describe three cases seen in the psychiatric emergency room (PER) in which triage errors occurred and to review whether it is widespread for psychiatric patients with organic pathology or in need of medical care to be wrongly triaged. Methods: We retrospectively reviewed three cases seen in the PER of Hospital Clínic in July 2023 in which triage errors happened. Triage error was considered when patients triaged directly to the PER presented symptoms that either needed medical treatment or required medical clearance before being considered purely psychiatric. Results: Case 1: A 27-year-old woman with history of depressive syndrome was triaged for a speech disturbance that had occurred fifteen minutes after intercourse. After being evaluated, she was referred to neurology where she was diagnosed with an acute ischaemic stroke in left middle cerebral artery territory, requiring thrombectomy and posterior admission to neurology. Case 2: A 50-year-old man with history of alcohol use disorder was brought to the PER after saying that "he was seeing people doing magic" at home. When evaluated, significant distal tremor, tachycardia and hypertension were observed, being compatible with withdrawal symptoms, so he was transferred to the ER. There he was monitored and treated, finally requiring admission to internal medicine due to persistent symptoms. Case 3: A 26-year-old man with history of substance use disorder was triaged for loss of consciousness and "spasms". After evaluation, he was transferred to the ER, where organic screening was carried out, being oriented as a probable tonic-clonic seizure and discharged with outpatient follow-up. Conclusions: The cases presented are instances in which somatic diseases in patients pre-labelled with psychiatric histories were wrongly assumed to be recurrences of their psychiatric disorders. In all cases, they needed to be re-examined by the corresponding medical specialty and required diagnostic tests, in two cases hospital admission was needed. Emergency physicians and emergency psychiatrists often disagree on how to medically clear patients (Alam et al. Psychiatr. Clin. North Am. 2017;40(3):425–33; Janiak et al. JEM. 2012;43(5):866–70), some authors have even proposed protocols for doing this in a more systematic way (Shah et al. JEM. 2012;43(5):871–5). To avoid a delay in diagnosis and treatment and the consequences that may result from it, establishing guidelines for proper triage of patients with psychiatric history should be considered. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Chemsex refers to the use of drugs, typically stimulants and/or psychoactive substances, in a sexual context, often in the context of casual or group sex encounters. Currently, the practice of chemsex focuses on men who have sex with men (MSM). On the other hand, Pre-exposure prophylaxis (PrEP) is a biomedical method that has proven effective in preventing HIV transmission, particularly among individuals at a heightened risk, including those who engage in chemsex. MSM account for two thirds of new HIV cases in the US. It is estimated that in 70% of cases seroconversion occurs through "condomless anal sex" (CAS). According to the CDC, one in six MSM will be infected with HIV during their lifetime. The consumption of methamphetamine (MA) has been identified as the main driver of the practice of CAS, alteration of rectal immunological function and faster seroconversion. One in three new HIV infections have been associated with MA consumption. (Grov C et al. JAIDS 2020; 85 272-279). Objectives: The primary goal of this study is to describe the prevalence of chemsex engagement among PrEP users, delineate user characteristics and requirements, gain deeper insights into this phenomenon within the Barcelona region, and formulate customized strategies accordingly. Methods: This study conducts a literature review to explore the current correlation between engaging in chemsex and the utilization of PrEP. We identified research articles published between January 2020 and December 2022, that discussed the utilization of chemsex drugs prior to or during sexual activities. The findings were synthesised using a narrative approach and conceptualised using a behavioural analysis framework. Results: According to a recent cross-sectional study performed at Hospital Clínic de Barcelona, SUD among patients who are being followed-up in the outpatient clinic of PrEP was higher (89%) compared with other European regions such as England (38.5%) or Amsterdam (41%). Moreover, according to data collected in the EMIS 2017 survey, Barcelona is the city with the highest prevalence of chemsex in Spain. (De La Mora L et al. AIDS Beh. 2022; 26: 4055-4062). Conclusions: The frequency of chemsex practice among individuals using PrEP in Barcelona surpasses what has been observed in other groups. Nearly 25% of the participants express worries and a requirement for assistance regarding the management of drug use, matters associated with their sexuality, and sexually transmitted infections (STIs). MSM who suffers from substance use disorder may experience difficulty achieving effective daily oral PrEP adherence prevention levels that may serve as early indicators of increased risk of disengagement from PrEP care and discontinuation the PrEP. These results highlight the importance of adopting aninterdisciplinary approach that incorporates education about substances and the implementation of risk mitigation strategies within the context of riskier sexual behaviors. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Objective: To determine the number of hypotensive drugs required to control the intraocular pressure (IOP) in patients with primary open angle glaucoma (POAG) and diabetes mellitus (DM), as well as describing their demographic characteristics., Design: Observational, cross-sectional, and descriptive study., Methods: Twenty four patients (47 eyes) with definitive diagnosis of DM and POAG were included for a six month follow up, recording demographic data and IOP control., Results: The mean age was 67.04±8.9 years, and 79% of patients were female. Mean time from diagnosis of DM was 13.87 years, and 6.21 years for POAG. No statistical difference was observed between initial and final visual acuity (P = 0.49). There was a statistical difference between initial and final IOP once treatment was started (P = 0.002), requiring 1.9 hypotensive drugs (P < 0.05). Beta-blockers were the most used hypotensive drugs for the initial (41%), as well as the final IOP control medication (28%)., Conclusion: The mean IOP in patients with DM and POAG was 16.8 mmHg, with the use of 1.9 hypotensive drugs., (Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)