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Key-points Bone turnover makers (P1nP, B-ALP, CTX), bone modulators (Dkk1, sclerostin) and BMD were measured prospectively in rheumatoid arthritis patients treated with tofacitinib. Sclerostin increased significantly after treatment with tofacitinib, P1nP and B-ALP (markers of bone formation) decreased significantly.

IntroductionTechnology-facilitated sexual violence (TFSV), i.e. the use of digital communication technologies for facilitating sexual violence and harassment, represents a concern due to its exponential growth, particularly among youths. Few studies investigated TFSV, mainly due to the lack of a validated assessment tool, such as the TFSV-Victimization scale (TFSV-VS). Our study aimed to investigate the TFSV phenomenon in a sample of Italian young adults (aged 18-24), through the validation of the Italian translated version of TFSV-VS.MethodsThe study consisted of two phases: 1) validation of the Italian version of TFSV-VS; b) evaluation of TFSV lifetime and during the last 12 months among Italian youths.ResultsIn our sample, 78.6% and 56.1% of subjects reported a lifetime and 12-months TFSV victimization, respectively. Digital sexual (70.4% and 46.6%), gender and/or sexuality-based harassment (43% and 29.6%) are those most represented. A gendered and sexuality-based pattern in lifetime TFSV was observed, mainly observed among females (p=0.005) and sexual/gender minority (SGM)(p=0.001). Being female (p

VEXAS syndrome is a newly described autoinflammatory entity characterized by somatic mutations in the UBA1 X-linked gene in hematopoietic progenitor cells. Several studies have demonstrated that the presence of vacuoles in progenitor cells from bone marrow aspirates is a hallmark finding for this syndrome. Therefore, this study aimed to characterize leukocytes from VEXAS patients versus patients with ANCA-associated vasculitis (AAV), familial Mediterranean fever (FMF), and healthy donors (HD) to define a specific cytological pattern that can support VEXAS diagnosis. Twelve VEXAS patients were included in the study. Blood samples from FMF (n = 16), AAV (n = 16) and HDs (n = 20) acted as controls. May-Grünwald Giemsa (MGG) staining was used for studying cellular morphology, including cytoplasm, granules, and vacuoles and to perform a cytogenic evaluation of leucocytes. Plasma IL-1β, IL-1α, TNFα, IL-18 and IL-8 were measured using ELISA assay. The cytological analysis from blood smears confirmed the presence of immature neutrophils in VEXAS patients. We found a greater number of vacuoles in VEXAS patients vs. FMF, AAV and HD. Micronuclei (MNi) and cell death rate were higher in VEXAS patients vs. HD. Cell death correlated with IL-1β and IL-8 levels. MNi were positively associated with IL-8 and IL-1β levels, and with the percentage of immature neutrophils and vacuoles. In conclusion, our findings suggested that cytological test may be supportive for VEXAS diagnosis, despite genetical analysis is mandatory for confirming the disease. Finally, we identified several cytological hallmarks that may distinguish the VEXAS “cytotype” not only from HD but also from other inflammatory diseases.

BackgroundObsessive-compulsive disorder (OCD) ranks as the fourth most prevalent psychiatric disorder, with selective serotonin reuptake inhibitors (SSRIs) as its mainstay pharmacological treatment. However, approximately 40 to 60% of patients do not adequately respond to initial treatment, highlighting the need for alternative options. N-acetylcysteine (NAC) is one of the several medications that have been used in augmentation with SSRIs to enhance their efficacy.ObjectivesWe aimed to investigate the safety and efficacy of NAC, a glutamate-modulating agent, as an augmentation in the treatment of moderate to severe OCD.MethodWe conducted a thorough search across PubMed, Scopus, Web of science, and ProQuest to identify relevant trials published until December 2023. The primary outcome of interest was the mean difference between the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores before and after administrating augmented NAC among patients with moderate to severe OCD. Furthermore, we compared the occurrence of adverse drug events between the experimental and control groups.ResultsWe included six randomized controlled trials with 195 patients. The results of our study indicated a positive outcome for the experimental group in terms of the total Y-BOCS score when using the medication for a period of five to eight weeks (p-Value = 0.05). However, no significant difference was observed for durations shorter than five weeks or longer than 12 weeks. Additionally, no significant difference was found between the two groups in terms of the obsession and compulsion Y-BOCS scores. Furthermore, no significant differences were observed in terms of adverse events.ConclusionAugmentation of NAC with SSRIs may benefit patients with moderate to severe OCD. However, it is necessary to conduct additional multi-center trials over extended periods to develop a comprehensive strategy for action.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023463683.

The relationship between spirituality and behavioural addictions is complex. Although some studies have suggested spirituality to be a protective factor helping in recovery from addictive behaviours, others have found spirituality to be a potential risk factor. To better understand the relationship between spirituality and various behavioural addictions, this review summarises the literature on the association between spirituality and the following behavioural addictions: gaming disorder, gambling disorder, problematic internet use, problematic smartphone use, compulsive sexual behaviour disorder and compulsive buying/shopping disorder. Implications for clinical practice and future research are discussed.

Abstract Background Hikikomori (HK) is characterized by self-isolation and social refusal, being more likely also associated with affective disorders, including depression. This case–control study primarily aimed at identifying (if any) predominant affective temperaments are associated with HK in depressed versus not-depressed individuals. Secondary objectives comprise assessing which other psychopathological dimensions (e.g., boredom, anxiety) are associated with the HK specifier in depressed individuals. Methods From the larger SWATCH study, 687 Italian young people were screened for depression, as measured by 9 items-Patient Health Questionnaire (PHQ-9) and HK-like social withdrawal, through the Hikikomori Questionnaire-25 (HQ-25). All subjects were administered a brief-Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-M), the 7 items-Generalized Anxiety Disorder (GAD-7) and the Multidimensional State Boredom Scale (MSBS). Results Males reported significantly higher scores at HQ-25 total score than females (p = 0.026). In the total sample, HK social withdrawal is positively predicted by MSBS low arousal, disengagement, depressive levels, depressive and irritable affective temperaments, while negatively by anxiety (F(6, 680) = 82.336, p

Non-suicidal self-injury (NSSI) can both precede and co-occur with suicidal attempts (SA). Underlying mechanisms/factors leading to the transition to SA in NSSI youths have been proposed (including the role of social cognition), despite they should be yet confirmed. Therefore, the study aims at exploring the role of the Theory of Mind in the differentiation of a sample of NSSI youngsters (aged 15-24) according to the presence of SA. We divided the sample into 4 groups using the Deliberate Self Harm Inventory (DSHI) and Columbia Suicide Severity Rating Scale (C-SSRS): control group (notNSSInotSA), NSSI without SA (NSSInotSA), NSSI with SA (NSSIplusSA), and SA without NSSI (SAonly). NSSIplusSA patients displayed higher Reading the Mind in the Eyes Test (RMET) scores (indicative of ToM abilities) than both the NSSInotSA (p=0.0016) and SAonly groups (p=0.0198), while SAonly patients showed lower RMET scores compared to the control group (p=0.0214). Multiple regression models used to differentiate NSSInotSA and NSSIplusSA found a significant association between RMET and LOSCS-CSC (Level Of Self-Criticism Scale-Comparative Self-Criticism) (pC=0.0802, pD=0.0016, pG=0.0053). Our findings supported the hypothesis that a hypertrophic affective ToM may possibly be associated with the occurrence of SA in youth NSSI. Further larger and longitudinal studies should confirm these preliminary findings, by exploring all social cognition dimensions.

IntroductionNonsuicidal-self-injury (NSSI)-related content recently emerged on social networking sites (SNS), despite its relationship with NSSI conducts is still unclear.MethodsHence, the current population-based cross-sectional study investigated the interplay between SNS use, NSSI content engagement, risky social media challenges (RSMCs), in a sample of 404 young adults (aged 18–24), focusing on the influence of problematic social media use (PSMU) and fear of missing out (FoMO).ResultsAround 51.5% of the samplewas engaged inNSSI-related contents on SNS, being mostly females (p

Introduction Nomophobia, a neologism derived from the combination of “no mobile,” “phone” and “phobia,” represents one of the syndromes of today’s digital and virtual society. By this term, we refer to the discomfort, anxiety, nervousness, and distress generated by the individual’s loss of connection to his or her cell phone or other technological medium that allows connection to the Internet. No study has attempted to evaluate the impact of disconnection syndrome on a clinical sample of patients with Severe Mental Illness (SMI). Objectives Our study has the objective of characterizing subject affected by SMI with nomophobia. Methods Our study is conducted on inpatients (>16 years) referred to our Psychiatric ward in Ancona (Università Politecnica delle Marche, Italy). The following rating scales were administered to these subjects: Nomophobia Questionnaire (NMP-Q), Smartphone Addiction Scale - Short Version (SAS-SV), Multidimendional State Boredom Scale (MSBS), Intolerance of Uncertainty Scale (IUS), Temperament Evaluation in Memphis, Pisa and San Diego (TEMPS-M), Coping Orientation to the Problems Experiences-new Italian version (COPE-NVI). Results Most of the subjects included in the study tested positive for nomophobia (99%; n=97). The mean score scored on the NMPQ is 69.2±27.9, while the mean score obtained at SAS-SV is 25.1±12.7. Gender has no influence on the scores obtained at the NMPQ (p=0.823), as well as the type of SMI (p=0.376). Those not in a relationship scored a higher mean score than who has a relationship (p=0.02). Patients who suffer from insomnia scored higher mean score on the NMPQ (p=0.21). A linear univariate regression between SAS-SV and NMPQ was observed (R2=0.575, F=129.731, p

Introduction Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition marked by difficulties in attention, hyperactivity, and impulsivity. Its subtypes—predominantly inattentive, predominantly hyperactive-impulsive, and combined—vary in symptom presentation and impact on daily functioning. Understanding these subtypes is crucial for tailored interventions and support. Objectives Our aim is to clinically characterize the psychopathological aspects of the subtypes of ADHD. Methods Our study is conducted on patients (>18 years) referred to the adult ADHD outpatient service of the Psychiatric Clinic of Ancona (Università Politecnica delle Marche, Italy). The Diagnostic Interview for ADHD in adults (DIVA 5.0) was used for diagnosing ADHD. The following rating scale were administered: Temperament Evaluation in Memphis, Pisa and San Diego (TEMPS-M), and Temperament and Character Inventory-Revised (TCI-R). Results 76% (n=170) of all screened patients were diagnosed with ADHD in adulthood. 57.6% (n=98) were diagnosed with ADHD combined subtype, 35.3% (n=60) with ADHD inattentive subtype, and 7.1% (n=12) with ADHD hyperactive subtype. Only 12.9% (n=22) were diagnosed with ADHD in childhood. Based on the results obtained at TEMPS-M, 43.8% (n=32) of patients were found to have cyclothymic temperament. Subjects with ADHD combined subtype scored significantly higher mean on the irritable temperament subscale of the TEMPS-M than those with ADHD inattentive subtype (p=0.016), while patients with ADHD inattentive subtype had a significantly higher mean score on the disorderliness subscale of the TCI-R than those with ADHD hyperactive and combined subtype (p=0.010). Given the logistic regression analyses using the TCI-R, developing an inattentive type of ADHD is negatively predicted by the disorderliness subscale of the TCI-R (exp(B)=0.788, IC95%=0.669-0.929, p=0.005) and positively predicted by the extravagance subscale of the TCI-R (exp(B)=1.104, IC95%=1.009-1.208, p=0.031), the hyperactive subtype of ADHD is negatively predicted by the fatigability subscale of the TCI-R (exp(B)=0.775, IC95%=0.597-1.005, p=0.055) and the combined subtype that is positively predicted by the disorderliness subscale of the TCI-R (exp(B)=1.140, IC95%=1.011-1.287, p=0.033). Regarding temperament, through a logistic regression analysis, the inattentive subtype of ADHD is negatively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=0.904, IC95%=8.39-0.974, p=0.008), while for the combined subtype of ADHD it is positively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=1.088, IC95%=1.014-1.167, p=0.019). Conclusions The results show that irritable temperament is a predictor for the inattentive and combined subtype, but with different polarities. In addition, how different patterns of personality are specific to the various subtypes of ADHD are highlighted. Disclosure of Interest None Declared

Introduction Non-suicidal self-injury (NSSI) is defined as any deliberate destruction of one’s body tissue, engaged in for reasons that are non-suicidal. Online platforms, notably social media, witness a surge in NSSI-related content, amplified by the COVID-19 pandemic. Young individuals increase video and post uploads, prompting scholarly inquiry into the impact on vulnerable demographics in the online environment. Despite potential benefits, concerns surface regarding content reinforcing self-injurious behavior. The Blue Whale phenomenon exemplifies serious consequences in this digital landscape. Objectives The present study aims at screening the prevalence of NSSIs on SNS among Italian young people. Methods An observational cross-sectional study was conducted by recruiting 373 Italian young people (aged 18-25). Bergen Social Media Addiction Scale (BSMAS), Fear Of Missing Out Scale (FOMO), Inventory of Statements About Self-Injury (ISAS) were administered to investigate the relationship between NSSIs, social media use and frequency and underpinned motivations. Results Overall, 99.7 % (n=372) of participants declared to have used at least one social network. Around 92.5 % (n=345) declared to know Blue Whale Challenge and more than half of the sample (51.5%) referred to have looked for NSSI contents on SNS, mostly (28.7 % (n=107)) have sought for curiosity, 17.7 % (n=66) have sought for help/support. 53.4 % (n=199) of the sample was found to have problematic social media use (PSMU) according to BSMAS. 85 % (n=317) have committed self-injurious gestures in the past, 66.2 % (n=247) practice NSSI currently, most subjects practice them to vent 51.7% (n=193), calm themselves 41.6% (n=155), and punish themselves 30% (n=112). The mean age of transgender and nonbinary subjects (30 % n=112)) who sought/saw content pertaining to NSSIs appears to be lower (p=0.033) than cisgender subjects. Those who searched for content inherent to NSSIs scored higher mean scores on the FOMO (p=0.022) and BSMAS (p=0.013) scales. Those who follow social pages inherent to NSSIs scored higher on the FOMO scale (p=0.035). Subjects who practice NSSIs at their present state, on average, have higher scores on the FOMO and BSMAS scales (p=

Introduction Several studies have shown an association between suicidal behavior and increased C-reactive-protein (CRP) levels (Ghayour-Mobarhan M. et al. Comb Chem High Throughput Screen 2022; 25 1047-1057) although most studies evaluated the association between CRP levels and suicidal ideation in depressed patients (Olié E. et al. Eur Neuropsychopharmacol 2015; 25 1824-31). Objectives Our study assessed baseline high-sensitivity CRP (hsCRP) levels in a cohort of adult inpatients affected by severe mental illness (SMI) and their association with Mini-International Neuropsychiatric Interview-5 subscale suicidality (MINI-5-s). Methods A naturalistic, observational, cross-sectional study was carried out by retrospectively recruiting 127 adult SMI inpatients, excluding patients with an organic pathology. HsCRP levels were assessed at the ward admission. To assess the suicidal behaviour all patients filled the same day the MINI-5-s. Results The number of patients with hsCRP>3mg/l were significantly higher among those with thoughts of death (p=0.002) and suicidal attempt (p=0.026). No statistically significant associations were observed between hsCRP levels and other suicidality dimensions. Limitations: Small sample size, heterogeneous diagnoses, lack of diagnostic sub-analysis, cross-sectional design, and lack of a healthy control group. Conclusions The study reveals a transdiagnostic association between inflammation, thoughts of death and suicidal attempt in SMI inpatients. Our preliminary findings could support a routine introduction of hsCRP measurement, due to its relatively low cost, possible utility in trans- diagnostically suicide risk assessment. Large-scale clinical trials would be recommended to evaluate the effects of early anti-inflammatory therapy in patients with death ideation and/or suicidal attempt and concomitant low-grade hsCRP elevation. HsCRP could potentially represent an early biomarker for suicidal risk. Disclosure of Interest None Declared

Noonan syndrome (NS) is a genetic disorder characterized by multiple congenital defects caused by mutations in the RAS/mitogen-activated protein kinase pathway. Male fertility has been reported to be impaired in NS, but only a few studies have focused on fertility status in NS patients and underlying mechanisms are still incompletely understood. We describe the case of a 35-year-old man who underwent an andrological evaluation due to erectile dysfunction and severe oligospermia. A syndromic facial appearance and reduced testis size were present on clinical examination. Hormonal evaluation showed normal total testosterone level, high FSH level, and low–normal AMH and inhibin B, compatible with primary Sertoli cell dysfunction. Genetic analysis demonstrated the pathogenetic heterozygous variant c.742G>A, p.(Gly248Arg) of the LZTR1 gene (NM_006767.3). This case report provides increased knowledge on primary gonadal dysfunction in men with NS and enriches the clinical spectrum of NS from a rare variant in the novel gene LZTR1.

Abstract Rheumatoid arthritis (RA) causes bone loss, only partly related to inflammation. The impact of RA treatments on bone metabolism and their ability to mitigate bone loss remains uncertain. The primary goal of our study was to examine the influence of abatacept on serum levels of markers and regulators involved in bone turnover. Secondary objectives included evaluating changes in bone mineral density (BMD), bone health parameters, erosions, and exploring potential correlations among these parameters. We conducted a prospective observational study on patients with active seropositive RA failure to biological disease modifying anti-rheumatic drugs initiating treatment with abatacept. We measured at baseline and after 1, 2, 3, 6, 9 and 12 months: serum bone turnover markers (CTX, P1nP, B-ALP), bone modulators (Dkk-1, sclerostin, vitamin D, PTH, OPG and RANKL), BMD and radiographic parameters (modified Sharp van der Heijde score [mSvdH], bone health index [BHI] and metacarpal index [MCI]). Disease activity and glucocorticoid intake was monitored. 33 patients were enrolled in the study. We found a significant increase in markers of bone formation (B-ALP and P1nP) from baseline to M6 and M12. PTH increased significantly at M6 but not at M12. All other bone markers and modulators did not change. We found a significant decrease in BHI and MCI from baseline to M12 (median difference − 0.17 95% CI − 0.42 to − 0.10, p 0.001 and − 0.09 95% CI − 0.23 to − 0.07, respectively). BMD at femoral neck transitorily decreased at M6 (mean difference − 0.019 g/cm2 95% CI − 0.036 to − 0.001 p 0.04). BMD at total hip, lumbar spine and mSvdH score did not change significantly. P1nP delta at M12 correlated with delta mSvdH. Treatment with abatacept was associated with a significant increase in bone formation markers. The secondary and transient increase in PTH serum levels may be responsible of the transitory bone loss.

As the use of assisted reproductive technologies (ART) and in vitro embryo production (IVP) expand in the equine industry, it has become necessary to further our understanding of semen physiology as it applies to overall fertility. This segment of our two-section review will focus on normal sperm parameters, beginning with development and extending through the basic morphology of mature spermatozoa, as well as common issues with male factor infertility in IVP. Ultimately, the relevance of sperm parameters to overall male factor fertility in equine IVP will be assessed.

After the decrease of ozone-depleting substances (ODSs) as a consequence of the Montreal Protocol, it is still challenging to detect a recovery in the total column amount of ozone (total ozone) at northern high latitudes. To assess regional total ozone changes in the “ozone-recovery” period (2000–2020) at northern high latitudes, this study investigates trends from ground-based total ozone measurements at three stations in Norway (Oslo, Andøya, and Ny-Ålesund). For this purpose, we combine measurements from Brewer spectrophotometers, ground-based UV filter radiometers (GUVs), and a SAOZ (Système d'Analyse par Observation Zénithale) instrument. The Brewer measurements have been extended to work under cloudy conditions using the global irradiance (GI) technique, which is also presented in this study. We derive trends from the combined ground-based time series with the multiple linear regression model from the Long-term Ozone Trends and Uncertainties in the Stratosphere (LOTUS) project. We evaluate various predictors in the regression model and found that tropopause pressure and lower-stratospheric temperature contribute most to ozone variability at the three stations. We report significantly positive annual trends at Andøya (0.9±0.7 % per decade) and Ny-Ålesund (1.5±0.1 % per decade) and no significant annual trend at Oslo (0.1±0.5 % per decade) but significantly positive trends in autumn at all stations. Finally we found positive but insignificant trends of around 3 % per decade in March at all three stations, which may be an indication of Arctic springtime ozone recovery. Our results contribute to a better understanding of regional total ozone trends at northern high latitudes, which is essential to assess how Arctic ozone responds to changes in ODSs and to climate change.

Introduction: Medullary thyroid cancer (MTC) is a rare endocrine tumor, which can be sporadic or familial, as a component of multiple endocrine neoplasia 2 (MEN2). Overall, 10% of MTC cases have already developed at presentation or will develop metastasis during follow-up. Testicular metastases are exceptional and only one case of unilateral testis involvement by metastatic MTC has been already reported in literature. We described the first known case of asymptomatic bilateral testicu lar MTC metastases, discovered incidentally at testicular ultrasound (US) performed for unrelated reasons. Case presentation: A Latin American 32-year-old man with MEN 2A syndrome and metastatic MTC underwent andrological and urological examination due to premature ejaculation. US imaging showed two symmetrical hypoechoic lesions involving both testes. Suspecting a bilateral testicular cancer, the patient underwent excision biopsy of both testicular lesions. Histopathology and immunohistochemical examinations documented metastatic MTC of both testicular lesions. Conclusion: Beyond its rarity, testis should be considered as a potential metastatic site of MTC, especially in patients with advanced disease.

The Tibetan Plateau (TP) contains the largest amount of snow outside the polar regions and is the source of many major rivers in Asia. An accurate long-range (i.e. seasonal) meteorological forecast is of great importance for this region. The fifth-generation seasonal forecast system of the European Centre for Medium-Range Weather Forecasts (SEAS5) provides global long-range meteorological forecasts including over the TP. However, SEAS5 uses land initial conditions produced by assimilating Interactive Multisensor Snow and Ice Mapping System (IMS) snow data only below 1500 m altitude, which may affect the forecast skill of SEAS5 over mountainous regions like the TP. To investigate the impacts of snow assimilation on the forecasts of snow, temperature and precipitation, twin ensemble reforecasts are initialized with and without snow assimilation above 1500 m altitude over the TP for spring and summer 2018. Significant changes occur in the springtime. Without snow assimilation, the reforecasts overestimate snow cover and snow depth while underestimating daily temperature over the TP. Compared to satellite-based estimates, precipitation reforecasts perform better in the west TP (WTP) than in the east TP (ETP). With snow assimilation, the reforecasts of snow cover, snow depth and temperature are consistently improved in the TP in the spring. However, the positive bias between the precipitation reforecasts and satellite observations worsens in the ETP. Compared to the experiment with no snow assimilation, the snow assimilation experiment significantly increases temperature and precipitation for the ETP and around the longitude 95∘ E. The higher temperature after snow assimilation, in particular the cold bias reduction after initialization, can be attributed to the effects of a more realistic, decreased snowpack, providing favourable conditions for generating more precipitation. Overall, snow assimilation can improve seasonal forecasts through the interaction between land and atmosphere.

Abstract Background Use of social media (SM) has exponentially grown particularly among youths in the past two years, due to COVID-19-related changing lifestyles. Based on the Italian COvid Mental hEalth Trial (COMET), we investigated the association between SM use and depressive symptoms among Italian young adults (aged 18–24). Methods The COMET is a nationwide multi-center cross-sectional study that investigated socio-demographic data, social networking addiction (BSNAS), depression, anxiety, and stress (DASS-21), as well as impulsiveness (BIS-15) and aggressiveness (AQ) in a large sample of youngsters, in order to assess the association between BSNAS and DASS-21 indices. Mediation analyses were performed to evaluate the role of impulsiveness and aggressive personality traits in the association between SM use (SMU) and depression. Results 75.8% of the sample (n = 491) had a problematic SMU. SMU was reduced by high AQ and high DASS-21 scores (F = 42.338, p

Abstract The atmospheric response to Arctic sea ice loss remains a subject of much debate. Most studies have focused on the sea ice retreat in the Barents-Kara Seas and its troposphere-stratosphere influence. Here, we investigate the impact of large sea ice loss over the Chukchi-Bering Seas on the sudden stratospheric warming (SSW) phenomenon during the easterly phase of the Quasi-Biennial Oscillation through idealized large-ensemble experiments based on a global atmospheric model with a well-resolved stratosphere. Although culminating in autumn, the prescribed sea ice loss induces near-surface warming that persists into winter and deepens as the SSW develops. The resulting temperature contrasts foster a deep cyclonic circulation over the North Pacific, which elicits a strong upward wavenumber-2 activity into the stratosphere, reinforcing the climatological planetary wave pattern. While not affecting the SSW occurrence frequency, the amplified wave forcing in the stratosphere significantly increases the SSW duration and intensity, enhancing cold air outbreaks over the continents afterward.

A new postmodern depression type, named “Modern-Type Depression” (MTD), is emerging in Western countries. MTD is often underdiagnosed, mainly due to potentially higher comorbidity with technology-based addictions, including Internet Gaming Disorder (IGD). However, the definition of the relationship between MTD and IGD is still controversial, as few data have been published thus far. In particular, there are no data specifically investigating the prevalence of MTD within Italian young subjects with IGD, as well as their mutual association. Hence, within the SWATCH (Social Withdrawal and TeCno-mediated mental Health issues) project, our study aimed to identify the prevalence of MTD in a sample of Italian young adults who play video games by providing a clinical characterization of MTD within a group of IGD individuals (IGD+) versus a group without IGD (IGD−) who play video games. Our cross-sectional case–control study recruited a sample of 543 Italian young video-gaming players (aged 18–35) from the larger SWATCH database, stratified as IGD+ versus IGD−. Subjects were administered the 22-item Tarumi’s Modern-Type Depression Trait Scale (TACS-22), the Motives for Online Gaming Questionnaire (MOGQ), and the Internet Gaming Disorder Scale-Short Form (IGDS9-SF). Around 21.7% of the total sample was represented by MTD individuals, while within the IGD sample, around 34% of subjects had MTD. Within the MTD group, significantly higher scores at IGDS-9SF (p < 0.001), MOGQ “Escape from reality” (p < 0.001), “Fantasy” (p < 0.001), and MOGQ total score (p = 0.003) were found compared to MTD−. According to the multivariate regression model, controlled for sex and age, higher scores in the TACS-22 were positively predicted by the total score of IGDS9-SF (p = 0.003), the MOGQ “Escape from Reality” subscale (p = 0.014), and MOGQ “Fantasy” (p = 0.011), and negatively predicted by the MOGQ “Competition” subscale (p = 0.035) [F (4538) = 17.265; p < 0.001]. Our findings suggested that MTD displays a strong association with IGD. Video-gaming players who do not have IGD appear to be less prone to MTD; this suggests that further studies could be carried out to specifically investigate whether pathological use of video games could also be determined by the presence of MTD.

Se presenta el caso de un hombre de 57 años que consulta por parálisis alta del nervio radial, con dolor y prueba de Tinel positiva en la cara lateral del brazo dominante, de inicio súbito, luego de grandes esfuerzos musculares repetitivos, sin mejoría clínica al tercer mes de evolución. Se realizó un tratamiento quirúrgico descompresivo. El paciente tuvo una rápida recuperación a partir del séptimo día, y remisión completa a los 25 días de la cirugía. Conclusión: El atrapamiento del nervio radial en el brazo es un cuadro poco frecuente. Según los estudios publicados, la evolución clínica es variada, pero si no hay remisión o la evolución de la parálisis no es favorable en 3 meses, creemos que la cirugía es el tratamiento de elección.

Ekbom Syndrome (ES) is characterised by fixed, delusional beliefs that one’s body is infested by parasites or other vermin in absence of supporting clinical evidence. Antipsychotic (AP) treatment, including long-acting injectable (LAI) AP in subjects with poor compliance, is prescribed to manage behavioural and psychotic symptomatology.

Abstract Background Aripiprazole long‐acting injection (LAI) is approved for the treatment of schizophrenia in adults. Recently, Europe and Canada approved the use of the two‐injection start regimen: two separate injections of 400‐mg long‐acting aripiprazole along with a single 20‐mg dose of oral aripiprazole. Aripiprazole showed efficacy in the treatment of adolescents with acute schizophrenia in several controlled trials, leading to its approval for 13‐ to 17‐year‐old adolescents with schizophrenia by the EMA. However, the LAI formulation still remains off‐label in adolescents. Case presentation The patient was admitted to the General Psychiatry inpatient unit with a Positive and Negative Syndrome Scale (PANSS) total score of 136 and the Clinical Global Impression (CGI) score of 7. Aripiprazole was started and up‐titrated to 30 mg/d. After 3 weeks, the positive symptoms were significantly reduced; however, he still showed prominent negative symptoms. Clozapine 100 mg/d was added, and in the following 2 weeks, the patient appeared slightly more communicative and generally more aware of himself and the others. The PANSS total score decreased to 81. Due to poor insight, the patient was at‐risk not to take medications upon returning home; therefore, aripiprazole LAI was proposed. Since he urged to be discharged from the hospital, we opted for the two‐injection start. The medication was optimally tolerated, with no evidence of akathisia or other side effects. One month later, global functioning and illness insight improved; Positive and Negative Syndrome Scale score was 43 and CGI score 2. Conclusions Aripiprazole LAI showed good efficacy and tolerability in an adolescent with schizophrenia. The two‐injection start regimen was a safe and effective option.

Abstract Grief is the physical or mental suffering experienced after a major loss, usually the death of a loved one. It is a universal experience, but sociocultural factors, such as cultural or ethnic identity and religious beliefs predict and shape the expression of grief. The circumstances under which people are experiencing grief during the coronavirus outbreak have adversely affected the grieving process. Unexpected deaths, social distancing rules and visitor restrictions in healthcare facilities have posed a heavier burden on the loss and have heightened the risk of grievers experiencing complicated or persistent grief. This concern led us, as early career psychiatrists (ECPs) from 14 different countries connected by the Early Career Psychiatrists Section of the World Psychiatric Association (WPA), to share our country-specific experiences on the mourning, grief tradition, and burial rites during the COVID-19 pandemic. In this paper, we discuss our experiences, similarities and differences with relation to the: ‘Effect of the pandemic on mourning’, ‘Restrictions and Guideline on burial rites due to the pandemic’, ‘Effect of the pandemic on social support’ and ‘Role of media and telecommunication on mourning practices and burial rites’. We conclude that while telecommunication means have attempted to bridge the gap and provide some form of social connectedness, the total and global effect of the pandemic is yet to be fully seen and understood.

Abstract The digital revolution is evolving at an unstoppable pace. The dissemination of interconnected networks, the growth and spread of new digital technology across all ages at different levels, has rapidly led to an increasing usage of the Internet, smartphones and digital social networking, particularly among young people. Smartphones, social networking and digital videogaming platforms are currently being used as primary means of online access, source of information and as preferred mode for social communication and peer interaction. However, despite digital world is progressively replacing the ‘physical world’ concerning socialization process and communication modalities, there is poor attention on the ‘digital trauma load’ experienced by individuals belonging to the Z and alpha generations in term of potential impact of digital instruments on mental health. Disclosure of Interest None Declared

Abstract Over the past twenty years a large number of new psychoactive substances (NPS) have entered and modified the recreational drug scene. Their intake has been associated with health-related risks, especially so for vulnerable populations such as people with severe mental illness, who might be at higher risk of suicidality or self-injurious behavior. The consumption and frequent poly-consumption of NPS result in death, suicide, serious self-injury behaviours as well as adverse effects on medical and mental health. Hence, the talk will deal with current data on suicidality and self-injury behaviours due to the use of NPS, particularly considering the suicide and self-injury risk due to the NPS intake among vulnerable people with preexisting severe mental illness. Disclosure of Interest None Declared

Abstract Software-driven therapeutic interventions aiming at preventing, managing or treating medical or chronic diseases are referred to as Digital Therapeutics (DTx). DTx are developed to target a specific disorder or disease, including mental disorders. DTx are regarded as an emerging class of medicines and, hence, have obtained the approval of the relevant regulatory authorities, based on clinical evidence for the effectiveness similar to conventional medicine supplies and medicines. Social media-based DTx can represent both a means to quantify mental health as well as a source of both positive and negative interactions, including a source of social support for many who have been socially isolated and lonely. Recent researches using monitored social networks as interventions has shown promise in youth with several mental health issues, despite it is noteworthy that social media are not without risks. Disclosure of Interest None Declared

Introduction Several studies investigated the role of inflammation in the etiopathogenesis of psychiatric disorders, by also evaluating how CRP may exert a pathoplastic and/or psychopatological role in mood disorders. Objectives The aim of our cross-sectional study is evaluating the high-sensitivity C-reactive-protein (hsCRP) levels in a cohort of unipolar and bipolar depressive inpatients, in relation with psychopathological, temperamental and chronotype features. Methods Among 313 screened inpatients, we recruited 133 moderate-to-severe depressive patients who were assessed for hsCRP levels, chronotype with Morningness-Eveningness Questionnaire (MEQ) and affective temperament with Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS). Results hsCRP levels were significantly higher among those with previous suicide attempt (p=0.05), death (p=0.018) and self-harm/self-injury thoughts (p=0.011). In addition, hsCRP levels were significantly higher among patients with hypertension (p=0.020) and dyslipidemia (p=0.013). Moreover, positive correlation were found between hsCRP levels and the number of illness of years (p

Introduction Peripartum period is a risky period for mental ill health among women. Biologically endocrinal changes, pregnancy complications, and lack of sleep due to childcare may increase psychopathology. From a social perspective, there is a role translation from women into mother, which is highly demanding. Moreover, the psychological approach underlines interpersonal relationships during the peripartum period. Even though the clinical focus is on postpartum depression, research shows its roots in pregnancy depression. Objectives The present study aims to detect predisposing factors to pregnancy depression. Methods One hundred-six pregnant women admitted to Salesi Pediatric Hospital of Ancona, participated in the study between April 2021- February 2022. Participants completed the sociodemographic form and Edinburgh Postpartum Depression Scale (EPDS). EPDS scores higher than or equal to 9 are considered psychometric depression. Results The mean age of participants were 33.30 ± 4.64. Most were Italian (97.2%) and cohabiting/married (97.2%). Almost half of the participants were university graduates (50.9%). 84% were employed. The pregnant women were predominantly in the third trimester (71.7%). 58.5% had no children before. No participants were using alcohol or drugs. Pregnancy depression was 13.2% prevalent (See Table 1). Table 2 summarizes binary logistic regression analysis: Higher age, gestational comorbidity, and pregnant women’s and their partner’s psychiatric disorder history predicted depressive symptoms above the threshold. Image: Image 2: Conclusions Our study reveals well-known risk factors for pregnancy depression and a new finding: expectant fathers’ mental health history predicts actual depressive symptomatology in pregnant women. Fathers should be included in perinatal mental health care. Prevention programs targeting peripartum depression should cover fathers’ mental health. Disclosure of Interest None Declared

Introduction Coping and emotional regulation mechanisms may play a significant role in the neurodevelopment and in the subsequent psychopathological trajectories, especially in youth. The boredom dimension may also have a pathoplastic role. Objectives Considering the poor literature in adolescents and young people (15-24 years-old), our study aims at investigating the relationships between coping patterns and emotional dysregulation as well the mediatory role of boredom, by particularly focussing on a sample at early onset of mood disorders. Methods Cross-sectional, observational design study. Descriptive analyses were performed considering a set of socio-demographic and clinical variables (DERS, MSBS, COPE-NVI). Kruskal-Wallis, Spearman correlations and linear regression models were performed between DERS (dependent variable) and COPE-NVI (independent variable), together with mediation analyses (MSBS as mediator). Results 86 subjects (mean age=18.4±2.8) were enrolled. DERS score was 114.8±33.3, COPE-NVI was 129.1±22.1, MSBS was 136.22±45.8. Positive correlation between DERS total and avoidance strategies (r=+0.6,p

Abstract Digital mental health interventions and digital psychiatry have been rapidly implemented over the past decade, particularly with the intent to offer a potential solution in those problematic circumstances and logistic issues for which the current mental health service infrastructure is not able to adequately accommodate to the needs of most patients. Indeed, most mental health workforce does not always own an enough and appropriate theoretical either practical training in digital psychiatry and in delivering remote consultations safely and effectively. Most European countries do not have curricula-specific training requirements, either at core or higher specialty level, for psychiatry trainees to demonstrate competence in digital skills that may be considered essential to good clinical practice, including abilities and competencies needed to provide and deliver mental health interventions by using digital tools. The talk will provide an overview on the level of the current state-of-the-art of the European techno-digitalicus psychiatrist and psychiatry trainee. Disclosure of Interest None Declared

Introduction During the last decade, a growing digitalization allowed to implement technologies in daily life activities. Conversely, the increased use of technologies in general population, particularly in youths, facilitated the emergence of new web-based psychopathologies, including Pathological Internet use (PIU). Objectives Our study aims at investigating the relationship between PIU and boredom as well as loneliness dimensions in youths, by also focusing on the association with the main psychopathological symptomatology (i.e., depression, anxiety and stress). Methods A nationwide population-based cross-sectional case-control study was conducted by recruiting a sample of Italian young adults (aged 18-24), using a snowball sampling strategy. After data cleaning, only 1,643 participants were selected for analysis based on age and classified according to the presence/absence of PIU/non-PIU. Linear regression analyses as well as Pearson correlation analyses were conducted to check for possible associations and correlations between PIU and stress/anxiety/depression. Subsequently, mediation analyses regarding boredom and loneliness were conducted on these relationships. Results Participants were predominantly females (68.7%; n = 1,129). The mean age was 21.8 years (SD = 1.7), particularly ranging 20-24 years-old (88.5%; n = 1454). Around 41.7% (n = 685) of the sample declared previous psychological issues without a history of professional support (psychological and/or psychiatric), while 32.7% (n = 538) stated that they had an overt mental disorder and were currently receiving professional support. Mediation analysis demonstrated that both boredom and loneliness act as mediators in the association between PIU and depression. Conclusions Further studies are needed to evaluate how boredom and loneliness dimensions could be managed in order to alleviate the emergence of PIU in youths with clinically relevant depressive symptomatology. Disclosure of Interest None Declared

Introduction In recent years, more evidence is emerging in favor of a new form of depression, aka “Modern-Type Depression” (MTD). It has also been theorized that MTD may have multiple relationships with other psychiatric disorders, including techno-addictions. Objectives Our study aims at clinically characterizing subjects with MTD in a sample of individuals affected with Internet Gaming Disorder (IGD). Methods 1,157 subjects were recruited from a sample of Italian young people (aged 18-35), and selected only if they declared to be video game players (48.6%, n=542). Video game players filled out the 22-item Tarumi’s Modern-Type Depression Trait Scale (TACS-22), Motives for Online Gaming Questionnaire (MOGQ), Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), Problematic Online Gaming Questionnaire (POGQ), Multidimensional State Boredom Scale (MSBS), Symptom Checklist-90 (SCL-90). Subjects were classified as IGD+/IGD- and MTD+/MTD-. Descriptive analysis, Mann-Whitney’s U-test for independent data and Chi-square tests were carried out. Results 60.5% (n=328) of the sample were male. 21.7% (n=118) were positive to MTD. MTD subjects reported significantly higher scores at IGDS9-SF (p