The term cycloid psychosis was first introduced by Karl Kleist in 1926 to describe cases that did not meet the typical presentations of schizophrenia or manic-depressive illness. The concept was later developed by Karl Leonard, who proposed three distinct types of cycloid psychoses. Perris and Brockington established the first operational diagnostic criteria for the condition. Cycloid psychosis is characterized by its acute onset, brief duration, polymorphous and shifting symptomatology, a tendency for periodic recurrence, and full inter-episode recovery, with no residual functional impairment following the episodes. Despite its distinct characteristics, cycloid psychosis is not included in the current international psychiatric classification systems.

We aim to present a case report and conduct a literature review.

A narrative review of the literature was conducted, with data collected from the PubMed database. Only English-language studies published in peer-reviewed journals were included in the selection.

Case: A 35-year-old female patient has been presenting, over the last seven years, with episodes characterized by a sudden onset of agitation, acute anxiety (described by the patient as ‘an inexplicable sense of fear’), and frequently accompanied by persecutory delusions and auditory commanding hallucinations. Upon observation, the patient typically presents with confusion and perplexity and exhibits a lack of recollection of some previous events. Following the initiation of antipsychotic treatment, a complete recovery is always observed within a few days, with no residual symptoms remaining. In the most recent episode, the patient drove for a few hours to a different city from the one where she lives and had to ask for help from a fire department, as she felt lost and confused and had no memory of the previous events. According to reports from her family, the patient exhibited disorganized behavior, increased irritability, and a reduction in sleep duration during the week preceding the episode. The patient later acknowledged discontinuation of antipsychotic medication. These episodes occurred without any prior substance use, cognitive decline, or underlying medical conditions. The patient had no previous psychiatric complaints or family history of psychiatric disorders. Although the patient was a smoker, there was no history of substance or alcohol abuse. A comprehensive evaluation, including laboratory tests, imaging studies (head CT and brain MRI) and electroencephalography (EEG), revealed no abnormal findings. Considering the range of symptoms and characteristics observed in this clinical case, the patient meets Perris’s criteria for cycloid psychosis.

Our case report highlights that cycloid psychosis exhibits a distinctive symptom pattern and clinical outcome, which can support its validity as a nosological construct distinguishable from other disorders in classification systems.

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In 2002, the euthanasia law was voted in Belgian parliament, depenalising physician-assisted dying under certain conditions for irremediable physical or mental suffering caused by an incurable condition for which all therapeutic options have been exhausted. The euthanasia request needs to be repeated, well-considered and voluntary and the patient should be competent. If the patient is not in a terminal condition, there should be at least one month between the written request and the euthanasia and three independent physicians have to be involved in the evaluation.

Psychiatric suffering was not excluded in the law, but there is discussion whether the possibility of psychiatric euthanasia was intended by the legislator. In the first years after the euthanasia law, psychiatric euthanasia was limited to a few cases, but then rose to a mean of 25 cases per year. There was a peak in 2013 of 54 cases, but after 2013 there was no more increasing trend.

In 2017, the Flemish Association for Psychiatry issued an advice regarding due diligence in psychiatric euthanasia. Controversy regarding psychiatric euthanasia kept stirring the public debate, especially after one court case in which a psychiatrist and general physician were accused and acquitted after a psychiatric euthanasia.

Another prominent topic in the public debate in Belgium is broadening the euthanasia law for advanced dementia based on an advance directive. Now euthanasia is only possible in the earlier stages of neurodegenerative disease, when competence is still sufficiently intact.

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Burnout is characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. Medical students are particularly susceptible to academic burnout compared to students in other disciplines, due to the demanding nature of their training, which offers limited time and resources.

Our study aimed to assess academic burnout in a sample of students from the Faculty of Medicine of Sfax, Tunisia, as well as the link between these two entities.

This was a cross-sectional and descriptive study, conducted using GOOGLE FORMS in February and March 2024, with a sample of students from the Faculty of Medicine in Sfax, Tunisia.

Data collection was carried out based on a questionnaire including an information sheet and the Maslach Burnout Inventory-Student Survey (MBI-SS) assessing academic burnout according to a three-dimensional structure : Emotional Exhaustion (EE) due to the study requirements; Cynicism (CY), which refers to a detached attitude towards one’s studies and Academic Effectiveness (AE) linked to a sense of achievement as a student.

Our study included 154 students. They were predominantly females (64.9%). Their median age was 22 years (IQR = [20 – 23 years]).

According to the MBI-SS, the prevalence of academic burnout was 98.1%.

The distribution of scores showed that academic burnout was mild in 15.9% of cases, moderate in 43.7% of cases and severe in 40.4% of cases.

The median scores on the EE, CY and AE dimensions were 17 (IQR = [13 – 20]) ; 11.5 (IQR= [7 – 16]) and19 (IQR = [15 – 23]), respectively.

The distribution of medical students according to the level of academic burnout is illustrated in Figure 1.

Our results showed that medical students experience high levels of educational burnout. To mitigate this high prevalence, it essentiel to raise awareness about its symptoms and to implement educational programs focused on mindfulness and well-being. Higher education institutions play a vital role in supporting students’ professional development and resilience by fostering a healthy learning environment and providing psychological and pedagogical support.

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One of the little-studied nosologies with severe delay in psychomotor development in the first year of life is children with risks of damage to the auditory analyzer, which requires the development of an adapted method for diagnosing impaired auditory function and taking into account some external factors that do not depend on the state of the child’s auditory function.

to study the characteristics of the auditory function in infants at risk for hearing impairment with delayed psychomotor development.

60 children (4-11 months) with suspected hearing loss were examined (Federal State Budgetary Scientific Institution “Institute of Correctional Pedagogics”); interview with parents; psychiatric and pedagogical examination.

Three groups of children were identified depending on the level of psychomotor development (a level close to the norm, with a slight delay of 1-3 months, with a significant delay - from 4 months):

The first group (34%) included children admitted with suspected hearing loss, with a level of psychomotor development close to the norm, without concomitant developmental disorders. All children in this group were found to have significant and minor hearing loss. In two children, the hearing condition (according to the better hearing ear) was assessed as normal with atresia of the auditory canal on one side.

The second group (50%) consisted of children with suspected hearing loss, whose psychomotor development was delayed by 1-3 months. Most of them had significant hearing loss. In two children, the suspicion of hearing loss was not confirmed.

The third group (16%) included children with suspected hearing loss with a significant delay in psychomotor development for more than 4 months. Half of them (8%) had disharmonious development. Most had significant hearing loss.

given that each group included children with significant hearing loss and deafness, it became obvious that their psychomotor development level is independent of their hearing status.

The identified risks of sensory impairments combined with a pronounced delay in psychomotor development in the first year of life necessitate a search for markers of these disorders, and above all, factors and conditions that affect their manifestation and the dynamics of psychomotor development in children in the first year of life; presumably, this may be the child’s social environment.

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The conversion symptom, present in current medical practice, traces its origins to Ancient Egypt, having had, over time, several interpretations. Under the name Hysteria, it was studied by Charcot with hypnosis at the Salpêtrière Hospital. Currently, it belongs to Conversion Disorders, and neurology has given the term psychogenic nonepileptic seizures (PNES), to differentiate these phenomena from epileptic seizures.

This work proposes to describe the history of Conversion disorder, from Freud’s hysteria to the concept of psychogenic nonepileptic seizures, and to summarize useful concepts in approaching patients with conversion disorder, in different contexts.

Non-systematic review of the literature with selection of scientific articles, using PUBMED as database the following keywords: «Conversion disorder», «hysteria» and « psychogenic nonepileptic seizures». Seven articles were included. We also selected 5 reference books.

In the 19th century, the conversion symptom constituted a very important milestone in Psychiatry, as it was through monitoring patients with hysteria that Freud created Psychoanalysis. Then, the physical symptoms of hysteria (paralysis, convulsions…) began to be understood as symptoms of psychic origin, and as a symbolic expression of a representation that was unacceptable to the Self and, therefore, repressed. According to psychoanalysis, in hysteria, body is invaded by psychic and serves as a stage for unconscious representations. Nowadays, the term hysteria can include psychogenic nonepileptic seizures, which are paroxysmal episodes of changes in behavior, movement, sensitivity or consciousness, similar to epileptic seizures, but which, unlike epileptic seizures, are not caused by a change in brain’s electrical activity.

With the description of the evolution of conversion disorder, from Freud’s hysteria to nowadays, it is possible to find that conversion pathology will not tend to disappear. It represents a specific mode of psychic functioning, characterized by an organization of defense mechanisms, cognitive styles, memory functions and specific personality traits. Therefore, it is important to continue investigating strategies to individualize the approach to these patients. Also, it would be beneficial to extend access to important psychological knowledge to more general doctors, in order to improve the capacity of managing conversion disorders cases that arise in different health contexts. We highlight the importance of understanding the suffering of these people. Patients with conversion symptoms do not choose to have a certain symptom and shouldn’t be a target of stigma. Each person develops their own psychic functioning process, as each person constitutes an unique identity and deserves an individualized and inclusive approach.

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The burnout develops gradually, unnoticed by the person, and its symptoms may appear after several years and leads to serious mental and behavioral changes. The processes underlying burnout are largely unknown due to the lack of specialized studies aimed at identifying specific biomarkers. Based on this, it is necessary to detect the first, critical moment - the first symptoms of burnout.

We aimed to examine the EEG frequencies changes relating to severity of Anxiety Tension stage of Emotional Burnout.

In this study 752 participants, students and staff of Taras Shevchenko National University of Kyiv (Kyiv, Ukraine) were involved (209 males, mean age = 19.2, 543 females, mean age = 18.28). We used the 84-item Boyko’s Syndrome of Emotional Burnout Inventory to measure the emotional burnout formation. We analyzed separate artefact-free EEG segments in all frequency bands from 0.2 to 45 Hz during resting state (3 min, closed eyes condition). In order to identify the EEG signs of emotional burnout the normalized power spectral densities (PSD) were calculated on the segment from 61 to 70 seconds of recordings.

The revealed burnout-related (Anxiety Tension stage) variables in the spectral characteristics of the EEG characterized by the significant changes in the theta 2 (frontal area and left temporal-parietal cortex), alpha 2 (right parietotemporal cortex) and beta 1 subbands (left frontal-central-right parietal axis).

These data pointed to the influence of Anxiety Tension development mostly on the processes associated with short-term memory and focused attention.

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Attitude towards death is an individual’s psychological reaction to death, which includes basic components, such as thinking about death, fear of death, and defence mechanisms. Due to the nature of their work, nurses often accompany patients at the end of life and choose different ways to cope with this difficult situation.

The aim of this study was to analyze the psychological aspects of nurses’ attitudes towards the death of a patient, and to determine the variables that influence their choice of strategies to deal with this difficult situation.

This survey-based study was performed using the author questionnare, and standardized research tools, namely the Polish adaptation of the Death Attitude Profile Revised (DAP-R-PL), and the Mini-COPE inventory.

The study involved 315 subjects with a license to practice nursing, 85.7% of whom were women. The age of the respondents ranged from 21 to 70 years, and was on average 40.5 years (SD = 10.7). The nurses’ dominant attitudes towards death were neutral acceptance (5.40 ± 0.97 points) and escape acceptance (5.09±1.01 points). Age, sex, work experience, and having a specialty credential influenced the attitudes towards death according to the DAP-R-Pl. The predominant stress coping strategies among the nurses according to the Mini-COPE were: self-distraction (1.98 ± 0.75 points), active coping (1.88 ± 0.69 points), planning (1.87 ± 0.77 points), and acceptance (1.84 ± 0.62 points). Factors that had an impact on the choice of stress coping strategies according to the Mini-COPE were: sex, place of residence, marital status, education, having a specialty credential, work experience, and place of work. Based on the collected data, statistically significant correlations were also found between the nurses’ attitudes towards death according to the DAP-R-PL and stress coping strategies according to the Mini-COPE.

The nurses showed different attitudes towards the death of a patient, the most common of which were neutral acceptance and escape acceptance. Age, sex, marital status, and place of residence had a significant impact on the nurses’s attitudes towards the patient’s death. Contact with dying patients evokes many negative emotions in nurses, such as sadness, compassion, helplessness, regret, and a sense of injustice. Therefore, it is important to provide them with psychological support when not coping with the death of a patient. Due to the strong emotional reaction associated with the death of a patient, nurses choose coping strategies, such as: self-distraction, active coping, planning, and acceptance. Both sociodemographic and work-related variables influence the choice of coping strategies for the patient’s death.

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Autism Spectrum Disorder is usually diagnosed in early childhood, but an increasing number of adults are identified as autistic later in life (Huang et al., 2020). Many experience frustration due to missed early intervention opportunities. The lack of recognition of their condition during childhood or adolescence may have contributed to secondary mental health issues, such as anxiety, depression or low self-esteem, complicating the adjustment process after diagnosis (Bargiela et al., 2019). However, providing appropriate support can enhance their quality of life and promote better mental health outcomes.

To assess the patient’s clinical case to identify autism spectrum disorder in older adulthood.

A 23-year-old male patient complained of an inability to concentrate, stress and fear when around people, and difficulties in social situations. Objectively observed: stereotyped movements, noticeable anxiety, avoidance of eye contact, non-compliance with social rules, specific language use and slow thinking. The patient had no history of diagnosed psychiatric illness. Since childhood, he has disliked the feeling of clothes touching his body, physical contact with others, making eye contact. The patient also exhibited impaired social development, being unable to initiate and maintain relationships with peers. Stereotypical, repetitive movements, sensory processing deviations have been observed since childhood. The patient has various phobias from a young age. Psychological examination revealed insufficient attention with observed fluctuations, impaired attention-shifting ability. The pace is very slow, the thinking is characterized by an average level of generalization, concreteness, and stereotypy. Personality traits included rigidity, depression, compulsiveness, internal tension. Based on the clinical picture and psychological tests, the patient was diagnosed with F84.0 Autistic Disorder, according to the International Classification of Diseases, 10 th Revision. In this case, the following methods were used in the assessment: Kraepelin’s and Schulte’s methods, pictograms, the 4-1 method, the Childhood Autism Rating Scale.

The literature highlights that ASD involves difficulties in social interaction, repetitive behaviors, sensory sensitivities, and distinct thinking patterns. Up to 90% of individuals with ASD experience sensory irregularities, which is consistent with this case, as the patient shows social challenges, repetitive movements, slow thinking, and sensory issues. Diagnosing autism in adulthood can improve quality of life by fostering understanding and access to support. In this case, the patient’s past social and workplace difficulties may be attributed to autism, guiding the development of effective support strategies.

In conclusion, while a late autism diagnosis can be life-changing, it also comes with unique challenges that must be addressed through appropriate support.

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Individuals diagnosed with schizophrenia experience a 2- to 3-fold higher mortality rate compared to the general population, with cardiovascular disease being the primary cause. On average, they lose about 15 years of potential life. Additionally, up to 15% of individuals with schizophrenia develop type 2 diabetes, further exacerbating their health challenges.

This study aimed to evaluate the efficacy of Semaglutide, a glucagon-like peptide-1 receptor agonist, as an adjunctive treatment to antipsychotic therapy in patients with schizophrenia spectrum disorders, prediabetes and overweight.

We conducted an investigator-initiated, randomized, placebo-controlled, double-blind trial across two clinical sites in Denmark. Out of 402 possible eligible participants, 154 were enrolled. Participants were receiving second-generation antipsychotic treatment, were overweight or obese, and had prediabetes (HbA1c 39-47 mmol/mol). Data collection spanned from January 1, 2022, to May 1, 2024. The primary outcome measure was changes in HbA1c, with secondary outcomes including psychotic symptoms, quality of life, BMI, and cardiometabolic parameters. A pre-specified statistical analysis plan was registered with ClinicalTrials.gov prior to unblinding the treatment arms.

The trial is spear-headed by Odense University Hospital with recruitment from community psychiatry settings in the Region of Southern Denmark and Region Zealand.

The last patient visit was May 1, 2024 and unblinding occurred primo September 2024. Results will be analyzed in Q4, 2024 and primary and secondary results presented at the conference.

Semaglutide holds potential as a novel therapeutic option for individuals with schizophrenia who experience prediabetes and antipsychotic-induced weight gain.

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Recently, there has been an increase in media reports regarding crimes committed by individuals with mental disorders, leading to a deterioration in public opinion on this issue. Misconceptions about the dangerousness of individuals with mental disorders can negatively impact the prevention, treatment, and social reintegration of these patients.

Public attitudes toward crimes committed by individuals with mental disorders are influenced by media and public opinion, and psychiatric hospital staff are not exempt from these influences. Since the prejudices of these staff members can directly affect psychiatric patients, it is crucial to assess their attitudes.

This study surveyed the attitudes of psychiatric hospital staff regarding the risk of criminal behavior in individuals with mental disorders and compared these attitudes with those of the general population.

The findings revealed that psychiatric hospital staff exhibited less prejudice than the general population across six dimensions related to crimes by individuals with mental disorders: recent increase in crime, cruelty, impulsivity, violence, criminal tendency, and crime rate. Additionally, psychiatric hospital staff displayed less prejudice regarding specific disorders (schizophrenia, depression, bipolar disorder, panic disorder, post-traumatic stress disorder, dementia, attention-deficit/hyperactivity disorder, intellectual disability, and developmental disorders) compared to the general population.

Psychiatric hospital staff demonstrated less prejudice toward the criminal behavior of individuals with mental disorders than the general public. This difference may be attributed to their direct contact with psychiatric patients. The findings suggest potential directions for policy development aimed at reducing public prejudice toward mental disorders and associated criminal behavior.

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Our team faced two challenges in prescribing for patients with ADHD. On 27 September 2023, a shortage of methylphenidate prolonged-release capsules and tablets, lisdexamfetamine capsules, and guanfacine prolonged-release tablets was announced in the UK.

SCP is an agreement between secondary care, patient and GPs, which asks GPs to continue prescribing ADHD medication when young person is stable on a dose, this also applies to when the doses are changed. However, many GP practices in Oxfordshire declared a position statement that they would decline prescribing ADHD medication to adult or child patients on a “shared care” basis due to funding issues to support specialist reviews. These challenges led us to adapt our practices and create a protocol.

To make all staff members aware of recent updates on ADHD medication stock availability at local depots to ensure continuity of care and minimise distress.

To help reduce the number of declined shared care requests by GPs in 6–17-year-olds.

To identify the patients of GP practices that do not prescribe ADHD medication to adults so that a planned discontinuation of treatment can take place prior to discharge from CAMHS services.

Young people’s and their carers’ feedback regarding the medication shortage were carefully recorded.

Concerns were raised and discussed in multi-disciplinary meetings via MS Teams and in person.

Team members shared information with each other with a view to creating a protocol to minimise the risk to patients’ safety and distress in families.

Regular updates on ADHD medication availability, along with equivalent conversions of long-acting medications were sent to all staff members via email by the Trust.

Our service developed a “protocol for CAMHS ADHD when the children and young people’s (CYP) shared care protocol is declined and how to handle discharges at age 18.”

We agreed to make young people and carers aware of the current situation for prescribing ADHD medication in adults within Oxfordshire to explore the need for continuing medication in reviews.

ADHD medications were planned to be discontinued prior to discharge, if patients are 17, on ADHD medication, whose GP practice declines SCP. and do not meet threshold for community adult mental health team referral.

We agreed to consider prescribing for a brief time beyond age 18 on a case-by-case basis if patients are preparing for, or are currently taking, A-level (or other) exams or whereby discontinuing medication poses significant risk.

Patients and staff members were greatly affected by the ADHD supply issues as well as current changes in SCP. However, team members took necessary steps to address the current issues proactively.

We plan to develop guidelines about stopping stimulants under supervision prior to discharge from CAMH services.

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Mental health is essential for overall well-being and resilience in facing life’s challenges. Self-esteem, a crucial mental health determinant, affects how individuals perceive and manage stress, and may be linked to worse health outcomes when conditions like anxiety and depression are concerned. Consequently, understanding the role of self-esteem in mental health is essential for developing effective preventive strategies and interventions.

In this study we aimed to investigate the relationship between self-esteem levels and anxiety, depression and stress, with a hypothesis that the presence of the aforementioned mental health challenges is significantly correlated with lower levels of self-esteem. We sought to explore the potential impact of self-esteem as both a risk factor and a target for interventions in mental health care.

A cross-sectional study design was employed, involving 100 participants based in the Republic of Croatia and divided equally into two groups: support-seeking individuals or patients from the daily clinical setting and a control group with no psychiatric treatment history. Participants completed the Rosenberg Self-Esteem Scale (RSE) and the Depression Anxiety Stress Scale (DASS-21). The self-esteem scores classified individuals into low, average or high self-esteem categories. Statistical analyses, including chi-square tests and Mann-Whitney U tests, assessed differences in DASS-21 scores between groups, with adjustments for sociodemographic factors.

Psychiatric patients showed significantly lower self-esteem (mean = 20.84, SD = 7.161) than the control group (mean = 29.84, SD = 7.709). Additionally, psychiatric patients experienced higher levels of anxiety (mean = 12.60, SD = 5.237), depression (mean = 12.04, SD = 5.595) and stress (mean = 14.06, SD = 4.433) when compared to the control group, which exhibited mild anxiety (mean = 5.14, SD = 5.018), low depression (mean = 4.90, SD = 5.296) and minimal stress levels (mean = 6.96, SD = 4.973). Statistical analysis revealed a statistically significant association between low self-esteem and support-seeking or patient status (p = 0.001). Additionally, low self-esteem was associated with more severe mental health symptoms across all categories (p < 0.05).

This study emphasizes the interconnectedness between self-esteem and mental health, demonstrating that lower self-esteem is associated with higher anxiety, depression and stress levels. Therefore, integrating self-esteem enhancement into therapeutic settings may be an effective strategy for mitigating mental health risks, providing a proactive approach to psychological care and prevention.

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Attention deficit disorder with or without hyperactivity (ADHD) is a neurodevelopmental disorder. It represents the most common psychiatric disorder in pediatric population. Children with ADHD can experience academic and social difficulties, as well as psychological complications.

The objective was to determine the prevalence rate and the clinical profile of children with ADHD symptoms in the governorate of Monastir (Tunisia) and to study the comorbid symptoms.

We carried out a cross-sectional study, applying the Strengths and Difficulties Questionnaire (SDQ) scale and the short versions of Conners 3 to parents and teachers of 435 school children in a sample of 18 public and private schools randomly selected from 6 delegations in the governorate of Monastir.

The prevalence of ADHD symptoms was 12% of which 51.9% were boys and 48.1% were girls. The average age was 9.8 [9.2;10.4] years.

We found a predominance of the inattentive form with a frequency of 57.7% compared to the impulsive-hyperactive and combined forms which have a frequency of 17.3% and 25% respectively.

In 40% of the ADHD group, an emotional disorder was found, and in 54% of cases there were behavioral disorders, with a statistically significant difference. Relationship problems rise to 74%, but with no statistically significant difference.

The prevalence of ADHD symptoms in the governorate of Monastir is similar to the rate found in other parts of the world. Identifying predisposing factors helps early intervention, which in turn reduces the psychosocial impact of this disorder.

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Negative consequences of acute and chronic stress caused by information overload, environmental problems, natural disasters, man-made disasters, military clashes, and acts of terrorism have become increasingly evident in recent decades. They can lead to a painful “breakdown” of socio-biological adaptation mechanisms, a decrease in adequacy in assessing the environment, and, as a consequence, the formation of disturbances in the psycho-emotional sphere, manifested in the development of behavioral disorders (aggression and depression). Therapy for behavioral disorders does not provide a complete cure, apparently due to the formation of a “vicious circle” that can only be broken by normalizing the regulatory relationship between the central nervous system and the immune system. One way to solve this problem is to develop new methods of therapy based on immunological approaches. The method of choice may obviously be immunotherapy with autologous immune cells with a certain, including in vitro modulated, functional activity.

The aim of the study was to investigate the possibility of obtaining a positive psychoneuroimmunomodulatory effect in aggressive and depressive-like animals by transplanting immune cells, the functional activity of which was in vitro modulated by a psychoactive substance (PAS).

Male (CBAxC57Bl/6)F1 mice aged, in which aggressive or depressive-like states were formed under the influence of long-term social stress, were used as donors and recipients in the experiments. Immune cells for transplantation were obtained from a suspension of donor’s splenocytes, cultured in vitro with PAS (chlorpromazine or caffeine, respectively) and then intravenously administered to syngeneic recipients. In the control group of animals, cell preparation and transplantation were carried out under similar conditions, except that the latter were cultured without the presence of PAS. In recipients the parameters of the nervous and immune systems functional activity were recorded.

Transplantation of in vitro PAS-modulated splenocytes to recipients with stress-induced behavior patterns resulted in targeted changes in their motor and exploratory activity in the Open field test, motor activity in the Porsolt test, and decreased anhedonia in recipients with a depressive-like phenotype, recorded against the background of changes in the content of a number of pro- and anti-inflammatory cytokines IL-1β, IL-2, IL-4, IL-6, IL-10, IFNγ, TNFα in pathogenetically significant brain structures. In recipients, a positive change in the parameters of the immune system functional activity were also revealed.

The possibility of immunoediting stress-induced forms of behavior by transplanting in vitro PAS-modulated immune cells, which have a positive psychoneuroimmunomodulatory effect in the body of syngeneic recipients, has been demonstrated.

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Individuals with personality disorders (PD) are overrepresented in emergency psychiatric settings, leading to both frequent and prolonged hospitalizations, compulsory care and high healthcare costs.

1. (1) To delineate the extensive care needs of participants, (2) To identify commonalities in their life situations, comorbidities, and treatment interventions, and (3) To investigate patient experiences with the healthcare system to uncover precipitating and contributing factors to extensive care needs.

The quantitative study utilized a descriptive cross-sectional design, drawing on data from 61 individuals diagnosed with PD who exhibited extensive care needs, operationally defined as having made five or more visits to the emergency department, at least three hospitalizations, or a total of 60 hospitalization days during 2023. The qualitative study involved in-depth interviews with 11 of these individuals, analyzed using interpretative phenomenological analysis (IPA) to explore patient experiences and needs.

The findings indicate that individuals with comorbid conditions experienced significantly more frequent and prolonged hospitalizations. However, there was no significant difference in the number of emergency department visits between the two groups. Qualitative insights revealed four main themes with two focusing on precipitating factors, and two addressing perpetuating factors. The results indicated that emergency department visits were frequently driven by emotional distress and social isolation. Patients described their treatment experiences as impersonal and lacking direction, with frequent medication adjustments resulting in adverse effects and heightened feelings of hopelessness.

The study highlights that extensive care needs among individuals with personality disorders (PD) arise from a combination of high psychopathological burden and social marginalization. Many high-care consumers rely on hospitalization as their primary support, reflecting a psychiatric system ill-equipped to meet their complex needs. This mismatch leads to patient dissatisfaction and a revolving-door effect, where repeated hospitalizations further detach patients from their social environments, increasing the risk of continued high care consumption. Overmedicalization and frequent hospitalizations exacerbate social isolation, fueling a cycle of increased care dependency. To address these challenges, the study proposes targeted interventions, including: (1) early assessment of risk factors such as social isolation, comorbid conditions, and lack of social roles, (2) promoting alternative forms of hospitalization, (3) implementing a stepped care model for crisis management, and (4) improving comorbidity management and medication oversight.

None Declared

The mental health of medical students is a critical concern, as their well-being directly influences academic performance and the overall success of educational institutions. The high academic demands, heavy workload, and emotional stress encountered by medical students can lead to significant mental strain, potentially resulting in mental disorders. Understanding these factors is essential for developing effective support mechanisms.

This study aimed to investigate the mental well-being of medical students across the Visegrad Four countries (Hungary, Czech Republic, Poland, Slovakia) by identifying key predictors of well-being and categorizing students into well-being clusters based on psychological and physical health indicators.

A cross-sectional exploratory study was conducted using an anonymous, English-language online questionnaire. The survey gathered general demographic data, health-related information, and academic attitudes. Mental well-being was assessed using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), coping strategies were evaluated with the Brief COPE inventory, and somatic symptoms were measured using the Patient Health Questionnaire-15 (PHQ-15). Regression analysis was performed to identify predictors of mental well-being, and a two-step cluster analysis was employed to classify students into distinct well-being groups.

A total of 1,703 medical students (467 males) participated in the study. Regression analysis identified adaptive problem-focused and emotion-focused coping, social support, satisfaction with the university experience, healthy eating habits, and a sense of control over personal health as positive predictors of mental well-being. In contrast, maladaptive coping strategies (avoidant and passive) and frequent somatic symptoms were negative predictors. The cluster analysis revealed three distinct groups: (1) a stable group with high well-being and satisfaction, low somatic symptom frequency, and low incidence of mental disorders; (2) a risk group with moderate well-being, low satisfaction, higher somatic symptom frequency, and increased incidence of mental disorders; and (3) a problematic group characterized by low well-being, low satisfaction, high somatic symptom frequency, and frequent mental disorders.

The findings suggest that enhancing adaptive coping strategies, the sense of control, and perceived social support may significantly improve mental well-being of medical students. Furthermore, identifying risk and problematic groups can support the development of targeted interventions. These insights not only contribute to a better understanding of medical students’ mental well-being but also offer practical implications for designing preventive and supportive programs to address mental disorders.

None Declared

Psychosocial interventions play a role in recovery and in the patient’s journey. Recovery is individual and so needs individual responses from the mental health services with individual goals set. Different interventions will be useful at different stages and, of course, they only “work” for some people. Three main strategies are often referred to – reducing symptoms, reducing barriers to recovery, and extending and maintaining recovery to achieve some stable and acceptable (to the patient) optimal level of functioning. Psychosocial intervention strategies are beneficial for each of these, and they are often thought of as independent, but they are inter-related with one type of therapy leading to reductions in the need for other therapies. Even though many of these strategies are included in guidelines, the process of considering which one to start with is a choice. We need to work out how that choice is made.

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Chronic and transient loneliness are two clinically distinct conditions that have different impacts on mental health. However, there is limited information regarding the prevalence of chronic and transient loneliness, and their associated risk factors.

This study aims to (1) assess the prevalence of chronic and transient loneliness among Spanish adults, (2) identify and compare the risk factors associated with both forms of loneliness, (3) examine how perceptions of loneliness contribute to its persistence, and (4) evaluate the effects of chronic versus transient loneliness on depression, anxiety, and substance use disorders.

A total of 1,503 Spanish adults were interviewed by phone from May to June 2024. Loneliness was measured with a direct question, and the three-item loneliness scale from the University of California, Los Angeles, was used for the sensitivity analyses. Chronic loneliness was defined as reported loneliness both two years ago and currently, while transient loneliness was defined as reported loneliness only two years ago. The CAGE Adapted to Include Drugs (CAGE-AID) questionnaire was used to assess substance use disorder within the previous month, anxiety symptoms were measured using the GAD-2, and depressive symptoms were assessed using the PHQ-2. Logistic regression models were constructed to examine sociodemographic and behavioral risk factors for chronic and transient loneliness, as well as the impact of loneliness perceptions on the likelihood of chronicity and the association of both types of loneliness with mental disorders.

11.4% of the sample reported chronic loneliness, while 9.5% reported transient loneliness. Risk factors associated with chronic loneliness included being a younger adult, female, living alone or with roommates, having low education level, and poor health status. In contrast, the risk factors for transient loneliness included being single or separated and frequent use of social media. Poor social support was a risk factor for both types of loneliness, though it had a significantly stronger impact on chronic loneliness (OR = 10.1, 95% CI: 5.5–18.4) compared to transient loneliness (OR = 2.2, 95% CI: 1.2–3.8). Feelings of emptiness (OR = 2.7, 95% CI: 1.4–5.4) and perceiving loneliness as insurmountable (OR = 2.6, 95% CI: 1.4–4.6) were risk factors for chronicity among individuals feeling loneliness. Sensitivity analyses showed similar results to the main findings. Only chronic loneliness was longitudinally associated with higher odds of depression (OR = 5.0, 95% CI: 3.4–7.4), anxiety (OR = 3.1, 95% CI: 1.3–4.1), and substance use disorder (OR = 3.6, 95% CI: 1.9–6.6).

Chronic loneliness can be identified through its risk factors and the perceptions of those experiencing it, highlighting the importance of addressing these issues to improve mental health outcomes.

None Declared

Major Depressive Disorder (MDD) is a pervasive global health issue, contributing significantly to disability and impaired quality of life. A substantial proportion of individuals with MDD develop Treatment-Resistant Depression (TRD), characterised by the failure to respond to at least two adequate antidepressant treatments (at an adequate dose and duration). TRD poses additional challenges due to its complex clinical presentation and limited treatment options, making it crucial to better understand its impact and develop more effective care strategies.

To investigate the prevalence and clinical profiles of TRD in a large NHS Mental Health Trust and explore the treatment experiences and perceptions of TRD patients and healthcare professionals (HCPs) involved in their care.

A concurrent mixed-methods approach, incorporating patient and public involvement (PPIE), was used. Quantitative analysis of anonymised electronic health records (EHRs) identified the TRD cohort and key characteristics (e.g. age, gender, employment status). Binary logistic regression explored predictors such as comorbidities and service use. The qualitative component included semi-structured interviews with TRD patients (n=7) and HCPs (n=8), analysed using thematic analysis to explore lived experiences and treatment barriers. Findings from both approaches were integrated to provide a comprehensive understanding of TRD.

TRD was prevalent in 48% of patients diagnosed with MDD. Predictors of TRD included recurrent depression (OR=1.24, CI 95%=1.05–1.45), comorbid anxiety (OR=1.21, CI 95%=1.03–1.41), personality disorders (OR=1.35, CI 95%=1.10–1.65), and cardiovascular diseases (OR=1.46, CI 95%=1.02–2.07). Qualitative findings highlighted the severe emotional impact of TRD on patients’ lives and revealed significant dissatisfaction with treatment options, particularly frustration with the “trial and error” approach of pharmacological treatments. HCPs echoed concerns about the lack of standardised treatment pathways, with both groups emphasising the need for more holistic and personalised care, citing limited access as a serious barrier to effective treatment.

This study highlights the significant burden of TRD, affecting nearly half of MDD patients within the examined NHS Trust. By combining quantitative and qualitative methods, it offers a comprehensive understanding of TRD’s prevalence and complexities. The findings support a shift toward holistic, patient-centred care, addressing institutional barriers and enhancing healthcare provider resources to improve outcomes.

None Declared

A frequent developmental condition of inattention that may or may not be accompanied by hyperactivity is known as Attention Deficit Hyperactivity Disorder.1One’s inability to focus, excessive activity, and behavior that is inappropriate for their age, all of these traits are indicative of ADHD.2The data for Atomoxetine indicates that it is safe and effective in treating ADHD in children and teenagers3. For kids and teenagers with disruptive behaviors, ADHD, and developmental disorders, Risperidone may be a safe, effective medication. Numerous investigations have demonstrated the high effectiveness of risperidone4

To study the Efficacy of Atomoxetine alone vs. Atomoxtine with Antipsychotic (Risperidone) on ADHD children.

This follow-up study was carried out from January to June 2024 on 54 ADHD children (6–18 years old) who were receiving treatment at the psychiatry clinic at Al Hussian University Hospital in Cairo, Egypt. This study was authorized by the Al-Azhar Faculty of Medicine’s Ethical Committee. Following an explanation of the purpose of the study and the acquisition of verbal agreement, all children underwent semi-structured clinical interviews and were excluded from other psychiatric & medical conditions.

Based on the DSM IV criteria, ADHD has been diagnosed in all of the study children. Conner’s 2 test for ADHD, or SCID, was used for every child in the study. Implementing medicinal treatment for every child and monitoring their progress, who were divided into two groups. The first group, which consisted of 27 children diagnosed as ADHD children, received only Atomoxetine, independent of the kind of ADHD. In contrast, 27 recently diagnosed children with ADHD, irrespective of their kind of ADHD, received a combination of Atomoxetine and antipsychotic(Risperidone) medication in the second group.

SPSS 20.0 was employed. The qualitative data were expressed in terms of percentages and figures, and the significance of the outcomes was assessed at the 5% level.

When Atomoxetine was administered to 27 children, it demonstrated a moderate level of efficacy to 12 from 27 patients (44.4%) for all children with ADHD, regardless of type, but it significantly improved the inattention type of ADHD in 4 from 4 patients (100%).Given to 27 children, the combination of Atomoxetine and Risperidone demonstrated greater effect on 24 from 27 patients with (88.9%) for all ADHD children, and it showed a discernible improvement on 9 out of 9 with (100%) for ADHD hyperactivity type.

All types of ADHD are responsive to Atomoxetine or Atomoxetine / Antipsychotic (Risperidone) combination, But Atomoxetine effect is more on Attention deficit variant than other variants, while Antipsychotic (Risperidone) is more effective on hyperactivity and aggression.

None Declared