To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The number of people exposed to trauma has increased due to disasters, epidemics, wars, and various man-made causes occurring worldwide- including Turkey. Therefore, the principles of trauma-informed care should be applied in all healthcare settings and incorporated into policies and institutional frameworks (Saunders et al., 2023; Greer, 2023; Huo et al., 2023). Although mental health professionals are experienced in the effects of trauma, a more systematic approach is required to enhance awareness of and achieve widespread trauma-informed care. In Turkey, there is no standardized guide or algorithm for providing care and treatment to trauma victims, and no guide has been developed to ensure a common understanding of care in approaching trauma among mental health professionals.
Objectives
This study examined the knowledge, skills, and stance of professionals providing mental health services in Turkey regarding trauma-informed care, as well as their intervention skills related to trauma. This constitutes the first phase of the studies to establish a fundamentally trauma-informed care model in existing mental health settings.
Methods
The study was conducted with a cross-sectional design, and the convenience sampling method was used. The study population was mental health services professionals in Turkey. The participants were recruited by researchers through social media platforms, and only those accepting participation were included in the study. The study was completed with 197 participants who filled out the survey forms.The data were collected using the Trauma-Informed Care Scale and the Trauma Intervention Skills Scale through an online survey. The data were analyzed using Spearman correlation analysis, Mann Whitney U, and Kruskal Wallis tests.
Results
More than half of the participants were unaware of the concept of trauma-informed care (55.3%), and only 14.2% felt competent in presenting this care model. In trauma-informed care scores, gender, age, and education level did not create a significant difference (p>0.05), while those who have received information about trauma-informed care during their years of education scored higher (p<0.05). Compared to other professionals, nurses had higher trauma-informed care scores, and psychologists had an augmented ability to intervene in trauma patients.
Conclusions
The results of the research indicated that while mental health professionals possess knowledge about trauma, they did not reach the desired level in developing attitudes towards trauma-informed care and feeling competent in this area. Trauma-informed care seemed more about providing information related to procedures performed in the clinic or ensuring that the patient was not traumatized during the procedure. Therefore, more studies are needed to evaluate TIC practices in the much-needed mental health field.
Previous research has shown chronic pain to be more prevalent in individuals with psychiatric disorders, compared to the general population.
Objectives
We performed a systematic review of studies relating to chronic pain in patients with schizophrenia (PWS), to explore its cause, prevalence and presentation.
Methods
Our search strategy yielded 4963 studies. Once duplicates were removed, and studies were screened according to our inclusion/exclusion criteria, 15 studies on chronic pain and quality of life (QOL) in PWS remained.
Results
Our results showed that the prevalence of chronic pain in PWS was equal to, or greater than, healthy controls. Studies assessing chronic headaches specifically, found headaches to be more prevalent. Studies that compared chronic pain in PWS to individuals with other psychiatric disorders, such as depression or bipolar disorder, found PWS to have lower levels of pain. Pain intensity ranged from mild to moderate and was most frequently reported in the abdomen and head. The presence of pain was associated with anxiety, depression, psychotic symptoms, and older age. No clear links were found between chronic pain and patient gender, education, or wealth. QOL, particularly health-related QOL, was lower in patients with higher levels of pain, and such patients experienced greater functional impairment. However, when PWS performed self-assessments of QOL and health satisfaction, no difference was seen between individuals with and without pain.
Conclusions
These variations in pain perception may be due to disturbances in somatosensation, with PWS being internally more preocccupied. Specifically, computational models suggest this may be due to aberrant salience, where PWS attribute meaning or value to innocuous stimuli. Understanding the link between chronic pain and schizophrenia is essential as this may contribute to premature death. Further research is required to explore the link between comorbidities as a cause of chronic pain in PWS.
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
Objectives
To study the Efficacy of Atomoxetine alone vs. Atomoxtine with Antipsychotic (Risperidone) on ADHD children.
Methods
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.
Results
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.
Conclusions
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.
The Dark Tetrad of Personality includes factors commonly recognized as socially aversive. So far, they have been recognized as psychopathy, narcissism and Machiavellianism. Nowadays, sadism has also been included in the scope of dark personality traits. There are many tools for examining the Dark Triad of Personality, while tools dedicated to the Dark Tetrad are under development. One such tool is The Short Dark Tetrad scale (SD4) by Paulhus et al. (2021), which, due to its popularity, may enable cross-cultural research in the future.
Objectives
The aim of the study was to assess the preliminary psychometric properties of the Short Dark Tetrad tool - Polish version (SD4-PL).
Methods
972 people with an average age of 34.39±11.09 SD years were recruited for the study. The 28-item Short Dark Tetrad scale (SD4) was translated into Polish (SD4 Pl) and used for a study. As part of the statistical analyses, a confirmatory factor analysis (CFA) was used, based on the structural equation modeling. The internal consistency of the tool was also assessed.
Results
Confirmatory factor analysis (CFA) parameters turned out to be satisfactory. The original structure of the tool was maintained, which consists of four 7-item scales dedicated to psychopathy, narcissism, Machiavellianism and sadism. The obtained psychometric parameters turned out to be similar to the results obtained in several countries where the Short Dark Tetrad scale has already been introduced. Satisfactory measures confirming the reliability of the tool (Cronbach’s α) were also obtained, ranging between 0.68 and 0.79.
Conclusions
Short Dark Tetrad - Polish version (SD4-PL) presents satisfactory psychometric properties. By maintaining the original structure of the tool, it opens the possibility of examining its equivalence with other language versions and, in the future, the possibility of conducting international research focusing on factors such as psychopathy, narcissism, Machiavellianism and sadism.
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that attracts interest, fascination, and controversy. Due to their developmental characteristics that hinder autonomy and socialization, children with ASD appear to be vulnerable and prone to victimization. Indeed, victimization has severe consequences for these children, who face risks of rejection and stigmatization. However, research on this phenomenon in Tunisia is still limited, highlighting a significant gap in the current knowledge base.
Objectives
Our study aimed to determine the prevalence of victimization among children and adolescents with ASD consulting at the Regional Rehabilitation Unit of Monastir- Tunisia and identify the associated factors.
Methods
This is a cross-sectional analytical study. It included children and adolescents with ASD aged between 5 and 18 years consulting at the Regional Rehabilitation Unit in Monastir during the year 2023. Sociodemographic and clinical data of the children were collected using a pre-established form created by the working group. We used the Juvenile Victimization Questionnaire ScreenerSumVersion (JVQ-SSV) to assesse childhood victimization and major forms of aggression against youth.
Results
Our study included 74 participants, demonstrating a male predominance with a sex ratio of 6.4. The average age of the patients was 9 years, ranging from 6 to 14 years.The main results of our study showed that participants with ASD are particularly vulnerable to victimization, with 77% having experienced at least one victimizing event in their lifetime and nearly 69% in the past year. The most commonly reported victimization events included bullying (56.7%), peer or sibling aggression (50%)… Our results revealed that 56.2% of these incidents occurred at school. Additionally, nearly 46% of children with ASD were reported by their parents to be perpetrators of victimization towards other. Univariate analysis identified significant factors associated with victimization, including the parent’s age, attendance at specialized education centers, and being a perpetrator of victimization.
Conclusions
The social inclusion of children with ASD, though crucial, remains fragile amid widespread victimization in both school and family environments. The concerning repercussions of these experiences necessitate focused efforts to develop and implement strategies that safeguard and support these children. Addressing the multifaceted nature of victimization and promoting protective measures are essential for improving their well-being and fostering a more inclusive environment.
In high-income countries, Coordinated Specialized Care for First Psychotic Episode (FEP) programs have been shown to be effective in reducing symptoms and disability. Chile guarantees universal access to these services through a national policy, but previous research indicates that evidence-based approaches are not used. Our team adapted the OnTrackNY (OTNY) program to the Chilean context, called OnTrackChile (OTCH), to evaluate its effectiveness and implementation. This summary presents preliminary results on model fidelity, one of the primary outcomes of the study.
Objectives
To evaluate the fidelity of the implementation of the OTCH program in comparison with usual care services for FEP, analyzing its compliance in 18 key domains of care and its alignment with the National Mental Health Plan.
Methods
A fidelity scale was designed to guide data collection on OTCH implementation. The scale included the name and definition of each domain, along with a set of expectations. The scale assessed 18 key domains, such as staffing, team integration, communication, burden of care, service flexibility, crisis, treatment planning, prescribing, care management, working with families, and education and employment support, among others. The scale was applied in the 5 OTCH intervention sites and 8 control sites that maintained usual care included in the cluster-randomized controlled clinical trial.
Results
OTCH sites met more than 80% of the criteria for the domains assessed in the fidelity scale, which is more than twice the compliance observed in the control sites. In domains related to the usual functioning of the centers coincident with those established in the National Mental Health Plan, OTCH intervention sites exceeded compliance standards to control sites (p<0.001). In situations where the frequency of problems was similar between both types of centers, such as suicidal risk and risky substance use, OTCH centers showed significantly better performance (p<0.001) compared to control centers.
Conclusions
The implementation of the OTCH model has not only allowed the introduction of specific aspects of the program, but has also improved the overall performance of the centers in key areas defined by the National Mental Health Plan. This suggests that the implementation of OTCH in the Chilean context is not only feasible, but can also improve the quality of community mental health care.
OnTrack Chile is funded by the U.S. National Institute of Mental Health (R01MH115502).
Adoption is a process which aspires to protect the children and provide them a secure home. Nevertheless these minors present very often in their new environment a wide range of different difficulties, that enhances them to adapt in their personal and academic spaces. ADHD is one of the most prevalent neurodevelopment diseases among adopted children (Mulas et al., 2016; Doom et al., 2016).
Objectives
The objective of this review is to shed light on the association between ADHD and adoption.
Methods
A literature review has been carried out of scientific studies on the prevalence and risk factors for developing ADHD among adopted children from different countries of origin. Systematic reviews of papers and studies on new developments in the etiology of ADHD were also consulted.
Results
The prevalence of ADHD in adopted children is estimated to be around 25-50% (Mulas et al., 2013; Enriquezet. al., 2017). However, this percentage varies considerably depending on the origin of the children (Eastern Europe (de Maat et al., 2018), versus China (van Ginkel et al. 2016)). However, adopted children are more easily referred to a mental health specialist, as a consequence of the fact that adoptive parents are often particularly focused on the adaptation of these children (Sánchez et al., 2012).
The postnatal environment of adopted and institutionalized childrenchildren is often marked physical, emotional, sexual or other types of abuse (Doom et al., 2016). The quality of these orphanages and foster homes contributes to the lack of stimuli that children should receive in the first 2 to 3 years of life (Mullas et al., 2015). Consequently, this social and emotional deprivation among adopted children has been related to attachment disorders and ADHD (Elovainio et al., 2015).
On the other hand, other pre- and perinatal risk factors that influence the etiology of this disorder are especially prevalent in adopted children: premature birth, low birth weight and exposure to alcohol during pregnancy (Macke et al., 2020).
The role of culture as a possible protective factor is supported by research, with immigrants showing lower rates of ADD than adopted children of the same age range (Tan et al., 2016).
Finally, early foster care in adoptive families and the promotion of family bonding and appropriate parenting strategies can help adopted children improve their regulatory skills and other typical ADHD symptoms (Barca et al.,2017).
Conclusions
The deprivation of affective care and the lacking opportunity to establish a relationship with a main caregiver experienced by institutionalized children can lead to the expression of this disease in genetically predisposed individuals. These fenomenon reveals the importance of connection to family and culture to promote better mental health.
Substance abuse among adolescents has risen significantly in recent years, with serious implications for mental health and development. Factors such as peer pressure, socio-economic stress, and mental health issues contribute to this trend. Early substance use is linked to long-term risks, including substance use disorders and co-occurring psychiatric conditions. This study examines data from CHC Rijeka, highlighting trends in adolescent substance use over recent years, emphasizing the need for targeted prevention and treatment strategies.
Objectives
This study aims to analyze the number of adolescent patients having issues with drug abuse, who were hospitalized at the Adolescent Psychiatry ward in order to identify trends, assess associated risk factors.
Methods
We compared the numbers of hospitalized patients who were dignosed with substance abuse, as well as the percentages of those patients per year, from 2019 until 2024.
Results
From 2019 to 2024, the number of adolescents hospitalized for substance abuse at the Adolescent Psychiatry ward increased. In 2019, substance abuse was diagnosed in approximately 20% of all adolescent admissions, whereas by 2024, this figure had risen to 28%. This rise in the percentage of substance abuse diagnoses, relative to the total number of admissions, indicates a growing prevalence of substance use disorders among hospitalized adolescents. This trend mirrors broader national patterns of increasing adolescent substance use and underscores the urgent need for targeted prevention and intervention strategies, both in clinical settings and within the community.
Conclusions
The rising percentage of adolescents hospitalized for substance abuse highlights a critical public health issue. To address this, efforts should focus on early intervention, increasing access to mental health and substance use services, and implementing school-based prevention programs. Additionally, enhancing community support networks and reducing the stigma around substance abuse treatment are key to preventing further escalation of this growing trend.
Internet gaming addiction (IGA) can have a significant impact on the characteristics of individual gamers, and may even be a contributing factor to the development of social anxiety symptoms. This study of adolescent Saudi Arabian Internet gamers examined the influences of Internet gaming time and probable Internet Gaming Disorders (IGDs). It investigated the association between Internet game addiction and social anxiety symptoms among them.
Objectives
The aim of this study was to investigate the association between internet game addiction and social anxiety symptoms among Saudi adolescents. Since very few researches examined the association between internet game addiction and psychiatric illnesses among Saudi youth, Our study focused on social anxiety symptoms which has not been done so far.
Methods
A cross-sectional, survey was conducted from March to June of 2023 among adolescents in the Saudi population. Probable Internet Game Addiction was measured by using the DSM-5 checklist and the Arabic version of the Social Phobia Inventory (SPIN) was used to evaluate social phobia or anxiety.
Results
A total of 764 participants were enrolled in the current study, majority of gaming addiction participants were 15-16 years old. There was a significant association between gender and gaming addiction (p-value ≤ 0.05). 86.6% of Saudis have been significantly associated with gaming addiction. The majority of the participants have moderate social phobia compared to severe social phobia. There was a significant association between social phobia and age (p-value ≤ 0.05). 34.9% of male participants have moderate social phobia and 24.6% of females have moderate social phobia. There was an insignificant association between social phobia and nationality. The participants with gaming addiction showed 37.2% had mild, 60.5% had moderate, 68.1% had severe and 79.5% had very severe social phobia. There was a significant association between Social Phobia and gaming Addiction (p-value≤0.05).
Conclusions
This study examines the association between video game addiction and social anxiety amongadolescents in Saudi Arabia. Despite its limitations of less sample size and small setting, the findings imply a significant correlation between IGA and these psychological concerns, particularly among male adolescents. Excessive video gaming use leads to higher levels of social anxiety. Future research should adopt experimental or longitudinal designs to establish causal relationships and consider the potential reciprocal nature of the association. Mental health educators and practitioners should be mindful of the adverse impacts of excessive video gaming, with a specific focus on male adolescents who might be more susceptible to heightened social anxiety.
Disclosure of Interest
B. Alsubaie Employee of: General physician in psychiatry department. Declare no conflict of interest, N. Alhujaili Consultant of: Psychiatry. Declare no conflict of Interest, S. Alzahrani Employee of: General physician. Declare no conflict of interest, F. Aljahdali Employee of: Medical Intern. Declare no conflict of interest, W. Alghamdi Consultant of: Associate professor of psychiatry. Declare no conflict of interest, M. Almatrafi Consultant of: Psychiatry. Declare no conflict of Interest, A. Alghamdi Consultant of: Psychiatry. Declare no conflict of interest
Bipolar disorder is a chronic disorder characterized by intense fluctuations in mood, which seriously affects the mental health and quality of life of the individual (APA, 2022). The most prominent features of this disorder include episodes of mania, hypomania and depression. In between these episodes, individuals may generally experience periods of emotional stability; however, the severity and frequency of emotional fluctuations may show individual differences. Bipolar disorder affects not only individuals’ mood, but also their cognitive functioning, social relationships, and overall mental health. In this context, the strategies these individuals use to cope with emotional difficulties play an important role in mental health. Especially in manic episodes, individuals often struggle with an uncontrolled increase in excessive positive emotions, while in depressive episodes they have to cope with intense negative emotions (Gruber, 2011). Research shows that individuals with bipolar disorder often resort to dysfunctional emotion regulation strategies, which may have a negative impact on the frequency and severity of episodes. However, studies on the effectiveness of emotion regulation strategies in individuals with bipolar disorder are limited. In particular, more research is needed on how these strategies play a role in different stages of the illness and to what extent the effects of these strategies on individuals’ overall functioning differ.
This study aims to examine the effects of emotion regulation strategies used by individuals with bipolar disorder on functioning.
Objectives
The aim of this study is to examine the effect of emotion regulation strategies used by individuals with bipolar disorder on their functioning. In particular, it is aimed to analyze the differences between functional and non-functional strategies on functioning.
Methods
This study was planned according to a descriptive correlational design. Data will be collected from individuals diagnosed with bipolar disorder using the Cognitive Emotion Regulation Scale, Difficulty in Emotion Regulation Scale-Short Form (DERS-16), Young Mania Rating Scale, Brief Psychiatric Functioning Rating Scale and Sociodemographic Data Form. Participants will fill in these scales and the effect of emotion regulation strategies on functioning will be evaluated. The data will be subjected to appropriate methods for statistical analysis.
Results
Data extraction is still on going in detailed style by principal authors. Description of studies and the key findings will be presented.
Conclusions
The results of this study aim to determine the different effects of functional and dysfunctional strategies on functioning in individuals struggling with bipolar disorder and to provide recommendations for interventions that can improve the mental health of these individuals.
Women with bipolar disorder (BD) face a high risk of adverse mental health outcomes during the perinatal period, including a high prevalence of affective episodes and postpartum psychosis. The challenge of management BD in this period includes balancing maternal stability while securing fetal safety, given the teratogenic risks of mood-stabilizing medications.
Objectives
To evaluate the course of BD during the perinatal period, assess the impact of risk factors, and examine the effectiveness of therapeutic interventions.
Methods
This prospective cohort study included 23 patients with various sociodemographic characteristics, diagnosed with BD (ICD-10 criteria). They were monitored over the course of 6 months utilizing EPDS (Edinburgh Postnatal Depression Scale), and the Young Mania Rating Scale at baseline, 3 – months and 6-months follow up, in addition to a clinically guided interview, non-standardized sociodemographic and risk factors questionnaire. The patients were treated with a combined approach in a specialized unit for mothers, including individual and group therapy, along with pharmacological treatment. Nearly all patients were switched to atypical antipsychotics with stabilizing effects while valproate was excluded due to teratogenic risks.
Results
The cohort comprised mostly of women over 30 (69.6%, p = 0.006), married (78.3%, p = 0.000), with stable socioeconomic status (69.6%, p = 0.008). Combined treatment (inpatient and outpatient) was predominant (82.6%, p = 0.000), with antipsychotics either alone (21.7%) or in combination with other medications as the most common treatment (91.3%, p = 0.000). All participants reported risk factors, including history of affective episodes (95.6%), traumatic events, intimate-partner violence (34.8%), substance abuse (26.1%), and unplanned pregnancy (21.7%).The EPDS scores showed a low likelihood of depression at baseline, 3, and 6 months (56.5%, 69.6%, 69.6%; p < 0.05), with mean scores decreasing from baseline to three months and slightly increasing at six months (p = 0.81). The YMRS scale indicated a significant reduction in mania from baseline to six months (p = 0.038). There was no significant correlation between risk factors and postnatal depression (p > 0.05).
Conclusions
The study confirms that BD women are at high risk for affective destabilization during the perinatal period. While continuous treatment mitigates severe mood deterioration, BD women remain vulnerable, necessitating long-term monitoring. One or more risk factors were registered in all of the participants. Although no direct significant correlation was observed in this study, existing literature suggests that risk factors such as unplanned pregnancy, abrupt medication changes, and intimate-partner violence are associated with adverse outcomes in BD women during the perinatal period. Understanding and managing these risks is essential for comprehensive BD care.
This paper examines state-business relations in Somalia. It argues that the Somali case presents a unique model of private sector development, where advanced businesses in the telecommunications, banking and financial sectors emerged despite the lack of formal state structure. The establishment of a formal government in 2012, however, raised questions about the ‘nexus between state and capital’, particularly on whether state institutions were ‘pivotal’ for business. In interrogating this question, the paper employs a qualitative process tracing approach and examines the relationship between the state and one of the largest private sector players – the telecommunications sector. It focuses on tracing the tax relations, which, as the material basis of the social contract between the state and society, offered fundamental clues into the sector’s willingness to invest in the state project. The article finds that despite capital’s capacity to survive in such contexts, there are certain junctures when formal state institutions emerge as critical for business operations. Thus, rather than a straightforward structural relationship between public and private power, the Somali case explicates the moments and instances when the state becomes critical for capital accumulation and offers greater insight into the molecular processes that underlie state-capitalist relations within the African context.
Wisdom is a capacity which is needed to cope with difficult situations in life. Wisdom can be trained like other capacities. Wisdom psychotherapy has been developed as a method of cognitive behavior therapy to help patients who are stuck in negative life experiences, or confronted with unsolvabale dilemmas.
Objectives
Test the efficacy of wisdom psychotherapy in patients with adjustment disorders.
Methods
patients with adjustment disorders (>18 on the ADNM8 scale) were randomly assigned to group wisdom therapy (WT: N=114), or group behavioral activation therapy (BA: N=109). Additionally a matched group of patients was build, which were not included in any study procedures but underwent routine treatment only (RT: N=114). Wisdom was measured with the Multidimensional Wisdom Competency Scale (MWC15).
Results
There was an increase on the MWC15 of 5.3 in the wisdom group as compared to 0.4 in the activation group and 0,2 in the routine group. This is statically sigificant in the pre-post comparison and in the time/goup interaction (F4,42, p=0,13). The ADNM8 score, the SCL90 GSI, the BDI score decreased, with a trend for more side effects in the wisdom than the activity group.
Conclusions
The results confirm that wisdom psychotherapy can make a difference in the improvement of wisdom capacities. Wisdom therapy, different from other psychotherapies, does not aim at increasing hedonic or symptom free wellbeing but rather eudaimonic wellbeing in order to teach patients to live a decent and successful life.
The COVID_19 pandemic has affected all facets of living, notably our sleep-wake cycle. In fact, sleep disturbances have been reported, not only during the acute phase, but also after the episode. Previous studies have shown that some socio-demographic characteristics are associated with sleep problems.
Objectives
To assess the relationship between sleep disturbances and the sociodemographic profile of the COVID-19 survivors.
Methods
We conducted a prospective cohort study including 121 Tunisian COVID-19 inpatients who had been discharged alive from hospital. Each enrolled patient was asked about the period before the hospital stay, and the 6-9 month-period after hospital discharge, using the Arabic validated version of Pittsburgh sleep quality index “PSQI” scale to assess sleep problems.
Results
The median age of our participants was 59 years old. Among them, 62 (51.2 %) were females. One hundred and eleven patients were married (91.7%), 102 patients (84.2%) had at least a primary educational level, while 19 (15.7%) patients were illiterate. Among the participants 86 (71.07%) had a job at the time of the infection, among them, 9 (7.4%) were Heath care providers. Ninety-five (78.5%) participants were non-smokers. As for alcohol use, 11 patients (9.1%) consumed alcohol. According to PSQI, the incidence of sleep disturbances after COVID was 48.8%. Sleep duration, sleep quality as well as sleep onset latency, sleep disturbances and sleep efficiency were the most affected domains in the PSQI. Females showed significantly higher PSQI after the COVID-19 infection (p<0.001). Non-married participants reported significantly higher scores of hypnotic drug use and daytime dysfunction (p=0.006, p=0.02 respectively). Quality of sleep was significantly poorer in illiterate patients (p=0.036). Health care providers had worse daytime dysfunction in comparison to other occupations (p=0.035). Non-smokers showed a deteriorated sleep efficiency as well as daytime dysfunction (p=0.03, p=0.021 respectively). No statistical association was found between sleep problems and age nor alcohol consumption.
Conclusions
Our study highlighted several associations between sleep problems and sociodemographic characteristics of COVID-19 survivors. This helps clinicians to pinpoint the at-risk people, in order to intervene when needed.
This paper makes a twofold contribution to the study of expressivity. First, we introduce and study the novel concept of conditional expressivity. Taking a universal logic perspective, we characterize conditional expressivity both syntactically and semantically. We show that our concept of conditional expressivity is related to, but different from, the concept of explicit definability in Beth’s definability theorem. Second, we use the concept to explore inferential relations between collective deontic admissibility statements for different groups. Negative results on conditional expressivity are stronger than standard (unconditional) inexpressivity results: we show that the well-known inexpressivity results from epistemic logic on distributed knowledge and on common knowledge only concern unconditional expressivity. By contrast, we prove negative results on conditional expressivity in the deontic logic of collective agency. In particular, we consider the full formal language of the deontic logic of collective agency, define a natural class of sublanguages of the full language, and prove that a collective deontic admissibility statement about a particular group is conditionally expressible in a sublanguage from the class if and only if that sublanguage includes a collective deontic admissibility statement about a supergroup of that group. Our negative results on conditional expressivity may serve as a proof of concept for future studies.
Culture fundamentally influences human thinking, feeling and behaviour. The integration of cultural contexts into psychotherapeutic treatment is therefore essential, especially in light of the increasing diversity of our society. In addition, psychological stress following experiences of migration or flight requires special treatment expertise. Thus, intercultural psychotherapy is an essential approach in addressing mental health issues across diverse populations.
Life-threatening events, to which we feel helpless and at the mercy of, can inflict severe psychological trauma on us. If the event is too aversive, too horrific, and therefore cannot be autobiographically interwoven, fragments of memory are created that are not modified over time - like ordinary memories - but remain rigid, as if ‘frozen’. They are activated by triggers reminiscent of the original situation and then reappear, e.g. in the form of flashbacks. The high number of people with migration and refugee backgrounds with trauma-induced secondary disorders calls for culturally sensitive, trauma-focussed psychotherapies to close the enormous gap in care. Numerous psychotherapies are available for the treatment of trauma-related disorders, some of them have yet to be evaluated - or modified for the treatment of traumatised persons in the context of migration and flight in the case of those that have already been well evaluated. This presentation will give an overview on cultural and migration-related aspects of trauma-related disorders.
Cognitive impairments are present from the first manifestations of the disorder, including social cognition in individuals at ultra-high risk for psychosis (UHR). While advances in psychopharmacology in recent decades have significantly altered the course of the illness, antipsychotic therapy is more effective in treating positive symptoms than negative symptoms, comorbid depression, and cognitive and social cognitive dysfunction. Again, cognitive impairment has a significant impact on functional outcome, more so than symptom severity.
Due to the particular significance of cognitive deficits, it is very important to identify them accurately at an early stage. Strategies for identifying cognitive deficits are presented in an EPA guidance paper.
To improve cognition in patients with schizophrenia, it has been suggested to combine pharmacotherapy with neuropsychological training. A meta-analysis showed the positive effect of cognitive remediation programmes in schizophrenia. While the strategies available today for the treatment of cognitive dysfunction are useful and should be implemented, it is hoped that pharmacological add-on strategies will come onto the market to have a greater effect on cognitive impairments.
Adults with intellectual and developmental disabilities (IDD) often struggle to access suitable psychiatric care due to cognitive and communication challenges. Traditional mental health services are not always well-equipped for these needs, highlighting a critical need for evidence-based, IDD-specific guidelines. Expanding research, especially randomized controlled trials (RCTs), is essential to develop personalized, effective treatments for this population.
Objectives
This poster aims to outline current gaps in psychiatric care for adults with IDD, propose strategies for treatment adaptation, and emphasize research priorities to advance evidence-based care for this underserved group.
Methods
A literature review assessed studies on treatment adaptations for IDD, focusing on the effectiveness of current interventions and limitations in existing research. Priority was given to innovative care approaches and adaptations in standard mental health treatments.
Results
Psychiatric care for adults with IDD often involves adapting treatments like cognitive-behavioral therapy (CBT) and pharmacotherapy with simplified, patient-centered methods. For example, CBT adaptations may include breaking techniques into smaller steps, using visual aids, and shorter sessions, which accommodate cognitive limitations. Personalized care is essential due to varying abilities within this population. Pharmacological treatments also require careful titration and close monitoring, as the risk of side effects is higher among those with IDD. However, few RCTs assess the efficacy and safety of treatments for severe psychiatric disorders in the IDD population, underscoring the need for more rigorous research to support clinical guidelines. To overcome recruitment and follow-up barriers in RCTs, studies suggest alternative methods such as targeted outreach through day centers, provider organizations, and one-on-one approaches, which have been effective in reducing dropout rates. Furthermore, bipolar disorder treatment in IDD is particularly under-researched, despite its significant impact on quality of life, highlighting a need for focused studies in this area.
Conclusions
Enhancing psychiatric care for adults with IDD will require systemic changes, including increased research funding, IDD-specific clinical guidelines, and improved provider training. RCTs focused on adapted therapies and pharmacological interventions are crucial to build a strong evidence base. By promoting individualized, evidence-based approaches, the field can better meet the unique needs of adults with IDD, ultimately improving mental health outcomes and quality of life.
We resonated with the idea that dreaming is important, and that climate fiction is a way of dreaming with environmental educators. A well of resistance lives in art collaborations around the world which harness the power of the collective to face terrible realities and twist, bend, and dance them into alternative hopeful pasts, presents and futures. Engaging with other people and more-than-human lives, through creative collaborations have led us to understand complex and unfamiliar perspectives in ways that are unreachable alone, regardless of how much academic study we do. This story emerged from online meetings that crossed time zones and oceans: Vancouver to Istanbul. Our climate fiction surfaced from improvised, spontaneous story creation. It was as if the story was waiting for us to find her, if we acted with care and love while facing directly our own dark shadows and fears about climate catastrophe. This story of Cassandra, alongside our interpretations of its emergence, invites the reader to draw from any evoked confusion or other feelings as well as their own learnings to reflect on burdens of knowledge not acted upon. Leaning into confusion is a way to open up to the power of uncertainty for environmental education.
Hemodialysis, although crucial for maintaining the survival of patients suffering from end-stage renal disease, can have severe repercussions on patients’ overall quality of life and sexuality.
Objectives
To determine the prevalence and factors associated with sexual dysfunction in hemodialysis patients.
Methods
This is a multicenter, descriptive, cross-sectional study with analytical aims, conducted at 3 hemodialysis units (the Mahmoud El Matri Hospital in Ariana, the El Manzah private hemodialysis center and the El Omrane polyclinic) over a 5-month period (August-December 2023). Patients’ sexual dysfunction was assessed using the IIEF5 scale.
Results
Our study population comprised 73 patients. Patient ages ranged from 25 to 86 years, with a median age of 56.87 years. Twenty-eight subjects (38.4%) were between 56 and 70 years of age. Sixty patients (82.2%) were married, with 68 living with relatives. Regarding anamnestic data, organic comorbidity was found in all patients with diabetes in 67.1% and arterial hypertension in 50.7% of cases. The median duration of hemodialysis was 48 months. The frequency of hemodialysis sessions was 3 per week in 69 patients (94.5%).
Erectile dysfunction was diagnosed in 64 patients, corresponding to a prevalence of 87.7%. The dysfunction was mild in 24.7% of cases, moderate in 45.2% and severe in 17.8%.
Erectile dysfunction was significantly correlated with age over 55 with an adjusted OR = 2.43 and the presence of diabetes with an adjusted OR = 1.5.
Conclusions
The prevalence of erectile dysfunction is high in hemodialysis patients. A systematic sexological approach is needed to ensure early and appropriate management.