Ketogenic Diet (KD) has been introduced as a treatment option for epilepsy over a century ago and since then it had gained and lost its popularity. Its current revival is heavily sensationalized and KD is promoted as a cure-it-all for a wide range of mental illnesses. The present review aims to review the validity of the evidence supporting KD use in psychiatry.

1. 1. To review the origins and types of ketogenic diet as well as the possible rationale for its use in psychiatry

2. 2. To provide a narrative review of effectiveness of ketogenic diet for management of major mental illnesses

Scoping review of research articles published in PubMed without restrictions in terms of language or publication date.

We conducted a scoping review using a wide range of keywords. There are multiple studies dedicated fully or partially on ketogenic diet and a variety of mental illnesses. Majority of studies are focused on low-carbohydrate diets and not necessarily on KD per se, which complicates interpretation of findings. At the same time, we were able to identify multiple case studies and case series as well as some open-label and placebo-controlled studies involving small groups of participants receiving KD mostly as an adjunct treatment for their respective condition. There was a significant degree of heterogeneity both in terms of methodological aspects and clinical outcomes of these studies, which do not allow for further data synthesis at this point. At the same time, there are some indications that KD may be useful in certain clinical scenarios.

The objective data on impact of ketogenic diet on major mental illnesses are scarce, but show some promise. Further research is needed to elaborate both the mechanisms and the degree of impact of ketogenic diet on mental health. There is not enough evidence to suggest that ketogenic diet is an independent treatment option for any psychiatric condition, but at the same time it can be suggested as an adjunct measure.

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Child sexual offending is a significant societal concern with profound consequences. While some individuals with a history of childhood sexual abuse (CSA) may reenact their traumatic experiences later in life, the link between CSA and subsequent offending patterns among individuals convicted of child sexual offending (ICSOs) remains complex and under-researched.

This study aimed to investigate the prevalence of self-reported physical and sexual violence among ICSOs and explore the link between self-experienced CSA and offending behavior, particularly focusing on the age and relationship with their victims. We hypothesized that ICSOs would replicate their own victimization experiences when perpetrating CSA.

A cohort of 78 male ICSOs referred to the Danish Sexual Offender Treatment and Research Program (DASOP) between October 1, 1997, and October 1, 2001, for court-ordered pre/post-trial evaluations was analyzed. Data on self-reported experiences of CSA, physical violence, and characteristics of their victims were collected and examined for patterns.

Of the 31% of ICSOs who reported CSA exposure, 82% of those abused before age 11 targeted victims under 11, while 71% of those abused at 11 or older offended against victims in the same age group, indicating a significant association (p=0.004) between offenders’ age at the time of abuse and the age of their victims. Additionally, 86% of those who reported CSA by family members, predominantly targeted children within their households, suggesting a link between family-based CSA and intra-familial offending (86% vs. 48%, p-value= 0.059). Furthermore, among the 55% exposed to physical violence, more used physical force on their victims than those who did not report such adverse experiences (75% vs. 25%, p-value 0.401).

The findings indicate a potential link between offenders’ own CSA experiences and their subsequent victim selection, supporting the hypothesis that reenactment of trauma may play a role in offending behavior (Garbutt et al., 2023). These results emphasize the importance of understanding the influence of early trauma to inform prevention and intervention strategies aimed at reducing CSA perpetrated by both children and adults with prior victimization histories. However, most victims of such trauma do not reenact their trauma.

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The COVID-19 pandemic had a major impact on the world’s emotional health, and knowledge is limited about the efficacy of traditional interventions in this context. The TelePSI Project, initiated by the Hospital de Clınicas de Porto Alegre in collaboration with the Brazilian Ministry of Health, aimed to provide online

mental health care to essential services professionals during the pandemic. Single session of enhanced psychoeducation (EP) is an innovative strategy proposed by TelePSI, suggesting lifestyle changes based on individual risk and protective factors or physical, emotional, psychological, and well-being.

Single-session interventions are an effective strategy for reducing emotional distress. Enhanced psychoeducation, which includes empathic listening, risk stratification, symptom monitoring, and habit modification is particularly suitable for single-session interventions. We investigated predictors of response to an online enhanced psychoeducation intervention among essential service professionals during the pandemic in Brazil.

The TelePSI Project, financed by the Brazilian Ministry of Health, was a nationwide initiative that served more than 3,300 individuals in various psychotherapeutic modalities. Data were collected from April 2020 to December 2021. We included all participants with high levels of emotional distress who received single-session interventions

Final sample 460 individuals (89.1% women, 81.1% health professionals). After 1 month, 300 participants were reassessed. Overuse of social media, use of social networks to contact family and friends, playing video games, smoking, drinking alcohol, and spending time with pets were associated with less improvement in symptoms, whereas playing an instrument and previous psychological treatment were associated with greater symptom improvement. This highlights the impact of lifestyle factors on the efficacy of single-session interventions.

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Online EP with support videos, as proposed by TelePSI, appears to be an effective intervention strategy for healthcare professionals with symptoms of anxiety, depression, and irritability. Although a significant proporion of the participants improved, some variables were associated with less improvement, such as spending time with pets, tobacco use, alcohol use, and playing video games. In this study, we set out to analyze variables associated with participant improvement because, by evaluating these factors, we can better understand this new model of psychoeducation, which represents a promising alternative for individuals during crises such as the COVID-19 pandemic. Furthermore, the intervention should be explored beyond the context of the pandemic and social isolation. Further research on TelePSI is forthcoming, including a comparison of intervention arms

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Eating disorders (EDs) are characterized by intrusive thoughts about food, weight loss, and body image, often accompanied by compulsive behaviors related to weight control. Obsessive-compulsive behavior is frequently observed in individuals with EDs. The relationship between obsessive-compulsive disorder (OCD) and EDs is complex due to overlapping symptoms. Research indicates that individuals with both OCD and EDs are prone to depression and anxiety, which may manifest as secondary responses to stress. Symptoms of OCD can significantly impair functioning, leading to maladjustment. Some studies have noted a correlation between increased body mass index (BMI) and reduced depressive symptoms in patients suffering from anorexia nervosa.

This research aimed to investigate the severity of anxiety-depressive and obsessive-compulsive symptoms in relation to changes in BMI among patients with eating disorders.

The study was conducted at the Center for Eating Disorder Research in collaboration with the Department of Psychiatry and Medical Psychology at the Peoples’ Friendship University of Russia. A sample was created from patients undergoing inpatient treatment with diagnoses according to ICD-10 (F50.0, F50.1). Clinical interviews were conducted during the first and fourth weeks using PHQ-9 (for depression), GAD-7 (for anxiety), and the Yale-Brown Obsessive Compulsive Scale. Statistical analysis was performed using Jamovi 2.3.28.

Thirty female patients participated in the study. All received psychopharmacotherapy. The average age was M=14.4, SD=1.5. The mean BMI at the start was M=13.3, SD=1.69, increasing by M=1.20, SD=0.612 by the second assessment. Depressive symptoms were observed in 28 (93.33%) during week one and in 25 (83.33%) during week four. Elevated anxiety levels were noted in 24 (79.99%) during week one and in 25 (83.33%) during week four. Significant OCD symptoms were present in 25 (83.33%) during week one and in 21 (70%) during week four. Correlation analysis revealed no significant relationships (p > 0.01) between BMI levels and OCD symptoms on the Yale-Brown scale (r = 0.099), depressive symptoms on the PHQ-9 scale (r = 0.28), or anxiety levels on the GAD-7 scale (r = 0.369).

Findings indicate certain relationships between BMI and psycho-emotional states among patients with eating disorders; however, statistically significant correlations were not identified (p > 0.01). This underscores the need for further research to deepen understanding of these relationships, especially since none of the respondents achieved normal BMI values (18.5). Future studies should involve larger sample sizes and extended time frames for more reliable data.

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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.

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Studies focusing on the relationship between chronotype, sleep disorders and temperament traits in Attention-Deficit/Hyperactivity Disorder (ADHD) are limited, particularly in the context of adolescents. In adolescents aged 11 to 18 diagnosed with ADHD, we hypothesize that chronotype, sleep problems, and temperament traits may be dynamically interrelated across a broad spectrum. Conducting in-depth studies to examine these relationships could enhance our understanding of ADHD treatment and management strategies, potentially leading to more effective interventions.

We aimed to explore the relationship between chronotype characteristics, sleep disturbances, and temperament traits among adolescents diagnosed with ADHD and to compare them with healthy controls.

Participants included 102 adolescents aged 11 to 18 years with an ADHD diagnosis from the Child and Adolescent Psychiatry outpatient clinic at Marmara University Pendik Training and Research Hospital, along with 101 age-matched controls from a secondary and a high school. Clinical assessments were conducted using the K-SADS-PL. Parents completed the Sleep Disturbance Scale for Children and Children’s Chronotype Questionnaire while adolescents completed the Junior Temperament and Character Inventory Revised. These assesments evaluated chronotype characteristics, sleep disturbances, and temperament traits.

Adolescents with ADHD demonstrated significantly higher rates of sleep disturbances and delayed chronotype compared to the controls. Additionally, adolescents with ADHD exhibited significantly higher levels of novelty seeking and harm avoidance scores, while the control group exhibited higher levels of persistence and self-directedness compared to the ADHD group. In the ADHD group, chronotype total score correlated negatively with self-directedness (r=-0.201, p=0.042) and reward dependence (r=-0.199, p=0.045). Novelty seeking was pronounced in those with an evening chronotype and positively correlated with severe sleep disturbances, including difficulties initiating and maintaining sleep (r=0.210, p=0.034). Logistic regression analyses indicated that novelty seeking significantly predicted evening chronotype, while linear regression revealed that both novelty seeking and chronotype scores significantly predicted overall sleep disturbance severity. (R2=0.112, p=0.006).

This study represents one of the initial investigations emphasizing the intricate relationships between chronotype characteristics, sleep disturbances, and temperament traits in adolescents diagnosed with ADHD. More profoundly underscoring these relationships and their clinical significance could be crucial for targeted interventions to improve ADHD management.

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On October 7, 2023, a Hamas terror attack targeted both Jewish and Arab Israelis. The unprecedented scale of the event resulted in over 1,400 deaths and numerous kidnappings, leading to the ongoing Hamas-Israel war. The attacks also exposed a wide range of sexual violence, which was broadcasted or witnessed by family members (Association of Rape Crisis Centers in Israel, 2024; UN SRSG-SVC, 2024). This event has exacerbated collective trauma and anxiety, influencing various societal issues, including public attitudes toward justice, particularly sexual offenses (Feingold et al., 2024).

This study aims to explore how exposure to a war characterized by violent crimes affects public support for restorative justice (RJ) processes, particularly in sexual offenses, and whether the collective trauma has led to a decline in the belief that sexual offenders can be rehabilitated.

The research surveyed 339 Israeli participants at two points: before the war and during its early weeks. The study employed quantitative analyses to measure attitudes toward offender rehabilitation and support for RJ. A paired t-test was conducted to assess changes over time, and correlation analyses examined the relationship between the perceived malleability of offenders and support for RJ.

The findings revealed a significant decline during the war in the belief that sexual offenders can be rehabilitated (t(51) = 2.67, p < .01). This belief was correlated to reduced support for RJ (rp = .45, p < .001). The exposure to sexual violence during the war, combined with widespread testimonies highlighting its brutality, likely contributed to a shift in public attitudes. The attacks served to instill terror and dehumanize the victims, reinforcing the public’s resistance to perceived “lenient” justice alternatives such as RJ.

In addition to the well-known effects of trauma, the study highlights the profound influence of collective trauma on public attitudes toward justice, particularly in sexual offenses. Exposure to extreme violence, during a war characterized by violent crimes creates significant barriers to the acceptance of RJ. While RJ can potentially provide healing avenues for survivors of sexual offenses (Klar-Chalamish & Peleg-Koriat, 2021) the widespread trauma and public anxiety pose significant barriers to its acceptance.

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Vicarious trauma can significantly affect the physical and mental health of mental health professionals, as well as their ability to provide quality of care, particularly in the population of child and adolescent psychiatry residents who frequently encounter traumatic narratives.

This study aims to determine the prevalence of vicarious trauma in child and adolescent psychiatry residents.

This is a cross-sectional study conducted from 19 august to 16 september 2024. An anonymous Google Forms questionnaire was sent to child psychiatry residents via the college email and private groups. We used the Compassion Fatigue Questionnaire to measure levels of vicarious trauma.

A total of 48 child psychiatry resident out of 70 participated in the study. The sex ratio was 1:8,6. The mean age was 28,8 years. The residents were married in 33,4% of cases, in a romantic relationship in 29,1% and single in 37,5%. We found that 54,1% of residents practiced a leisure activity, 22,9% had history of psychiatric disorder and 14,5% had addictive behaviours. We found that 74% of the residents exhibited a high to very high risk of vicarious trauma. The mean score of Compassion Fatigue Questionnaire was 44,18.

This study underscores the need to recognize and address vicarious trauma among child and adolescent psychiatry residents in Tunisia, as its effects can detrimentally influence both clinician well-being and patient care. By fostering an awareness of this often-overlooked issue and integrating supportive measures into residency training, it can help residents develop healthier coping strategies and resilience.

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This study explores whether high-dose treatment with SGA LAIs may benefit patients with schizophrenia who are inadequately controlled on a standard dose

The objectives of this study have been to evaluate the retention, effectiveness and tolerability of high doses of second-generation antipsychotic long-acting injectable formulations (SGA LAI) in the treatment of patients with severe resistant schizophrenia.

A 72-month observational, mirror-image study of patients with severe (CGI-S ≥ 5) resistant schizophrenia receiving treatment with ≥75 mg of risperidone long-acting injectable (RLAI) (N = 60), ≥175 mg of monthly paliperidone palmitate (PP) (N = 60), and ≥600 mg of aripiprazole once-monthly (AOM) (N = 30). All of the patients were previously treated with at least two different APs, with poor outcomes. Patients were eligible if deemed likely to benefit from treatment with SGA LAIs: at risk of medication non-compliance, with a lack of effectiveness, or adverse effects with previous APs. The assessment included the CGI-S, the WHO-DAS, the Medication Adherence Rating Scale (MARS), laboratory tests, weight, adverse effects, reasons for treatment discontinuation, hospital admissions and suicide attempts.

The average antipsychotic doses were: RLAI = 111.2 (9.1 SD) mg/14 days; PP = 231.2 (12.3 SD) mg eq./28 days; and AM = 780 (120 SD) mg/28 days.

Tolerability was good for all LAIs, reducing the side effects reported and the changes in biological parameters compared to previous treatments, especially in the AOM group. Weight and prolactin levels decreased in all LAI treatments; the reduction was statistically significant only among patients treated with AOM (p < 0.05). Two patients discontinued treatment due to side effects with AOM, five with PP and nine with RLAI .

There were four discontinuations with RLAI, two with PP, and one with AOM due to a lack of effectiveness. After three years, the scores decreased in CGI-S (p < 0.01) and in WHO-DAS in the four areas with all injectables. MARS increased with all LAIs (p < 0.01), especially with PP and AOM.

We report a statistically significant decrease in both hospital admissions (p <0.001) and suicide attempts (p < 0.001) at the end of 36-month treatments, compared to the previous three years, without any difference across the three LAIs. In the previous three years, 60 patients discontinued their AP treatment, and 11 during the three-year follow-up (p < 0.0001

Our study indicates the good effectiveness and tolerability of RLAI, PP and AM at high doses. These SGA LAI treatments improved treatment adherence and outcomes of the patients, with good tolerability, helping them to achieve clinical stabilization and better functioning. Therefore, we suggest that, in some illness-critical conditions, high doses of SGA LAIs could represent an alternative to clozapine.

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Sleep is not something that occurs in isolation—it is embedded in a context. These contexts include biological, psychological and social factors, as well as a range of environmental considerations.

Throughout Europe psychologists engage in research and practice and collaborate with colleagues from allied professions such as psychiatry and those with lived experience on the topic of sleep.

Insights are gathered from throughout the network of the European Federation of Psychologists’ Associations (EFPA). Individual examples and emergent themes are identified from a wide range of contexts including:

The role of sleep in European policy

Sleep in times of crisis

Community-oriented approaches to supporting healthy sleep patterns

The role of sleep and rest in the workplace

How concern over topics like climate change affects sleep

Competency around sleep in practitioner training and standards

The implications of digitalisation on sleep

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The theory of attachment is one of the most influential theories in developmental psychology. It was formulated by British psychologist John Bowlby in the 1950s and 1960s. This theory states that early relational experiences, particularly those with primary attachment figures (usually parents), influence the formation of internal working models that guide social interactions and attitudes toward oneself and others throughout life. The theory of attachment has important implications for adult relationships. An important time to study attachment is during university years, when many young adults are on their own for the first time and must establish new relationships which represents a moment of vulnerability.

The purpose of this study was to evaluate the prevalence of different attachment styles among medical externs using the RSQ scale and to examine the relationship between these attachment styles and suicidality.

This is a cross-sectional, descriptive, and analytical study. It was conducted over a period of five months among students at the Faculty of Medicine of Sfax using an online form that included sociodemographic data, medical history, lifestyle habits and the “Relationship Scale Questionnaire” (RSQ)

The average age was 21.63 years. The distribution of students according to their attachment styles showed that avoidant attachment was the most prevalent (29%, n=150), and women exhibited more ambivalent attachment than men (p=0,031). Ambivalent attachment was significantly associated with sexual orientation (p=0,025).

Personal psychiatric history was associated with secure (p=0.008), ambivalent (p=0.005), and disorganized attachment styles (p=0.011). A significant link was found between personal history of suicide attempts and ambivalent attachment style (p=0.005).Our results were compared with existing literature and studies on this topic agree on the importance of assessing students’ attachment styles and their emotional needs.

This study highlights the significant relationship between attachment styles and suicidality among students at the Faculty of Medicine of Sfax.

Further research is needed to advance our understanding of the implications of these findings and how to address the emotional and psychological needs of students.

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Therapeutic window in psychopharmacology is the range of drug concentrations that achieve desired effects safely, with treatment failure more likely when levels fall outside this optimal range. The role of dopamine receptor partial agonists (DRPA) in the treatment of depression is a case in point.

We discussed the unique mechanisms, and effective antidepressant doses of DRPAs within their therapeutic windows.

PubMed search was conducted, focusing on randomized controlled trials, open-label studies, and reviews evaluating aripiprazole, brexpiprazole, and cariprazine as augmentation therapies for major depressive disorder in adults.

Clinical trials have investigated aripiprazole, brexpiprazole, and cariprazine as adjuncts to antidepressants, and the effective antidepressant dose is generally lower than the minimal antipsychotic dose. Specifically, the antidepressant doses are 2 – 10 mg for aripiprazole (antipsychotic dose 10 – 30 mg), 2 – 3 mg for brexpiprazole (antipsychotic dose 4 mg), and 1.5 – 3 mg for cariprazine (antipsychotic dose 1.5 – 4.5 mg). This is because at subantipsychotic doses partial agonists increase the dopamine signal, but at antipsychotic doses they reduce the dopamine signal to the level of the intrinsic activity of the drug (generally 25 – 40% of the maximal dopamine signal) which is generally inadequate for an antidepressant response.

DRPAs can increase or reduce the dopamine signal depending on receptor occupancy. At higher receptor occupancy they reduce the dopamine signal, while at lower receptor occupancy (when unoccupied receptors can interact with endogenous dopamine) their intrinsic activity can increase the dopamine signal. Understanding the drug-receptor relationship is crucial, as the assumption that higher doses are always more effective is incorrect.

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Lewy body dementia (LBD) is characterized by a range of complex neuropsychiatric symptoms that can initially mimic other psychiatric disorders, particularly melancholic depression. Failure to recognize these symptoms can lead to delayed diagnosis and inappropriate management.

This case report highlights the importance of a thorough evaluation of neuropsychiatric symptoms in the diagnosis of Lewy body dementia (LBD).

This case report was compiled through clinical observations, patient history from family members, and medical testing. Literature on LBD was reviewed to assess treatment strategies in light of this patient’s condition.

Mr. T.C., 75 years old, followed for hyperthyroidism and benign prostatic hyperplasia, was admitted for a severe depressive episode with melancholic features. Despite treatment with fluoxetine, mirtazapine, and olanzapine, his clinical condition did not improve. The patient exhibited food refusal, active suicidal ideation, and thoughts of incurability, along with a delusional syndrome. The Mini Mental State Examination (MMSE) revealed cognitive impairment with a score of 21/30. An initial brain MRI showed no abnormalities. The treatment was adjusted with the introduction of paroxetine alongside olanzapine and mirtazapine, but there was no significant improvement. A follow-up brain MRI revealed periventricular vascular leukoencephalopathy and moderate cortical atrophy, directing the diagnosis towards Lewy body dementia. The appearance of additional neuropsychiatric symptoms, including visual hallucinations, cognitive fluctuations, and mild parkinsonian signs, further supported the diagnosis of LBD. Treatment was then adjusted with the introduction of quetiapine, which is better tolerated in the context of LBD due to its favorable therapeutic profile.

This case emphasizes the importance of accurately diagnosing neuropsychiatric disorders in Lewy body dementia. Appropriate management, based on a thorough clinical evaluation, can prevent treatment errors and improve the patient’s quality of life.

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Deep brain stimulation (DBS) was first used in 1999 for the treatment of resistant obsessive-compulsive disorder (OCD), and it was not until 2009 that the Food and Drug Administration approved it for this purpose.

The aim of our study was to investigate the safety and efficacy of DBS through a systematic review.

A systematic review was conducted. PubMed via Medline, Google Scholar and Semantic Scholar were used as search engines. The keywords used were (“Obsessive compulsive disorder” or “OCD”) and (“Deep brain stimulation” or “DBS”). Clinical trials and observational studies assessing the efficacy of DBS for OCD, published from inception to December 2023 and written in English or Frensh were analysed. The inclusion criteria were a main diagnosis of OCD, DBS conducted for therapeutic purposes and a response to DBS assessed by the Yale-Brown Obsessive-Compulsive scale (Y-BOCS).

Thirty four studies were included in the final analysis with a reported total of 316 cases. In 58.2% of cases, patients were female. The average age at the time of surgery of implanting the stimulation device was 40.9 ± 7.8 years. The mean time from onset of symptoms to surgery was 22.4 ± 4.6 years. The mean initial Y-BOCS score was 33 ± 3.7. The mean response rate, defined as a reduction in Y-BOCS score of more than 35 % was 70.7% ± 24.8. The maximum symptom reduction was reached between 12 to 14 months after implantation in most studies. Hypomania was the most frequent side effect reaching 45% in some studies. Intracranial hemorrhage secondary to surgery was the most serious complication and did not exceed 5 % in any study. No clear predictive factors for response to DBS were identified.

DBS appears to be a promising therapy for patients with resistant OCD. This innovative approach, combined with ongoing advancements in neurotechnology, offers hope for the future of OCD treatment. However, no predictors of response have yet been established.

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Under the rubric of cinema therapy, or movie therapy, research has been undertaken for some time to test the effect of films in different therapeutic settings and with different patient groups. Taking a closer look at the history of film therapy, it becomes apparent that at the time of the silent film, there was already a medical discourse on the effect of films in a therapeutic context. In this lecture, principal philosophical-therapeutic elements of consideration regarding cinema therapy are presented along with historical and current discourses; the most important publications are indicated; and the author’s own cinema-therapeutic models, experiences and reflections are reported. In addition, selected case studies show how films can be utilized in a clinical context and which effects and unwanted side effects result from film therapy. The final focus of the lecture is on films that depict psychotherapy, love films, and films that address the phenomena of intoxication, ecstasy, and addiction, and how these have been applied by the author in the inpatient treatment of addicts.

Martin Poltrum (2025) Cinema Therapy––The Film as a Medicine. From the Silent Film Era to the Present Day. In: Martin Poltrum et al. (eds.) The Oxford Handbook of Mental Health and Contemporary Western Aesthetics, Oxford: Oxford University Press.

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Alzheimer’s disease (AD) is a progressive neurodegenerative disease and the most common form of dementia; currently there is no effective causal treatment for AD. The main targets of new drugs for AD are processes related to amyloid beta and tau neurotoxicity, neurotransmission, inflammation, metabolism and bioenergetics, synaptic plasticity, and oxidative stress.

The effects of methylene blue, curcumin, ginkgolide B, and melatonin are being tested as antioxidants, tau-aggregation inhibitors, and mitochondrial-targeted therapies. These antioxidants will also be tested as protective agents against tau-induced mitochondrial dysfunction caused by oligomers of phosphorylated tau (P-tau). The aim of our study is to systematically investigate tau-induced mitochondrial dysfunction in isolated brain mitochondria and the protective effects of AD drugs, adjuvants, against mitochondrial dysfunction.

Isolated pig brain mitochondria were used as an in vitro biological model to evaluate the effects of antioxidants. Hydrogen peroxide formation was determined by fluorescence measurements (starting with Amplex Red, horseradish peroxidase). Mitochondrial respiration was measured using high-resolution respirometry. The effects of tested drugs were measured at concentrations in the range 0.1 to 500 μmol/l; the effect of P-tau was measured in the range 3-120 nmol/l.

Methylene blue and curcumin significantly reduced hydrogen peroxide production at high concentrations. The antioxidants were further tested in combination with effect of P-tau oligomers in various states of mitochondrial respiration.

The results of this study will contribute to the connection of today’s most accepted hypotheses of AD (amyloid, tau and mitochondrial), to the understanding of intracellular processes associated with the formation and progression of AD. The applied impact of the study will be the introduction of an in vitro mitochondrial assay to evaluate the anti-tau effects of new AD drugs, which will allow the selection of agents with high potential for causal treatment of AD.

J. Hroudová Grant / Research support from: Supported by Ministry of Health of the Czech Republic, NU23-04-00032, Z. Fišar Grant / Research support from: Supported by Ministry of Health of the Czech Republic, NU23-04-00032.

Outpatient compulsory observation and treatment by a psychiatrist (OCOTP) is, according to Russian Law, a coercive measure of medical nature. It was put into effect in 1997 and may be assigned by the court to persons suffering from mental disorders who have committed criminal offenses. Forensic psychiatric examination is a mandatory condition for the court to make a decision.

To provide an overview of (1) the purposes of OCOTP, (2) the differences between OCOTP and outpatient mandatory psychiatric treatment, (3) the basis for judicial decisions to order and terminate OCOTP, the duration of OCOTP, and its effectiveness.

An analysis of scientific publications and professional literature on the topic and my own practical experience as a forensic psychiatrist who recommended such a measure to the court, and the treating psychiatrist who carried it out in a mental institution.

OCOTP may be imposed by the court (1) in relation to defendants found NGRI, who committed socially dangerous acts primarily in a state of “temporary mental disorder”, (2) following completion of compulsory inpatient treatment of an insane person, (3) as a preventive measure in conjunction with punishment when the offender is found guilty but has a mental disorder that can be treated on an outpatient basis. OCOTP is ordered for an indeterminate period, and the court considers its extension or termination annually.

OCOTP is an evolving concept and the topic of discussion in professional literature.

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A person-centered outcomes-based quality improvement program is lacking within palliative care in Mainland China. The well-established Australian Palliative Care Outcome Collaboration (PCOC) national model improves palliative care quality.

This study aimed to explore the barriers and facilitators perceived by healthcare providers to integrating the PCOC model in a Chinese hospital-based palliative care unit.

A qualitative descriptive study was conducted using semi-structured focus group and individual interviews. A rapid deductive analysis approach was selected for data analysis. The Consolidated Framework for Implementation Research framework was used to guide the study design, data collection, analysis, and interpretation.

Eighteen healthcare professionals participated in this study, four focus group interviews and five individual interviews were completed. Barriers to the PCOC integration included clinical application and workload concerns (patients in terminal stage, patients’ dialects, workload concerns, and staff shortages); attitudinal barriers (negative attitudes toward PCOC); psychological barriers (numbness to their work) and barriers related to knowledge and self-efficacy (lack of knowledge, capacity, and self-efficacy in palliative care). Facilitators included adapting the program to local contexts, ongoing education and feedback, effective PCOC data use, a supportive work and clinical environment and staff’s perceived advantages of the model across clinical, research and process domains.

The successful integration of the PCOC program hinges on local adaptation, improved data utilization, education, and IT support. In regions with less developed palliative care, enhancing professionals’ knowledge and self-efficacy is crucial. Incorporating assessment and clinical response protocols into technology can accelerate palliative care development and implementation.