Some individuals might be more prone to acquire assertive behaviors earlier in their lifespan than others. Nevertheless, assertiveness can be learnt, and studies suggest that developing them would be beneficial in various fields, including healthcare and medical studies.

This study was conducted to assess medical students’ level of assertiveness, and to characterize the factors that might influence it.

A cross-sectional study was conducted, targeting a representative sample of undergraduate medical students. In total, 91 medical students agreed to participate in an online questionnaire survey. They completed a sociodemographic questionnaire as well as the French validated versions of Rathus Assertiveness Scale (RAS), Depression, Anxiety and Stress Scale, Rosenberg Self-Esteem Scale, General Self-Efficacy.

The response rate was 31.1%. Results showed that 53.8% of participants were considered nonassertive. Assertiveness training was requested by fifty-six students (61.5%). Moderate to extremely severe levels of depression, anxiety and stress were reported by 61.5%, 69.2% and 43.9% of participants respectively. Medical students who practiced individual sport or played music showed significantly lower RAS scores, indicating a higher level of assertiveness (p= .022 and p = .003 respectively). Rosenberg self-esteem scores and general self-efficacy scores were strongly correlated with assertiveness. Depression, anxiety and stress scores were strongly and positively correlated with assertiveness scores. Hierarchical regression analysis revealed that playing music, Self-esteem and self-efficacy were independent predictive variables of assertiveness with beta values of -.219, -.247, and -.209, respectively, explaining 44% of the model.

Assertive communication can provide medical students with an opportunity to become more effective in dealing with those around them, fostering better relationships, and promoting mental well-being. Reinforcing music and individual sports activities may serve as valuable preventive and interventional strategies to improve assertiveness in medical students.

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Schizophrenia is a chronic illness that causes severe disability and dysfunction.The traditional approach focusing on symptom control does not always result in improvement in functioning. Functional recovery is considered to be the achievement of social and occupational functioning and independent living in addition to symptom remission.Factors like negative symptoms, depression, cognitive dysfunction, treatment compliance, internalised stigma, and education impact functional recovery. MetS may impact functional recovery by contributing to depression, reducing treatment compliance, and impairing cognitive functions, but studies on this are limited.

This study aimed to investigate the relationship between MetS and functional recovery in schizophrenia, along with related clinical features.

The study sample included 115 schizophrenia patients aged 18-65, who applied to Gazi University Psychiatry Outpatient Clinic, spoke Turkish, no exacerbation in the last year.Exclusion criteria were serious medical/neurological illness, alcohol/substance use disorder.MetS was diagnosed per American College of Cardiology criteria. Functional Remission of General Schzophrenia Scale (FROGS), Schizophrenia Cognition Rating Scale (SCoRS), Positive and Negative Syndrome Scale (PANSS), The Calgary Depression Scale for Schizophrenia (CDSS), Medication Adherence Rating Scale (MARS), Schedule for Assesing the Three Components of Insight (SAI), Internalized Stigma of Mental Illness Scale (ISMI) scales were applied to all participants. SPSS 22.0 was used, and p<0.05 was considered significant.

The mean age of participants was 48.61, 54.8% were male and 44% had a high school education. MetS was 55.7% of patients.Patients with MetS had significantly lower scores of FROGS, showed more cognitive impairment in problem solving, there were no significant differences between the groups in the other variables examined.The proportion of patients with MetS (79.7%) showing low level of functionality was higher than those without MetS.The total score of FROGS was positively correlated with years of education, scores of MARS and SAI, while it was negatively correlated with age and CDSS scores.Among the components of MetS, fasting glucose level and diastolic blood pressure were found to be significantly correlated with the scores of the FROGS.The negative predictors of functioning were found to be education level, MARS scores, MetS, SCoRS attention domain and PANSS negative scores.

Our results show that MetS associated with lower functionality in schizophrenia. Therefore, good metabolic control in patients with schizophrenia is important for cognitive skills and functionality as well as physical health.

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Financial capability, which encompasses both financial competence and financial performance, is a key requirement for an autonomous and independent life. However, individuals with psychiatric disorders often report difficulties with financial capability and financial stress.

The current study aims to disclose the impact of affective disorders (AD) on financial performance using prospective data from wave 8 and wave 9 of the Survey of Health, Retirement and Ageing in Europe (SHARE).

The SHARE project includes individuals born on or before 1971 or households with at least one member meeting this age criterion. During each wave, participants reported whether they received one of 17 diagnoses, including “affective or emotional disorders, including anxiety, nervous or psychiatric problems”. Furthermore, monthly household net income and whether participants experienced difficulties in managing money, challenges in making ends meet, and their debt situation were recorded. The differences between the AD and a control group (i.e., participants without affective or neurological conditions) on monthly household net income and the three financial performances were examined for both waves. Logistic regression analyses were performed to analyze whether an AD diagnosis predicted financial performances in wave 8 and wave 9.

2,645 individuals reported an AD diagnosis in wave 8, and 47,068 were classified as controls. In wave 9, 3,574 individuals indicated having an AD diagnosis and 60,902 were classified as controls. In both waves, individuals with AD received a lower monthly household net income and reported more difficulties across all three financial performances relative to controls. Furthermore, in both waves, AD individuals reported having more debts on cars and other vehicles, debt on credit/store cards, loans, debts to relatives or friends, overdue bills, and other types of debts than controls. In wave 8, the odds of experiencing difficulties in managing money, making ends meet, and having debts were 3.61, 1.45, and 1.73 times higher, respectively, in AD individuals than in controls. A diagnosis of AD increased the likelihood of future (i.e., during wave 9) financial difficulties: 2.67, 1.38 and 1.68 times for managing money, making ends meet, and having debt, respectively.

Individuals with AD are more prone to experiencing impairments with both current and future financial performance and might face financial difficulties. The present study emphasizes the importance of recognizing financial difficulties in individuals with AD and offering financial assistance when necessary, especially since financial difficulties might exacerbate affective symptoms.

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Up to 10% of women experience severe anxiety symptoms during pregnancy and the postpartum period, which are often underdiagnosed and undertreated, leading to negative outcomes for both mother and child.

This observational study aims to assess: 1) the prevalence of Generalized Anxiety Disorder (GAD) in the postpartum period, and 2) identify its predictors.

All women attending the Gynecology and Obstetrics Department at “L. Vanvitelli” University Hospital were invited to participate in the study. Women who provided consent were assessed within three days after delivery using a specifically designed form for sociodemographic and clinical data collection, the Labor and Delivery Questionnaire (LDQ) for obstetric and gynecological information, and the Italian versions of the following assessment tools: Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder 7-item scale (GAD-7). A GAD-7 score of ≥10 was used as the cutoff for moderate to severe Generalized Anxiety Disorder.

A sample of 110 women with a mean age of 30.74 (±5.67) years, predominantly Caucasian (91.8%), was recruited. Of these, 18.8% (n = 20) had GAD-7 scores indicating a diagnosis of Generalized Anxiety Disorder. Compared to women without GAD, those with GAD were significantly more likely to be unemployed or face difficulty finding work (p < 0.05), have a family history of anxiety disorders (p < 0.05), have other children (p < 0.05), experience conflicts with their parents (p < 0.001), and score higher on the EPDS (p < 0.001). Logistic regression analysis showed a higher likelihood of having GAD among younger women (OR: – 0.029; p < 0.05), those with a positive family history of anxiety disorders (OR: 0.63; p < 0.05), and those with higher EPDS scores (OR: 0.044; p < 0.001).

The study highlights that age, employment status, and a family history of anxiety disorders may be significant predictors of GAD in peripartum period. Further studies with larger samples are necessary to confirm these findings; however, collaboration between psychiatrists, gynecologists, and obstetricians is recommended to identify women at risk of developing GAD early on, facilitating timely and appropriate diagnosis and treatment, and reducing the risks to the mental health of both mother and child.

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Deliberate self-harm (DSH) is a strong predictor of future suicide attempts (SAs), highlighting the need to evaluate interventions that reduce recurrence risk.

This systematic review and meta-analysis aimed to evaluate pharmacological and non-pharmacological interventions for preventing repeated DSH in individuals recently engaged in DSH. We also examined how participants’ characteristics and trial inclusion criteria impacted interventions’ effectiveness.

Randomized controlled trials (RCTs) with participants engaged in DSH within one month before enrollment were included. Studies with participants showing only suicidal ideation or older DSH were excluded. We searched five databases (PubMed, Embase, PsycINFO, WHO ICTRP, and ClinicalTrials.gov) with no language restrictions through September 2023. Two reviewers independently selected studies and resolved discrepancies through discussion. Outcomes were assessed at three time points: T1 (0–6 months), T2 (6–12 months), and T3 (>12 months). The primary outcome was repeat DSH; secondary outcomes included suicidal ideation, suicide deaths, all-cause mortality, anxiety, depression, hopelessness, and quality of life. Interventions were categorized by type and delivery format (individual or group, remote or in-person).

The PRISMA flowchart is shown in Image 1. Sixty-one trials involving 125 comparisons and 21,147 participants were included in this review. Average age was 31.5 years, with most being female (66.58%), unmarried (60.82%), and white (65.49%). Participants’ history of self-harm was noted in 48 studies, with at least 56% having engaged in another act before inclusion. In 42 studies, suicidal intent was either not investigated or not required. The most common types of interventions were Treatment As Usual (TAU) (46 arms), Psychotherapy (36), and Active Contact and Follow-up (25). Interventions were primarily applied individually and in person (84), with Cognitive Behavioral Therapy (16) being the most frequent psychotherapy framework. Psychotherapies were associated with a reduced risk of new self-harm acts within the first six months (T1) compared to TAU (k = 12; N = 2110; OR = 0.69; 95% CI 0.48–0.99). Active contact and follow-up interventions outperformed TAU in the longer-term follow-up (T3) (k = 4; N = 3724; OR = 0.83; 95% CI 0.70–0.99).

Image 1:

The superiority of psychotherapies at six months was not sustained at twelve months. However, active contact and follow-up interventions may offer benefits in reducing the risk of self-harm recurrence after one year.

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Neuroinflammation and the Kynurenine Pathway (KP) have gained attention in the last decades in the pathogenesis of cognitive impairment in schizophrenia. Pro-inflammatory cytokines and microglia activation induce oxidative stress, neurodegeneration, white matter (WM) disruption and increased synaptic pruning and, importantly, activate the KP, whose metabolites have neurotoxic/neuroprotective and neuromodulatory properties on cholinergic and glutamatergic neurotransmission, two pivotal systems in cognitive processes.

This study aims to investigate the relationship between levels of inflammatory markers and KP metabolites and cognition in schizophrenia with a focus on the differential impact of these biomarkers on the different phases of the illness.

Associations between levels of biomarkers and cognitive domains in the wholw sample of 120 patients with schizophrenia were firstly assessed. Then, patients were divided in two subsamples depending on the duration of illness, with the aim to evaluate the impact of inflammatory biomarkers and kynurenines on cognition depending on disease progression. Finally, we performed cluster analysis to investigate kynurenines as possible clustering variables with the final aim to attribute a different cognitive profile to each cluster.

In the whole sample we found negative correlations between multiple inflammatory markers including IL-1β, IL-6, TNF-α, and cognitive functions, particularly verbal memory. Negative associations between verbal memory and TNF-a, IFNg and IL-5 were found in early-phase patients compared to late-phase patients, who showed a less strong associations. Interestingly, kynurenines showed significant associations with cognition in multiple areas regardless of the duration of illness. Regarding clustering, Cluster 1 included patients with lower levels of Tryptophan, Quinolinic Acid, and Kynurenic Acid, as well as higher levels of 3-hydroxykynurenine, compared to Cluster 2 (Fig. 1). Interestingly the two clusters showed different cognitive profiles. Verbal memory, psychomotor speed and attention significantly differed between the two clusters, with Cluster 1 showing the most impaired cognition in all these domains (Fig. 2).

Image 1:

Image 2:

These results stress the primary importance of inflammation and KP abnormalities in cognitive impairment. The effects of inflammation on cognition seems to decline over time, while metabolites of the kynurenine pathway continue to have an impact. Probably, pro-inflammatory cytokines impact cognition more in patients with a shorter duration of illness as the biological bases of cognitive functions are more preserved (cortical volumes, synapses, WM integrity), whilw the neuromodulation of KP metabolites combined with their neurotoxic/neuroprotective profile can explain the diferential effect.

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Impairment in emotion regulation and impulsivity are components of addiction-related mechanisms. The ability to perceive the internal state of the body is known as interoceptive awareness (IA). Impaired IA is believed to contribute to the development and progression of alcohol use disorder (AUD). IA is considered to have two dimensions: interoceptive accuracy (IAc), which measures precise monitoring of bodily sensations, and interoceptive sensibility (IS), which reflects the subjective experience of these sensations. Traits associated with alcohol use vulnerability, such as emotional dysregulation and impulsivity, may also be linked to IA.

Our objective was to compare emotional dysregulation, impulsivity, IAc, and IS levels between abstinent patients with AUD and healthy controls. Additionally, we aimed to investigate potential associations between the dimensions of IA and emotional dysregulation and impulsivity.

The study included 52 abstinent patients with AUD and 52 healthy control subjects. Of the participants, 92.3% (n=48) in each group were male, and 7.7% (n=4) were female. Emotional dysregulation was assessed using the 16-item Difficulties in Emotion Regulation Scale (DERS-16), and impulsivity was measured using the Barratt Impulsiveness Scale 11 (BIS-11). IAc was evaluated using the heart rate tracking task, which assessed participants’ awareness of their own heartbeat by comparing the number of heartbeats they perceived with an objective heart rate measurement. IS was measured using the Multidimensional Assessment of Interoceptive Awareness Version 2 (MAIA-2). The study included patients who had completed detoxification and been abstinent for at least three weeks while participating in or undergoing a 28-day abstinence-based inpatient treatment program.

Individuals with AUD scored significantly higher on self-reported measures of emotional dysregulation (AUD group: 41.50 ± 17.66; control group: 31.19 ± 8.93; p < 0.001, F = 14.106) and impulsivity (AUD group: 61.63 ± 12.30; control group: 53.06 ± 7.50; p < 0.001, F = 17.828), and significantly lower on the heart rate tracking task (IAc) (AUD group: 0.65 ± 0.15; control group: 0.84 ± 0.13; p < 0.001, F = 43.615). No significant difference was found in self-reported IS scores (AUD group: 114.06 ± 21.38; control group: 113.37 ± 13.52; p = 0.844, F = 0.039). There was a significant correlation between emotion dysregulation and impulsivity scores (r = 0.633, p < 0.001). IAc and IS scores showed significant negative correlations with emotional dysregulation scores (r = -0.243, p = 0.013; r = -0.425, p < 0.001, respectively) and impulsivity scores (r = -0.204, p = 0.038; r = -0.416, p < 0.001, respectively).

Our findings support the hypothesis that emotional dysregulation and impulsivity, which are linked to the development and progression of AUD, are associated with interoceptive processes.

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Up to 40% of patients diagnosed with Parkinson’s disease (PD) may experience a psychotic episode during the course of the disease, with antiparkinsonian medications being the main cause. Frequently, aging is associated with a higher risk of comorbid delirium in this population.

To analyze the treatment strategy for delirium in a geriatric patient with Parkinson’s disease.

An 88-year-old male patient, diagnosed with Parkinson’s disease for 12 years, was admitted to the Acute Psychiatry Hospitalization Unit due to a treatment-resistant confusional state. He presented fluctuating symptoms characterized by verbal and physical hetero-aggressiveness, visual illusions and hallucinations, as well as delusional ideas of harm, control, and mystical-religious content. The patient exhibited significant psychological distress, refused to eat, and had erratic medication adherence.

Following a comprehensive organic assessment and treatment of intercurrent conditions, a readjustment of dopaminergic medication was performed, and quetiapine was introduced (up to 900 mg/day), with a partial response. Subsequently, the doses of quetiapine were reduced, and ziprasidone was introduced, achieving total remission of symptoms with good tolerance (quetiapine 450 mg/day, ziprasidone 80 mg/day, levodopa/carbidopa 150 mg/day).

Following pharmacological recommendations for managing delirium, initial treatment with quetiapine (first-line) was established. Subsequently, clozapine (second-line) was introduced, achieving a better response and cessation of symptoms. This case highlights the complexity of managing delirium in geriatric patients with PD, considering the patient’s age and lack of response to standard therapeutic guidelines. Clozapine, with a more favorable profile regarding motor effects, presents as the preferred option compared to other antipsychotics that may exacerbate parkinsonism.

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Cognitive deficits are a fundamental characteristic of schizophrenia, similar to positive and negative symptoms. They lead to significant disability due to their impact on various domains of life.

This study aimed to study the relationship between cognitive impairment and sociodemographic, clinical, and therapeutic factors in patients with schizophrenia.

This study was carried out in the Psychiatry « c » Department at Hedi Chaker University Hospital in Sfax, Tunisia, involving 15 patients with schizophrenia. We used the Screen For Cognitive Impairment in Psychiatry (SCIP) in its literary Arabic version to assess cognitive functions. Data were analyzed using SPSS version 20.0 software.

The mean age of the patients was 40 ± 12.72 years. Among the participants, 80% (n=12) were single. Seven cases (46.7%) had not exceeded primary education. The mean age of illness onset was 27.8 years, and the mean duration of illness was 13.7 years. Five patients (33.3%) had a family history of psychiatric disorders. All patients were receiving antipsychotics (AP), and 13.2% of them were on Haloperidol decanoate (HD). The mean scores for the total SCIP (ST) and its five subscales (verbal learning test-immediate (VLT-I), working memory test (WMT), verbal fluency test (VFT), verbal learning test-delayed (VLT-D), and processing speed test (PST)) were 37.40, 12.87, 14.27, 3.93, 2.47, and 3.93, respectively. A negative correlation was found between age and performance on the ST, WMT, and PST (r values: -0.515, -0.629, -0.615, respectively). Regarding marital status, VLT-I scores were better in single patients (p=0.007). Our study revealed that the low level of education was significantly correlated with several cognitive tests measured by the SCIP, including the ST, VLT-I, WMT, VFT, and PST. Mean scores for ST, VLT-I, WMT, VFT and PST were significantly lower in patients with illness onset after age 40 (p<0.05). The WMT score was significantly lower in patients with an illness duration exceeding 5 years and in patients with a family history of psychiatric disorders (p values: 0.05; 0.021). The PST score was significantly lower in patients on HD (p=0.038).

Sociodemographic, clinical, and therapeutic factors harm the cognitive abilities of patients with schizophrenia. Thus, it is essential to carry out neurocognitive assessments during the follow-up of these patients, taking into account factors likely to predict cognitive impairment.

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Physical activity has been identified as a therapeutic intervention for the treatment of depressive disorders. It can be conducted as a standalone intervention or as a complementary therapy method within a multimodal treatment framework. Engaging in physical activity is important for maintaining physical and mental health. There is a need for research on the implementation of exercise therapy interventions that takes into account everyday clinical practice outside the controlled conditions in study protocols. Physical activity is particularly promoted in the context of sports therapy.

Therefore, the objective of this study is to examine the impact of exercise therapy in a day clinic setting on depressive symptom severity and cardiovascular fitness.

The study sample includes patients with a primary diagnosis of depression who had completed a minimum of four and a maximum of nine weeks of inpatient treatment in a psychotherapeutic and psychosomatic hospital in Germany. Patients in the intervention group (IG) receive exercise therapy at least twice a week throughout their treatment, while patients in the control group received a maximum of 0.5 units/week of exercise therapy. As part of the multimodal treatment setting, the exercise therapy interventions in both groups include spinal exercises, equipment-based strength and endurance training, soccer and table tennis. The BDI-II is administered to both groups to assess the severity of depressive symptoms. Cardiovascular fitness of IG is monitored using a submaximal cycle ergometer aerobic fitness test (PWC test) at baseline and at the end of treatment.

The total number of patients included in the analysis was n=37 in IG (male=78%, M age=42.05) and n=20 in CG (male=60%, M age=47,35). A significant reduction in the BDI-II score was observed in both the IG (M ΔBDI-II=-16.0, p<.001) and CG (M ΔBDI-II=-8.0, p<.05) from the beginning to the end of the treatment period. When comparing reduction in depressive symptoms between two groups, IG achieved statistically significant greater reduction in depressive symptoms compared to the CG (M ΔBDI-II=-8.0, p<.01). Participants in the IG showed a statistically significant improvement in performance, with an increase of 7 watts for the PWC130 and 12 watts for the PWC150 (p<.05), as measured by the submaximal cycle ergometer aerobic fitness test throughout treatment.

The integration of exercise therapy into a multimodal treatment framework was observed to positively impact both physical and mental health outcomes. Given the presence of physical comorbidities and relapses, further research should investigate the long-term impact of behavioral changes related to physically active lifestyle.

None Declared

Work-related mental health issues are becoming increasingly prevalent, particularly in professions involving direct communication and care, such as healthcare. Primary Health Care (PHC) plays a critical role in prevention, health promotion, and the management of emergency situations. The mental and emotional well-being of healthcare professionals in PHC is essential for maintaining high levels of performance and work effectiveness. However, there is limited research on the psychosocial conditions of healthcare staff in PHC settings, particularly regarding anxiety, stress, depression, and psychological distress.

The objective of this study is to evaluate the prevalence of anxiety, stress, depression, and psychological distress among medical and nursing staff working in primary healthcare units in Peloponnese. Additionally, the study aims to examine the associations between these mental health indicators and various individual and professional characteristics, such as age, gender, and professional role.

An online survey was conducted to gather data from a final sample of 103 healthcare professionals. A questionnaire was constructed ad hoc and comprised two well-established measurement tools. The Depression, Anxiety, and Stress Scale (DASS-21) was employed to assess anxiety, stress, and depression, while the K6+ was used as a self-report measure to evaluate psychological distress.

The results demonstrated that the participants exhibited generally low levels of anxiety, stress, and depression. As indicated by the DASS-21 scale, approximately 75% of respondents reported minimal to no anxiety, with only 7.8% reporting severe anxiety. Similarly, 75% of respondents indicated minimal to no stress, with only 4% reporting severe stress. Regarding depressive symptoms, 76% of participants exhibited minimal to no depressive symptoms, while only 4% demonstrated severe depressive symptoms. However, approximately 20% of the sample exhibited signs of psychological distress, which may indicate a significant mental health concern. Significant correlations were found through statistical analysis: older employees exhibited lower levels of anxiety, while nursing staff demonstrated higher levels of anxiety compared to medical staff. Additionally, women reported higher anxiety levels than their male colleagues.

In conclusion, while anxiety, stress, and depression levels are generally low among healthcare professionals, a notable portion of the workforce is at risk of serious psychological distress. These findings indicate the need for targeted mental health interventions, particularly for younger staff, nurses, and female employees, to ensure the well-being of healthcare professionals and maintain the efficacy of primary healthcare services.

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Approximately 16 million individuals experience a first-time stroke annually, with vertebrobasilar (VB) strokes accounting for 20% of all strokes and transient ischemic attacks. Neuropsychiatric symptoms affect at least 30% of stroke survivors and are associated with low quality of life, an increase in the burden of caregiving, and impaired functional status. These complications can range from mood disorders to psychosis. Psychosis is a relatively rare complication after stroke but is among the most serious of the poststroke syndromes. However, there are no specific guidelines for its treatment.

To describe a case of psychosis following a vertebrobasilar stroke and review the relevant literature on the topic.

We report a case of post-stroke psychosis in a man with no prior psychiatric history and conduct a non-systematic review of the literature.

A 46-year-old man with a history of dyslipidemia and testicular cancer 13 years prior and no previous psychiatric history was admitted to the Stroke Unit under the care of Internal Medicine and Neurology due to a vertebrobasilar stroke. Liaison Psychiatry was called to assess the patient on the 27th day of hospitalization due to visual hallucinations. On examination, the patient presented with a suspicious facial expression, persecutory and infidelity delusions, and both visual and auditory hallucinations. No other psychopathological changes were observed. The case was discussed with the Neurology team, and the patient underwent laboratory tests, a new head computed tomography, and an electroencephalogram, none of which showed recent significant abnormalities. The patient was started on olanzapine 5 mg daily. The patient was reassessed after one week and continued to have the described psychotic symptoms, leading to an increase in the olanzapine dose to 10 mg. After two weeks of treatment, there was a noticeable reduction in the psychotic symptoms.

Psychosis is a possible complication of stroke and is associated with impairment and increased mortality. According to the literature, strokes in the vertebrobasilar territory can cause hallucinations. Guidelines for managing poststroke psychosis are currently lacking, and to assure evidence-based care, further research is needed. This case underscores the importance of early detection and intervention, emphasizing the need for a multidisciplinary approach to managing post-stroke psychosis.

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Bullying is a persistent aggressive behavior characterized by a power imbalance and driven by the intent to cause harm. Examining the connection between past experiences of victimization and current bullying behaviors is essential for a comprehensive understanding of this phenomenon..

This study aims to assess the prevalence of bullying and cyberbullying among Tunisian adolescents and to explore the relationship between current bullying behaviors and a history of childhood victimization.

This cross-sectional study was conducted via a survey among adolescents attending middle and high schools during the 2023-2024 school year. Participants provided written consent and completed a demographic information sheet, the Adolescents and Peer Relations Instrument (APRI), and the Adverse Childhood Experience-International Questionnaire (ACE-IQ).

The study population consisted of 1,005 adolescents, with a sex ratio of 0.73 and a mean age of 14.62 years. We find that 92.1% of adolescents experienced traditional bullying within the year, with 54.9% exposed to school bullying more than once a month. The most prevalent form was verbal bullying (88%), followed by relational bullying (77.3%) and physical bullying (73.9%). Among the participants, 38.5% had no history of past bullying but were currently victimized, 53.7% had experienced bullying in the past and continued to be victimized, 1.3% had been victimized in the past but no longer experienced bullying, and 6.5% had never been bullied, either in the past or present.

We identified a significant association between peer violence and bullying victimization, with a p-value <0.001 and an odds ratio (OR) of 4.11 (95% CI: 2.5-6.66). There was also a significant correlation between peer violence and the APRI scale (p < 0.001). Further analysis showed a strong correlation between peer violence and verbal bullying victimization (p < 0.001, OR = 3.75 [2.53-5.56]), relational bullying victimization (p < 0.001, OR = 2.8 [2.1-3.8]), and physical bullying victimization (p < 0.001, OR = 2.64 [1.97-3.53]). The risk of being victimized by all three forms of bullying was tripled (p < 0.001, OR = 2.75 [2.1-3.6]).

This study highlights the alarmingly high prevalence of bullying among Tunisian adolescents and emphasizes the significant link between past victimization and current bullying experiences. These findings underscore the need for targeted interventions that address the underlying trauma from past experiences to promote positive youth development.

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Cervical spine injuries are serious traumatic situations

Aim-Aim of this study was to evaluate the attentional skills in cases with serious cervical spine injuries, in young sports men.

Material and Methods-10 young male amateur sports men (1 soccer player, 1 basketball player, 1 volley-ball player, 1 hand ball player, 1 boxer, 1 long runner, 1 fast runner and 3 swimmers) were participated in this study, 20 days more or little less after serious cervical spine injuries. Range of age 19-39 years and mean age 29 .We used specific performance tests, letter cancellation exam, naming trials and iq tests.

Results-All of them(10,100%) reported deficits in all areas of attention function and also cognitive and emotional status.9 of them(90%) reported also difficulty in complex task activities, especially when time limits were imposed.

Conclusions-All these exams are good and efficient tools in order to evaluate this kind of patients.

None Declared

Dual diagnosis, involving both a mental disorder and an addiction disorder, significantly impacts patients’ functionality and quality of life. In Colombia, from 2009 to 2017, an average of 20,590 individuals with dual diagnosis were treated annually, representing 7.2 Disability-Adjusted Life Years (DALYs) (Ministerio de Salud, Boletín de Salud Mental No. 7, 2018). This study investigates effective therapeutic strategies for this complex condition by examining six patients with schizophrenia or other psychotic disorders and comorbid addiction who were treated with depot antipsychotics. We assessed their personal and social functioning, symptom severity using various surveys.

Describe outcomes of long-acting injectable antipsychotics in patients with dual diagnosis beyond the clinic

To promote research involving a larger number of subjects with dual diagnosis and co-occurring mental disorders, like schizophrenia

Continue the pursuit of tools aimed at improving the quality of life in patients with dual diagnosis.

This case series involved six patients, all men, aged 20-40 years, all of them using depot antipsychotics (paliperidone quarterly = 2, paliperidone monthly = 3, and risperidone biweekly = 1), followed over 12 months in an addiction program with quarterly evaluations (T0=initial contact, T1=three months, T2=six months, T3=nine months, T4=twelve months) from July 2022 to August 2024 on an outpatient basis. All participants had an addictive disorder and schizophrenic and schizoaffective disorder diagnosed. We administered four periodic surveys (ASSIST, CGI-I, PSP) to evaluate personal and social functioning and symptom severity. Results were collected in a database through in-person visits or telephone contact, with surveys conducted by a multidisciplinary team including psychology, social work, occupational therapy, and psychiatry.

the ASSIST scores improved from [T0=1.333 (44.43%) to T4=2 (44.67%)], CGI-I scores decreased from [T0=4.33 (61.9%) to T4=3 (42.8%)], and the PSP scale showed improvement from [T0=1.666 (55.53%) to T4=2.166 (72.20%)]. These results reflect enhanced cognitive and social functions, particularly in social functioning. Similar results were observed in patients with schizophrenia in a study by Shi et al. (Neuropsychiatr Dis Treat. 2016;12:2095-2104), supporting the potential benefits of depot antipsychotics for dual diagnosis patients.

Depot antipsychotics can be a valuable tool for managing dual diagnosis, enhancing treatment adherence, general functionality and reducing symptom severity. However, this observational study did not account for substance types or socioeconomic factors.

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Liaison psychiatry mostly deals with consultations that are required in different department of somatic hospitals. The patients range from surgery to dermatology and the consultations vary depending on the department. As far as we know, in Europe, there is no psycho-oncology department with a psychiatrist on board full-time. In Ljubljana, Slovenia, this has been the case since 1984, with a short break for a few years, but an addition again in the last three years. Working as a psychiatrist in a very specific and demanding environment at oncology has its; challenges, as well as integrating the work with a team of clinical psychologists.

We wanted to analyse how many and what kind of patients are referred to the psycho-oncology department, either to a psychiatrist or a clinical psychologist.

We gathered the data from referrals; How many patients were checked in an office or in a hospital setting, how many of these were first referrals. We also compared the checkups by a psychiatrist or by a clinical psychologist. Out of these, we looked at the oncological diagnosis and if they were referred by an oncologist. Out of our first referrals checked which diagnosis was most prevalent.

In the year 2023 the statistical data of the psycho-oncology department was gathered by the psychiatrist and clinical psychologist. Number of referrals for a psychiatrist was 895 and for a clinical psychologist was 1511. The psychiatrist performed 215 first referrals, so 24% out of all checkups. The psychologist did 325 first referrals, which is 21% out of all check-ups. For the psychologist and the psychiatrist the most common adjoining cancer diagnosis with a referral was breast cancer, making up 47% in the psychiatrist case and 44% in the psychologist case of all of the first checkups. Most common indication for a referral to a psychologist was mental distress, while for a psychiatrist was depression. Interestingly both the psychologist and psychiatrist would afterwards diagnose their patients most often with the diagnosis of adjustment disorder.

The data showed interesting differences and similarities between referrals to a psychologist and a psychiatrist. It is important to note, that the distinction of referrals to psychiatrist or clinical psychologist at the psychooncology department is rather new. It should be mentioned, that the distinction is also that there is only one psychiatrist compared to three psychologists. The data will continue to be gathered as to ascertain the adaptation of the entire oncology clinic to a better accessibility of a consultation psychiatrist.

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HIV infection can lead to neurological and psychiatric disorders by affecting the central nervous system. Toxoplasma gondii can cause encephalitis in immunocompromised individuals, particularly damaging brain regions such as the frontal cortex and basal ganglia. These neuroanatomical disruptions can influence dopaminergic and serotonergic neurotransmitter pathways, resulting in severe neuropsychiatric symptoms like behavioral disinhibition, personality changes, and psychotic manifestations (Vidal JE. J Int Assoc Provid AIDS Care 2019; 18:2325958219867315).

This case seeks to demonstrate the neuropsychiatric effects of HIV and Toxoplasma gondii infections on neuronal function and behavior, emphasizing the importance of continuous assessment and integrated treatment approaches.

A 49-year-old male patient, with no known medical history, developed Toxoplasma gondii encephalitis after being diagnosed with HIV. Following discharge from the infectious disease ward, the patient exhibited increased irritability, impulsivity, hypersexuality, visual hallucinations, disorganized speech, and risky behaviors, along with cognitive dysfunction and social norm violations. The patient’s symptoms partially improved with a treatment regimen of 15 mg olanzapine and 1000 mg valproic acid. However, the patient’s ongoing course, parkinsonism symptoms emerged, prompting the discontinuation of valproic acid and the consideration of quetiapine. The patient’s follow-up treatment is ongoing.

HIV and Toxoplasma gondii disrupt neuronal function through inflammatory responses and microglial activation in the central nervous system. HIV does not directly damage neurons, but inflammation from cytokines released by microglia can lead to neurodegenerative conditions. Dopaminergic dysfunction is linked to psychotic symptoms, while serotonergic disruptions contribute to depression and anxiety. Frontal lobe and basal ganglia damage impair executive functions (planning, decision-making, impulse control), causing increased impulsivity, risky behaviors, emotional dysregulation, irritability, lack of empathy, behavioral disinhibition, hypersexuality, and cognitive dysfunction. These changes are tied to structural damage in the frontal cortex, necessitating long-term follow-up and comprehensive treatment. Diagnostic imaging often shows white matter lesions, basal ganglia damage, and frontal cortex atrophy. Treatment involves antiretroviral therapy, low-dose antipsychotics, mood stabilizers for managing symptoms (Bartolomé Del Pino LE et al. Actas Esp Psiquiatr 2024; 52(2):149-60).

HIV and Toxoplasma gondii infections induce significant central nervous system impairment, leading to neuropsychiatric disorders. This case illustrates their impact on neurotransmitter systems, manifesting as psychosis, cognitive dysfunction, and behavioral disturbances. Continued monitoring and comprehensive treatment are essential.

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Hypericin and hyperforin, key secondary metabolites of Hypericum spp., commonly known as St. John’s Wort, are known for their ability to modulate neurotransmitter systems in the mammalian brain. These compounds, which evolved as plant defense chemicals, have significant implications for their interaction with mammalian neurobiology, particularly concerning serotonin, dopamine, and norepinephrine pathways.

This review aims to elucidate the precise molecular mechanisms by which hypericin and hyperforin influence mammalian brain function. The focus is on understanding how these compounds interact with neurotransmitter transporters and receptors, and how these interactions may lead to both therapeutic and adverse neurobiological outcomes.

A comprehensive review of neurobiological and pharmacological literature was conducted, focusing on studies that detail the molecular interactions of hypericin and hyperforin with key components of neurotransmitter systems in mammals. in vitro binding assays, in vivo neuropharmacological studies, and molecular dynamics simulations were reviewed to understand these compounds’ binding affinities, receptor modulation, and downstream signaling effects.

Hypericin, with its planar polycyclic structure, exhibits a strong affinity for serotonin transporters (SERT), where it acts as a non-competitive inhibitor, leading to increased synaptic levels of serotonin. This mechanism mirrors that of selective serotonin reuptake inhibitors (SSRIs) but also introduces the potential for serotonin syndrome when combined with other serotonergic agents. Additionally, hypericin’s ability to generate reactive oxygen species (ROS) under light exposure contributes to neurotoxicity, particularly in regions of the brain exposed to higher oxidative stress.

Hyperforin, characterized by its phloroglucinol core and multiple prenyl groups, exerts its effects primarily through modulation of synaptic vesicle function and ion channel activity. It non-selectively inhibits the reuptake of several neurotransmitters, including serotonin, dopamine, and norepinephrine, through a mechanism involving transient receptor potential (TRP) channels. This broad-spectrum inhibition can lead to significant changes in synaptic plasticity and neurotransmission, impacting mood regulation, anxiety, and cognition.

The interaction of hypericin and hyperforin with mammalian neurotransmitter systems underscores their potential as both therapeutic agents and neurotoxins. The molecular mechanisms by which these compounds modulate neurotransmitter transporters and receptors reveal a delicate balance between beneficial and adverse effects. Understanding these mechanisms is critical for evaluating the safety and efficacy of Hypericum extracts in clinical contexts, particularly regarding their impact on brain function and the potential for neurotoxicity.

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Treatment resistant schizophrenia (TRS), according to HOWES et al. 2017, is defined as a patient’s condition in which, despite two or more treatment cycles with adequate dosage and duration of antipsychotic treatment, the patient’s condition does not improve to the extent expected with positive or negative or cognitive symptoms persisting. The heterogeneity of patients with resistant psychosis is high, and some may show the resistance in the course of the disease after years. However, several patients show resilience from the first psychotic episode.

Treatment resistant psychosis is probably a distinct subtype of schizophrenia, with a different etiopathogenetic mechanism. Clozapine is currently considered the drug of choice with proven efficacy, whereas atypical antipsychotic drugs are inferior in efficacy in the treatment of resistant psychosis.

The mechanism of action of the drug is unknown and there is a potential for serious side effects to occur, which necessitates the adoption of a specific protocol for clozapine administration and patient monitoring in regular psychiatric clinical practice.

The Adult Psychiatric Clinic of Sismanoglio General Hospital in Athens, Greece, in its effort to create a systematic and integrated treatment and monitoring of patients who take clozapine, has created, in collaboration with the cardiology and hematology department of Sismanoglio Hospital a special unit for paients with treament resistant scizophrenia.

The unit called “CLOZAPINE UNIT” will ensure the regular and continuous monitoring of patients receiving clozapine during and after their hospitalization in the psychiatric clinic.

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Borderline Personality Disorder (BPD) is primarily characterized by emotional dysregulation, impulsivity, and unstable relationships. While much of the research on BPD focuses on its impairments, recent studies suggest a possible link between certain BPD traits and enhanced creativity. Emotional intensity, cognitive disinhibition, and non-linear thinking—common in individuals with BPD—are also characteristics frequently associated with creative processes. This review aims to synthesize existing literature exploring the connection between BPD traits and creativity.

The primary objective is to review and summarize the existing literature on the association between BPD traits and creativity, focusing on how emotional and cognitive aspects of BPD may facilitate creative thinking.

A non-systematic review of the literature was conducted by searching academic databases such as PubMed, PsycINFO, and Google Scholar for articles published up to 2023. Search terms included “Borderline Personality Disorder,” “creativity,” “personality traits,” and “emotion regulation.” Articles were selected based on relevance to the topic, focusing on studies that explored the link between BPD traits and creativity.

The review identified studies showing a nuanced relationship between BPD traits and creativity. Individuals with BPD traits may access a wider range of emotional experiences, which can enhance creative expression. Impulsivity was linked to spontaneous idea generation and creative risk-taking, although it may also hinder the focus needed for refining creative work. Some research points out that the extreme emotional dysregulation associated with BPD can undermine creative productivity. While emotional intensity might inspire originality, it can also lead to difficulty in structuring ideas, or an inability to complete creative tasks. A few studies even suggest that high levels of interpersonal difficulties, common in individuals with BPD, may further complicate the consistent pursuit of creative projects, as social conflicts or emotional crises might divert focus and energy. In contrast, a smaller body of literature found that individuals with BPD traits might excel in creative fields that value expression, such as art, music, or writing, where emotional intensity and non-linear thinking can be channeled into meaningful creative outputs.

While the reviewed literature suggests that certain BPD traits may enhance creativity, the relationship is complex and multifaceted. Emotional intensity and impulsivity, while potentially beneficial for creative output, can also disrupt focus and long-term creative endeavors. Overall, while BPD traits may foster creativity, they also pose challenges to sustaining long-term creative productivity.

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