ADHD has been seen by current science as an expression of complex traits that go beyond the symptomatological triad of “inattention-hyperactivity-impulsivity”. Among the new notes, experiences of deep concentration (DC) are mentioned as a frequent phenomenon in the daily lives of those with ADHD, which encourages research on this topic.

The main objective of this integrative review was to investigate how empirical scientific studies have evaluated, associated and understood this hyperfocused attentional pattern in individuals with a diagnosis or symptoms suggestive of ADHD.

For searches in the electronic databases PubMed, Scopus, LILACs, Pepsic and Scielo, the terms “attention deficit hyperactivity disorder”, “hyperfocus” and “flow state” were chosen. As inclusion criteria, studies were considered with (a) full texts available, (b) with an empirical design, (c) in English and (d) published in any year. In total, 10 empirical studies were analyzed (8 quantitative and 2 qualitative), Regarding the critical analysis of the included publications, relevant data were extracted about: (a) assessment instruments for deep concentration measures, (b) ADHD assessment instruments, (c) associations between hyperfocus, flow and ADHD and (d) general understandings of researchers on the representation of DC experiences in the lives of those with ADHD.

The sudies indicated a plurality of assessment instruments for both CP constructs (hyperfocus, flow, perseveration) and ADHD symptoms. As main findings, the articles suggest a high prevalence of hyperfocus in adults with ADHD compared to those without the disorder, as well as positive correlations between ADHD symptoms, hyperfocus, perseveration, internet addiction and emotional dysregulation. Different perspectives on the manifestation of DC in ADHD were captured from the studies, whose interpretations ranged from harmful behavior to the potentiality of ADHD.

It was observed that, despite the recent expansion of research trying to understand the phenomenon of hyperfocus in the context of ADHD, scientific knowledge on the topic is still quite limited. In addition to having the unprecedented character of bringing together what modern science has postulated about CP in relation to ADHD, this research is relevant because it contributes to expanding the visibility of ADHD beyond the diagnostic criteria established by the DSM-V-TR and ICD-11.

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The COVID-19 pandemic has evolved into substantial mortality and morbidity worldwide, with 5-8% of patients requiring intensive care. Years after the emergence of COVID-19, there is a heightened interest about the Long COVID, a heterogeneous condition characterized by persistent or emergent symptoms that last for weeks or months after patient’s recovery from acute infection, with a negative impact on physical and mental health. Research indicates that depression and anxiety often co-occur and may serve as predictors for Long COVID. Given the scale of the pandemic, even a small proportion of patients with long-lasting symptoms will create a significant health burden. Therefore, gathering data on the long-term evolution and outcomes of these patients is of utmost importance.

To identify depressive and anxiety symptoms in severe COVID-19 survivors 1-year after discharge and to analyse their association with sex, age and fear of recurrence and sequelae of COVID-19.

The cohort analysed is part of MAPA research project and includes adult patients admitted due to COVID-19, in an Intensive Care Medicine Department of a University Hospital in Portugal. Participants were evaluated 1-year after discharge to home with a comprehensive protocol, which included Patient Health Questionnaire (PHQ-9; depressive symptoms), General Anxiety Disorder scale (GAD-7; anxiety symptoms) and a brief questionnaire about fear of recurrence and sequelae of COVID-19.

The final sample (n=159) had a mean age of 62.2 years and mostly (69%) was male. About 19% and 21% of survivors scored for depressive and anxiety symptoms, respectively. Both symptoms were significantly more prevalent among younger participants (p=0.031; p<0.001) and were associated with fear of recurrence (p=0.002; p=0.009) and sequelae (p=0.001; p<0.001) of COVID-19 1-year after discharge.

Overall, there is a significant prevalence of anxiety and depressive symptoms among COVID-19 survivors 1-year after discharge. These findings emphasize the need for greater attention to these symptoms in this population, since its recognition and treatment can improve quality of life and reduce symptoms in the long term, especially in younger patients.

This work was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDP/4255/2020)

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Burnout is a longstanding issue among educators and has been associated with psychological and physical health problems such as depression, and insomnia.Chronic stress has been associated with burnout, defined by three dimensions of overpowering exhaustion (emotional exhaustion), cynicism (feelings of cynicism and detachment from work), and inefficacy (a sense of ineffectiveness and lack of accomplishment) which conceptualize the individual stressful experience in a social context.

To assess the prevalence and predictors of the three dimensions of burnout (emotional exhaustion, depersonalization and lack of professional accomplishment) among elementary and high school teachers.

This is a quantitative cross-sectional study with data collected via an online survey. The Maslach Burnout Inventory-Educator Survey (MBI-ES), the Brief Resilience Scale (BRS) and the Perceived Stress Scale were used, respectively, to assess burnout, resilience and stress among teachers. Data was collected between September 1st, 2022 and August 30th, 2023. SPSS (version 28, IBM Corp) was used for the data analysis.

Overall, 1912 educators received a link to the online survey via a text message, and 780 completed the burnout survey questions, resulting in a response rate of 41%. The prevalence of emotional exhaustion, depersonalization, and lack of professional accomplishment were 76.9%, 23.2%, and 30.8%, respectively. Participants with high-stress symptoms were 6.88 times more likely to experience emotional exhaustion (OR = 6.88; 95% CI: 3.31–14.29), 2.55 times (OR = 2.55; 95% CI: 1.65–3.93) more likely to experience depersonalization and 2.34 times (OR = 2.34; 95% CI: 1.64–3.35) more likely to experience lack of professional fulfilment. Additionally, respondents with low resilience were 3.26 times more likely to experience emotional exhaustion symptoms (OR = 3.26; 95% CI: 2.00–5.31),) than those with high resilience. Males were about 2.4 times more likely to present with depersonalization compared to female teachers, whilst those who indicated their marital status as partnered or cohabiting and those who selected “other” were 3.5 and 7.3 times respectively more likely to present with depersonalization compared with those who were single. Finally, Physical Education were 3.8 times more likely to present with depersonalization compared with English teachers.

The current study highlights the predictive effects of low resilience and high stress on the three dimensions of burnout among teachers in Canada. Interventions aimed at addressing systemic stress and fostering resilience are needed to reduce burnout among teachers.

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The increasing prevalence of mental health issues presents a significant challenge for modern societies. There’s a crucial need for quick, affordable interventions that can be widely implemented by practitioners to support as many individuals as possible.

In this paper we aimed to investigate the mediating role of executive functions and emotional regulation in the relationship between sleep quality and physical activity, on one hand and negative affect, on the other.

Our proposed model is a serial mediation model, with executive functions as the first mediator and the two components of emotional regulation as the second mediator. We collected data from 286 participants who completed a series of questionnaires.

The initial model did nit fit the data well. Therefore, we added two paths: the direct relationship between sleep quality and negative affect and the direct relationship between executive functions and negative affect. The final model had a very good fit with the data. Thus, both the hypotheses regarding the direct relationships and those regarding the indirect relationships are supported by the data.

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The results highlight the importance of interventions aimed at improving sleep quality and promoting physical activity. These interventions can serve to promote optimal mental health in both clinical and non-clinical populations. Additionally, this research provides a basis for developing effective strategiesfor the prevention and treatment of these populations.

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Social cognition impairments are well-recognized in both Schizophrenia Spectrum Disorders (SSDs) and Autism Spectrum Disorder (ASD), significantly impacting interpersonal relationships and overall quality of life. While some studies have suggested differences in social cognition between these two disorders, recent research has shown that these differences may be non-significant when controlling for factors such as age and symptom severity(Pinkham et al. Psychol Med 2019; 1-9). Given the overlap in symptoms and the potential for autistic traits to influence social cognitive functioning in SSD, it’s crucial to investigate how these traits can impact social cognition in individuals with SSD.

The aim of this study is to evaluate autistic traits in SSD and its relation with social cognition and clinical variables.

73 participants with SSD (56 patients (mean age 37.80 ± 11.519) with schizophrenia and 17 patients (mean age 36.47± 10.909) with schizoaffective disorder) participated in the study. All participants were interviewed using the Structured Clinical Interview for DSM-IV. Current psychotic, negative and positive symptoms of all patients were evaluated using the Scale for the Assessment of Positive Symptoms and the Brief Negative Symptom Scale (BNSS). The Screen for Cognitive Impairment in Psychiatry(SCIP) was used for measuring cognitive function. Autistic traits are evaluated with the Comprehensive Autism Trait Inventory (CATI). In the assessment of social cognition, facial emotion recognition was evaluated with Penn Emotion Recognition Test (PERT), theory of mind was assessed Reading Mind in The Eyes (RMET) task.

Total CATI scores weren’t correlated with RMET and PERT scores. Communication and social camouflage subscores of CATI were negatively correlated with total RMET score (r=-0.289, p=0.013; r=-0.265, p=0.024). CATI total/subscale scores didn’t have a relationship with age, education years, BNSS and SCIP scores. SCIP score was correlated with RMET(r=0.358, p<0.01) and PERT (r=0.259, p=0.027). Age had a negative relationship with RMET(r=-0.27, p=021) and PERT (r=-0.397, p<0.01) scores while education was positively correlated with RMET even though the the strength was low (r=0.246, p=0.036).

Contrary to expectations, the results did not show a relationship between higher autistic traits in SSD and social cognitive performance. The social subscales of CATI revealed a negative correlation between higher autistic traits and theory of mind performance, but no correlation with emotion recognition. In accordance with literature, aging shows a relationship with lower social cognition scores. Future research should further investigate how autistic traits impact theory of mind deficits in SSD. Interventions regarding social cognitive deficits with age should be evaluated.

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An opportunity arose to compare the outcomes of patients of one psychiatrist in two different clinical settings – a community mental health center CMHC) in which the psychiatrist saw people on average for 15 minutes every 6 weeks (range 4 to 12 weeks) and a community clinic setting (CCS) in which the psychiatrist controlled the time allotted per patients and the frequency of visits. We assumed that the psychiatrist’s beliefs, attitudes, and style of practice did not change between the two settings except as influenced by time constraints. Psychotherapy was provided by social workers in both settings, with an average of 45 minutes every 3 weeks in the CMHC and 40 minutes every week in the CCS. Three optional groups existed in the CCS compared to one in the CMHC. New patients received a 30 minute evaluation in the CMHC and a 60 minute evaluation in the CCS.

To compare the dominant style of practice in the United States with an older style of practice in which psychiatrists spent more time with clients.

The psychiatrist administered the MYMOP2 (My Medical Outcome Profile, version 2) and the Brief Psychiatric Rating Scale (BPRS) to all patients at baseline in both settings. The MYMOP2 was repeated monthly (or at the next visit in the CMHC) and the BPRS at intervals of every three months. The study lasted two years and the average length of follow-up was 31 weeks in the CMHC and 49 weeks in the CCS, which was statistically significant.

No statistically significant differences appeared in demographic variables. Percent funded by Medicaid, Medicare, other insurance, gender, and age distribution were the same in both settings. Clinical improvement was not observed among patients on average on both measures in the CMHC. Clinical improvement was observed on both measures in the CCS (MYMOP-2; p < 0.01 on worst symptom; BPRS, p < 0.01). The CMHC showed higher profits than the CCS. Time spent per patient was statistically significantly greater in the CCS (p < 0.01).

Increased opportunity for contact and relationship with the psychiatrist may play a greater role than assumed by the biomedical model. A public health question arises in relation to models for provision of care that are more profitable but less health effective.

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Pentazocine dependence, although rare, poses serious risks in patients with chronic pain, especially after surgical interventions. Misuse of prescribed opioid analgesics, such as Pentazocine, can lead to a wide range of medical and psychiatric complications. This case study explores the long-term effects of Pentazocine dependence in a patient with coexisting psychiatric conditions and chronic medical illnesses.

MAM, a 57-yer-old female patient, was first introduced to Pantozocine following pancreatic surgery in 1999 for Wirsung duct calcifications, a hereditary condition. Initially prescribed for pain relief, the patient increased her dose to 14-20 vials/day over six months. Psychiatric issues, including suicidal ideation and financial distress, emerged shortly after her addiction took hold.

Between 2002 and 2024, the patient was admitted to psychiatric wards approximately 55 times. In 2003, after an accidental burn injury to her lower limbs, she began injecting Pentazocine directly into the wounds, as intramuscular administration no longer produced the desired effects. Her conditionworsened with multiple suicide attempts, including an overdose of 22 vials of Pentazocine, which she survived. During her hospitalizations, she presented with complications such as insulin dependent diabetes mellitus, mixed tissue disease, cervical spondylosis, and Raynaud’s syndrome. Multiple reconstructive surgeries were performed for the wounds caused by repeated injections.

Meanwhile, the patient followed methadone substitution treatment until 2008, later and until now she only requiring antidepressant treatment for recurrent depressive disorder, her current diagnosis.

This case highlights the significant risks associated long-term opioid dependence, particularly in patients with medical conditions and psychiatric comorbities. Managing Pentazocine dependence requires careful monitoring of pain medication, early psychiatric intervention, and long-term follow-up. Comprehensive care, including psychological support and substitution therapies, is essential for improving prognosis in such cases.

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Pyromania is an impulse control disorder where repeatedly setting up intentional fires provides instant gratification after failing to control the urge. Within the psychiatric population, 6% of the individuals meet the lifetime criteria of pyromania, making it a rare diagnosis of high medico-legal significance. We aimed to estimate the prevalence of pyromania, identify psychiatric comorbidities, substance use, and related sociodemographic factors in patients with a history of pyromania within a psychiatric center in South Bronx. We hypothesize that individuals with fire-setting behavior are more likely to have antisocial tendencies, substance use disorders, and psychiatric comorbidities, leading to increased mental health service use.

The objective of this study is to estimate the prevalence of pyromania and fire-setting behavior in a psychiatric center in South Bronx, and to examine the associated psychiatric comorbidities, substance use disorders, and sociodemographic factors. By analyzing these relationships, we aim to provide insights into the characteristics and mental health service utilization patterns of individuals with pyromania or fire-setting behavior, thereby informing future treatment strategies and interventions in urban mental health settings.

We searched for patients aged 12 and older, including all genders, who were evaluated or admitted through a psychiatric center within the South Bronx between December 2013 and December 2023 for a retrospective observational study. After applying inclusion/exclusion criteria, we included 11 patients diagnosed with pyromania or fire-setting behavior (ICD-10-CM code F63.1 or ICD-9-CM code 312.33), based on evaluation notes. We extracted and analyzed the data for demographics, substance use, comorbid psychiatric, and medical diagnosis.

We found that pyromania diagnosis was found in individual’s age range of 12 to 59 years (Mean Age-33.36 ± 14.72 years). All individuals were single, 82% were unemployed, 72.73% were US-born, and 91% were male. Psychotic disorders, primarily schizophrenia, were diagnosed in 73%, while 64% had a substance use disorder. The group comprised 45% Hispanic and 55% African American individuals.

Our study, conducted over ten years in the Bronx, revealed a strong association between firesetting behavior and psychiatric comorbidities, particularly psychotic disorders and substance use. Contrary to our initial hypothesis, we found no significant link between firesetting and antisocial tendencies. These findings emphasize the need for targeted interventions addressing both psychiatric and sociodemographic factors, especially in urban mental health settings like the Bronx.

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Sydenham chorea (SC) is the most common form of autoimmune chorea and is one of the major clinical manifestations of acute rheumatic fever. Although related to group A streptococcal infection, its pathogenesis is not fully understood, and neither is its contribution to the development of Obsessive-Compulsive Disorder (OCD), with hypotheses like autoimmune mechanisms and neuroinflammation being probable. The prevalence of OCD in SC patients is higher than in the general population, with one study reporting obsessive-compulsive symptoms in 24% of SC patients (Moreira et al. Parkinsonism Relat Disord 2014;20(2):233-236). Psychiatric symptoms often fluctuate with motor symptoms, but their prognosis is poorly understood.

To describe a case of a patient who developed OCD symptoms after SC.

We report a case of OCD that followed the development of chorea, and we perform a non-systematic review of the literature.

A 34-year-old woman is referred to a Liaison Psychiatry consultation due to cognitive anxiety related to her non-psychiatric history. The patient, with no previous psychiatric history, has a personal history of rheumatic fever (9 years ago) and SC previously evaluated by Neurology consultation where brain magnetic resonance imaging and head computed tomography changes were ruled out, as well as the genetic panel for Huntington disease. No relevant family history. Medicated with sertraline 100mg daily, alprazolam 1mg three times a day, clopidogrel 75mg daily, propranolol 10mg three times a day and atorvastatin 10mg daily. Upon the evaluation, the patient referenced anxiety related to a programmed cardiac surgery and initial and intermediate insomnia. When questioned, the patient reported, after the development of chorea, obsessive ideas and verification rituals/compulsions. These symptoms are time-consuming and cause clinically significant distress and impairment in her work and social functioning. The patient was started on risperidone 0.5mg daily due to its high-potency dopamine D2 receptor blockage that could benefit the chorea and its proprieties in obsessive-compulsive disorder. Six months later, the patient presented an improvement in motor symptoms and a satisfactory Y-BOCS reduction response to the initiated plan.

This case underscores the unusual but significant association between SC and the development of obsessive-compulsive symptoms, contributing to the growing body of evidence that autoimmune processes may underlie neuropsychiatric manifestations such as OCD. The patient’s favorable response to risperidone, a dopamine receptor antagonist, emphasizes the role of dopaminergic dysregulation in both SC and OCD. This case underscores the need for a multidisciplinary approach, including neurology and psychiatry, to manage SC’s neuropsychiatric effects. Further research is needed to clarify how SC relates to OCD and to improve treatment strategies.

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The field of psychiatry is going through a rapid transformation as a result of the rapid advancements in artificial intelligence (AI), which are providing novel opportunities for the diagnosis, treatment, and management of mental health disorders. AI can deliver more precise and personalized mental health care by utilizing machine learning algorithms, natural language processing (NLP), and neuroimaging analysis. This paper investigates the current applications of AI in psychiatry, its prospective benefits, and the challenges that must be overcome in order to effectively integrate AI into clinical practice.

To investigate contemporary advancements in artificial intelligence (AI) applications in psychiatry, emphasizing enhancements in diagnostic precision, therapeutic personalization, and ethical considerations for integration into clinical practice.

A thorough examination of AI applications in psychiatry was performed, encompassing AI utilization for psychiatric diagnosis, digital mental health therapies, neuroimaging analysis, and suicide risk assessment.

Artificial intelligence demonstrated considerable potential in enhancing diagnostic precision, especially via technologies such as natural language processing for evaluating speech and text, and machine learning algorithms for assessing brain imaging. AI-driven chatbots and virtual therapists shown effectiveness in administering cognitive behavioral therapy (CBT) and facilitating continuous mental health care. Predictive algorithms for suicide risk and digital phenotyping instruments present opportunities for early intervention. Nonetheless, obstacles including algorithmic bias, data security issues, and the necessity for human oversight were identified as barriers to full implementation.

Artificial intelligence possesses revolutionary potential in psychiatry, facilitating earlier diagnoses, more individualized treatment strategies, and continuous monitoring of mental health disorders. For AI to be included into standard psychiatric care, continuous efforts are required to guarantee ethical implementation, mitigate algorithmic bias, and preserve the vital human connection in psychiatric therapy. Collaboration among AI engineers, physicians, and ethicists will be essential to fully leverage AI’s potential while ensuring the safety of patients.

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Efficacy of clozapine has now been proven for all symptoms of resistant schizophrenia. Yet it remains underused in view of the prevalence of drug resistance and unevenly prescribed worldwide despite a general trend towards increasing prescribing (Bachmann et al. Acta Psychiatr Scand 2017; 1-15). Data on hospital clozapine prescribing in France are older and single-center (Mercier et al. L’Encéphale 2009; 35, 321-329). Collaboration between a national multi-professional network (pharmacist, general practitioner, psychiatrist) working in various public or private mental health establishments (the PIC network) and a regional psychiatric research federation (FERREPSY Occitanie) has enabled a broad and up-to-date study of practices.

To assess the prevalence of clozapine prescribing among patients hospitalised in full-time psychiatry on a given day. To assess the prevalence of clozapine prescribing in inpatients with a diagnosis of non-organic psychotic disorder (ICD 10: F20-F29). To study the characteristics of patients treated, prescribing methods and clinical monitoring.

A cross-sectional observational study was carried out in December 2023 with teams from establishments belonging to the PIC and/or FERREPSY network who had volunteered.

30 centers took part in the study, with a total of 795 patients included. The average age was 44.1 years (66% men and 34% women). 14.05% of hospitalised patients were receiving clozapine treatment on the day of the survey. 25.07% of patients with a diagnosis of non-organic psychotic disorder were receiving clozapine treatment. 26.83% of clozapine prescriptions were off-label, mainly for patients with mood disorders. 91.94% of patients had had their blood pressure measured in the quarter preceding the survey, and 91.82% had been weighed. Conversely, only 31.94% had their umbilical circumference measured.

This study found that the prevalence of prescribing among patients with non-organic psychotic disorders in the hospital was higher than expected, according to European data on clozapine prescription Further data on outpatient use are still required.

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Identifying early-life risk factors for chronic depression symptomology in young people, is essential to informing early targeted interventions. One highly prevalent symptom (and potential risk factor) in depression is sleep problems, such as insomnia or hypersomnia. However, most studies have measured sleep disturbances and depression symptoms at only one time point, and the prospective relationship between persistent shorter or longer sleep duration in childhood and chronic depression symptoms in adolescence through to adulthood has not been explored.

To identify whether longitudinal trajectories of persistent shorter sleep and persistent longer sleep duration between 6 months to 7 years of age, are associated with increased risk of developing chronic depression symptoms between 13-22 years of age.

Prospective associations were explored using the Avon Longitudinal Study of Parents and Children (ALSPAC), in the UK. Childhood night-time sleep duration was parent-reported at 6, 18, and 30 months and at 3.5, 4 to 5, 5 to 6, and 6 to 7 years. Depression symptoms were self-reported via the Short Mood and Feelings Questionnaire (SMFQ) at, 12.5, 13.5, 16, 17.5, 18, 21 and 22 years of age. Latent Growth Curve Analysis was used to identify longitudinal trajectories of night-time sleep duration from 6 months to 7 years of age (i.e. longer (63%), shorter (2%), average-shorter sleep (22%) and average-longer sleep (13%)) and depression symptoms (i.e. chronic (5%), non-chronic (95%)) from 13 to 22 years. Logistic regressions were conducted to identify the prospective association between persistent shorter and persistent longer sleep trajectories and chronic depression symptoms.

Preliminary results revealed that persistent shorter sleep duration across childhood was associated with increased likelihood of presenting with chronic depression symptoms, even after adjusting for the effects of sex, birthweight, maternal age, child ethnicity, family adversity and maternal socioeconomic status (OR = 1.94, 95% CIs, 1.01, 3.73 p =. 046). Persistent longer sleep however did not show significant associations.

A persistent pattern of shorter sleep duration across childhood is associated with chronic depression symptoms in adolescence through to adulthood. Sleep is a modifiable risk factor and targeted interventions for those presenting a sustained pattern of shorter sleep duration across childhood is suggested to prevent future mental health problems, such as depression.

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Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent mental disorders diagnosed in children and is characterized by complex, interacting symptoms. Although executive functioning systems are most frequently examined in functional magnetic resonance imaging (fMRI) activation studies of ADHD, atypical reward processing may also play a central role in ADHD and influence other symptoms, such as hyperactivity and impulsivity. This meta-analysis aims to advance our understanding of the neural basis of reward processing in ADHD, as measured by fMRI activation studies.

The present study aims to advance our understanding of the neural basis in reward processing in participants with ADHD by identifying aberrant functional activation in various brain regions compared with healthy controls.

We conducted a comprehensive literature search in PubMed for whole-brain, task-based fMRI activation studies comparing participants diagnosed with ADHD to healthy controls in accordance with PRISMA guidelines. We then used multilevel kernel density analysis (MKDA) with ensemble thresholding (α = .05–.0001; FWE-corrected) to explore neural activation patterns associated with ADHD across all tasks and during reward processing tasks.

We obtained 57 primary studies (N = 4,366) that met our inclusion criteria. We found that patients with ADHD (n = 1,591), relative to healthy controls (n = 2,775), exhibited statistically significant (p < .005; FWE-corrected) differential activation in multiple brain regions of the cerebral cortex and basal ganglia, including robust effects across various tasks and task-specific effects observed during reward processing.

These findings strengthen our understanding of the neural basis of reward processing in ADHD, which may inform new neurocognitive models of this heterogeneous disorder. Future studies should investigate disorder-specific and transdiagnostic neural features of ADHD and reward processing and explore clinical applications such as non-invasive brain stimulation and neurofeedback training.

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Bipolar disorder (BD) is characterized by mood and cognitive fluctuations that manifest in speech patterns. Current assessments rely on subjective clinical evaluation, but advances in natural language processing (NLP) offer new opportunities for objective monitoring. This study analyzes speech from BD patients across different mood states—euthymia, mania, and depression—using structured tasks, spontaneous speech, and standardized text reading. Key acoustic, linguistic, and emotional features are extracted and correlated with clinical scales. Machine learning models are being developed to predict symptom severity and mood phase. This approach could provide reliable digital biomarkers, enhancing diagnosis, monitoring, and early relapse detection in BD. Standardized speech protocols may pave the way for international collaboration and large-scale validation.

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Psychosis has long been known to have an association with epilepsy. Slater’s 1963 descriptive case series provided the first modern definition of epilepsy-related psychosis, described as psychotic symptoms developing after the onset of epilepsy and occurring in clear consciousness, not exclusively during or right after a seizure. Up to 7% of individuals with epilepsy have a co-morbid psychotic illness. Consensus guidelines by the International League of Epilepsy recommend treating epilepsy-related psychosis similarly to other categories of psychosis. Despite the widespread consensus that the prescription of an antipsychotic is possible without risk in an epileptic patient treated with AEDs, there have always been special considerations about prescribing antipsychotics for seizure-related psychosis. Furthermore, a review article by Adachi et al. specifically warns that concerns regarding seizure threshold can lead to the undertreatment of this particular type of psychosis.

Case report.

Case report.

Case presentation: Our patient has generalized epilepsy, with several incomes due to generalized tonic-clonic seizure and mild diffuse encephalopathy since childhood. By the age of 15 years, he started developing suspicion, self-reference, persecutory and damage delusions, visual hallucinations and episodes of aggressiveness towards people surrounding him. He had been treated with multiple antiepileptics and antipsychotics drugs, without achieving a long-term stabilisation until now. While the seizures were controlled in his early ages; ever since the onset of the psychosis both the psychotic symptoms and the seizures got impossible to handle, mainly because of his lack of tolerance to almost every antipsychotic used. Our primary hypothesis is that these antipsychotics lowered the seizure threshold, triggering new episodes of tonic-clonic seizures and arousing the patient’s desire of abandon the treatment -the latter has been confirmed by the patient-. At this point, we considered the recently released brexpiprazol as a potentially efficient treatment. After a proper explanation of our clinical reasons to prescribe this new drug, especially its unique pharmacodynamics, we adquired the patient’s consent to start with it. So far, the response is being excellent, which is particularly impressive given the fact that he is taking the maximum daily dose of brexpiprazol (4mg). Not only the psychotic symptoms are restrained, but also he has not experienced any seizure since the introduction. As a key outcome, the patient has developed a significant insight regarding his condition and the need of treatment.

The treatment of epilepsy-related psychosis is a really delicate subject. Brexpiprazol is a modern drug, with an innovative pharmacodynamics and an excellent side-effect profile, and should be taken into consideration in every patient with seizure-related psychosis.

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Suicide is a significant concern among individuals with schizophrenia, yet it often receives insufficient attention in clinical settings. Understanding the specific risk factors associated with suicide in this population is critical for implementing targeted and effective prevention strategies, enhancing patient care, and ultimately reducing this substantial risk.

To identify suicide risk factors within a population of patients with schizophrenia.

This was a descriptive retrospective study conducted at the Psychiatry Department D of Razi Hospital in Tunisia. Clinical records of patients diagnosed with schizophrenia according to DSM-5 criteria, aged over 18 years, without substance-related disorders or somatic pathology explaining psychiatric symptoms, were reviewed. Patients were followed in the department for ten years (2013-2023) and identified as having at least one suicide attempt during their follow-up. Data collected included sociodemographic information (age, education level, residence, socioeconomic status, marital status, offspring, profession) and clinical details (number and nature of suicide attempts, clinical scores at the time of suicide attempt using PANSS and CDS scales, current antipsychotic treatment, family history of suicide and psychosis, and treatment adherence).

We collected data from 60 patients, with a mean age of 42 ± 12.02 years; 66% (n=40) were male. Regarding education and employment, 60% (n=36) had primary education, and 55% (n=33) were employed. 65% (n=39) were unmarried, and 80% (n=48) had a low socioeconomic status. The average number of suicide attempts per patient was 3.52 ± 1.02, with the most common methods being medication ingestion (60%) and strangulation (20%). Approximately 70% (n=42) of patients had a family history of mental disorders, and 40% (n=24) had a family history of suicide. During suicide attempts, mean scores on PANSS-positive, PANSS-negative, and CDS subscales were 25.4 ± 4.7, 18.6 ± 3.2, and 12.8 ± 2.5, respectively.

We found that male gender (p=0.03; OR=3.33; 95% CI [1.12 - 9.89]), low socioeconomic status (p=0.002; OR=2.25; 95% CI [1.04 - 4.86]), family history of suicide (p=0.04; OR=2.90; 95% CI [1.15 - 7.32]), high PANSS-positive scores (p=0.0019; OR=1.98; 95% CI [1.42 - 3.51]), and high CDS scores (p=0.005; OR=2.50; 95% CI [1.32 - 4.72]) were suicide risk factors in our study participants.

The identified factors, including male gender, low socioeconomic status, family history of suicide, and elevated clinical symptomatology, highlight specific areas that warrant focused attention when evaluating and managing patients with schizophrenia.

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Electroencephalography (EEG) has been extensively studied for decades in psychiatric research. However, its integration into clinical practice as a diagnostic or prognostic tool remains unachieved. We hypothesize that a key reason for this is the underlying heterogeneity among patients, which is often overlooked in psychiatric EEG research that relies on a case-control approach.

The main objective of this study is to quantify the electrophysiological heterogeneity of psychiatric disorders.

We combine HD-EEG with normative modeling to quantify this heterogeneity using two well-established and extensively investigated EEG characteristics—spectral power and functional connectivity—across a cohort of 1,674 patients with attention-deficit/hyperactivity disorder, autism spectrum disorder, learning disorder, or anxiety, and 560 matched controls, see figure 1.

Normative models revealed that deviations from population norms among patients were highly heterogeneous and frequency-dependent. The spatial overlap of deviations among patients did not exceed 40% for spectral power and 24% for connectivity. Taking individual deviations into account significantly enhanced comparative analysis and the identification of patient-specific markers, which showed a correlation with clinical assessments.

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Our study underscores the necessity of moving EEG research in psychiatry beyond the group-level approach to achieve precision psychiatry.

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The interaction between grapefruit juice and certain psychiatric medications can lead to significant clinical implications due to the inhibition of the cytochrome P450 3A4 (CYP3A4) enzyme (Fuhr et al. CPT 2023, 114(2), 266-275; Guttman et al. Phytother. Res 2020, 34(5), 1168-1176; Paine et al. Drug Metab. Dispos 2004, 32(10), 1146-1153; Paine et al. J. Pharmacol. Exp. Ther 2005, 312(3), 1151-1160; Schmiedlin-Ren et al. Pharmacol. Ther 1997, 66(2), 234-241). Grapefruit juice contains furanocoumarins, specifically bergamottin and 6’,7’-dihydroxybergamottin (DHB), which irreversibly inhibit CYP3A4, potentially increasing drug plasma concentrations and the risk of adverse effects (Bailey et al. CPT 1998, 64(3) 248-256; de Castro et al. J. Agric. Food Chem 2006, 54(7) 2498-2503; Row et al. J. Med. Chem 2005, 49(20), 6139-6146).

This review aims to quantify the impact of grapefruit juice on the plasma concentrations of buspirone, carbamazepine, and diazepam and to understand the duration of these effects to better manage patient safety.

A comprehensive review of existing pharmacokinetic studies (Furukori et al. BJCP 2003, 55(3), 307-311; Lane et al. Psychopharm 2001, 155(3), 356-359; Tanaka et al. Clin. Pharm 2013, 52(5), 397-420; Wang et al. CPT 1993, 65(3), 314-321; Yasui et al. Psychopharm, 145(1), 84-87) was conducted to gather data on the effects of grapefruit juice on CYP3A4 substrate psychiatric medications. Quantitative increases in plasma concentration metrics (AUC and Cmax) were extracted, and the duration of the inhibition effect was analyzed.

Buspirone plasma concentrations increased by 4.3-fold, with effects lasting 24 hours. Carbamazepine showed a 1.4-fold increase in AUC and a 1.2-fold increase in Cmax, with effects persisting up to 24 hours. Diazepam concentrations increased by 3-fold in AUC and 2-fold in Cmax, with an effect duration of 24 hours. No significant interaction was observed for clozapine and haloperidol.

Grapefruit juice significantly increases the plasma concentrations of buspirone, carbamazepine, and diazepam by inhibiting CYP3A4, with effects lasting up to 24 hours. Clinicians should educate patients on avoiding grapefruit consumption while on these medications and monitor for potential toxicity. Further research is needed to develop guidelines for managing these interactions and to explore genetic variations in response to grapefruit consumption.

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Psychotic disorders, particularly schizophrenia, are severe mental illnesses associated with high rates of disability and functional impairment, causing significant individual burden and incurring high societal costs. Typical onset of schizophrenia is in late adolescence or early adulthood and the complex management requires often life-long pharmacological and non-pharmacological treatment. Early symptom recognition and timely intervention can improve the course of illness and result in better outcome and prognosis, effective management leads to a functional recovery. However, recent reports have identified significant gaps in access to timely assessment and shared decision-making interventions, with inadequate care pathways. In the face of an unprecedented demand for mental healthcare for young people, it can be challenging for health services to deliver high-quality mental healthcare which, according to the World Health Organization, should be timely, effective and evidence-based, safe and person-centered. The project covers nine countries in Europe.

Building on the European Brain Council Rethinking Schizophrenia Beyond The Voices Policy Report (2024), the survey and literature review aim to: (1) evaluate the effectiveness of integrated models of youth mental healthcare on a broader range of outcomes, including both mental health outcomes, such as clinical symptoms, functioning and quality of life and health service outcomes, including access and satisfaction with care in young people; and (2) identify the common components of integrated care pathways for young people with first episode psychosis.

Using the care pathway as a tool at the first step of the research, a cross-country survey was co-designed with the Board of experts and anonymously launched earlier this year. By complementing the survey, the literature review on the care pathway will address quality and continuity of care from the first onset of psychosis and schizophrenia to long-term care in the selected countries including existing guidelines and overview country health situation assessments.

Patients and mental health professionals’ insights will be collected. Obtained data will also be analysed by the stakeholders and used to formulate recommendations for policy makers, care payers, mental health professionals, patients and their families (both country specific and at the EU level).

A policy report, based on the consensus, will be released at the Brain Awareness Week 2025 with results and recommendations which will provide valuable insight into understanding the needs of patients with first-episode psychosis and defining the optimal care pathways to engage with them. In order to show that there is a progress in the field of care for schizophrenia patients, the utilization of new technologies is included.

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