While generative AI (genAI) has made significant advances, millions of people are facing humanitarian crises, resulting in the denial of their basic human rights. One humanitarian response to addressing humanitarian crises is crisis support teams with knowledge of psychological first aid (PFA). In humanitarian crises, skilled practice in PFA by crisis support teams can strengthen the mental health of affected individuals, which can be crucial to ensuring societal well-being. At the same time, there are major challenges in training crisis support teams in PFA. With advancements in genAI, there are opportunities to develop virtual patient systems to enhance PFA training for crisis support teams. This presentation will share preliminary data collected through the genAI-agents survey, which explores technological openness, attitudes and learning through genAI and genAI-based virtual patient systems in healthcare education as well as specifically targeted questions to the genAI-based VP system Crisis Support-VR. This survey is a part of a larger project focusing a central research question Does Crisis Support-VR enhance the skills and ability of crisis support teams to deliver effective PFA, thereby strengthening the mental health of individuals affected by humanitarian crises with two interconnected sub-goals; • to empirically explore health and medical staff within children, youth and adult services learning in Crisis Support-VR, • to develop an educational module for training and practice opportunities in PFA to support and help national and international organizations train crisis support teams in applying PFA to children, youths an adults affected by humanitarian crises.

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Current evidence on psychological adverse effects (AEs) of antipsychotic medication after remission of First Episode Psychosis (FEP), and the impact of these AEs on daily life, is limited.

To investigate serial cross-sectional associations between antipsychotic medication regimen and psychological AEs after remission of FEP.

This Ecological Momentary Assessment (EMA) study investigates baseline data of 56 participants from the HAMLETT trial (Handling Antipsychotic Medication: Long-term Evaluation of Targeted Treatment). Momentary mental states indicative of blunted affect intensity and variability, reduced initiative of social contact, avolition and tiredness were assessed 10x/day for eight consecutive days. Based on neurobiological mechanisms likely mediating these psychological AEs, antipsychotic medications were grouped based on their Dopamine-2 (D2) and Histamine-1 (H1) receptor profile. Multilevel mixed-effects regression models were employed overall and separately for mornings, daytimes and evenings, to investigate serial cross-sectional associations between medication type or dosage and concurrent psychological AEs. All models were adjusted for fixed effects of age, gender, tobacco and cannabis use in the past month and symptom severity during FEP (based on the Comprehensive Assessment of Symptoms and History, CASH).

In total, 85 out of 453 HAMLETT-participants took part in the EMA add-on study. At baseline, 56 (66%) of those participants completed >26 EMA questionnaires and were currently taking antipsychotic medication, yielding a total of 3,005 questionnaires for our analyses. The distribution of antipsychotic medication regimens was relatively equally spread (25% high affinity D2 antagonists, 48% low affinity D2 antagonists, 27% partial D2 agonists). Higher dosage (Beta (B) = -1.11 [95% Confidence Interval (CI): -1.97; -0.24]) and use of high affinity D2 antagonists, as compared with partial D2 agonists (B = 12.98 [95%CI: 2.43; 23.53]) and low affinity D2 antagonists (B = 10.04 [95% CI: 0.59; 19.49]), were associated with decreased positive affect (PA) (see Figure 1). Higher dosage was also associated with small increases in PA variability (B = 0.23 [95% CI: 0.04; 0.42]. The remaining psychological AEs were not associated with dosage or D2 profile, neither was H1 profile associated with these AEs. Results were relatively consistent across daytimes, though effect sizes were greatest in the evenings.

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After remission of FEP, higher dosage of antipsychotic medication and use of high affinity D2 antagonists, as compared with partial D2 agonists and low affinity D2 antagonists, can be associated with decreased, though not invariable, positive affect as estimated using EMA.

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Cyberchondria is usually defined by health-related worries and repeated searches on the Internet for data on health conditions, although this behavior is associated with significant discomfort, distress, or anxiety. However, no consensus on a definition exists, and the nosography of this disorder is still uncertain, as it is not recognized by any of the currently available classifications of mental disorders. Still, cyberchondria has been associated with a negative impact on the quality of life and comorbid anxiety-depressive clinical manifestations (Ambrosini et al. Heliyon 2022;8(5) e09437), thus highlighting the need for early detection and treatment of this disorder.

This review aimed to assess the data supporting the diagnosis and therapeutic management of cyberchondria and to identify areas for further research in this field.

The review included three databases (Google Scholar, PubMed, and EMBASE), explored from their inception to June 2024, for papers published in English using the keywords “cyberchondria,” and “diagnosis,” “clinical scales,” or “treatment.”

According to data extracted from 34 primary and secondary sources, health anxiety (HA) was positively correlated with seeking online information about health and with cyberchondria. Studies exploring the overlap between HA and cyberchondria have found the two conditions were distinct on multiple measures, including functional impairment and healthcare resources use. The construct of cyberchondria has several dimensions, such as “compulsion,” “distress,” “excessiveness,” “reassurance,” “mistrust,” “illness-related Internet use,” and “metacognitive beliefs,” which are explored by specific structured methods. Two questionnaires have been created for this purpose, i.e., the Cyberchondria Severity Scale (CSS) (McElroy & Shevlin J Anxiety Disord 2014;28(2) 259-65) and the Online Health-related Beliefs and Behaviours Inventory (Singh & Brown Anx Stress Coping 2014;27(5) 542-54). Prevention should target Internet users’ expectations (avoiding self-diagnosis, verifying data on the Internet with a health specialist, and searching for low-quality information on unofficial sites). Group cognitive-behavior therapy delivered by the Internet was associated with favorable results, based on the CSS scores, but there is a need for further, larger group studies to confirm these observations.

Cyberchondria still needs extensive explorations to be defined as a nosographic stable condition, although dimensions of this concept have begun to be explored in a systematic manner, and studies investigating psychotherapeutic approaches for this disorder have been initiated. Due to the continually increasing access of the general population to medical data online, the exploration of HA and cyberchondria is expected to attract more interest from mental health specialists in the near future.

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Psychologically, traumatic incidents often involve physical injuries that threaten a person’s survival and sense of security. After a sudden health problem or other kind issues, hospital admission can be an experience that negatively affects psychological health and recovery, often including symptoms of post-traumatic stress disorder, anxiety, and depression. Nurses who spend a longer time with patients can determine the initial changes in individuals and play a crucial role in the decision-making process.

This systematic review aimed to investigate the effect of nurse-led interventions in reducing post-traumatic stress disorder symptoms in inpatients.

In this review, we investigated studies from Pubmed, Cochrane Library, Medline (OVID), Scopus, Web of Science, CINAHL, Dergipark and TR Dizin (a directory) databases that met the inclusion criteria. The methodological quality of the studies was assessed using the Cochrane Risk of Bias 1 tool. This study was performed based on the Guidelines of Systematic Reporting of Examination presented in the PRISMA checklist. The search protocol has been registered at the PROSPERO International Prospective Register of Systematic Reviews.

This systematic review included seven studies with a total sample size of 736 inpatients (intervention group: 350 participants; control group: 345 participants). The meta-analysis revealed that nurse-led interventions showed no statistically significant impact on post-traumatic stress disorder symptoms (SMD: -4,08, Z = .79, p = .43), anxiety (SMD: .28, Z = .18, p = .86) and depression (SMD: -.60, Z = .87, p = .38) in inpatients.

Out of seven studies, five of them indicated that these interventions were not effective in reducing PTSD symptoms while in two studies, the interventions were found to be effective in alleviating PTSD symptoms. To effectively reduce or prevent post-traumatic stress symptoms in inpatients, it is recommended to integrate a comprehensive range of therapeutic, evidence-based practices into clinical settings, facilitated by a multidisciplinary team approach within a educative and collaborative working environment.

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Negative symptoms of schizophrenia include abulia, anhedonia, alogia, blunted affect, and social isolation. These symptoms strongly correlate with health-related quality of life and treatment outcomes. (Azaiez et al., 2018; Galderisi et al., 2018; Kirkpatrick et al., 2006). According to current negative symptoms diagnosis and treatment guidelines, the Brief Negative Symptom Scale (BNSS) is the instrument of choice for the psychometric evaluation of negative symptoms (Galderisi et al., 2021). Unfortunately, BNSS was not available in Lithuania.

To validate the Lithuanian version of the BNSS in a Lithuanian-speaking sample.

We performed a double translation from English to Lithuanian and then back to English. The final version of the Lithuanian BNSS (Lit-BNSS) was finalized according to comments from two native Lithuanian-speaking experts, who evaluated the forward translation, and the representatives of the authors of the BNSS, who evaluated the back translation. We performed a validation study in an inpatient setting in a university hospital in Lithuania and asked patients diagnosed with schizophrenia spectrum diagnosis according to ICD-10 to participate in the study. We evaluated the included patients with the Positive and Negative Symptoms Scale (PANSS), Montgomery Asberg Depression Rating Scale (MADRS), Self-Evaluation of Negative Symptoms Scale (SNS), and Calgary Depression Scale for Schizophrenia (CDSS). PANSS Marder factors were calculated for more accurate PANSS scores. We check the convergent validity with the Marder negative symptoms factor, the total score of SNS, and the discriminant validity with the Marder positive symptoms factor, MADRS, and CDSS total scores.

The study included 122 patients. The Lit-BNSS showed great internal consistency for the 13 items (α=0,944) and good consistency for six subscores (α=0,874). Convergent validity was good, with the total score of Lit-BNSS having a strong positive correlation with the Marder negative symptoms factor and a weaker correlation with the SNS total score. Discriminant validity was adequate because there were insignificant correlations with MADRS and CDSS subscores and the Marder positive symptoms factor. Correlation scores can be seen in Table 1.Table 1.

BNSS TS correlation with other scores. MARDER-NEG – PANSS Marder negative symptoms factor; SNS-TS- SNS total score; MARDER-POZ- PANSS Marder positive symptoms factor; MADRS – MADRS total score; CDSS-TS- CDSS total score

The Lit-BNSS is a valid and effective psychometric tool for evaluating negative symptoms in a Lithuanian-speaking sample.

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Social deficits are a significant impairment in adult ASD, leading to difficulties in socio-emotional cognition, communication, and relationships. Effective social skills interventions are crucial during the transition to adulthood. The UCLA PEERS® (Program for the Education and Enrichment of Relational Skills) for young adults is a prominent and well-researched intervention, implemented in over eighty countries and translated into numerous languages. This program includes concurrent sessions for young adults and their parents, aiming to improve social skills and reduce ASD-related social issues

The current study aimed to test the effectiveness of a culturally adapted Persian -translated version of PEERS® for young adults with ASD without intellectual disabilities.

Three psychiatrists and two psychologists underwent PEERS® training and translated the manual into Farsi, adapting it culturally for Iran. Twenty-four young adults with ASD and their parents participated in the study, randomly assigned to a treatment group or a control group. Inclusion criteria were males aged 18-30 years with an ASD diagnosis, predominant social difficulties, motivation to participate, and a family member acting as a social coach. Exclusion criteria included intellectual disability, major psychiatric conditions, and significant verbal or literacy difficulties.

Participants attended 16 weekly 90-minute group sessions, covering topics like conversations, humor, electronic communication, dating etiquette, conflict management, and bullying. Sessions were led by a PEERS-certified psychologist and an assistant behavioral coach. Weekly meetings were held to align session content and address potential issues.

The culturally adapted Persian -translated version of PEERS® was perceived as beneficial by young adults with ASD and their caregivers, improving social skills and quality of life. However, quantitative measures did not show significant changes, indicating a need for further refinement and investigation to achieve measurable improvements in social functioning.

While qualitative feedback indicates that both young adults with ASD and their caregivers found the caregiver-assisted social skills intervention to be beneficial in improving social skills and overall quality of life, the quantitative measures did not show significant changes. This suggests that while the intervention may have positive perceptual impacts, further refinement and investigation are needed to achieve measurable improvements in social functioning.

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This case study investigates the combined use of pharmacotherapy and music therapy in treating a 44-year-old male patient with recurrent depression and subthreshold autism traits. These traits contributed to emotional rigidity and reduced treatment outcomes, requiring an interdisciplinary approach to enhance treatment effects.

To explore the efficacy of pharmacotherapy and music therapy in treating recurrent depression complicated by subthreshold autism traits, focusing on emotional regulation and coping strategies in a neuroatypical patient.

The patient was treated in outpatient psychiatry with citalopram (10 mg/day) and nortriptyline (100 mg/day) while attending 18 months of individual music therapy at Aalborg University Hospital. The music therapy involved listening and improvisation aiming at addressing neuroatypical emotional rigidity and sensitivity.

While pharmacotherapy alleviated depressive symptoms, music therapy enabled expression and management of difficult emotions improving emotional flexibility and enhancing coping strategies. The patient was not diagnosed with Asperger’s syndrome, but exhibited traits of autism that influenced the treatment response.

The combination of pharmacotherapy and music therapy proved beneficial for the patient, offering a non-verbal approach to emotion regulation. This case highlights the value of interdisciplinary approaches for treating depression in patients with subthreshold autism, especially in complex, treatment-resistant cases.

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During the workshop about this complex case, I will discuss aspects of the case and the challenges the individual has faced from a neurodevelopmental and transdiagnostic perspective. It is the norm that those presenting for treatment or support with problematic drug/alcohol use will also have co-occurring neurodevelopmental, mental and physical health traits or disorders. Their relationships are often complex and ingrained. It is generally unhelpful to consider such complexity in terms of ‘primary’ vs ‘secondary’ as this may lead to exclusion from some services. For instance, someone with depression and problematic alcohol use may not be seen by psychiatric services or psychologists due to their drinking and an ‘addiction’ service may not have sufficient mental health expertise for managing their depression. Such ‘silos’ are common and need to be addressed through better understanding of the relationships between problematic drug/alcohol use and co-occurring neurodevelopmental, mental and physical health traits or disorders, through better training of health and social care staff and reducing stigma.

A. Lingford-Hughes Grant / Research support from: Research supported by Lundbeck, GSK, Indivior; unrestricted funds support from Alcarelle for a PhD, Consultant of: Silence, NET Device Corps, Sanofi-Aventis, Astra Zeneca and also consulted by but received no monies from Britannia Pharmaceuticals, GLG, Opiant, Lightlake and Dobrin, Paid Instructor of: Received Honoraria paid into her Institutional funds for speaking and Chairing engagements from Lundbeck, Lundbeck Institute UK, Janssen-Cilag, Pfizer, Servier; receives Honoraria for teaching for British Association for Psychopharmacology.

Stigma not only influences the willingness to disclose mental health conditions and self-esteem but may also diminish the overall quality of life in individuals with mental illnesses. However, limited research has examined the potential mechanisms underlying this complex relationship.

This study aims to explore the mediating roles of disclosure and self-esteem in the association between mental illness stigma and quality of life.

We utilized the meta-analytic structural equation modeling (MASEM) approach and conducted a comprehensive literature search across various electronic databases to identify relevant publications up to July 2023. MASEM was employed to derive bivariate correlation matrices for stigma, disclosure, self-esteem, and quality of life. Additionally, two simple mediation models and one serial mediation model were tested to examine the relationships between these variables.

The analysis included 181 articles reporting 195 independent samples (N = 33,162) and 278 effect sizes. The single mediator model indicated that self-esteem (β = −0.155, 95% CI [−0.276, −0.070], p < .001), rather than disclosure (β = −0.019, 95% CI [−0.094, 0.031], p > .05), served as a mediator. In the multiple mediator model, disclosure and self-esteem were found to have serial mediating roles between stigma and quality of life (β = −0.016, 95% CI [−0.0546, −0.0003], p < .05).

This study makes a significant contribution to understanding how stigma attitudes impact the quality of life in individuals with mental health problems, providing a strong empirical foundation for the development of mental health interventions. Future research directions and practical implications are also explored.

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The Covid-19 pandemic has been an integral part of our lives since late 2019, bringing significant changes to the way we live. These changes have brought with them a wave of pandemic-related psychological distress including fear, anxiety, feelings of threat. The Covid-19 pandemic presented several global challenges to the functioning of the health system in general and to medical personnel in particular. Unfortunately, the discussion on how staff in health facilities deal with pandemic-associated distress has remained in the background.

The main aim of our study was to investigate the impact of the COVID-19 pandemic on the mental health of healthcare workers and trainees and specifically on the development of anxiety symptoms. We aimed to track levels of anxiety among physicians, health care professionals, and medical students, and their relationship to various sociodemographic indicators-gender, age, marital status, education and occupation, familial predisposition to anxiety disorders, and previous consultation with a psychologist/psychiatrist.

The study was led among fifth and sixth year medical students in Sofia university and Trakia university and also doctors and nurses working in hospitals in Sofia and Stara Zagora - MHC “Prof. Н. Shipkovensky”, University Hospital “N.I Pirogov”, University Hospital “Prof. Dr. Stoyan Kirkovich”. The study used a questionnaire created by the researchers and the Coronavirus Anxiety Scale by Lee and the Covid-19 anxiety syndrome scale by Nikcevic and Spada.

The mean age of the study participants was 28.21±10.11 years ranging from 22 to 68. Majority of the study participants (72.3%) were students followed by doctors with 19.8% and nurses with 5.6%. After statistical analysis of the data, there was a linear relationship between having a close friend or relative who had died or had a serious illness due to Covid-19 infection and having marked anxiety and fear for the health of loved ones. In this group frequent checking for coronavirus symptoms, both in the respondents themselves and by them to their friends and relatives was observed more often. Pre-pandemic visits to a psychologist/psychiatrist for anxiety symptoms appeared to be a predictor of avoidance behaviour in respondents e.g.not using public transport to reduce the risk of infection.

Having a close friend or relative who had a severe infection with Covid-19 and pre-pandemic visits to a mental health professional were predictors of increased pandemic-related anxiety and avoidance behavior among health care professionals and medical students. Due to the high prevalence of this mental health problem among medical students and frontline health workers, it is suggested that healthcare institutions provide mental health services for these working groups in order to appropriately manage anxiety.

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Prevalence of posttraumatic stress disorder (PTSD) has been documented in war-affected populations. A third of Ukrainians met diagnostic requirements for PTSD according to the UN, but the information on the mental health of medical staff is still insufficient. Well-known increased risk of mental disorder is the result of traumatic experiences in healthcare workers as part of their professional duties.

Based on this we aimed to analyze the potential sources of traumatic experience at work and the severity of PTSD and depression symptoms among medical staff in war condition.

The online and paper-pencil survey was conducted in November 2023 - January 2024. The study included a sample of 96 health care workers (doctors, nurses and paramedics). We used the structured interview on work characteristics of physical and psychosocial factors and standardized questionnaires on PTSD (Posttraumatic Stress Disorder Checklist; PCL-5) and depression (Patient Health Questionnaire; PHQ-9) symptoms. Additionally the needed source of support to cope with stress at work has been investigated.

The correlation and regression analysis allowed revealing patterns between potential sources of traumatic experience at work and the severity of PTSD and depression symptoms among Ukrainian medical staff. The results of the correlation analysis of physical and psychosocial stressors, depression and PTSD symptoms indicated that psychosocial stressors define PTSD development. There were detected job-related specific psychosocial stressors among medical staff in Ukraine leaded to PTSD and depression development: “Conflict in organization/community”, “Being threatened/abused”, “Lack of appreciation by the organization/community in which you work”.

The analysis identified the most important factors (psychosocial stressors) determining levels of PTSD in medical personnel at war. These data contribute to a significant debate on the negative role of job conditions at war for health care workers.

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PTSD is a mental disorder that may develop after exposure to threatening or horrifying events. PTSD is characterized by the following: 1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares. Re-experiencing may occur via one or multiple sensory modalities and is typically accompanied by strong or overwhelming emotions, particularly fear or horror, and strong physical sensations; 2) avoidance of thoughts and memories of the event or events, activities, situations, or people reminiscent of the event(s); and 3) persistent perceptions of heightened current threat. The symptoms persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.

Some reviewes found that PTSD is prevalent during pregnancy and after birth and may increase during postpartum if not identified and treated. It can affect women, their relationship and birth outcomes aswell as infant emotion regulation and development. The findings indicate that there are links between psychological, traumatic and birth-related risk factors as well as the perceived social support and the possible PTSD following childbirth in mothers and partners.

A case report is presented alongside a review of the relevant literature regarding the prevention, diagnosis, and treatment of PTSD.

We present a case report of a 34-year-old woman with no previous contact with Mental Health Services. She got pregnant unexpectedly in the context of a long stable relationship. At the beginning she was feeling uncertain about carrying on with the pregnancy but finally decided to keep it. She states she felt well throughout the pregnancy. The night after giving birth her baby suffered from a cardiorespiratory arrest, which was noticed by the nursing team but not by the mother. The baby recovered with no medical sequelae but the patient started feeling depressed and presenting anergy, apathy, irritability, flashbacks, and intrusive memories of her sick baby and insomnia, checking every hour during the night that her child was still breathing. Later she developed separation anxiety from her baby, not being able to leave her in the kindergartner nor to leave her alone with other family members (including the father). Guilty feelings were persistantly observed during the therapy sessions.

Psychotherapeutic and pharmacological treatment was started with moderate improvement. Since breastfeeding was a rewarding experience and enforced the mother-daughter bond it was taken in consideration for the therapeutic plan.

The postpartum period is of special vulnerability and early treatment of symptoms in mothers is of great importance. Early diagnosis in maternity services should be a priority.

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Psychogenic aging, an emerging field in biogerontology, seeks to integrate psychological factors into the biological framework of aging. Traditional models of aging emphasize molecular and cellular mechanisms, often overlooking the significant role of psychological well-being. Our studies show that psychosocial factors influence biological age similarly to physical health conditions. Psychogenic aging is a novel phenomenon that addresses this gap by providing a holistic understanding of the aging process that encompasses both biological and psychological components.

The primary objective of this research is to explore the relationship between psychological factors and biological aging. Specifically, it seeks to quantify the impact of psychosocial stressors and well-being on biological age and compare these effects with established biological markers of aging. This study also aims to position psychogenic aging within the established Hallmarks of Aging framework.

Data from the China Health and Retirement Longitudinal Study (CHARLS), including 16 blood biomarkers and psychological well-being indicators for over 11,000 adults, were used to train a deep neural network (DNN) to predict biological age.Psychosocial factors such as happiness and loneliness were regressed against biological age using elastic net regression to quantify their effects.

Additional findings from a non-systematic review on stress and aging were used to frame the psychogenic aging model within the Hallmarks of Aging framework by Lopez-Otín et al. 2013 Cell.

Galkin et al. Aging 2022 developed a deep-learning aging clock using blood test data to assess the influence of psychological factors on biological aging. The results show that negative psychological factors, such as loneliness and unhappiness, can accelerate biological age by 1.65 years, surpassing the effect of smoking, which contributes an additional 1.25 years. These findings highlight the substantial impact of mental well-being on biological age, comparable to serious health conditions like stroke and lung disease. Faria et al. Trans Psych 2024 developed a theoretical framework from which to conceptualize the mechanisms and mediators behind these psychogenic aging effects with the latest high-throughput methods.

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The integration of psychogenic aging into the Hallmarks of Aging framework represents one of the most significant advancement in our understanding of the aging process. Psychological stressors and resilience should be recognized as fundamental contributors to aging, akin to molecular and cellular processes. By addressing both the biological and psychological dimensions of aging, this interdisciplinary approach offers novel opportunities for anti-aging therapies and interventions. Future research should focus on validating these findings across diverse populations and exploring the mechanistic pathways linking psychological health to biological aging.

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A systems approach to understanding late-onset depression points to its association with cardiovascular disease, cerebrovascular disease, tissue and organ trophic disorders, cognitive impairment, anergy, and decreased lifespan. These features are consistent with progressive aging

literature analysis

general scientific method

Cellular senescence is characterized by irreversible cell growth arrest. Characteristic features of senescent cells include increased cell size, accumulation of β-galactosidase and lipofuscin in the cytoplasm, accumulation of DNA damage foci, condensed heterochromatin regions, shortened telomeres, and increased expression of cell cycle regulatory markers. Telomere attrition has been linked to depression. Individuals with MDD have shorter white blood cell length compared to subjects without a history of depression. Telomere attrition is also associated with more unstable IL-6 levels and oxidative stress markers in major depressive disorder. Postmortem studies of the brain have revealed that severe depression leads to depletion of various areas of the cerebral cortex and oligodendrocytes. According to the authors, there is a link between severe depressive disorders and cellular aging of the brain. Mitochondrial dysfunction. Mitochondrial dysfunction in depression and aging includes genomic instability, defects in biogenesis, electron transport chain and mitochondrial scavenging, nutrient regulation mechanisms, proteostasis. In late depression, the number of mitochondrial DNA copies decreases. Increased production of ROS is a marker of mitochondrial dysfunction. In contrast, depressed individuals have elevated lipid peroxidation markers and an imbalance between oxidative stress and antioxidant stress markers. MtDNA oxidation and fragmentation are consequences of elevated OS, with high levels of fragmented mtDNA being associated with more severe depressive episodes and also a biomarker of aging and tissue damage. In patients with late-onset depression, ccf mtDNA has been found to correlate with chronic levels of IL-6, a master regulator of inflammation and a major component of SASP.

Total scores assess indicators of mitochondrial dysfunction, telomere length, cognitive tests, and structural changes on MRI in women with late depression higher than in elderly men.

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Prevention is key to maintain a healthy lifestyle and to ensure a positive outcome of any given condition, especially in such a vulnerable one, as is pregnancy. The progress made in prenatal care in the last century is astounding and professionals nowadays are able to provide state of the art investigations and inventions throughout pregnancy and even before, but there is a dire need to address the mental health approach of the soon-to-be mothers. Since studies have shown the link between mother’s emotions and the child’s well-being, providing support in order to maintain a good mental health status should be part of the prenatal care programmes.

The initial hypothesis is that pregnancy is a delicate period for the mother to be, therefore anxiety levels can be high or prenatal depressive episodes can occur in the absence of good psychological support. We aim to prove that integrating psychotherapy as part of the prenatal care programmes has benefits for both mothers and child and can significantly reduce the struggle of battling these symptoms on one’s own.

We launched an online questionnaire on groups and sites that targeted pregnant women or women who have just given birth. The questions were designed to address the anxiety and/or depressive symptoms throughout the pregnancy, the support they received from the health care providers and the impact these had on how they handled the pregnancy period. Anxiety symptoms were assessed using the HAM-A scale, meanwhile for depressive symptoms we used PHQ9 questionnaire. The study was conducted anonymously and was approved by the local ethics committee.

We received 200 answered questionnaire, from which 189 were valid and relevant to the study.

The results showed that the majority of pregnant women (83%) have struggled with anxiety and/or panic attack throughout the pregnancy and the prenatal care appointments proved insufficient to alleviate their concerns. Most of them (94%) turned to the internet for answers, which was an aggravating factor for the symptoms. The impact these symptoms had on their pregnancy varied from tensions between them and their partners, insomnia, feelings of worthlessness and irritability to moderate depressive episodes. Almost all the respondents (91%) have answers affirmatively to the proposal to undergo a few therapy sessions to manage these symptoms, if they were to be part of the prenatal care programme.

Pregnant women are at risk for various mental health issues which can be prevented with proper care, thus addressing further risk for both the mother and the baby. The need for integrating therapy in prenatal care programmes could have a great impact on the outcome of the pregnancy and even in women desire to bear children.

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Non-invasive brain stimulation (NIBS) is emerging as a promising option for the treatment of psychiatric diseases, including major depressive disorder (MDD). In this context intermittent white light at a specified frequency holds high promise. We have previously shown that 60Hz stimulation in mice induces selective brain entrainment associated with microglia-mediated remodeling of the perineuronal nets (Venturino et al., Cell Reports 2021).

Here, we extend our previous findings with 60Hz stimulation to assess behavioral effects in mice and EEG response in healthy volunteers.

For the preclinical data, we exposed C57Bl6/J mice to a battery of behavioral tests to assess anxiety level, learning capability, and response to various stress paradigms after 60Hz light (2h per day/5 days) compared to constant light. Weight change, water and food intake were recorded. For human studies, a cohort of 12 healthy volunteers (6M, 6F) was recruited; their EEG response was investigated with an 8-channel EEG setup following acute (same day), short (5 days), and intermediate (3 weeks) stimulation with 60Hz entrainment (n=6) or sham light (n=6).

Preliminary data from the preclinical behavior studies indicate that 60Hz treatment improves the social interaction of socially defeated mice compared to sham light stimulation. Furthermore, the animals showed less anxiety-related behavior when exposed to the elevated plus maze. No differences were noticed in weight change, water and food intake following 60Hz stimulation.

In healthy volunteers, we observed robust and widespread entrainment at 60Hz after acute 60Hz stimulation; the entrainment spread beyond the visual cortex and reached the frontal cortex. The normalized power of the 60Hz component slightly declined over time but remained significant as compared to sham stimulation at three weeks, indicating sustained EEG response. The stimulation was very well tolerated overall, without major side effects.

60Hz intermittent light induces strong and sustained neuronal response in mice and humans, is well tolerated, and ameliorates depressive-like symptoms in the social defeat model in mice. 60Hz might represent a novel NIBS for the treatment of psychiatric disorders, including MMD.

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Metabolic syndrome (MS) is a prevalent condition in individuals with bipolar disorder (BD) and may influence the expression of psychiatric symptoms. Factors contributing to this association include limited access to physical healthcare, lifestyle influences related to psychiatric symptoms, and adverse effects of psychotropic medications.

To compare the clinical characteristics of patients with Bipolar Disorder Type 1 (BD-1) with and without metabolic syndrome (MS).

This was a cross-sectional descriptive study conducted over a three-month period from August to October 2023 at the Psychiatric Service D of Razi Hospital in Tunisia. Patients diagnosed with Bipolar Disorder Type 1 according to the diagnostic criteria of the DSM-5, aged 18 years or older, and in a euthymic phase (confirmed by Hamilton Depression Rating Scale (HDRS) score <8 and Young Mania Rating Scale score <13) were included. Sociodemographic data, clinical features, and treatment information were initially collected from medical records and then verified and completed through direct interviews using a predefined information sheet and psychometric assessments. Metabolic syndrome was diagnosed according to the criteria of the International Diabetes Federation.

All participants provided informed consent before enrollment, and confidentiality of their personal and medical information was strictly maintained. The study protocol was approved by the Institutional Review Board (IRB) of Razi Hospital, ensuring that the research was conducted in accordance with ethical guidelines and principles of patient autonomy, beneficence, and non-maleficence. Participants were informed about the voluntary nature of their participation and their right to withdraw at any time without consequences. Data collection and storage adhered to strict privacy regulations to protect participants’ rights and ensure data security.

Forty patients were included in the study, of whom 28 had MS and 12 did not. The mean age of patients was 34.5 ± 8.2 years in the MS group and 32.1 ± 6.5 years in the non-MS group. Participants with MS had a significantly younger mean age of disorder onset (22.6 ± 8.25 years) compared to those without MS (27.9 ± 4.86 years) (p = 0.02). We found that the mean number of suicide attempts was significantly higher in the MS group (2.8) compared to the non-MS group (1.6) (p = 0.001). Anxiety comorbidity was significantly higher in patients with MS compared to those without MS (57% vs 35%, p < 10^-3).

Our study underscore the importance of addressing metabolic syndrome in the management of patients with BD-1. Given the higher prevalence of metabolic syndrome in this population and its impact on clinical outcomes, interventions aimed at preventing and managing metabolic syndrome components such as obesity, diabetes, and dyslipidemia are crucial.

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Schizophrenia remains a complex psychiatric disorder characterized by varying symptoms and levels of insight. The Frankfurt Complaint Scale (FBS) and the “My thoughts and feelings” questionnaire provide quantitative measures of symptom severity and insight, respectively. Previous literature has emphasized the importance of these tools in both clinical assessment and therapeutic planning.

Exploring the Relationship Between Schizophrenia Symptom Severity and Insight based on the Frankfurt Scale and the “My thoughts and feelings” Questionnaire.

The study utilized data extracted from an Excel dataset comprising demographic information and specific scores from the FBS and the Insight questionnaire. The sample was divided into four subgroups based on their FBS scores, and the average Insight score for each subgroup was calculated.

The study found the following average Insight scores across FBS-defined subgroups: Mild symptoms: 9.67, Moderate symptoms: 8.25, Severe symptoms: 8.22, Very severe symptoms: 9.29. The correlation analysis revealed a weak and non-significant correlation between FBS scores and Insight scores (r = -0.017, p = 0.925). The demographic analysis showed a prevalence of male patients (n=20), with the most common age group being 36-45 (n=11). Most participants resided in large cities (n=16), with the highest educational attainment being a Bachelor’s/Master’s degree (n=12), and the majority were single (n=21). The study group displayed diverse demographic characteristics,

with a significant male predominance and a concentration in urban environments. This demographic distribution may influence the generalizability of the findings and provides a context for interpreting the varied experiences and perceptions of illness within the group.

This study underscores the complexity of schizophrenia, where symptom severity does not straightforwardly correlate with insight into the illness. It highlights the importance of using a range of assessment tools to fully capture the multifaceted nature of patient experiences. Future studies should explore these relationships further to refine the tools used for assessments and to tailor intervention strategies effectively.

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Vaginismus is characterized by phobic avoidance, involuntary pelvic muscle contraction, anticipation, fear, and experience of pain during vaginal penetration. In addition to anxiety and fear, vaginismus-specific cognitive and metacognitive beliefs are thought to play a role in the etiology of vaginismus. Impaired sexual functions and decreased sexual satisfaction in women with vaginismus are claimed to be associated with anxiety and depressive symptoms. However, in clinical practice, it is observed that women who do not exhibit anxiety and depressive symptoms also experience sexual dysfunction and reduced sexual satisfaction, but it is noteworthy that the causes of this deterioration have not been sufficiently investigated.

The purpose of this study is to assess the impact of metacognitive beliefs on sexual functions and satisfaction in women with vaginismus.

A total of 64 women with vaginismus and 30 healthy controls were examined through Sociodemographic Data Form (including age, education status, duration of marriage, etc), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Arizona Sexual Experiences Scale (ASEX), Golombok-Rust Inventory of Sexual Satisfaction (GRISS), and Metacognition Questionnaire-30 (MCQ-30).

The mean ASEX, GRISS, and MCQ-30 scores were significantly higher in the vaginismus group than the healthy controls. No significant difference were found between groups in terms of BDI and BAI scores. Hierarchical Regression Analysis revealed that 13% of ASEX total scores in the vaginismus group were predicted by BDI and BAI scores (F=4.59, p< 0.05), and the predictability increased significantly to 32% by the addition of MCQ-30 scores to the model (F=3.79, p<0.01). However, GRISS-Total scores were not statistically significantly predicted by BDI and BAI scores (F=1.76, p>0.05), but the predictability of variance increased significantly to %26 (F=2.87, p<0.05) with the addition of MCQ-30 scores to the model. Moreover, the metacognitive dimension of uncontrollability and danger of thoughts, and cognitive self-consciousness were found to be significant factors in predicting both ASEX (b=0.52, p=0.004 and b=-0.49, p=0.003, respectively) and GRISS (b=0.58, p=0.002 and b=-0.40, p=0.017, respectively) scores in vaginismus.

The current findings of the study indicate that metacognitive beliefs, especially dimensions of uncontrollability and danger of thoughts and cognitive self-consciousness, predict sexual functioning and sexual satisfaction in women with vaginismus. Understanding the metacognitive characteristics accompanying vaginismus and including metacognitive interventions in sexual therapy for both cognitive self-consciousness and negative beliefs about the uncontrollability of thoughts and danger, may result in increased treatment success, improved sexual functioning, and sexual satisfaction in women with vaginismus.

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Preclinical Alzheimer’s disease (AD) is characterized by subtle cognitive changes that precede the onset of clinical symptoms. Neuropsychiatric symptoms such as anxiety have been increasingly recognized for their potential role in accelerating disease progression. Although various theories have been proposed, anxiety may exacerbate cognitive decline through mechanisms involving stress-induced neurochemical dysregulation, affecting brain regions vulnerable to AD pathology.

This study examines the neural correlates of preclinical AD in individuals with low anxiety scores, employing MRI to explore potential early biomarkers and elucidate the complex role of anxiety in the progression of AD.

A total of 172 participants from the German Center for Neurodegenerative Diseases Longitudinal Cognitive Impairment and Dementia Study (DELCODE) were categorized into three groups: Healthy Controls (HC, n=59), Subjective Cognitive Decline (SCD, n=77), and Mild Cognitive Impairment (MCI, n=36). Anxiety levels were assessed using the Geriatric Anxiety Inventory-Short Form (GAI-SF), and neural responses to novelty were examined using 3-Tesla MRI. Statistical models were adjusted for relevant covariates, including age, education and study site. The differences of the three groups were analysed by one-way ANOVA contrasts and post-hoc analyses were performed with two sample t-tests.

Significant neural differences were observed across groups, particularly in the precuneus, right angular gyrus, and right cerebellum exterior (p < 0.001, p = 0.001, and p = 0.002 respectively). The SCD group demonstrated greater activation in the right angular gyrus compared to HC (p = 0.008), while the MCI group exhibited more pronounced differences L-R precuneus, right cerebellum exterior, right angular gyrus, and right middle frontal gyrus regions indicating further cognitive decline (p< 0.001, p< 0.001, p= 0.001, p= 0.017 respectively).

This study identifies critical brain regions, with a particular emphasis on the right angular gyrus, associated with the early stages of AD in individuals with low anxiety scores. The activation in these areas likely correlates with an early inhibition deficit at the systems level in individuals with preclinical memory impairment. However, the role of anxiety in preclinical AD is complex and variable among individuals. Anxiety may serve as an early response to subtle cognitive changes in some, while in others, it might emerge as a consequence of these changes. Moreover, the relationship between anxiety and neural alterations in AD could be bidirectional, where anxiety both influences and is influenced by the disease’s progression. These findings highlight the importance of considering anxiety when identifying early biomarkers for AD and suggest that targeted interventions addressing anxiety may help slow cognitive decline.

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