Mental illness is a kind of change in mental health status which affected thought, feeling, emotion, behaviors, and so on. Labor work training is one of common rehabilitation programs in psychiatric medical institutes in Taiwan. This rehabilitation program has been implemented for many years, being an important indicator of psychiatric hospital accreditation. However, we couldn’t analysis and apply effectively.

We aim to investigate different labor work training performances of the patients with mental illness in a public psychiatric center in Taipei City. Furthermore, we can apply in shared decision making and modifying the labor work training project according to the data results.

In this cross-sectional study, 89 participants with mental illness who were stably engaged in labor work training for at least 1 month were included in Taipei City Hospital Songde Branch. Descriptive statistics will be used in characteristic of population, incentive record and score of the comprehensive occupational therapy evaluation scale (COTES). We used one-way ANOVA to test the difference of work behavior scores in different labor work training.

This study results showed that the percentage of participants in the cleaning labor group, manual group, and sales & delivery group were 15% (N=13), 49% (N=44), and 36% (N=32) respectively. The most people engaged in the manual group. The average total score of psychiatric patients’ work behavior was highest in the sales & delivery group (p<.05). There were significant differences at scores of work behavior items, including motivation (p=.006)、duration (p=.001), responsibility (p=.002), comprehension (p=.002), technique (p=.005), and fine motor coordination (p=.005).

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In comparison, the patients with mental illness in the sales & delivery group are better at work behavior. According to the analysis of the result data, when the therapist and the patient make shared decisions, they can discuss appropriate labor work training based on the patient’s work behavior.

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Sustained attention deficit is a core feature of schizophrenia, however, its between-subjects and within-subject fluctuations are little understood. Moreover, although the pertinence of sustained attention for daily functioning has been widely discussed in the literature, research has not consistently demonstrated this association in schizophrenia. One possible reason is a use with non-ecological tasks for evaluation of SA, which may not fully capture real-world attentional demands. Indeed, existing tools demonstrate low ecological validity.

This study aimed to develop daily-life task-based test of SA - Ecological Sustained Attention Task (Eco-SAT), and investigate its reliability and criterion, construct, and ecological validity in schizophrenia.

Eco-SAT was developed based on well-established CPT paradigm (320 trials presented for 500-3000ms, 12 min) simulating vacuum cleaning task. Twenty-one individuals with schizophrenia (age: M=42, SD=12.5; female: N=12, 57%) and 34 matched by age and gender healthy controls completed the Eco-SAT, non-ecological CPT, measures of cognition (MATRICS consensus cognitive battery: BACS, TMT, RBVMT & CFT), schizophrenia symptoms, and daily functioning using Observed Tasks of Daily Living test (OTDL, functional capacity) and Adults Subjective Assessment of Participation in daily life in an interchangeable order during one session.

Eco-SAT demonstrated excellent test-retest reliability for Average RT (ICC = 0.84). Schizophrenia patients performed Eco-SAT significantly worse than controls on Average RT (U=545, p < 0.01), and variance RT (U=518, p < 0.01). Eco-SAT showed correlations with non-ecological SA task (all parameters; 0.45<r<0.75, p<.001), MATRICS sub-tests of BACS (d prime, average RT, RT variance: -0.54<r<0.3, p<.5), TMT-B (average RT: r=0.3, p<.05), RBVMT (average RT, RT variance: -0.5<r<-0.4, p<.01), and CFT (average RT, RT variance:-0.35<r<-0.34, p<.001), positive schizophrenia symptoms (hit rate: r=0.3, p<.05) and the OTDL (RT variance, d prime, hit rate: -0.35<r<0.3,p < .05).

The study provides initial evidence of the psychometric properties of the Eco-SAT, an ecological measure of sustained attention in schizophrenia. Criterion validity was established for all Eco-SAT indices, while reliability, construct validity, and ecological validity were demonstrated for specific indices. The results suggest that average RT and RT variance are the most trustworthy indices. Although further research is required, these findings indicate that this ecological measure may offer a more accurate way to assess attentional deficits in real-world activities, enhancing our understanding of attentional mechanisms in schizophrenia for both research and clinical applications.

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The existentialist approach to psychopathology emphasizes the need to understand the conditions that allow for the emergence of psychological disorders, referred to as “conditions of psychopathologization.” This perspective, rooted in phenomenological methodology, rejects deterministic biomedical models, favoring a holistic view that considers the subject’s lived experience, freedom, and choice. Drawing on the work of Jean-Paul Sartre, this study aims to analyze how existential conditions such as past events, personal choices, and social contexts contribute to the development of psychopathological states.

The primary objective of this research is to explore the existentialist understanding of psychopathology, particularly focusing on Sartre’s contributions to making psychopathological experiences comprehensible.

Narrative review of relevant literature.

The findings highlight that psychopathological conditions often arise when individuals are alienated from their own projects of being. These conditions are shaped by personal histories, societal structures, and choices made in “bad faith” (self-deception). Past events, such as family dynamics, social oppression, and traumatic experiences, play a critical role in shaping the individual’s choices and actions. Sartre argues that when individuals distance themselves from their authentic desires and intentions they experience existential alienation, which manifests as psychopathology. A key result is the understanding that psychopathology should not be seen as a mere malfunction of the brain, as suggested by the biomedical model. Rather, it is a comprehensible event in the subject’s individual and social history. The deviation from an authentic life project is central to understanding the origin of psychological disorders.

Sartre’s existentialist framework offers significant contributions to the field of psychopathology by making psychological suffering comprehensible through the lens of personal freedom and choice. The rejection of a purely biomedical or deterministic approach allows for a more nuanced understanding of the individual’s psychological struggles as part of their broader life context. Psychopathology is thus seen as a breakdown in the relationship between the subject’s life project and their historical or existential situation, where the individual either chooses to distance themselves from their authentic self or is forced to do so by external contingencies. Sartre advocates for a “reciprocal” clinical relationship that recognizes the patient’s subjectivity, transforming the clinical space into one of genuine listening and understanding. This existentialist clinical model focuses on the subject-in-situation.

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In the past, traumas have always occurred and continue on a social and individual level in humanity’s journey to this day. While there were world wars, atomic bombs dropped on Hiroshima and Nagasaki, Nazi concentration camps, the events of September 11, the events in Bosnia and Herzegovina, and the Iraq wars, today the Ukraine war, the Israeli-Palestinian conflict and many more continue on a national and regional level, and are increasing day by day on an individual level.

The aim of this study is to offer a different perspective on mood changes in individual and social life after trauma.

In this study, qualitative and quantitative research methods were used.

From the perspective of quantum thought, matter is energy and this is expressed with Einstein’s famous formula e=mc2. From the perspective of quantum thought, an external effect on a system in equilibrium causes a temporal displacement, a new form of existence in that system. For example, when an external effect is applied to a system A, the new energetic position of the system A will be A’, and its temporal dimension will be t at the beginning, but will become t’ as a result of the interaction. This t’ can be called temporal displacement. Just as the disruption of the voodoo biological clock on an individual level causes psychological and emotional changes, it is possible that post-traumatic temporal displacement - this can be any kind of trauma - will cause mood changes and disorders in mood states on a social and individual level.

The aim of this discussion is to perceive how the breaks in the temporal and energy processes of societies and individuals can create changes in their emotional states in the context of quantum philosophy. In terms of quantum thought, every intervention made to the system from outside or inside causes a temporal shift and energetic changes in the system. This temporal shift should not be understood as a disruption of the biological clock, but should also be perceived as a new energy and a new form of existence in the time cycle of the system after the trauma.

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This presentation will provide an overview of existing research on crisis-support training in virtual reality, highlighting both the opportunities and challenges of utilizing this training method. It will review current research trends in the field, identify gaps in knowledge, and propose directions for future research initiatives. Studies on crisis-support training that utilize a virtual reality training approach for professionals working with children and adolescents will also be presented.

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Epilepsy is a common disease that is mostly treated with antiepileptic drugs (AEDs). The sexual dysfunction (SD) side effects related to the use of AEDs have not received sufficient attention.

The aims of this study were to assess the prevalence of SD and to study the role played by the AEDs among patients with epilepsy.

A cross-sectional and analytic study was conducted from September to December 2023, among patients with epilepsy follow up in the neurology outpatients of the University Hospital in Gabes (Tunisia), received AEDs, married for at least six months and sexually active. We collected the therapeutics data including type and number of prescribed AEDs and medication adherence, using pre-established form. SD was measured using the Arizona Sexual Experience Scale (ASEX) questionnaire.

Forty-five patients were enrolled (68.9% male and 31.1% female). The average age was 46.76 years (SD=12.39). The majority of patients had a low socio-economic status (64.4%). Carbamazepine and phenobarbital were the most commonly AEDs prescribed (57.8% and 53.3% respectively), especially as monotherapy (62.3%). Poor medication adherence was observed in 13 patients (28.9%). The frequency of SD among patients, based on ASEX questionnaire, was 44.4%. The factors associated with SD included carbamazepine and phenobarbital prescription (p=0.036 and p=0.045 respectively), double or multiple drug therapies (p=0.006) and poor medication adherence (p=0.033).

SD is very common in patients with epilepsy. This seems to be related to AEDs such as using of carbamazepine and phenobarbital, polytherapy and poor medication adherence.

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Lung cancer is one of the most frequent forms of cancer worldwide. Its prevalence has increased substantially the last decades. About 85% of all cases are non-small-cell lung cancer, which can be further divided in other subtypes. The use of targeted therapies and immune check-point inhibitors in the last years has improved survival, such is the case of tyrosin-kinasa inhibitors as lorlatinib. This molecule can reduce neoplastic growth when ALK rearrangement is present.

To review the literature about psychiatric adverse effects of lorlatinib.

A narrative review of the evidence was performed. The search was focused on described psychiatric adverse effects in patients with lung cancer who have received lorlatinib as antineoplastic agent.

We report the case of a 54-year-old man with lung adenocarcinoma stage IV ALK+ diagnosed in 2024. Suprarenal metastases were found. He started antineoplastic treatment with lorlatinib as first line agent during hospitalization, with a dose of 100mg per day. Three months later, the patient experienced anxiety and impulse phobias of aggressive content which led to an intense psychological distress and behavioural repercussion (avoidance, overcompensation). He consulted because of these symptoms and the dose of lorlatinib was reduced to 75mg per day by his oncologist. By the time he was evaluated in Psychiatry Service, the symptoms had improved but remained present. Low doses of aripiprazole were prescribed as symptomatic treatment (2,5mg per day) with great results manifested one week later.

Most common adverse effects of tyrosin-kinasa inhibitors are fatigue, gastrointestinal symptoms, skin reactions or edema, among others. Although neuropsychiatric adverse effects are infrequent, they can occur and induce significative impairment and emotional distress. It’s important to recognize these other symptoms, especially on new drugs, and know how to approach them properly.

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Cognitive impairments are strongly associated with impaired everyday functioning in individuals with schizophrenia, and cognitive remediation (CR) has been identified as effective treatment. However, uncertainty remains regarding the most effective components of CR.

To identify (1) the most effective combination of core ingredients of CR (cognitive exercises, presence of a therapist, cognitive strategies, and generalization activities) and (2) the most effective type of CR to improve everyday functioning in individuals with schizophrenia (computer-assisted cognitive remediation, single domain computer-assisted cognitive remediation, social cognition interventions, paper and pencil interventions, integrative approaches, and combination approaches).

PubMed, PsycInfo, Medline, Embase were searched literature from inception until November 25, 2022. Reference lists of included studies and previous meta-analyses were searched for relevant studies. We included randomized controlled trials comparing CR with any control condition or a different type of CR, assessing everyday functioning pre- and post-intervention in individuals with schizophrenia. The studies were selected independently by two reviewers. We followed the PRISMA guidelines. Study data were extracted independently by two reviewers. Data were analyzed using Bayesian random-effects network models. Trial methodological quality was evaluated with the Clinical Trials Assessment Measure. Risk of bias was evaluated. Primary outcomes were changes in functioning and cognition from baseline to after CR and from baseline to followup (min. 3 months). Literature search was updated in September 2024.

86 studies and 6076 participants were included. For both outcomes, the most effective constellation of core elements of CR were cognitive exercises, CR provided by a therapist and the use of generalization procedures (functioning: g = 0.31, 95% CrI [0.14, 0.47]; cognition: g = -0.23, 95% CrI [0.03, 0.42]). Moreover, only combinations that included both cognitive exercises and a therapist were more effective than TAU. All four core elements were necessary to observe improved functioning at follow-up. For the specific types of CR, none was superior to any other CR type. All CR types were more effective in improving functioning compared to TAU (g = 0.19-0.45). Study quality did not influence the results. Results will be updated if necessary after inclusion of the updated literature search.

The findings indicate that the effectiveness of CR depends on the inclusion of four essential elements—cognitive exercises, therapist involvement, strategies, and generalization activities—rather than on the specific type of CR intervention. An update to the definition of CR is recommended.

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Recent advancements in large language models (LLMs) demonstrate their ability to perform verbal generalization and simulate agency, opening new possibilities for innovative applications in psychotherapy. One promising avenue is the integration of LLMs into Eric Berne’s Transactional Analysis, a psychotherapeutic approach that conceptualizes human personality through three distinct ego-states: Parent, Adult, and Child.

To investigate the potential of LLMs in Transactional Analysis.

LLM capabilities described in the literature were compared with demands derived from the theory.

By examining the interactions among ego-states in Transactional Analysis, individuals can become aware of their behavior patterns and modify ineffective ones, fostering healthier relationships and improving social adaptation. Incorporating LLMs into Transactional Analysis offers a novel tool for psychotherapeutic interventions. Therapists could utilize AI to help clients recognize emotional experiences and identify maladaptive interaction patterns. By simulating the Parent, Adult, and Child ego-states, an LLM could engage in dialogues that reflect these internal states, allowing the client to explore and better understand their emotional reactions and needs. This interaction would enable clients to actively engage with different parts of their personality, promoting self-awareness and providing valuable insights into the causes of relational difficulties. While the potential benefits are clear, further research is needed to assess the practical effectiveness of integrating LLMs into Transactional Analysis. Empirical studies should investigate the degree to which LLMs can accurately simulate ego-states and contribute to positive therapeutic outcomes. Additionally, ethical considerations must be addressed to ensure that the application of AI in psychotherapy is both responsible and beneficial for clients.

The proposed approach fosters a deeper understanding of internal conflicts and provides a structured, controlled environment where clients can work through problematic situations.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

None Declared