One of the forms of early comprehensive care for children after severe brain injuries is inpatient habilitation/ rehabilitation. Children receive help from a team of medical, psychological and pedagogical specialists. The process of special education consists mainly in the development of cognitive interest, because it is the basis of socialization.

To study cognitive activity in children who have suffered severe brain damage.

observation, pedagogical examination, psychiatric supervision.

36 children aged 1.2-1.8 years during hospital treatment.

According to the results of the pedagogical survey, three groups of children were identified.

Group 1 (11%): fixed gaze; emotional response to sound (smile); short-term eye tracking of an object; ability to touch an object and hold it for a short time; walking skill is formed.

Group 2 (33%): short-term gaze fixation; reaction to sound by involuntary hand movements; lack of eye tracking of an adult’s face; lack of ability to touch or hold an object; walking skill is formed.

Group 3 (56%): lack of fixed gaze; reaction to sound by shouting and increased motor activity; lack of ability to touch or hold an object; lack of walking skills.

Indicative responses to an adult’s voice and face, eye tracking of an object, sensorimotor activity, and so on. these are indicators that show whether a child has cognitive activity. The rehabilitation team can rely on these indicators when choosing treatment and the content of the special educational process.

Key words: early intervention, toddlers, organic damage of central nervous system, rehabilitation/ habilitation

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New data from the MRC funded project “Integrating psychological models with biological pathways in psychosis” will be presented. The overall objective of this project is to use both environmental and genetic data to understand the biological pathways in patients with schizophrenia and bipolar disorders. Specifically, to find out if polygenic risk and childhood adverse events increase the relative risk of mental illness above that of its individual case-control explained variance, and secondly, the effect of both polygenic risk and childhood adverse events on clinical characteristics and ageing processes. Both data from new unpublished systematic reviews and original data will be presented.

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Alcohol and sedative substance use disorders are escalating global public health challenges. Lebanon has grappled with multiple crises, including economic, healthcare, and social issues.

This study aimed to assess the correlates of the alcohol and sedative substance use risk scores with sociodemographic and clinical factors, including sleep disorders, chronotype, anxiety, and depression.

A cross-sectional study was conducted among the Lebanese population using several validated scales to assess the risk of alcohol and sedative substance use, including the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Other tools evaluated chronotype, sleep, and mood disturbances. Bivariate and multivariable analyses were then performed, taking the alcohol and sedative scores as dependent variables.

A total of 646 participants were included. Multivariate analysis revealed positive and significant correlations between higher ASSIST-alcohol scores and personal history of alcohol abuse (B=4.61), family history of prescription substance abuse (B=1.763), psychiatric disorders (B=2.898), and worse Insomnia Severity Index scores (Beta=0.14). Conversely, ASSIST-alcohol scores negatively correlated with weight (B= -0.39) and morning chronotype (B=-0.084). Positive correlations were identified between higher ASSIST-alcohol scores and personal history of illicit substance abuse (B=2.834), prescription substance abuse (B=2.252), sleep quality (B=0.130), and sleep severity (B=0.082), while negatively correlating with cigarette smoking (B=-0.038).

This study elucidates the role of several predisposing factors to alcohol and sedative use disorders in Lebanon, including history of substance abuse, psychiatric disorders, sleep disorders, and chronotype. These findings advocate, in particular, for the integration of sleep disorder assessment and management into addiction rehabilitation programs.

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DRESS (Drug Reaction with Eoshinophilia and Systemic Symptoms) syndrome, also called DIHS (Drug-Induced Hypersensitivity Syndrome) is a rare drug-induced systemic hypersensitivity reaction that can be potentially life-threatening (Choudhary et al. J Clin Aesthet Dermatol 2013; 6 -7). Risperidone is an antipsychotic drug with significant antagonist activity at the 5-HT2 and the D2 receptors. It has been reported that risperidone may be effective in controlling agitation, delusion, hallucination, and withdrawal behavior in geriatric patients (Yunusa & El Helou. Front Pharmacol 2020;11:596).

The aim of this study is to demonstrate the case of developed DRESS syndrome following the use of risperidone.

The 81-year-old female patient was admitted to the Dermatology Clinic due to skin rash, high fever and leukocytosis following the use of risperidone. The patient was consulted to Psychiatry.

In her history it was determined that risperidone 0.5 mg/d was started to the patient with depression due to agitative symptom. On the 4th day of treatment, targeoid lesions, starting from the back and spreading first to the trunk and then to the extremities, were observed. Further laboratory examinations revealed that the fever was measured at 39.5 C°, liver enzymes were elevated (ALT= 119 IU/ lt, AST= 124 IU /lt), and significant leukocytosis (WBC =12.000) was present along with the lesions. The patient was planned to be hospitalized to Dermatology Clinic on the 5th day and risperidone was stopped. The patient’s agitation increased and following the risperidone discontinuation thereupon the lesions tended to fade and desquamation began. After the treatment of the DRESS syndrome, aripiprazole was given to the patient for agitative symptom. The level of agitation symptoms decreased, and the patient tolerated aripiprazole well without any observed side effects.

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When initiating medication for the elderly population to address agitation, considering such rare side effects can prevent the patient from being hospitalized due to DRESS syndrome. To the best of our knowledge, this is the first case report associated with DRESS syndrome and risperidone treatment thus, it is necessary to be very careful when starting psychotropic medication for elderly patients.

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The Covid-19 pandemic has generated an unprecedented impact on multiple levels (health, occupational, economic, and social) which affected the general population and has been an enormous stress factor for individuals with obsessive-compulsive disorder (OCD), particularly for those with contamination symptoms. Many patients, as well as healthy individuals, experienced new obsessive-compulsive-like symptoms centered on COVID-19 during the pandemic. However, data on this population are still scarce.

To present a case exemplifying the association between the Covid-19 pandemic and the onset of OCD.

Case presentation and non-systematic review of existing literature on Pubmed using the keywords: Covid-19, OCD, pandemic, depression.

We report a case of a 30-year-old female who presented to the emergency department due to depressive mood and suicidal ideation associated with exacerbation of OCD symptoms, namely intense fear of being infected with Covid-19. These symptoms led to avoidance of touching objects, surfaces or even herself in addition to frequent and long rituals of hand-washing and showers. She was asymptomatic prior to being infected with Covid-19, when she started developing obsessive ideas of contamination. She sought psychiatric support and was medicated with fluoxetine, olanzapine and clonazepam. Due to insufficient symptom control, she was admitted to the psychiatry ward, where treatment was initiated with aripiprazol and fluvoxamine. After dose titration, gradual remission of OCD symptomatology and depressive mood was observed.

The present case illustrates the correlation between Covid-19 and the onset of OCD symptomatology. Existing studies demonstrate that the pandemic worsened the landscape of symptoms of OCD, both in diagnosed patients as well as in previously healthy individuals. However literature is still limited thus, multinational and cross-cultural, longitudinal studies are warranted to gain further insights on this topic.

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The effect of sleep disorders on the weakening of the students’ mental health potential is still underestimated. Students might not openly complain of having problems with sleep, considering them insignificant. Nevertheless, sleep disorders may be the sign of actual or developing mental health problems.

To reveal the prevalence of parasomnic and insomnic disorders in university students, who do not have health related complains.

We surveyed 77 first and second-year students of both genders by means of a questionnaire that included questions describing the signs of various sleep disorders.

One third of the students revealed having parasomnic disorders in the form of dissociated sleep states – 35.1% of the respondents talk in sleep (states of somniloquy or sleep talking), 6.5% get seated on their beds, 5.2% get up from their beds (states of partial awakenings and confusional arousals), 5.2% walk around the room or house (sleepwalking, or somnambulism). Over half of the students experience night phobias (53.2%), 2.6% out of them experience them constantly. Some students’ fears grow into nightmares. Half of the respondents (50.6%) state they very rarely see nightmares. Every fifth student (20.8%) sees nightmares only from time to time. 10.4% of the students see them very often or constantly.Over half of the respondents (55.8%) complain of insomnic disorders in the form of insomnia. 3.9% of them experience it constantly, 10.4% – often, 16.9% – sometimes, and 24.7% – rarely

The frequency of sleep disorders in students is very high. Consequently, it is important to inform university students timely about potential risks and ways to avoid them.

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Psychedelics are substances consumed for recreational use, the majority of these psychoactive substances are illegal and hard to obtain. Therefore, there is a demand for psychedelics legal and easier to access, these types of drugs are called ‘legal highs’. LSA (lysergic acid amide) is one of these new psychoactive substances, this drug is searched because it is known to have an effect similar to LSD. LSA has negative effects on body functioning not fully understood by the medical field.

This project aims to conduct a systematic review of the scientific health literature on LSA.

The following information was included in this review: articles reporting original data on physical effects, neurobiological effects, various bodily symptoms, social and cultural aspects in humans related to LSA, published in English, Portuguese, Spanish, Italian, and French. Studies involving animals, in vitro research, botanical studies, and non-original research were excluded. The following keywords were searched in the PubMed, Google Scholar, and Web of Science databases: (ergine or d-lysergic acid amide or LSA or d-lysergamide or lysergic acid amide). This study followed the PRISMA statement for systematic reviews and PRISMA checklist. The resulting data were tabulated and analyzed according to relevance.

LSA, also known as ergine, is an ergot alkaloid with a chemical formula very similar to LSD. Ergine is found in plants of the Convolvulaceae family and is primarily consumed through chewing the seeds of these plants, soaking them in alcohol, or preparing an extract. The amount of LSA in each seed is inconsistent, making it unpredictable how much will be consumed, and these seeds may contain other harmful compounds.

LSA is a partial agonist and antagonist of serotonergic receptors, with a preference for 5-HT1A and 5-HT2, and stimulation of D2 is related to nausea. It can cause symptoms including euphoria, hallucinations, anxiety, nausea, weakness, fatigue, tremors, and elevated blood pressure. In some cases, the use of LSA is associated with the use of other drugs, and there are case reports of LSA-induced PRES (Posterior Reversible Encephalopathy Syndrome), post-use suicides and the need for hospitalization due to psychosis-like states.

Studies conducted on the quality of information about LSA on digital platforms indicate misinformation with incorrect data that can be harmful to those who ingest the drug. Additionally, there are studies suggesting that LSA may improve symptoms of cluster headaches.

LSA is a legal drug in most countries, with widespread misinformation on the internet and limited control over its use. There are potential serious adverse effects caused by the drug, and it is often associated with other psychoactive substances. Greater knowledge about the drug is needed for diagnosing its use and abuse, as well as for educating the public.

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Pregnant women are particularly vulnerable to a wide variety of psychiatric symptoms, including anxiety related to pregnancy and childbirth.

The purpose of our study was to determine the sociodemographic characteristics of pregnant women and investigate their relationship with pregnancy-related anxiety.

The study was conducted from February to July 2023 among pregnant women in their 3rd-trimester consulting at the Gynecology-obstetrics department of the Hedi Chaker University Hospital of Sfax, Tunisia. Women with obstetric conditions favorable to vaginal delivery (cephalic presentation and eutrophic fetus) were interviewed using a questionnaire including their sociodemographic characteristics and the brief version of the pregnancy-related anxiety questionnaire PRAQ-R2.

A total of 350 women were included in our study. The mean age of the participants was 28 years [16-41 years] with the majority being married (95.7%). One hundred and eighty-eight women (53.7%) did not graduate from high school and 213 (60.9%) were housewives. Half of the participants (52.9%) lived in the city, and 38.9% reported low income. Almost half of them (46.28%) were multiparous.

The mean score of the PRAQ-R2 was 31.24 ± 7.53.

We found a positive correlation between the PRAQ-R2 scale score and age younger than 30 years (p<0.001), low educational level (p=0.006), and low income (p=0.031).

Our findings suggest that demographic factors seem to predict anxiety related to pregnancy and are worth examining in future studies for a better understanding of this symptom in pregnant women.

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There has been a 1000% increase in referrals for assessment of adult ADHD within Scotland over the past three years (The Scottish Government. 2023. NAIT adult Neurodevelopmental Pathways Report). These referrals are sent by general practitioners to the local community mental health team. The most junior clinicians (doctors who are pre-membership with the Royal College of Psychiatrists) in the team are often responsible for undertaking the initial assessment of these patients. Patients have on average waited almost a year to be seen and expectations are high.

The diagnosis of ADHD can be challenging, and adult ADHD is still a relatively new and evolving diagnostic entity. We set out to explore how junior clinicians were coping with this in their daily practice.

We developed a questionnaire that was sent to all junior clinicians working within Argyll & Bute (n=8) via an anonymised email link. The link was open for 1 week and then results were analysed.

The response rate to our survey was 87.5%. Prior to starting their current roles none of the respondents had ever undertaken an ADHD assessment before. All respondents answered “No” when asked if they felt they had adequate knowledge on ADHD in order to perform assessments. Only 14% (n=1) felt they had access to adequate resources about how to make an ADHD diagnosis. Participants were asked on a scale of 1-10 (1= not at all,10= very) to rate their confidence in conducting ADHD assessments. The average confidence score was 2.43. There was a space for free text feedback in which participants reported the following: “felt thoroughly out my depth”, “I felt chucked in the deep end”, “I felt very under qualified”

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Our results showed that junior clinicians did not feel confident or knowledgeable about undertaking adult ADHD assessments. In response to this we have now produced, in association with the consultant psychiatrists within our health board, an informative and engaging quick reference poster which explains how to undertake an ADHD assessment (see QR code attached as Image 1). It contains useful pointers about diagnosis, and more importantly guidance on language/phrases to use when explaining to patients whether or not you feel a diagnosis of ADHD is appropriate. It then also explains next steps that can be offered i.e. psychological support/medication options and how to prescribe these. We plan to send out a repeat questionnaire to the next cohort of junior clinicians to assess if they have improved confidence in managing and diagnosing ADHD following this intervention.

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There is a growing interest in understanding the impact of duty hours and resting times on training outcomes and the well-being of resident physicians. Psychiatry resident’s duty hours in Spain comprise a regular working schedule of 37.5h per week and a minimum of 4 mandatory on-call shifts. The most recent duty hours regulations in Spain were transposed from the European Working Time Directive (EWTD). According to Spanish Law, doctors cannot work for more than 48h per week and need to have resting times per day (at least 12h), per week (at least 36h) as well as annual leave (at least a month). However, there is practically no data on this situation in psychiatry resident physicians.

Our aim is firstly, to describe the number of shifts performed by psychiatry resident physicians in Spain. Secondly, to describe compliance with the daily and weekly rests compared to those set in national and European law. Finally, to analyse the difference by demographic variables (gender and year of residency), in both the number of on-call duty shifts and compliance with rests.

A descriptive cross-sectional study was designed through an online survey adapted from the existing literature. The target population were Spanish psychiatry resident physicians undergoing PGT who started their specialist training during the years 2018–2021. The survey was disseminated through the Spanish regional medical councils to all active psychiatry resident physicians by mail as well as through informal communication channels. The study was authorised by the Spanish Medical Organization’s General Assembly which is the highest ethical and deontological body of physicians in Spain.

55 responses were obtained, of which 61.82% identified as females. The mean number of on-call shifts in the last 3 months was 14.05. This mean was highest in women 14,32 and in the cohort of 2020 15.46 (first year of residency). Among the resident physicians surveyed, 66.07% exceeded the 48h per week limit set by the EWTD and 7% of them did not rest after a 24-h on-call shift. Furthermore, 22% of respondents did not have a day-off after a Saturday on-call shift. The mean working hours when not resting after an on-call-shift were 7 hours. The comparison by gender and year of residency of the main variables can be seen in figures 1 and 2 respectively.

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Psychiatry resident physicians in Spain greatly exceed the established 48 h/week EWTD limit. Likewise, non-compliance with labour regulations regarding mandatory rest after on-call duty and minimum weekly rest periods are observed. Differences can be seen by gender and year of residency. The situation described could potentially create a high-risk situation for the health and psychosocial well-being of resident physicians, hinder learning outcomes and could lead to suboptimal patient care.

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Psychosis is a common clinical presentation of mental disorder in many psychiatric patients, however, an etiological diagnosis is important when it occurs for the first time in a patient. Regarding a case seen in the Emergency Department recently, with major depression and acute cocaine use, a differential diagnosis was made after adequate organic screening. When presenting delusion of infestation after the consumption of the substance, the main hypothesis was what we call Ekbom syndrome. However, among other possibilities we consider a toxic psychosis or a major depression with psychotic symptoms.

Review the different causes of acute psychosis and the importance of a good clinical history to achieve a specific diagnosis. Perform a differential diagnosis between the main causes of psychosis in a patient with depression who has recently consumed cocaine.

Presentation of the case and review of the available literature on the risk of developing psychosis after cocaine use and depression concomitantly.

There is a low number of reported cases of delusional infestation after acute cocaine use, being more likely toxic psychosis or major depression with psychotic symptoms. A good anamnesis, with systematic questions about toxic habits, can lead us to a more accurate main hypothesis.

We mark the importance of a systematic anamnesis to achieve a better diagnosis, as well as a correct study by the clinician of the specific syndromes described in phenomenology such as Ekbom syndrome, to make a correct association of ideas in the differential diagnosis.

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Although birth is experienced, in most cultures, as a positive event, for a significant percentage of women, it is considered a traumatic event, which can be associated with the development of psychopathologies, with negative impacts for the mother and the baby .

As part of a larger, multicenter study called Intersect, we aim to assess the prevalence of women who considered childbirth traumatic, in a cohort of women in southeastern Brazil, and the association with the outcome of post-traumatic stress disorder (PTSD).

A total of 427 women who gave birth in two hospitals in southeastern Brazil in the period from May to October 2022 were included in the study, who answered self-assessment instruments, through on a telephone interview, in the period from 6 to 12 postpartum weeks. For the purposes of this study, the City Birth Trauma Scale stands out.

The participants had a mean age of 28.4 (± 6.4) years, 39.2% were primiparous and 76.1% had a partner. The results showed that 51.3% of them considered the birth moderately or extremely traumatic (N=218). Of these, 50.9% met criterion A for PTSD according to the DSM-5 (N=111) and among these, 20.7% had a PTSD profile (N=23; City-Birth >28 points). These mothers represent 5.4% of the total sample.

there is a high prevalence of traumatic experiences during childbirth, with high rates of PTSD associated with this condition, which requires attention from the medical community in order to track and treat PTSD associated with birth and, from the public authorities, in the institution of preventive measures, through public policies aimed at this population.

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Consultation-Liaison (CL) psychiatry is the branch of psychiatric practice developed to offer support to patients with concomitant non-psychiatric diseases. In Portugal, most hospitals follow a model delivered by teams with Psychiatrists and Psychologists that support the medical team in wards. They act by advising directly other specialties’ colleagues after the observation of the patient and/or discussion of the case.

Bigger units, such as Santa Maria Hospital, in Lisbon, have tried a model of proximity to the community medical centers participating in local medical meetings, training of family doctors, discussing clinical situations directly and even doing psychiatric consultations, in community centers. This approach intends to extend primary mental health interventions and promote treatment in the community.

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Substance use during pregnancy has become challenging clinical issue. Substance affects the brain, causing an addictive lifestyle. In pregnant women could lead more harm to neonatal life.

This study investigates the neonatal outcome of substance use and associated factors.

A cross-sectional study was designed. Data were collected from pregnant women who used substance during labor and refer to rehabilitative consultation between 2017-2020. Neonate data were collected from perinatal care. Chi-square test and Fisher exact test were performed to analyze associated factors. A p-value less than 0.05 is considered significantly.

162 participants were included in this study. Mean age was 27.37±6.46 years. Mean age at first substance used was 21.93±6.52years. No antenatal care was found 45.7%. Methamphetamine was the most used during the first use (67.9%) and latest used (72.2%). Average birth weight was 2,734.97±617.51 gram. Gestational age at birth was 36.75±2.83 week. Average head circumference was 32.81±1.39 centimeters. Average femur length was 47.77±2.17 centimeters. Apgar score > 7 at 1 minute and 5 minute was found 94.4% and 97.2% . Neonatal complications were preterm labor (34.6%), low birth weight (25.3%), small for gestational age (19.8%), premature rupture of membranes (4.9%), and stillbirth (3.7%). No antenatal care (p=0.048), no antenatal care and birth before admission (p=0.023), a cesarean delivery (p=0.024), and gestational age more than 37 weeks (p<0.001) were associated with neonatal outcome in maternal with substance used during labor. Using amphetamine as the first substance related to neonatal complication (p=0.028).

Preterm labor, low birth weight and small gestational age are the most found as neonatal complications in maternal substance used during labor. No antenatal care was related with neonatal complications in this group.

Therefore, an integrated system for the assessment of substances used in a pregnant woman and the system to reach out women who used substance and pregnant access to antenatal care should be established. Evaluation and rehabilitation are the interventions that should be done as soon as possible as primaray, secondary intervention.

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Chronic fatigue and psychiatric manifestations (depression, anxiety and sleep disturbances) appear to be key features of post-COVID-19 syndrome and increase significantly in prevalence over time (Lavienraj et al. J Neurol Sci 2022;434:120162). Several studies have suggested an association between altered levels of arginine metabolites and depression, anxiety and stress severity (Arisoy et al. J Psychiatr Res 2020;120:21-28). L-arginine supplementation has also been shown to improve walking performance, muscle strength, endothelial function and fatigue in adults with Long COVID (Tosato et al. Nutrients 2022;14(23):4984).

To study effects of L-arginine oral supplementation on chronic fatigue and depressive symptoms reported 3 months or more after acute COVID-19 onset in elderly outpatients without severe comorbid conditions.

This is a parallel-group, double-blind, randomized controlled trial conducted on 96 over 65 non-hospitalized patients suffering from Long Covid-related fatigue and depression. The first group included patients that received 1,66 g L-arginine twice a day in addition to a standard antidepressant therapy based on Selective Serotonin Reuptake Inhibitors (SSRIs), whereas the second group received antidepressant only. Severity of fatigue and depressive symptoms was evaluated at baseline and after 8 weeks of treatment using Fatigue Symptom Inventory (FSI) and Hamilton Rating Scale for Depression (HAM-D), respectively.

At baseline, 64 patients (66,7%) reported moderate fatigue (4-6) and the remaining 32 (33,3%) reported severe fatigue (7-10). In this phase the average HAM-D score was 12,85 ± 5,97; among patients, 57,3% experienced mild symptoms of depression, 32,3% experienced moderate symptoms and 6,4% experienced severe symptoms. After two months, patients treated with L-arginine supplementation exhibited a 30% greater improvement in fatigue-related symptom severity (p=0.008) and a significantly decrease in average HAM-D score (p=0.002) compared to the group treated with SSRI only.

According to our results, adding oral L-arginine to standard antidepressant therapy in elders with Long Covid-related fatigue and depression significantly decreases severity of both physical and affective symptoms. Further studies are needed to clarify the intriguing role of L-arginine in the treatment of Post Covid-19 syndrome and its potential effects in promoting geriatric patients’ health, wellbeing and quality of life.

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Gender identity may be experienced within a broad spectrum beyond the binary understanding of sex concerning genital characteristics. In people with gender identities not congruent with the gender culturally associated with the sex assigned at birth, distress related to biopsychosocial correlates of this condition may arise. In current diagnostic systems, this is considered within the framework of “Gender Incongruence” (ICD-11) and “Gender Dysphoria” (DSM 5). Although this diversity is known to be present throughout the ages, the terms related to gender identity were introduced to medical literature a hundred years ago. They were popularized with the advances in medical procedures that assist individuals in acquiring physical features aligning with their gender identity and expression. There has been an increase in research interest with increasing numbers in medical centers working on gender-affirmative medical procedures. Starting from the 1970s, international organizations prepared guidelines on the standards of care for trans and gender diverse (TGD) individuals. Despite all the progress in the gender-affirming medical care provided to TGD individuals and the changes in the legal recognition of gender, health inequalities persist globally. The discrepancy in mental and physical health conditions has long been shown to be associated with “minority stress.” The minority stress perspective suggests that distal and proximal chronic stressors arising from society are associated with adverse health outcomes for TGD individuals. Resilience against these stressors is more robust with better coping styles and social support. Lately, structural stigma and discrimination have been shown to be an important source of inequality. Therefore, much more progress is still required with respect to societal inequalities, human rights, and structural transphobia for the improvements in medical care to impact the global health condition of TGD people. However, lately, there have been attempts to restrict TGD individuals’ access to medical care and their legal rights, even if they were not close to the level they ought to be. This backlash mostly sits on the discussion on the management of TGD adolescents and children. Models of care for these age groups have been developed for decades, and despite evidence of the protective and beneficial effects on health and development, in many countries, there are attempts to block their access to medical care. Growing debate on TGD care turned into a political combat, where scientific evidence and human rights perspectives are often ignored. These tendencies present a strong challenge for public health and the professional identity and practice of healthcare professionals.

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During the last two years, many young people and adolescents in the Kyrgyz Republic started to visit specialists due to Non-suicidal self-harm. A significant rise in the amount of such cases allowed specialists from the Republican Center of Psychiatry in Bishkek to think about an “epidemic “of self-harming behavior.  Non-suicidal self-harm (NSSH) is defined as repeated, deliberate, direct injury to the body without suicidal intent that is not socially acceptable (Nixon et al., 2002) to reduce psychological discomfort in the absence of a conscious intention to take one’s life (ICD-10 codes X60-X84, and ICD-11 codes PB80-PD3Z).

To determine the causes of NSSH among adolescents and young adults who approached specialists in mental health sphere at Institute of Behavioral Health at the American University of Central Asia.

Over two years, forty-five adolescents and young adults under twenty-five who had committed self-harm visited specialists from the Behavioral Health Institute at the American University of Central Asia.

All the patients received either dialectical behavioral treatment or cognitive processing treatment, medication (paroxetine) was used in three cases.

Thirty patients were girls under twenty-one, and fifteen were boys and young male adults. The overwhelming majority (40 people) had self-inflicted cuts, two had imposed burns with matches and cigarettes, and one had used self-suffocation without a bond. Reasons for self-harm were the following: releasing internal tension and anxiety, getting some rest from intrusive thoughts, relieving the inner pain, and a desire to “feel as a whole person.” All the patients underlined that they did not want to attract attention from their family members; moreover, they tried to hide the consequences of self-harm.

Teens and young adults (twelve patients) from Kyrgyz traditional families visited a consultant or psychiatrist after a long drive through conventional or religious healers. All of the patients knew that they were addicted to self-harm, wanted to stop a problematic behavior, and could not stop it on their own. Ten patients have been diagnosed with borderline personality disorder. Two of them also had eating disorders. Five patients had PTSD, and five had social phobia. The others had recognizable anxiety symptoms.

The enormous rise of non-suicidal self-harm is a phenomenon that needs further research. Those cases often resist treatment due to the “addictive” component in the pathogenesis.

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Insufficient knowledge about the pathophysiological processes in bipolar disorder (BD) leads to difficulties in differentiating this disorder from other affective disorders. Quantitative analysis of serum protein profiles in BD expands our understanding of the pathophysiology of the disease and may aid in subsequent diagnosis. As a result of a previously conducted comparative mass spectrometric study of serum proteins in patients with depression, bipolar disorder and healthy donors, increased expression of Heat Shock 70kDa Protein1A (HSPA1A) and transthyretin was identified.

Determination of HSPA1A and transthyretin concentrations in the blood serum of patients with mental disorders.

Blood serum of 28 patients with bipolar disorder aged 49 years [33;52], 30 patients with recurrent depressive disorder aged 40 years [31; 51] and 130 patients with schizophrenia aged 38 years [31;49], as well as 20 mentally and somatically healthy individuals aged 35 years [31;40] was studied. The amount of Heat shock protein 1A (HSPA1A) and Transthyretin (thyroxine and retinol transport protein) was determined using a Enzyme-linked Immunosorbent Assay Kit from Homo sapiens (Cloud-Clone Corp). Statistical data processing was carried out in the Statistica 12.0 program.

A statistically significant (p = 0.016) increase in the level of HSPA1A was found in patients with BD (0.84 [0.59; 1.09] ng/ml), compared with healthy individuals (0.61 [0.51; 0.77] ng/ml). HSPA1A plays a pivotal role in the protein quality control system, ensuring the correct folding of proteins. It is known that this protein is involved in the embryonic development of the central nervous system, as well as in neuroprotection by preventing the death of neurons due to its anti-apoptotic properties. A statistically significant (p = 0.047) increase in the level of transthyretin was found in patients with BD 21.8 рg/ml, compared with healthy individuals 19.4 pg/ml. Transthyretin plays an important role in ensuring the normal state of the central nervous system and is involved in cognitive processes.

Thus, the HSPA1A and transthyretin are probably involved in the pathogenesis of BD and can be proposed as be proposed as an additional paraclinical criterion for differential diagnosis.

Support by RSF №23-75-00023.

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