Suicidal ideations are severe and serious symptoms in the clinical presentation of schizophrenia, as well as adverse reactions such as oculogyric crises. In certain situations, they may be associated with specific pharmacogenetic factors, such as gene variations for the serotonin transporter (SERT) and the CYP2D6 enzyme.

A 37-year-old patient with treatment-resistant schizophrenia, characterized by frequent suicidal ideations, is regularly treated with clozapine (100 mg/day). Additionally, during disease exacerbations, the patient is given haloperidol (10 mg/day) as supplemental therapy, resulting in the development of oculogyric crises.

Due to the lack of therapeutic response and a predisposition to side effects, a pharmacogenetic analysis revealed CYP2D6 genotype *4/*9 and 5-HTTLPR genotype SA/SA. This indicates CYP2D6 intermediate enzyme activity and SERT low activity. Due to these findings, haloperidol was discontinued, and paliperidone palmitate was introduced at a dose of 75 mg monthly, after which the oculogyric crises no longer occurred. The pharmacogenetic results showed reduced SERT activity, which may be associated with the decreased therapeutic response to clozapine and the persistence of suicidal ideations.

Haloperidol is metabolized via CYP2D6, and its intermediate activity can lead to higher plasma concentration, resulting in extrapyramidal side effects such as oculogyric crises. Paliperidone is a metabolite of risperidone, and the activity of CYP450 enzymes has a minimal impact on its therapeutic response and potential for adverse reactions. HTTLPR regulates the transcriptional activity of the 5-HTT gene, so genotypes with low expressions, such as S’/S’ or S’/L’, may exhibit a weaker response to clozapine, which may include the persistence of suicidal ideations.

The personalized antipsychotic treatment according to an individual’s pharmacogenetic profile may prevent adverse reactions and potentially explain therapeutic resistance in such cases where clozapine is otherwise indicated. Effective modern psychopharmacological treatment requires understanding pharmacogenetic factors and their influence on therapeutic response and the development of adverse reactions.

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This case highlights the interdisciplinary management of a 28-year-old Filipino female with recurrent depressive disorder and multiple medical comorbidities, including HIV, tuberculosis, and sexually transmitted infections. Managing depression in patients with complex medical conditions is especially challenging in resource-limited settings like the Philippines, where drug-to-drug interactions and access to high-quality care must be carefully navigated.

The objective of this case report is to illustrate the importance of personalized treatment decisions, the rationale for choosing Venlafaxine over SSRIs, and the value of psychodynamic psychotherapy in addressing underlying emotional conflicts in the context of maternal health challenges.

The patient was referred to the Psychiatry service due to suicidal ideations. She has a history of depressive episodes linked to family stressors and initial flashbacks and nightmares related to her physical abuse from her previous partner. Her extensive comorbidities made the usual first-line antidepressants (SSRIs) unsuitable due to drug interactions. Venlafaxine 75 mg/day was selected, and psychodynamic psychotherapy, trauma-informed psychotherapy, and psychoeducation were integrated into her treatment. Coordination with infectious disease, obstetrics, and internal medicine specialists ensured comprehensive care.

Venlafaxine was effective in improving mood, sleep, and appetite, with no significant side effects. Regular follow-ups confirmed adherence to the medication, and psychodynamic psychotherapy helped her address deep-seated emotional conflicts, particularly surrounding her history of trauma. Ongoing psychiatric care, along with monitoring her medical conditions, provided a supportive framework for her continued improvement. Despite financial constraints, the patient adhered to her treatment regimen, showing improved mental health and commitment to her care.

This case underscores the complexity of treating depression in patients with multiple comorbidities, particularly in resource-limited settings. The selection of Venlafaxine was crucial due to the potential interactions of SSRIs with the patient’s medical regimen. Psychodynamic and trauma-informed psychotherapy, combined with interdisciplinary collaboration, were key to the successful management of this case. This highlights the need for an integrated approach to mental health care, especially in low-resource environments, where interdisciplinary coordination is vital.

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The behavioral disorders of individuals with dementia, as well as the attitudes and behaviors of people with intellectual disabilities, create challenges both in their home environment and for the nursing staff responsible for their care in Social Welfare Centers. This phenomenon is widely examined in both international and Greek literature; however, it remains a complex and multifactorial issue, not only in defining behavioral disorders but also in identifying the factors that cause them.

This qualitative study aims to explore how nurses at Social Welfare Centers perceive behavioral disorders, the factors they associate with them, and their emotional reactions. The goal is to gain an in-depth understanding of the phenomenon, highlight its significance, and bring forward the nurses’ perspectives.

A qualitative approach was adopted to explore the relationship between nurses and beneficiaries due to behavioral disorders. A relational perceptual framework was used. Eight semi-structured interviews were conducted with permanent nursing staff from Social Welfare Centers. This was followed by a literature review of behavioral disorders, focusing on both nurses and beneficiaries.

The qualitative data analysis revealed three key themes: the role of the nurse and their relationship with beneficiaries in Social Welfare Centers, the behavioral disorders and emotional reactions of nurses based on their experiences, and the need for nursing staff education, along with the importance of an interdisciplinary team.

The onset, worsening, reduction, or elimination of behavioral disorders depends on the complex interaction between nurses and patients with dementia or intellectual disabilities. The need to focus on factors that increase the occurrence of such behaviors is emphasized, to assist nurses working in long-term care facilities in managing them without compromising the quality of care provided to the beneficiaries. More studies are required to provide guidelines for better management of behavioral disorders.

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There are recent studies examining the cognitive functions, depressive symptoms, social cognitive characteristics (Terms of Theory of Mind) and acute symptoms of patients with substance-induced psychosis, as well as varying effects of different substances on development of psychosis (Beckmann et al. Child Adolesc Psychiatr CNA.2020;131-143).

It was aimed to examine sociodemographic characteristics, clinical symptoms in acute psychotic period, cognitive functions, social cognition characteristics of hospitalized patients diagnosed with substance related psychosis; compare the severity of clinical symptoms, improvement in acute period symptoms with treatment, cognitive functions and social cognitions according to substance (methamphetamine, cannabis, polydrug).

34 hospitalized patients in acute psychotic episode diagnosed with Substance-Induced Psychosis according to DSM-5 were included in study. Socidemographic Data Form, Reading the Mind in the Eyes Test, Stroop Test, Calgary Schizophrenia Depression Scale and every 3 days during the treatment PANSS (Positive Negative Syndrome Scale) were administered.

Statistical analyses done with R program. Kruskal-Wallis test was used to compare numerical variables between groups. For the significant differences between groups, Bonferroni correction was applied in post hoc analyses. P-value of less than 0.05 was considered statistically significant for all analyses. Chi-square test was used to analyze categorical variables.

It was determined that drug-induced psychosis patients were mostly male, unemployed, young adults, started using drugs before the age of 18, lived in irregular urban areas. Methamphetamine, cannabis and polydrug-related psychosis were compared; There was no difference in cognitive functions and social cognition characteristics between all groups. At the end of treatment, it was observed that the rate of improvement in positive and negative symptoms and the decrease in PANSS scores were greatest in methamphetamine group, there was no difference between cannabis and polydrug groups. We found that PANSS and negative symptom severity before starting treatment were not different between methamphetamine and cannabis, and initial positive symptoms were more severe in methamphetamine than cannabis.

Methamphetamine group showed greater improvements in positive and negative symptoms and total PANSS scores compared to cannabis and polydrug. The fact that there was less improvement in cannabis group than in methamphetamine group supports the data in the literature identifying the relationship between cannabis and chronic psychosis (D’Souza et al, The World Journal of BP, 2022, 719–742).

No difference was found between social cognitions and cognitive functions of 3 groups.

Drug Induced Psychosis, Methamphetamine, Cannabis, Theory of Mind.

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In recent years, the rise of streaming platforms has given adolescents unprecedented access to vast libraries of series and films, often leading to hours of continuous viewing, a phenomenon known as binge watching. This emerging trend is reshaping how adolescents engage with media, often affecting their social behaviors, routines, and overall well-being. Understanding these factors is crucial for developing preventive interventions.

This study aims to explore binge-watching behavior among Tunisian adolescents and the key factors influencing this trend.

We conducted a descriptive and analytical cross-sectional study among Tunisian adolescents aged between 12 to 18 years old. Data were collected using an online questionnaire spread throughout social media (Facebook), using the Google Forms® platform in September 2024. We evaluated the epidemiological and social characteristics of the participants, as well as the binge watching behaviour, using Binge-Watching Addiction Questionnaire (BWAQ).

Eighty-two adolescents participated in our study, with a mean age of 16.02 ± 1.65 years and a sex ratio of 0.82. Our resultas showed that 86.5% of our population lived in urban areas, 13.4% in rural areas, and 18.3% did not live with both parents. Our results showed that 15.9% of our population reported low grades, 23.2% had repeated a grade, and 27.7% had issues with teachers or administration. Additionally, 21.5% had experienced bullying, 30.5% faced domestic violence, and 31.7% reported conflicts with parents. Regarding binge-watching, 41.5% of participants engaged in it more than once per week, 43.1% spent over two hours daily on school days, and 29.3% watched more than five episodes in one sitting. The most preferred content included drama series (56.1%), movies (24.4%), and sports shows (19.6%).The mean score on the Binge-Watching Addiction Questionnaire (BWAQ) was 39.43, with 27.7% showing moderate and 7.7% showing highly problematic binge-watching, with no sex difference. Highly problematic binge-watching was significantly associated with conflicts with parents (p = 0.01), peers (p = 0.02), school staff (p = 0.42), and poor academic performance, including grade repetition (p < 0.01).

These results highlight the potential negative impact of excessive media consumption on adolescents’ social interactions and and academic performance, underscoring the need to implement targeted interventions that not only raise awareness about the risks of excessive media consumption but also provide practical strategies to help adolescents manage their screen time.

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Cycloid psychosis, first described by Kleist and further developed by Leonhard, is characterized by a cyclic course of acute psychotic episodes, marked by delusions, hallucinations, affective and motor disturbances. It lies at the intersection of affective and schizophreniform disorders, presenting a diagnostic challenge due to its episodic nature and inter-episodic remission. Currently, no diagnostic category clearly encompasses such clinical pictures, and these patients are usually diagnosed with brief psychotic disorders.

This report aims to describe a case of cycloid psychosis, highlighting the nosological and treatment limitations of this entity.

Consultation and review of the patient’s clinical records and articles referenced on the PubMed platform.

This case report presents a 37-year-old male admitted to the emergency department with delusions of persecution and reference, auditory hallucinations, decreased need for sleep, and increased goal-directed activity, alongside a lack of insight into his condition. No significant mood disturbances were observed. Symptoms had progressively worsened over two weeks, and upon examination, the patient exhibited psychomotor agitation, incoherent speech, perplexity, and marked distress. Initial laboratory work and brain imaging were unremarkable. The patient was hospitalized for involuntary treatment, where antipsychotic therapy with risperidone (up to 4mg/day) was initiated but later switched to olanzapine (10mg/day) due to significant extrapyramidal symptoms. He was also started on valproic acid, titrated up to 1000mg/day. During hospitalization, the patient showed progressive behavioral organization, resolution of delusions and auditory hallucinations, improved sleep, and restored insight.

Upon review of his psychiatric history, it was discovered that he had experienced two previous psychotic episodes in 2018 and 2021, diagnosed as bouffées délirantes while residing in France. Both episodes were successfully treated with olanzapine, with restituto ad integrum within one month, and no signs of personality changes or biographical disruption. Based on these recurrent psychotic episodes and his current presentation, a diagnosis of cycloid psychosis was made, following the criteria proposed by Perris and Brockington.

The patient was discharged after two weeks of inpatient care, and at his one-week follow-up, showed complete remission of psychotic symptoms.

Cycloid psychosis presents significant diagnostic challenges due to its ambiguous nosological status. It does not fit neatly into conventional categories such as schizophrenia or bipolar disorder, as it shares characteristics with both while maintaining a distinct clinical course marked by episodic, self-limiting psychotic phases with full remission. This diagnostic ambiguity also poses difficulties in treatment, as no specific guidelines exist, and current literature is sparce.

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Academic procrastination is the deliberate action of postponing the completion of academic tasks that must be completed, despite the harmful effects that not completing them may entail, having a particularly high prevalence in university students. Numerous studies have analyzed the consequences of academic procrastination on mental health. Furthermore, scientific evidence has also found a high prevalence of suicide risk in youth and adolescents. Therefore, it is worth asking if academic procrastination is related to the risk of suicide and self-harming behavior in students.

To our knowledge, this is the first systematic review to analyze the relationship between academic procrastination and suicidality.

To analyze 1) the relationship between academic procrastination and suicidal tendencies, 2) whether this relationship, if it exists, is influenced by other variables.

Academic Search Premier, APA PsycArticles, APA PsycInfo, PSICODOC, Psychology and Behavioral Sciences Collection, MEDLINE, E-Journals, ERIC and Scopus were searched during October 2024. An additional search was also conducted using the Google Scholar search engine. The review was carried out following the criteria of the PRISMA 2020 declaration. Observational studies that analyzed the relationship between procrastination and suicidality were included, without language or time restrictions. Single case studies or case series, studies examining procrastination in non-academic settings, and studies using qualitative methodology were excluded. Each study was narratively summarized.

Ninety-three studies were identified; after eliminating duplicates and those works that did not meet the eligibility criteria, four studies were included for review. These studies varied in their origin (two articles from the United States, one from Spain, one from Peru, and one from Jordan) and the secondary variables evaluated. All studies found a positive and significant relationship between suicidality and academic procrastination (with correlation coefficients ranging from 0.19 to 0.51), observing a slightly higher correlation in women compared to men. Self-control was found to mediate the relationship between procrastination and suicidality.

Our findings suggest a strong positive relationship between academic procrastination and suicidality. However, there are still few studies that analyze this topic, so it is necessary to continue researching in this field.

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Over the past two decades, public health research has increasingly informed decision-making, but more evidence is needed on implementing interventions in real-life conditions. The COVID-19 pandemic highlighted these challenges, particularly in mental health. A study in Spain (RESPOND-HCWs) adapted and implemented psychological interventions for healthcare workers during the pandemic, showing significant reductions in anxiety and depression symptoms. This process evaluation aims to guide the practical implementation of these interventions in crisis settings.

This study provides a process evaluation of a successful stepped-care program involving eHealth interventions (Doing What Matters in Times of Stress [DWM] and Problem Management Plus [PM+]) designed for healthcare workers experiencing psychological distress (REsponding to Psychological distress among HCWs [RESPOND-HCWs] trial) conducted in Spain. The aim is to analyze program delivery context, assess implementation outcomes, and explore mechanisms of action.

We utilized mixed methods, gathering quantitative data through routine RCT monitoring and structured observation, complemented by qualitative insights from semi-structured interviews with trial participants (n = 12) and decision-makers (n = 7), and a focus group discussion involving intervention providers (n = 7). Quantitative data were analyzed descriptively using R Software. Qualitative data underwent thematic analysis with NVivo.

Context analysis identified implementation barriers, such as DWM visual design, confidentiality, time to practice, stigma, unrealistic expectations about stepped-care programme, DWM phone calls, trust in the health system, internet literacy and intervention provider profile; and enabling factors, such as flexibility in schedules, remote delivery and mental health awareness initiatives. The implementation of the interventions was feasible, appropriate, and had minimal protocol deviations, with good participant acceptance. Mechanisms of action included confidence in intervention effects, a strong therapeutic relationship, and specific intervention components.

The results serve as a complement to outcome evaluation and can guide wider implementation in similar settings. Recommendations include raising awareness about mental health and reducing stigma, providing brief orientation sessions, offering flexible schedules, and encouraging peer support.

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Families of patients with mental illness in Japan face the stigma and the significant burden of caregiving. The average hospital stay for psychiatric patients in Japan was 276.3 days in 2022. Strengthening community support for patients with mental illness and their families requires targeted support that promotes recovery for both patients and their families.

To clarify the attitudes and perceptions of psychiatric home-visiting nurses toward family support in the community, aiming to empower families of patients with mental illness and identify key support issues for family recovery.

1. 1) A 30-item, web-based, anonymous questionnaire survey was conducted involving psychiatric home-visiting nurses who care for patients with mental illness The survey measured respondents’ background information and perceptions regarding the frequency and importance of family care practices.

2. 2) Simple tabulations of the questionnaire items were performed, and the frequency of implementation was examined and related. 3) Items perceived as important but infrequently implemented were identified.

Sixty-six home-visiting nurses participated in the survey. The findings showed that 97% of respondents expressed interest in family support, 74% had family support experience, and 52% had attended family support training programs.

A significant correlation was observed between the perceived importance of family support and its perceived frequency of implementation across all items. The four items identified as important but less frequently implemented were:

Q08. Referring to other professional organizations for unresolved issues (22.7%).

Q11. Encouraging active participation from each patient and family member (20.6%).

Q12. Informing family members about the patient’s situation, so that they can work together to ensure the patient’s well-being (40.6%).

Q13. Encouraging patients to express appreciation to the family when needed (36.7%).

The survey results indicate that family care items requiring patient engagement or collaborative decision-making, such as referrals to other agencies, were implemented less frequently. Home-visiting nurses face challenges in enhancing their skills and knowledge in areas such as family engagement, interagency collaboration, and discerning the appropriate scope and timing of interventions.

Strengthening these competencies will support more effective connections between patients with mental illness, their families, and community resources.

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder that appears in early childhood. The diagnosis is based on a clinical dyad: impaired social communication and restricted and repetitive behavior. From the age of 13, children with ASD are integrated into the “Erraihan” therapeutic farm.

The aim of our study is to describe the clinical profile of adolescents with ASD followed at the “Erraihan” therapeutic farm.

This is a descriptive and analytical cross-sectional study of 43 parents of adolescents with ASD treated at the therapeutic farm.

The “Erraihan” therapeutic farm is a center that takes in adolescents aged over 13 with ASD.

A questionnaire using a pre-established form was administered to the parents by the same doctor to collect data relating to the adolescent.

Forty-three adolescents followed for autism spectrum disorder were included in our study. Their mean age was 17.79±2.29 years (min=13; max=20) with a male predominance 79.1% (n=34). Adolescents with autism were older in 48.8% of cases. They suffered from a chronic illness in 44.2% (n=19) of cases. The most frequently reported somatic antecedent was epilepsy (n=17).

Psychiatric comorbidity was found in 55.8% of adolescents. It was mainly mental retardation (n=22). Adolescent age at first consultation ranged from 1 to 4 years, with an average of 1 year 6 months. Age at diagnosis ranged from 3 to 6 years, with an average of 3 years 3 months.

Time to diagnosis ranged from 0 to 24 months, with an average of 5 months. Twenty-three adolescents (53.5%) communicated with poor speech intelligibility.

Behavioral problems were present in 72.1% of adolescents. Medication was prescribed in 62.8% of cases. The most commonly prescribed drug was risperidone (44.2%).

Sphincter autonomy was acquired in 69.8% of adolescents. Thirty-four adolescents (79.1%) had received speech therapy in childhood.

Almost half (44.2%) had entered kindergarten at an early age, and only 14% had started school and then withdrawn.

This study sheds light on the clinical profile of adolescents with autism spectrum disorders at the “Erraihan” therapeutic farm. The results underline the importance of early and appropriate care. Although the majority of adolescents have acquired certain skills, such as sphincter autonomy and access to speech therapy, challenges remain, particularly in terms of communication and behavior. This information underlines the need for ongoing follow-up and personalized approaches to improve the quality of life of these young people within their therapeutic environment.

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The Bible offers various insights into human struggles, including what can be interpreted today as mental illness. Although ancient texts do not explicitly refer to mental health using modern terminology, there are many accounts of emotional distress, depression, anxiety, and other psychological challenges. Throughout Scripture, several figures are portrayed grappling with deep sorrow, fear, and mental turmoil. These narratives provide spiritual reflections on suffering, healing, and divine intervention, shedding light on how biblical teachings have historically addressed human fragility.

To raises questions about how we can relate ancient wisdom to contemporary mental health issues, offering opportunities for spiritual growth, empathy, and care in our own lives.

A non-systematic review of the published literature was conducted using the Google Scholar database with the search terms “Bible” and “mental illness.” Articles were selected based on their relevance, and further information was obtained through direct consultation of biblical texts.

The prophet Elijah exhibits signs of reactive depression, triggered by stress after confronting the prophets of Baal and receiving a death threat from Jezebel (1 Kings 18:20-40). His symptoms—loss of appetite, isolation, low self-esteem, and hopelessness—are well-documented (1 Kings 19:3). God’s response (1 Kings 19:11-14) provides an example of care for depression, with affection, understanding, and patience.

James 5:15-18 references Elijah to highlight that depression can affect Christians, suggesting that illness, whether physical or spiritual, requires dialogue and support. James emphasizes God’s forgiveness, even if illness stems from sin, viewing depression as an organic condition in line with the holistic Jewish understanding. He advocates for confession and prayer as therapeutic (James 5:16), stressing that mercy triumphs over judgment.

Psalm 6:6-7 captures the deep despair of depression, showing the importance of seeking God amid mental anguish, which is often invisible to others.

The accounts of figures like Elijah and the reflections in Psalms demonstrate that conditions resembling modern definitions of depression and anxiety have long been acknowledged, albeit through the lens of ancient cultural and religious contexts. The compassionate care that God extends to Elijah, coupled with the guidance found in the New Testament, particularly in the book of James, underscores the importance of community and support in addressing mental health challenges.

By examining these stories, we gain a broader understanding of how faith communities have interpreted and coped with the complexities of mental illness - in light of their relationship with God.

These accounts present a holistic biblical view of depression, underscoring the need for empathy, spiritual care, and community support in mental health.

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“FareAssieme” (“Doing Together”) is a community psychiatry approach adopted by the Mental Health Service of Trento (SSM) since 1999. It is based on the active involvement of users and families, valuing “experiential knowledge”—the insights gained from their experiences with illness and recovery—to enhance mental health care and rehabilitation pathways.

To describe the “FareAssieme” model and analyze the effectiveness of Peer Support Experts (ESPs) in recovery processes, stigma reduction, and improving patient-perceived quality. ESPs are users or family members who have achieved life balance in their recovery journey and developed coping skills, sharing their stories to support others within the SSM of Trento.

The approach was implemented by systematically including ESPs in all SSM areas, such as front-office services, community mental health teams, territorial and hospital crisis areas, and residential facilities. Evaluation methods included satisfaction questionnaires, systematic PREMs and PROMs (Patient-Reported Experience and Outcome Measures), focus groups, and direct field observations, with particular attention to integrating ESPs into professional teams.

Introducing ESPs led to significant service quality improvements, increased active user involvement, and a better working climate. Patients reported greater trust in services and enhanced recovery experiences. ESPs helped overcome users’ initial resistance, especially among those less willing to trust health services, fostering stronger therapeutic relationships. Professional resistance diminished as the added value of ESPs became evident. The “FareAssieme” model also fostered the establishment of a Participatory Planning Group (GPP), a diverse team including ESPs and professionals. The GPP discusses relevant topics for the SSM’s operations and has produced several “Operational Guidelines”—recommendations compiled into booklets serving as operational instructions for all users, families, and service operators.

The “FareAssieme” model in Trento represents an effective example of recovery-oriented community psychiatry. ESPs have uniquely contributed to improving perceived service quality and promoting a culture of respect and co-participation, reducing the stigma associated with mental illness. The GPP has also served as a representative for mental health issues, voicing the SSM’s shared views through mass media to disseminate anti-stigma messages.

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Psoriasis is a chronic skin condition affecting 2-3% of the global population and is often associated with various comorbidities, including psychiatric disorders. The psychological burden of psoriasis is substantial and multifaceted. Patients frequently experience stigma, social isolation, and reduced self-esteem due to the visible and often disfiguring nature of the disease. These psychosocial stressors can precipitate or exacerbate psychiatric conditions such as anxiety and depression.

This study aims to identify the factors influencing psychopathological symptoms in patients with psoriasis, with a specific focus on the mediation role of physical and mental health on psychopathological distress in patient with psoriasis.

This observational study included 112 patients diagnosed with psoriasis. Dermatological and psychiatric evaluations were performed using Psodisk, the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the Symptom Checklist-90-Revised (SCL-90-R), and the 36-Item Short Form Health Survey (SF-36). Descriptive statistics, correlation analysis, mediation models were used for data analysis. To develop the mediation models, Psodisk subscales were used as independent variables, and the Global Severity Index (GSI) of SCL-90-R as the outcome variable; both physical (PCS) and mental (MCS) components of the SF-36 were used as mediators.

The sample consisted predominantly of middle-aged males (mean age 48.91 years). Females (p < 0.001), patients with arthritis (p < 0.05), and those leading a sedentary lifestyle (p < 0.05) exhibited higher scores for anxiety and depression. Psodisk subscales showed a significant correlation with psychiatric symptoms and QoL measures (p < 0.001). The mediation analysis revealed that the mental component of quality of life (MCS) had a statistically significant mediating effect in all models, being the only mediator for the effect of health, pain, and sleep domains of the Psodisk on GSI (p < 0.001; R2 = 0,2). Furthermore, when total Psodisk score was used as independent variable, MCS mediating effect on GSI was also significant (p < 0,001; R2 = 0,32) with a non-significant role of PCS.

This study highlights the complex relationship between psoriasis, psychiatric comorbidities, and QoL. Mediation analysis shows that mental component of quality of life can play a more significant mediating role than physical alterations in determining psychiatric symptoms in patients with psoriasis. All psoriasis patients, regardless of physical changes, should be considered at risk for developing psychiatric symptoms, and direct collaboration between general practitioners, dermatologists, and psychiatrists may be able to identify the most vulnerable patients and limit the onset of severe mental disorders.

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Abnormal cerebellar functional connectivity (FC) has been independently implicated in the pathophysiology of schizophrenia (SCZ) and bipolar disorder (BD). However, the relationship between cerebellar dysconnectivity patterns in these two disorders and their association with cognitive functioning and clinical symptoms have not been fully clarified. In this study, we used the state-of-the-art functional atlas of the cerebellum to examine cerebellar FC changes in the SCZ–BD spectrum and their association with cognitive and clinical variables.

Resting-state functional magnetic resonance imaging (fMRI) data of 39 individuals with SCZ, 43 BD type I and 61 healthy controls were examined. The cerebellum was parcellated into ten functional systems and we calculated seed-based FC for each cerebellar system. Cognitive abilities were investigated with the Wechsler memory scale, the California Verbal Learning test, the Stroop test, the Attentional network task, the Continuous performance test, the Task Switch task and the Stop Signal task. Psychopathological evaluation was carried out using the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms. We used principal component analyses to reduce the dimensionality of the diagnosis-related FC and cognitive variables, respectively. Multiple regression analyses were conducted to assess the relationship between FC and cognitive and clinical data.

We observed lower cerebellar FC with the frontal, temporal, occipital and thalamic areas in SCZ, and a more widespread decrease in cerebellar FC in BD, involving the frontal, cingulate, parietal, temporal, occipital and thalamic regions. SCZ presented increased within-cerebellum and cerebellar-frontal FC compared to BD. Higher cortico-cerebellar FC was positively associated with memory (p-FWE=0.036) and verbal learning (p-FWE=0.043). Exploratory analyses showed a negative correlation between cortico-cerebellar FC and positive symptoms (p-FWE=0.051).

These findings suggest a role for shared and distinct patterns of corticocerebellar dysconnectivity in the SCZ–BD spectrum that can result in cognitive impairment and psychotic symptoms. In addition, they highlight the potential role of cerebellar stimulation as a promising intervention for individuals with SCZ and BD-I that present cognitive impairment.

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The UK Royal College of Psychiatrists and the General Medical Council both recognise the value of and commend the use of Cognitive Behavioural Therapy (CBT) in understanding and treating Psychiatric disorders. It is now mandatory to incorporate in CBT in psychiatry training. Previous research and the authors’ own experiences as a trainee have shown that despite being trained in CBT, there continues to be limited use of CBT in routine clinical practice by psychiatry trainees. This study was conducted at a UK NHS Trust as an educational service evaluation.

Despite trainees receiving extensive CBT training and completing a 12-session CBT case early in their training, many do not use this skill. The objective of the study was to explore any barriers psychiatry trainees encountered in utilising CBT in routine clinical practise.

A qualitative, ethnographic approach using focus group discussions was used. Three Focus groups were conducted. These were audio-recorded and transcribed verbatim, then analysed using a General Thematic Analysis. A coding framework was used to organise emergent themes into five broad categories and are shown in the results section.

Table 1:

Barriers to CBT use

Psychiatry trainees were eager to use their CBT skills more often yet find barriers hindering their aspirations. In a specialty where talking with patients can sometimes be as effective as offering them medications, having a deeper understanding of the hindrances trainees encounter with regularly deploying this skill is crucial.

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It is important to support the Ukrainian mental health research and practice in time of war and after the war has ended. Norwegian universities engage in this by collaboration in psychiatric research and mental health initiatives.

With a grant from the University of Oslo and in collaboration with the Taras Shevchenko National University Kyiv, the Ukrainian Psychiatric Association, and the Norwegian Psychiatric Association, we launched a research school for young psychiatry and psychology researchers who are based in the Ukraine and who can travel outside the country. The research school and training class was held in Warsaw 2023, Krakow 2023 and in Oslo 2024. It offered scientific lectures, interaction with international researchers, and clinical site visits. The young Ukrainian researchers present their projects from early to completed phase to be openly discussed. Networking and scientific exchange is encouraged. The Oslo university library has opened their doctoral educational programs for Ukrainian doctoral students and the University of Oslo sponsors participation in international conferences.

We now aim for a renewed strategy to help meet the needs of mental health and clinical research in the Ukraine also after the end of the war.

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Second-generation antipsychotics (SGAs) have been increasingly used as off-label treatments for non-psychotic illnesses, there is a lack of updated data to describe its prescription among psychiatric populations.

This study aims to describe the most recent ten-year trend of SGA prescriptions and to identify the probable psychiatric diagnoses associated with the prescription among adult psychiatric patients in Hong Kong.

All patients aged 18 or older who had a psychiatric diagnosis and were initiated on an SGA based on the population-based electronic health record from the Clinical Data Analysis and Reporting System (CDARS) in Hong Kong between 2014 and 2023 were included. The probable psychiatric indication was defined as the diagnosis recorded within 6 months from the date of SGA initiation and was classified into four groups according to the ICD-9-CM categorization of Mental Disorders (290-319). Trends were examined using joinpoint analyses. The prescription trend was re-analyzed using an alternative classification into groups of Schizophrenia (SCZ), Non-schizophrenia serious mental illness (non-SCZ SMI), and Non-SMI.

A total of 79,681 patients (Female 57.9%, Age 56.8±22.5years) were included. There is significant increase in SGA prescriptions in patients with a probable indication within the ICD-9-CM category of ‘Non-psychotic Mental Disorders’ and ‘Organic Psychotic Conditions’, with an average annual percent change (AAPC) of 1.9% (p<0.01) and 1.7% (p<0.01), respectively; while the probable indications under ‘Other Psychoses’ decreased with an AAPC of -2.2% (p<0.01) (Figure 1). Importantly, the prescriptions among patients with probable diagnostic indications under the group of SCZ and non-SCZ SMI decreased with an AAPC of -6.9% (p<0.01) and -0.8% (p=0.03), respectively, while the non-SMI indications rose from 60.3% to 70.0% from 2014-2023 (AAPC=1.7%, p<0.01) (Figure 2).

Image 1:

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Our study provided important data demonstrating a trend of increasing proportions of SGA prescriptions for non-psychotic and non-SMI indications.

S. Pan: None Declared, B. Or: None Declared, T. Li: None Declared, N. Y. Chan: None Declared, T. Yip: None Declared, V. Wong Shareolder of: Stock: Co-founder of Illuminatio Medical Technology , Grant / Research support from: Research grants: Gilead Sciences, Consultant of: Consultancy: AbbVie, AstraZeneca, Boehringer Ingelheim, Echosens, Gilead Sciences, Intercept, Inventiva, Merck, Novo Nordisk, Pfizer, Sagimet Biosciences, TARGET PharmaSolutions, Visirna , Speakers bureau of: Lectures: Abbott, AbbVie, Echosens, Gilead Sciences, Novo Nordisk, Unilab, Y. K. Wing Consultant of: YKW received consultation fee from Eisai Co., Ltd., honorarium from Eisai Hong Kong for lecture, travel support from Lundbeck HK limited for overseas conference., J. Chan Speakers bureau of: JWYC received personal fee from Eisai Co., Ltd and travel support from Lundbeck HK limited for overseas conference.

Extremely preterm birth (defined as birth before 28 weeks’ gestational age) has been associated with an increased risk of developing autism spectrum disorder (ASD) in infancy. The underlying pathophysiological mechanisms driving the emergence of ASD in these children remain unknown, although growing evidence suggests that oxidative stress and inflammation play important roles.

To detect if urinary protein oxidation could serve as a non-invasive early predictor of ASD risk in extremely preterm newborns.

In two Spanish cohorts recruited between 2020 and 2022, consisting of 76 extremely preterm newborns, we collected urine samples from birth up to the first week of life (T1 = birth, T2 = 24–72 hours, T3 = day 7) and analyzed biomarkers of oxidative stress and inflammation. We assessed the risk for ASD at a corrected age of 24 months. Using liquid chromatography-mass spectrometry, we measured levels of lipid peroxidation, DNA and protein oxidation metabolites, along with markers of inflammation. We investigated the association between longitudinal urine marker levels and the primary outcome (risk for ASD, defined as an MCHAT-R/F score ≥ 2 at 24 months).

The study was supported by the Spanish Ministry of Science & Innovation, Instituto de Salud Carlos III (grant numbers PI17/01997, PI18/01352, PI20/01342, PI23/00368); co-financed by ERDF Funds from the European Commission, “A way of making Europe”, Fundación Familia Alonso & Fundación Alicia Koplowitz.

Thirty-two of the 76 patients completed the 24-month follow-up period and had samples available from at least two of the three time points. Compared to those with no risk for ASD (n = 21), patients at risk for ASD (n = 11) exhibited significantly lower O-tyrosine levels at birth (d = 1.296, p = .048). Moreover, O-tyrosine levels increased significantly over time in at-risk patients relative to non-ASD risk patients from birth to day 7 (p = .032), suggesting protein damage due to significant oxidative stress.

These findings indicate that urinary protein oxidation markers could serve as promising, non-invasive early predictors of ASD risk in extremely preterm newborns.

None Declared

Breastfeeding is an important determinant of both mother and child healths regarding its physical and psychological benefits. Working mothers usually consider the work as a barrier to breastfeeding, thus this population needs a particular attention to enhance their breastfeeeding rate.

Determining the prevalence of breastfeeding among active women in Tunisia and evaluating their perceptions and their practices towards this process.

We have conducted a descriptive and cross sectional study. Data were collected during one week through an online questionnaire designed by Google Forms and distributed via Social media. It had included active women who had a child aged between 6 months and 5 years. Exclusive breastfeeding (EBF) is feeding the baby only breast milk (not any other foods or liquids).

A total of 51 active mothers had participated with a mea age of 32.4±3.8 years. A proportion of 47.1% worked in healthcare facilities. Nineteen participants were doctors. All the participants had experienced breastfeeding with a mean duration of 12.7 ±7.5 months [ranging from 2 to 25 months]. The mean duration of EBF was 3.1±2.0 months [ranging from 0 to 6 months]. A percentage of 64.7% had experienced mixed feeding. Regarding breastfeeding perceptions, 92.2% of women always believe that breastmilk was the right option to feed their babies. Tweenty two (43.1%) always believe that they could successfuly breastfeed their child and sixteen (31.4%) consider that they was usually sure that they were able to balance between work and breastfeeding. Participants mothers had returned to their job within a mean of 12.7 ±7.5 months [ranging from 2 to 25 months]. After returning to work, 56.9% of participants consider that breastfeeding represented a big challenge. EBF was negatively associated to the number of working hours /week (p=0.026).

The participation of women in the labor force makes the continuation of breastfeeding a challenging option. Thus, promoting and supporting breastfeeding in the workplace are essential and have the potential to ameliorate babies and mothers lives, and to positively affect the employees productivity and well-being.

None Declared

Drug-induced movement disorders are a rare side effect of which some cases have been reported and published. It may be due to antidepressants, antipsychotics or other drugs. In these cases it is important to realize differential diagnosis, identify the medication that may have caused it and implement appropriate management to solve it.

To present the case of a 16-year-old adolescent diagnosed with major depressive disorder with movement disorders after treatment with escitalopram.

A literature review was conducted on movement disorders and treatment with antidepressants in child-adolescent population.

Our case is about a 16-year-old adolescent who is living with his family and he is studying at the high school. The patient has no personal psychiatric history and in his family only his father has an adaptive disorder treatment. The first time he comes to consultation, he said that in the last few weeks he has anxiety attacks in different environments and an increase in basal anxiety. He has been in a low mood for about two years with apathy, which has increased in recent weeks. He is diagnosed of major depressive disorder and we decided to continue with escitalopram 10 mg and chlorazepate dipotassium prescribed a week ago by his family doctor. After one month, he goes to the second consultation with difficulty in walking, stiffness and instability that is related to the introduction of treatment. In addition, he comments on mild improvement of anxiety and mood. Due to the timing of the onset of movement disorder and the onset of escitalopram, it is decided to suspend it. Chlorazepam dipotassium is maintained and short-term for evaluation of evolution. In the following consultation, no movement disorder symptoms are seen and the onset of another antidepressant with a different course of action is assessed.

Drug-induced movement disorders as in the case described are a rare side effect of which some cases have been reported and published. Different studies reveal the different behavior of antidepressants in the adult and child-adolescent population. In a meta-analysis on antidepressants and depression in the child-and-youth population (1), the results indicated that sertraline, escitalopram, duloxetine and fluoxetine could be considered as the first option although cases with associated extrapyramidal symptoms (EPS) were reported. According to a study on the association of antipsychotics, antidepressants with movement disorders in children and adolescents (2), the risk-benefit profile of antipsychotic use should be considered as an adjuvant to reduce EPS. In addition, in a post-marketing study (3), a potentially harmful association was found between movement disorders and the use of antidepressants mirtazapine, vortioxetine, fluvoxamine, citalopram, paroxetine, duloxetine, escitalopram, fluoxetine, sertraline, venlafaxine, among others.

None Declared