Bipolar disorder features recurrent episodes of mania, hypomania, and depression, with first-episode mania serving as an early indicator. The biological and psychological factors involved are not fully understood. Thyroid hormones play a vital role in brain metabolism, and their dysregulation has been linked to mood disorders, indicating potential abnormalities during manic episodes.

This study aims to evaluate the presence of thyroid dysfunction in drug-naive patients experiencing their first episode of mania compared to a healty control group.

This study included forty-eight drug-naive patients diagnosed with first-episode mania, who were hospitalized for treatment, and a control group of forty-eight healthy individuals. The healthy control group was matched for age and sex and had no history of psychiatric illness or treatment. There were no physical illnesses in either group. Symptom severity was assessed using the Brief Psychiatric Rating Scale (BPRS) and the Young Mania Rating Scale (YMRS). Serum T3, T4, TSH levels were measured in both groups. The study protocol was approved by the Local Ethics Committee of Selcuk Üniversity.

There were no differences in sex and age distribution between the groups. In the patient group, 54.2% (n=26) were female, with a mean age of 24.98 (±7.38). Additionally, 16.7% (n=8) had a history of depression, and 49.7% (n=23) exhibited psychotic features. Analysis of serum TSH, T3, T4, and the T3/T4 ratio showed no significant differences between groups (TSH: t=-0.466, p=0.642; T3: t=1.258, p=0.212; T4: t=-0.874, p=0.382; T3/T4: t=-1.291, p=0.200). T3 levels were higher in males overall and in the control group (t=-3.000, p=0.004; t=-3.753, p<0.001), but not in the patient group (p>0.05). Among patients, T4 levels were significantly higher in those with psychotic features (t=-2.410, p=0.020). Correlation analysis showed no significant relationships between thyroid function tests and clinical variables.

This study found no significant differences in thyroid function parameters between drug-naive patients with first-episode mania and healthy controls, suggesting that thyroid dysfunction may not be present at the onset of mania. While T4 levels were higher in patients with psychotic features, overall results indicate that thyroid abnormalities do not play a critical role in the immediate presentation of this disorder. These findings highlight the need for further research to explore the long-term relationship between thyroid function and bipolar disorder.

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Functional outcome is a central clinical concern in inpatient psychiatry. Neurocognition is known to be an important factor in achieving a good functional outcome.

We have previously investigated whether cognitive dysfunction improves over the course of inpatient treatment, where acutely admitted patients are offered a combination of pharmacological treatment and cognitive remediation (Maihofer et al. J Clin Med 2024, 13, 4843). We now investigate the extent to which the functional outcome of patients with psychotic and affective disorders is associated with cognitive function over time.

Adult inpatients aged 18-66 years (female = 57.9%, male = 42.1%) were assessed with the Screen for Cognitive Impairment in Psychiatry (German version, SCIP-G: Sachs et al. Schiz Res Cogn 2021, 25, 100197; Sachs et al. Schiz Res Cogn 2022, 29, 100259). According to ICD-10 research criteria, 83 patients received an F2 diagnosis (schizophrenia, schizoaffective and delusional disorders), 61 patients met the criteria for bipolar disorder or mania (F30/F31) and 90 for depression (F32/F33). All patients received state-of-the-art pharmacotherapy and cognitive remediation using the COGPACK® software package version 6.06. Functioning was assessed using the Global Assessment of Function (GAF).

SCIP scores at baseline correlate significantly with SCIP scores at time point two (r=.74, p<.001). The SCIP at baseline is significantly correlated with patients’ functional level (r=.32, p=.01). The higher the baseline SCIP score, the higher the GAF score (r=.33, p=.01). The higher the GAF score at baseline, the higher the SCIP score at time 2 (r=.26, p=.039). The higher the SCIP score at time 2, the higher the GAF score at time 2 (r=.42, p<.001).

During their stay in hospital, acutely admitted patients improved in function and neurocognition, regardless of their diagnostic classification. Functionality as measured by the GAF correlates significantly with cognitive ability as assessed by the SCIP-G.

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Alexithymia, the limited ability to recognize and describe emotions, reflects impairments in emotional awareness and is a prevalent dysfunctional trait in individuals with addiction. Pain is an interoceptive feeling processed through interoceptive pathways and serves as a homeostatic emotion that can motivate behavior. Pain sensitivity may play a role in the development and progression of alcohol use disorder (AUD). Interoceptive awareness (IA) refers to the ability to perceive the internal state of the body. Both interoceptive accuracy (IAc) and interoceptive sensibility (IS), the objective and subjective dimensions of IA, have been shown to be implicated in individuals with AUD.

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

The study comprised 52 abstinent patients with AUD and 52 healthy control subjects. 92.3% (n=48) of the participants in each group were male, and 7.7% (n=4) were female. Alexithymia was assessed using the 20-item Toronto Alexithymia Scale (TAS-20). Pain sensitivity was measured with the Pain Sensitivity Questionnaire (PSQ). IAc was assessed using the heart rate tracking task, which measured participants’ awareness of their own heartbeat by comparing the number of heartbeats they perceived with an objective heart rate measurement. IS was evaluated 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 alexithymia (AUD group: 53.35 ± 11.83; control group: 44.63 ± 6.43; p < 0.001, F = 21.768) 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) or pain sensitivity scores (AUD group: 5.22 ± 1.67; control group: 5.18 ± 1.06; p = 0.892, F = 0.018). Alexithymia scores showed significant negative correlations with IAc scores (r = -0.256, p = 0.009) and IS scores (r = -0.361, p < 0.001). However, pain sensitivity scores did not significantly correlate with alexithymia (r = 0.083, p = 0.402), IAc (r = -0.103, p = 0.299), or IS scores (r = 0.136, p = 0.169).

Our findings support the hypothesis that alexithymia, which is linked to the development and progression of AUD, is associated with the dimensions of IA.

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The recent years witnessed an increase in the knowledge regarding autoimmune encephalitis (AE). These autoimmune entities often present with mixed psychiatric and neurologic features and in up to 4% of the cases the presentation is purely psychiatric. The diagnosis can be made only through the discovery of Neuronal Surface Autoantibodies (NSAbs) in the Cerebro Spinal Fluid, but symptoms and signs of possible and probable diagnosis have been described (Pollack et al., 2020). However, NSAbs can be found also in peripheral blood in various percentage of patients. The role of these antibodies in psychiatric patients is yet not known.

The PHLAMES study aims at evaluating first episode psychosis (FEP) patients for signs and symptoms of AE in a psychiatric setting, with the double objective of assessing the diagnosis of AE and the role of circulating NSAbs in psychiatric patients, through clinical evaluation, biological samples, and neuroimaging.

In the PHLAMES study, all patients with FEP (<6 months from the onset) were tested with a diagnostic algorithm for signs or symptoms of AE. A complete psychiatric and neurologic assessment was performed; cognitive tests were administered. All patients underwent blood sample to test for circulating auto-antibodies against SNC structures.

A subsample also underwent MRI, including gadolinium contrast.

Analyses compared patients testing positive for serum NSAbs (NSAbs-POS) to those tested negative (NSAbs-Neg).

12.8% of the patients tested positive for serum NSAbs (NSAbs-POS). No difference in terms of age, sex, BMI, years od education, and ethnicity was found between groups.

Regarding the neurologic variables, NSAbs-POS significantly showed more memory deficits, parkinsonism signs, and speech disorders (p<0.001), compared to NSAbs-NEG patients. Similarly, NSAbs-POS patients presented a significant in TMT-A, Raven, and RAVLT scores (p<0.05) compared to NSAbs-NEG. Finally, NSAbs-POS patients presented an increased score at PANSS “Somatic implication” item and a reduced score at PANSS “Insight” (p<0.05) items, suggesting a higher concern of these patients regarding their help and a greater awareness of their condition.

Regarding MRI, differences are present between groups, both on structural and on contrasted images.

Our preliminary findings suggest the possibility that NSAbs-POS patients might represent a subpopulation of FEP with specific characteristics. These results are preliminary and need a confirmation in bigger samples, but they might represent a step towards the identification of clinically meaningful subgroups in FEP defined through an easy and not invasive test, helping to dissect the heterogeneity of psychiatric disorders and moving towards precision psychiatry.

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Post-ictal psychosis is a kind of epileptic psychosis in which psychotic features appear 12h – 7 days after the epileptic seizure causing them.

To present a challenging case reflecting upon presentation, management and considerations of post-ictal psychosis.

Case presentation and non-systematic literature review.

A 40-year-old female, living in a European foreign country with her partner and child, flies to Lisbon 5 days previously to her admission as a sudden decision because she believed she was the daughter of a portuguese yoga master. She was brought to psychiatry ER by the police due to disorganized and aggressive behavior in public, where she presented with severe agitation, disorganized and coprolalic speech, persecutory, mistic and filiation delusions, somatic and affective passivity, and very uncollaborative. She had no analytic or image alterations except for positive cannabinoids in urine. She was admitted in psychiatry and started on risperidone titled till 6mg and diazepam 15mg, with remission of symptomatology. When she was able to collaborate, she admitted she had a history of Epilepsy for which she was not having treatment, and a previous post-ictal psychotic episode some years ago. Family confirmed she had a generalized tonic-clonic seizure about a week ago, and delusional ideas starting the following day, having left home unannounced. Although the EEG was normal, considering suggestive history post-ictal psychosis was admitted ad most probable diagnosis and she was slowly stopped medication without symptom resurgence. The importance of anti-epileptic treatment in order to avoid subsequent seizures and post-ictal psychosis was explained, however the patient denied treatment and was discharged back to her hometown with indication to follow-up in neurology.

Post-ictal psychosis corresponds to 25% of epileptic psychosis. It is associated with temporal lobe epilepsy, psychotic symptoms of mistic and religious themes, aggressive behavior, and increased suicide risk. It has a sudden onset and complete remission although a risk of recurrence as in this case. Treatment consists of seizure control to avoid following episodes. Antipsychotics that don’t increase convulsive risk such has risperidone may be useful to acute control of psychotic features and behavior alterations.

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Suicide risk is a significant concern in bipolar disorder, with a notably higher rate of suicidal behaviors compared to the general population. Stabilized bipolar patients, while in remission, remain at risk due to the chronic nature of the illness and its associated mood dysregulation.

This study aims to evaluate the prevalence and characteristics of suicide risk in a sample of stabilized bipolar patients.

We approached 107 stabilized bipolar patients attending the psychiatry outpatient unit at the Hedi Chaker University Hospital in Sfax. Ninety-three patients agreed to participate in the study. We collected their sociodemographic and clinical data. Suicide risk was assessed using the Mini International Neuropsychiatric Interview (MINI).

The mean age of the participants was 41.49±12.33 years, with a predominance of males (72%). Among the patients, 58.1% were married, 47.3% were unemployed, and 44.1% reported low income. Medical comorbidities were reported by 35.5% of patients, while 11.8% had psychiatric comorbidities in addition to bipolar disorder.

Lifestyle factors revealed that 49.5% of the participants were smokers, 11.8% consumed alcohol, and 2.2% used cannabis.

Most of the patients were diagnosed with type I BD (74.2%), and 18 patients (19.4%) had a history of attempted suicide.

At the time of the study, 19.4% of the patients were assessed as being at risk of suicide with 17.2% presenting low risk and 2.2% exhibiting moderate risk.

This study reveals that a significant portion of stabilized bipolar patients remain at risk for suicide, with nearly one in five participants showing some level of suicide risk despite their clinical stabilization. While most were categorized as low risk, the findings underscore the necessity for continuous suicide risk assessments and preventive strategies, even during periods of mood stability.

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Persons with schizophrenia are currently excluded from psychedelic-assisted therapy due to concerns about psychedelic-induced acute or persistent psychotic symptoms. However, meta-analytic evidence of the precise risk for psychedelic-induced de novo and exacerbation of psychosis in people with pre-existing psychotic disorders is lacking.

We conducted an overview of reviews, systematic review, and meta-analysis to examine the incidence of psychedelic-induced psychosis and the exacerbation of psychotic symptoms in schizophrenia.

Our pre-registered protocol (CRD42023399591) covered: LSD, psilocybin, mescaline, DMT, and MDMA. Embase, PubMed, PsyARTICLES, PsyINFO, and trial registries were searched from inception until 11/2023.

The incidence of psychedelic-induced psychosis was computed using a random-effects model, and standardized assessments of study quality was performed. We retained 131 publications: 14 systematic reviews, 20 reviews, 35 randomized-controlled trials (RCTs), 10 case-control studies, 30 uncontrolled trials (UCT), and 22 cohort studies with overall low study quality. The meta-analysis included nine studies. Incidence of psychedelic-induced psychosis was 0.002% (95%CI 0-0.006, I2=0%, N=123,800; n=2) in population studies; 0.2% (95%CI 0.1-0.3, I2=0%, N=6,535; n=6) in UCT, and 0.6% (95%CI 0.2-1.8, I2=0%, N=563; n=3) in RCTs excluding individuals with a history of psychotic symptoms. In UCT including patients with schizophrenia, 3.8% (95%CI 1.6-8.9, I2=0%, N=133; n=2) developed long-lasting psychotic symptoms. In cohort studies, 13.1% (95%CI 9.4-17.9, I2=24%, N=353; n=3) of those with psychedelic-induced psychosis developed schizophrenia. Sensitivity analyses confirmed the main findings. The incidence for psychedelic-induced psychosis is low but slightly higher in studies including patients with schizophrenia. The risk of transition to schizophrenia after psychedelic-induced psychosis is considerable.

In summary, the reviewed evidence suggests that schizophrenia might not be a definite exclusion criterion for clinical trials exploring safety and efficacy of psychedelics for treatment-resistant depression and negative symptoms. However, given the low quality and limited number of studies, more high-quality research is needed, and a conservative approach is recommended until further data is available.

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Access to genetic testing and counseling for infertile couples is essential to provide them specialized care at the genetic level. Having access to psychological support during genetic fertility assessment can be very helpful for many patient and genetic counseling offers invaluable emotional support throughout the process.

Based on our twenty-four years’ experience in genetic counseling, we present here the main psychological challenges facing couples struggling with fertility problems.

We selected all infertile couples evaluated between 2000 and 2024, who were treating their infertility with assisted reproductive technologies. Patients’ psychological problems and emotional suffering, as well as the causes of these conditions, were evaluated retrospectively through our genetic counseling reports.

All couples suffering from primary infertility show a more obvious decline in general well-being and satisfaction as a couple, when they are compared to couples seeking ART for secondary infertility, but having already other children. Anxiety, depression and feelings of culpability in infertile partners are the most common psychological concerns. Besides the psychological distress related to infertility, ART itself is, despite the hope it offers in terms of parenthood prognosis, a stress factor and a cause of numerous emotional and psychological problems. This distress is related to the invasive features of the ART, such as intra-testicular sperm extraction in azoospermic men and oocyte puncture, and the hormonal use in the female partners, which disturb their behaviors and moods. Other problems are associated with the lengthy, arduous and economically burdensome procedures involved in the entire treatment process. In addition, the worries of failure and the distress of failure when it becomes a reality are a crucial factor in psychological distress for the couple. Furthermore, dissatisfaction and frustration when ART is undergone for infertility affecting only one partner were noted. Many religious issues and worries about fear or phobia concerning germ cell manipulation also contribute to psychological problems. Genetic testing is another burden for the couples in our study, given the widespread ignorance of genetics and the consequent phobia of the unknown, as well as the fear of results that, once revealed as abnormal, will affect self-esteem for life.

This study describe the psychological concers of infertile couples undergoing ART treatment in the Tunisian Context. The improvement of the understanding of psychological needs, which are certainly provided during genetic counselling, requires a multidisciplinary consultation, involving gynecologist, reproductive biologists, geneticists, psychiatrists and psychologists. This would enable holistic and personalized psychological intervention and support.

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Delirium has been considered a reflection of diffuse cerebral metabolic insufficiency, and the pathophysiology of underlying delirium is quite diverse.

We present a rare case of mixed delirium with shifting activity level between the hyperactive and hypoactive delirium types as the only manifestation in a 42-year-old woman presented with psychotic symptoms without any prior psychiatric history, one month after a reconstructive breast cancer operation.

To provide an overview, describe the clinical features and differential diagnosis, as psychiatric conditions are among the most difficult to differentiate from delirium, and finally review the clinical management.

Presentation of a 42-year-old female with a history of right breast cancer with triple negative B5b invasive carcinoma, twice operated after local recurrence (first operation 4 years ago), and a second reconstructive operation one month ago, with no past psychiatric history, who presented with symptoms of mixed delirium. During the clinical and laboratorial investigation, exams revealed hyperprolactinemia. The patient showed no other clinical signs or symptoms compatible with adrenal insufficiency and displayed normal ACTH and serum cortisol concentrations. Brain magnetic resonance imaging revealed pituitary macroadenoma without any brain metastasis. The patient was treated with antipsychotics and not corticosteroids, resulting in rapid remission of the psychotic symptoms.

Clouded sensorium and behavioral dysregulation in delirium can be easily mistaken as thought and behavioral disorganization in acute psychotic episodes, and detailed evaluation of precipitating factors is required to differentiate delirium.

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Occupational stress has been identified as a significant predictor of job satisfaction among university staff.

This paper aims to find out the relationship between occupational stress and job satisfaction among university workers in Sfax, Tunisia.

We conducted a cross-sectional study, during the period from September 2022 to October 2023. We used a self-administered questionnaire distributed to university staff. The questionnaire included socio-professional characteristics and assessment of occupational stress using the Work Stress Screener (WoSS-13). Job satisfaction was rated on a 5-point Likert scale from 1 (extremely dissatisfied) to 5 (extremely satisfied).

The average age of the workers was 49.31±8. years. There is a slight female predominance (78 (53.1%)). Among the respondents, 57 (38.3%) were very to extremely satisfied. The medians of WoSS-13 subscales were 11 for WOSS-A1, 6 for WOSS-A2 and 3 for WOSS-B. Job satisfaction was positively associated with WOSS-A1 and WOSS-A2 (positive stress) but negatively associated with WOSS-B (negative stress). In bivariate analysis, being extremely satisfied was positively associated to WOSS-A1 and WOSS-A2 (p=0.000 for each respectively). However, it was negatively associated to WOSS-B (p=0.000).

Occupational stress has a significant impact on job satisfaction among university workers. Addressing job stress through targeted interventions can improve job satisfaction, productivity, and overall well-being among university staff.

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Adults with intellectual and developmental disabilities (IDD) are more likely than the general population to experience psychiatric disorders, with prevalence rates estimated at 33-40%. These individuals often display atypical symptoms, complicating diagnosis. Primary care providers are often the first to encounter these patients but face challenges due to limited training and “diagnostic overshadowing”—the misattribution of psychiatric symptoms to the IDD itself rather than recognizing comorbid mental health conditions.

This study aims to: (1) highlight the prevalence and unique presentations of psychiatric disorders in adults with IDD, (2) discuss diagnostic challenges, particularly diagnostic overshadowing, in primary care, and (3) advocate for collaborative care models to improve diagnostic accuracy and outcomes.

A literature review across PubMed, Medline, and PsycINFO focused on studies addressing psychiatric prevalence in IDD, diagnostic barriers, and the efficacy of collaborative care models in managing complex cases in primary care.

Adults with IDD show high rates of mood disorders, anxiety, ADHD, and psychotic disorders, often presenting atypically. For example, ADHD may show as prolonged attentional and behavioral difficulties, impacting social and functional skills. Anxiety may present as agitation or sensitivity to routine changes, often misinterpreted as behavioral issues. Mood disorders, especially depression, tend to appear as irritability or somatic complaints, which are frequently attributed to the IDD itself. Psychotic disorders are also prevalent, particularly among individuals with certain genetic syndromes, and complicate diagnosis due to overlapping symptoms.

Diagnostic overshadowing significantly impacts accurate psychiatric diagnosis in adults with IDD, as primary care providers often attribute psychiatric symptoms to the disability itself. Limited IDD-specific training in primary care compounds this issue. Collaborative care models, where primary care providers collaborate with mental health specialists familiar with IDD, show promise in addressing these diagnostic and treatment challenges, especially for complex cases.

Effective psychiatric care for adults with IDD requires specialized provider training, comprehensive evaluations sensitive to atypical presentations, and collaborative care models. Addressing diagnostic overshadowing through improved training and integrated care can enhance psychiatric outcomes for this underserved population. Further research, particularly randomized controlled trials, is needed to develop evidence-based guidelines for tailored care in adults with IDD.

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Chronic (non-cancer) pain is a rising problem within Western population. Importantly, people with mental illness have disproportionally high levels of (chronic) pain. Prescription opioid medications are frequently initiated for the treatment of chronic pain. This, despite the growing evidence showing a lack of effectivity and an increased risk of complications such as the development of substance use disorders. Specifically, people with MH problems appear to be more vulnerable to lose control and develop opioid use disorders.

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In the post-migration period, individuals from diverse religious, linguistic, cultural, and traditional backgrounds strive to coexist in a shared social space. However, numerous adaptation challenges arise during this process. Additionally, individual personality traits significantly influence experiences during this time. For those suffering from psychiatric disorders, the integration process becomes even more complex, as these conditions can diminish an individual’s ability to cope with stress, making societal integration more difficult. This study aims to examine the level of integration among individuals with psychiatric disorders who have faced challenges after migration, with the goal of contributing to initiatives that facilitate their adaptation process.

This study aims to assess the integration levels of individuals with psychiatric disorders into society. In addition to examining psychiatric conditions, sociodemographic data will also be collected from participants to explore how additional factors influence the integration process. By doing so, the study seeks to provide insights that can inform efforts to facilitate the integration of these individuals into society.

Data were collected from 91 participants, primarily first- and second-generation Turkish immigrants with at least one psychiatric disorder, at the Neuro Psychiatric Center Riem (NPZR) clinic. The study employed the “Community Integration Scale for Adults with Psychiatric Disorders” along with a sociodemographic questionnaire, with informed consent obtained from all participants. SPSS analysis software was utilized to examine the relationship between integration levels and other relevant variables.

Statistical analyses indicate that variables such as age, education level, smoking, and drug use significantly affect the total score.

These findings reveal that individuals’ demographic and behavioral characteristics play a significant role in overall performance and achievement measures.

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In the past decade, techno-referentiality has increasingly influenced daily life, illustrating how technology can disrupt human relationships. A notable example of this phenomenon is “phubbing”—a combination of “phone” and “snubbing”—which refers to the act of ignoring someone in favor of engaging with a mobile phone, leading to diminished eye contact and interest during face-to-face interactions. Recent research has highlighted “parental phubbing,” suggesting it may adversely affect parent-child relationships and contribute to developmental and mental health issues in children and adolescents.

This study seeks to investigate the potential effects of parental phubbing on the mental health and development of children.

We conducted a systematic review and meta-analysis using Nested Knowledge software, adhering to PRISMA guidelines. Our search encompassed five databases: PubMed, Scopus, PsycINFO, Web of Science, and EBSCO. The inclusion criteria for studies were:

• • Cross-sectional or longitudinal design.

• • Quantitative data on parental phubbing and its potential impact on children’s mental health symptoms and developmental disorders.

• • Studies involving children aged 0 to 18-21 years.

• • Publications in peer-reviewed English-language journals.

The methodological quality and risk of bias in the included studies were assessed using the JBI Critical Appraisal Checklist. Publication bias was evaluated through funnel plot analysis and Egger’s regression intercept. Meta-analyses were performed using Jamovi with the MAJOR module, applying the Fisher r-to-z transformation for correlation coefficients. A random-effects model was used, and heterogeneity was estimated with the restricted maximum-likelihood estimator. Sensitivity analyses were conducted to ensure the robustness of the findings.

Our search identified 26 studies involving 22833 children and 2125 parents. We developed a unified theoretical model of the direct and mediating effects of parental phubbing on child mental health. The meta-analysis revealed that parental phubbing was significantly associated with:

• • Increased affective symptoms in children (k=10; r=0.319; 95% CI [0.269, 0.370]).

• • Higher levels of aggression or deviant behavior (k=3; r=0.260; 95% CI [0.134, 0.386]).

• • Greater internalizing problems (k=4; r=0.242; 95% CI [0.166, 0.319]).

• • More externalizing problems (k=4; r=0.158; 95% CI [0.081, 0.234]).

Additionally, parental phubbing was negatively correlated with children’s self-esteem (r=-0.233; 95% CI [-0.315, -0.150]).

This meta-analysis underscores the significant harm that parental phubbing can inflict on children’s emotional and social well-being. To safeguard and enhance children’s development, it is crucial to implement strategies that promote more mindful technology use and foster stronger, more engaged parent-child relationships.

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Whilst the DSM has streamlined research and standardized diagnoses, it faces criticism for falling short in addressing the intricate nature of psychiatric disorders. By relying on checklist-based diagnoses, it overlooks critical dimensions such as personality traits, cognitive functions, the motives driving maladaptive behaviors, and the unique narratives of individuals. In contrast, the Perspectives of Psychiatry (PoP) presents a comprehensive framework that enhances the understanding and treatment of mental health conditions. It integrates diverse origins of psychiatric disorders while emphasizing a thorough evaluation of a patient’s life story. The global reach of PoP, with textbooks translated into multiple languages, has led to the creation of an international fellowship program for clinicians and students worldwide.

The speakers will explore the PoP framework and share how this system is 1) implemented at Johns Hopkins (Baltimore, MD) in clinical practice and teaching, and 2) taught to international students with the newly established Perspectives of Psychiatry International Learners Program (PoPPIL).

Faculty from Johns Hopkins will outline how the PoP has been applied at their institution for the past 40 years, while international students from Sweden, Australia, and Ecuador will share their experiences from the PoPPIL.

The PoP provides a structured and integrated framework for clinical practice and teaching. It explicates the rationale behind various treatment methods — medications, psychosocial interventions, motivational strategies, and consolation — whilst enabling patients to contribute more discerningly in their own recovery. Patients undergo a comprehensive and systematic evaluation, before this information is analyzed from each of the 4 perspectives (figure 1). This encourages clinicians to consider the patient holistically, rather than as a collection of symptoms, leading to the creation of management plans that not only addresses their psychiatric symptoms but also their social needs and personal goals. These plans can then be used to work collaboratively and effectively with other providers such as social services, general practitioners and psychologists. The framework is now part of the core curriculum for all psychiatry residents at Johns Hopkins and since 2024, international students can partake in an immersive learning experience which includes clinical observation and teaching. The PoPPIL has also facilitated grassroot global communication among medical students, junior doctors and leading experts.

Image 1:

Moving beyond diagnostic checklists to a framework grounded in intelligible concepts can propel advancements in psychiatry. The program at Johns Hopkins illustrates how these concepts can be effectively applied in clinical settings and shared with students from around the world.

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Evidence has shown that perfectionism is linked with increased perceived stress, whereas self-compassion might mitigate poor outcomes related to stress. However, how these traits influence stress responses in a naturalistic setting is unclear.

The study aims to test the associations of perfectionism and self-compassion traits with stress-related biomarkers, namely C-reactive protein (CRP), alpha-amylase, and cortisol, in medical students exposed to pre-exam stress.

61 second-year medical students were enrolled in this study. At baseline, perfectionism and self-compassion were self-rated using the Self-Compassion Scale and the Short-Revised Almost Perfect Scale, respectively. Morning saliva samples were collected at baseline and one week before the exam. The levels of salivary CRP, alpha-amylase, and cortisol were quantified as biomarkers for inflammation, sympathetic activity, and hypothalamus-pituitary-adrenal axis, respectively, using enzyme-linked immunosorbent assay. Multiple linear regression analysis was performed to test the associations between the two traits with pre-exam salivary biomarkers, adjusted for baseline salivary biomarkers, age, sex, and body mass index (BMI). Other potential confounding variables, including acute illness, underlying mood disorder, and lifestyle factors, were also added to the model as sensitivity analyses.

Adjusted for the baseline level of biomarker, age, sex, and BMI, perfectionism traits significantly predicted pre-exam salivary alpha-amylase (B = 0.04, 95% CI 0.01 to 0.07, p = .007), but not CRP (B = -0.03, 95% CI -0.07 to 0.01, p = .177) or cortisol (B = 0.004, 95% CI -0.005 to 0.012, p = .424). No significant associations were found between self-compassion traits and the pre-exam levels of all three salivary biomarkers. The sensitivity analysis, additionally adjusted for other potential confounding factors, confirmed the significant positive association between perfectionism traits and pre-exam salivary alpha-amylase (B = 0.04, 95% CI 0.01 to 0.07, p = .006).

Perfectionism traits could positively predict the level of morning salivary alpha-amylase in naturalistic stress exposure, suggesting a heightened sympathetic activity among those with high perfectionism in response to stress. Replication studies in a larger sample with more diverse populations are warranted.

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The human body hosts a vast array of commensal microbes known as the gut microbiota, which plays a crucial role in various physiological functions, including immune system maturation, digestion, and central nervous system development. Recent studies suggest a significant link between gut microbiota and psychiatric disorders, particularly schizophrenia. Imbalances in gut microbiota composition have been associated with symptom severity and treatment response in schizophrenia patients.

This study aims to synthesize current knowledge on the role of gut microbiota in the severity of symptoms and the prediction of treatment response in schizophrenia, highlighting its potential as a biomarker for therapeutic strategies.

We conducted a systematic literature review following PRISMA guidelines, focusing on articles published between 2014 and 2024. Using databases like PubMed and Google Scholar, we searched for keywords related to gut microbiota, schizophrenia, first episode psychosis, treatment response, and symptoms severity.

Our review included eight studies that utilized 16S rRNA sequencing to analyze fecal microbiota. The findings revealed significant correlations between specific gut microbiota profiles and the severity of psychiatric symptoms. Notably, families such as Lachnospiraceae and Bacteroidocacae were linked to increased symptom severity, while others, including Flavobacteriaceae, Enterococcaceae and Flintibacter butyricus , correlated with symptom remission. Additionally, variations in gut microbiota composition were predictive of treatment outcomes, suggesting its role as a potential biomarker for response to antipsychotic treatments.

The gut microbiota presents a promising avenue for understanding the complex interplay between microbial communities and psychiatric health. By identifying specific microbiota profiles associated with symptoms and treatment responses in schizophrenia, we can pave the way for novel personalized therapeutic approaches.

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Mainstream literature classifies SARS-CoV-2 positive-sensed single-stranded RNA (ssRNA), and only a few literature mentioned the method being Reverse Transcription–Polymerase Chain Reaction -- one limited to ssRNA studies without method improvement of RNA interference (Wang et al. BMC Bio 2018; 18). Studies found the 3’-to-5’ exoribonuclease activity within CoV nonstructural protein 14 (NSP14) critical for CoV high-fidelity replication (Smith & Denison, PLoS Pathog 2013; 9 e1003760), and NSP15 a distinctive endoribonuclease able to cleave both ss- and double-stranded RNA (dsRNA) effectively (Frazier et al. NA Res 2022; 50 8290-8301). While MERS-CoV inhibit oligoadenylate synthetase–ribonuclease L, protein kinase R, and interferon (IFN), CoV-2 activates the former two and induces minimal levels of IFN (Li et al. PNAS 2021; 118 e2022643118), corroborating with S2 protein’s homogeneity with HIV gp41 (Zhang & Yap JMS: THEOCHEM 2004; 677 73-76) with differentiated impacts on macrophage activities via interleukin 6 (Ascierto et al. JIC 2021; 9). Image 1 indicates the post-vaccination pericarditis is caused by negative charge interference during depolarization in NCT05711810.

Primary objective of advancing treatment designs followed the fixed effect metaanalysis model and gathered relevant data (Nikolakopoulou et al. EBMH 2014; 17 64). Secondary objective is to compare effects between presynaptic and postsynaptic treatment efficacies in order to determine infection depth for post-COVID-19-vaccination neuropathic pain to appear, and adverse events (AEs) are collected for random effects metaanalysis. Tertiary objective is to weigh the evidences whether COVID-19 is ssRNA or dsRNA.

With the framework and paradigm of sebaceous immunobiology, the pathway bypassing blood-brain barrier is found with steroidogenesis (Pachankis JP 2023; 26 615; Pachankis GJMR 2023; 23C 5-11). NCT05839236 and NCT06357104 trials’ metaanalysis are illustrated in image 2 with the observational protocol NCT06107348 in image 3.

Sebaceous (purpura and ecchymoses) AEs appeared with postsynaptic treatments with valproate, and comparatively, presynaptic treatments with gabapentin afterwards attenuated them. Presynaptic treatments of gabapentin shows superiority by the equivalence tests on neuropathic pains’ attenuation in duration and intensities. The considerations of Ca2+ channel inhibition by the adoption of gabapentin in the proton-coupled electron transport chain are consistent with the electrocardiogram indications of negative charge interference on cardiac activities.

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Image 2:

Image 3:

Migraine AEs in NCT05711810 trial is the neuropathic pain resulted from immune activation with initial treatment. Infection depth of neuropathic pains from COVID-19 post-vaccination symptoms is extendable to the presynaptic vesicles with impacts to macrophage activities. Indirect evidences support that SARS-CoV-2 is negative-sensed dsRNA (Pachankis JCMI 2023; 6 1-4).

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Schizophrenia is a highly complex mental disorder. It is associated with hallucinations and delusions. Caring for a patient with schizophrenia presents major challenges, especially for mothers. The mother-child relationship is one of the first relationships to be formed, serving as the basis for other human relationships [1,2]. The mother is the most important person shaping the child’s behaviour.

Although schizophrenia has biological and genetic causes, the environment in which the person grew up is very important.

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To explore the childhood experiences of patients with schizophrenia with their mothers in order to identify the early mother-child relationship in these patients.

This was a descriptive cross-sectional study using a questionnaire including sociodemographic and clinical criteria as well as questions to assess patients’ childhood experiences with their mothers and patients’ feelings towards their mothers.

Inclusion criteria were patients’ willingness to participate in the study. Participants were male schizophrenic patients over 18 years of age hospitalised at the Arrazi Psychiatric Hospital in Salé.

Exclusion criteria: intellectual disability.

Schizophrenia, mother-child relationship, emotions, patients.

In this study, a total of 88 male patients with schizophrenia were collected. The majority had an average socio-economic status. Almost 77% were single and 89% lived with their families. All participants were unemployed. 91% had a substance use disorder, including tobacco and cannabis. 77% had reported psychological abuse by their mother and 55% had reported physical abuse. All the participants had received comparisons with other children and the majority reported having already felt that they were going to be abandoned by their mother. 75% reported having played the role of parent for their parents in childhood. 88% of the participants had feelings of anger and blame for their mother, 20% had feelings of security, 51% had ambivalent feelings of love and hate at the same time.

The present study showed that the early relationship between mother and child in patients with schizophrenia was associated with complex and ambivalent emotions and was also characterised by alternating feelings of hatred and love. Feelings of abandonment of the child and lack of attention to the child’s basic needs caused patients many emotional problems towards their mothers.

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